NR 505 Chapter 47 Gastric disorders Final Exam Complete Key Questions with 100% Correct Solutions||UPDATED 2025/2026 A+ GRADED!!! BRAND NEW VERSION

NR 505 Chapter 47 Gastric disorders Final Exam Complete Key Questions with 100% Correct Solutions||UPDATED 2025/2026 A+ GRADED!!! BRAND NEW VERSION 1. A patient comes to the bariatric clinic to obtain information about bariatric surgery. The nurse assesses the obese patient knowing that in addition to meeting the criterion of morbid obesity, a candidate for bariatric surgery must also demonstrate what? Knowledge of the causes of obesity and its associated risks Adequate understanding of required lifestyle changes Positive body image and high self-esteem Insight into why past weight loss efforts failed - ANSWER Ans: B Feedback: Patients seeking bariatric surgery should be free of serious mental disorders and motivated to comply with lifestyle changes related to eating patterns, dietary choices, and elimination. While assessment of knowledge about causes of obesity and its associated risks as well as insight into the reasons why previous diets have been ineffective are included in the client's plan of care, these do not predict positive client outcomes following bariatric surgery. Most obese patients have an impaired body image and alteration in self-esteem. An obese patient with a positive body image would be unlikely to seek this surgery unless he or she was experiencing significant comorbidities. 2. A nurse is providing patient education for a patient with peptic ulcer disease secondary to chronic nonsteroidal anti-inflammatory drug (NSAID) use. The patient has recently been prescribed misoprostol (Cytotec). What would the nurse be most accurate in informing the patient about the drug? It reduces the stomach's volume of hydrochloric acid It increases the speed of gastric emptying It protects the stomach's lining It increases lower esophageal sphincter pressure - ANSWER Ans: C Feedback: Misoprostol is a synthetic prostaglandin that, like prostaglandin, protects the gastric mucosa. NSAIDs decrease prostaglandin production and predispose the patient to peptic ulceration. Misoprostol does not reduce gastric acidity, improve emptying of the stomach, or increase lower esophageal sphincter pressure. 3. A nurse is providing anticipatory guidance to a patient who is preparing for bariatric surgery. The nurse learns that the patient is anxious about numerous aspects of the surgery. What intervention is most appropriate to alleviate the patient's anxiety? Emphasize the fact that bariatric surgery has a low risk of complications. Encourage the patient to focus on the benefits of the surgery. Facilitate the patient's contact with a support group. Obtain an order for a PRN benzodiazepine. - ANSWER Ans: C Feedback: Support groups can be highly beneficial in relieving preoperative and postoperative anxiety and in promoting healthy coping. This is preferable to antianxiety medications. Downplaying the risks of surgery or focusing solely on the benefits is a simplistic and patronizing approach. 4. A patient has just been diagnosed with acute gastritis after presenting in distress to the emergency department with abdominal symptoms. What would be the nursing care most needed by the patient at this time? Teaching the patient about necessary nutritional modification Helping the patient weigh treatment options Teaching the patient about the etiology of gastritis Providing the patient with physical and emotional support - ANSWER Ans: D Feedback: For acute gastritis, the nurse provides physical and emotional support and helps the patient manage the symptoms, which may include nausea, vomiting, heartburn, and fatigue. The scenario describes a newly diagnosed patient; teaching about the etiology of the disease, lifestyle modifications, or various treatment options would be best provided at a later time. 5. A nurse is providing care for a patient who is postoperative day 2 following gastric surgery. The nurse's assessment should be planned in light of the possibility of what potential complications? Select all that apply. Malignant hyperthermia Atelectasis Pneumonia Metabolic imbalances Chronic gastritis - ANSWER Ans: B, C, D Feedback: After surgery, the nurse assesses the patient for complications secondary to the surgical intervention, such as pneumonia, atelectasis, or metabolic imbalances resulting from the GI disruption. Malignant hyperthermia is an intraoperative complication. Chronic gastritis is not a surgical complication. 6. A patient is undergoing diagnostic testing for a tumor of the small intestine. What are the most likely symptoms that prompted the patient to first seek care? Hematemesis and persistent sensation of fullness Abdominal bloating and recurrent constipation Intermittent pain and bloody stool Unexplained bowel incontinence and fatty stools - ANSWER Ans: C Feedback: When the patient is symptomatic from a tumor of the small intestine, benign tumors often present with intermittent pain. The next most common presentation is occult bleeding. The other listed signs and symptoms are not normally associated with the presentation of small intestinal tumors. 7. A patient is recovering in the hospital following gastrectomy. The nurse notes that the patient has become increasingly difficult to engage and has had several angry outbursts at various staff members in recent days. The nurse's attempts at therapeutic dialogue have been rebuffed. What is the nurse's most appropriate action? Ask the patient's primary care provider to liaise between the nurse and the patient. Delegate care of the patient to a colleague. Limit contact with the patient in order to provide privacy. Make appropriate referrals to services that provide psychosocial support. - ANSWER Ans: D Feedback: The nurse should enlist the services of clergy, psychiatric clinical nurse specialists, psychologists, social workers, and psychiatrists, if needed. This is preferable to delegating care, since the patient has become angry with other care providers as well. It is impractical and inappropriate to expect the primary care provider to act as a liaison. It would be inappropriate and unsafe to simply limit contact with the patient. 8. A patient has been admitted to the hospital after diagnostic imaging revealed the presence of a gastric outlet obstruction (GOO). What is the nurse's priority intervention? Administration of antiemetics Insertion of an NG tube for decompression Infusion of hypotonic IV solution Administration of proton pump inhibitors as ordered - ANSWER Ans: B Feedback: In treating the patient with gastric outlet obstruction, the first consideration is to insert an NG tube to decompress the stomach. This is a priority over fluid or medication administration. 9. A patient with a history of peptic ulcer disease has presented to the emergency department (ED) in distress. What assessment finding would lead the ED nurse to suspect that the patient has a perforated ulcer? The patient has abdominal bloating that developed rapidly. The patient has a rigid, "boardlike" abdomen that is tender. The patient is experiencing intense lower right quadrant pain. The patient is experiencing dizziness and confusion with no apparent hemodynamic changes. - ANSWER Ans: B Feedback: An extremely tender and rigid (boardlike) abdomen is suggestive of a perforated ulcer. None of the other listed signs and symptoms is suggestive of a perforated ulcer. 10. Diagnostic imaging and physical assessment have revealed that a patient with peptic ulcer disease has suffered a perforated ulcer. The nurse recognizes that emergency interventions must be performed as soon as possible in order to prevent the development of what complication? Peritonitis Gastritis Gastroesophageal reflux Acute pancreatitis - ANSWER Ans: A Feedback: Perforation is the erosion of the ulcer through the gastric serosa into the peritoneal cavity without warning. Chemical peritonitis develops within a few hours of perforation and is followed by bacterial peritonitis. Gastritis, reflux, and pancreatitis are not acute complications of a perforated ulcer. 11. A nurse is performing the admission assessment of a patient whose high body mass index (BMI) corresponds to class III obesity. In order to ensure empathic and patient-centered care, the nurse should do which of the following? Examine one's own attitudes towards obesity in general and the patient in particular. Dialogue with the patient about the lifestyle and psychosocial factors that resulted in obesity. Describe one's own struggles with weight gain and weight loss to the patient. Elicit the patient's short-term and long-term goals for weight loss. - ANSWER Ans: A Feedback: Studies suggest that health care providers, including nurses, harbor negative attitudes towards obese patients. Nurses have a responsibility to examine these attitudes and change them accordingly. This is foundational to all other areas of assessing this patient. 12. A patient has been prescribed orlistat (Xenical) for the treatment of obesity. When providing relevant health education for this patient, the nurse should ensure the patient is aware of what potential adverse effect of treatment? Bowel incontinence Flatus with oily discharge Abdominal pain Heat intolerance - ANSWER Ans: B Feedback: Side effects of orlistat include increased frequency of bowel movements, gas with oily discharge, decreased food absorption, decreased bile flow, and decreased absorption of some vitamins. This drug does not cause bowel incontinence, abdominal pain, or heat intolerance. 13. A patient who is obese has been unable to lose weight successfully using lifestyle modifications and has mentioned the possibility of using weight loss medications. What should the nurse teach the patient about pharmacologic interventions for the treatment of obesity? "Weight loss drugs have many side effects, and most doctors think they'll all be off the market in a few years." "There used to be a lot of hope that medications would help people lose weight, but it's been shown to be mostly a placebo effect." "Medications can be helpful, but few people achieve and maintain their desired weight loss with medications alone." "Medications are rapidly become the preferred method of weight loss in people for whom diet and exercise have not worked." - ANSWER Ans: C Feedback: Though antiobesity drugs help some patients lose weight, their use rarely results in loss of more than 10% of total body weight. Patients are consequently unlikely to attain their desired weight through medication alone. They are not predicted to disappear from the market and results are not attributed to a placebo effect. 32. A patient has been diagnosed with peptic ulcer disease and the nurse is reviewing his prescribed medication regimen with him. What is currently the most commonly used drug regimen for peptic ulcers? Bismuth salts, antivirals, and histamine-2 (H2) antagonists H2 antagonists, antibiotics, and bicarbonate salts Bicarbonate salts, antibiotics, and ZES Antibiotics, proton pump inhibitors, and bismuth salts - ANSWER Ans: D Feedback: Currently, the most commonly used therapy for peptic ulcers is a combination of antibiotics, proton pump inhibitors, and bismuth salts that suppress or eradicate H. pylori. H2 receptor antagonists are used to treat NSAID induced ulcers and other ulcers not associated with H. pylori infection, but they are not the drug of choice. Bicarbonate salts are not used. ZES is the Zollinger Ellison syndrome and not a drug. 33. A patient who is obese is exploring bariatric surgery options and presented to a bariatric clinic for preliminary investigation. The nurse interviews the patient, analyzing and documenting the data. Which of the following nursing diagnoses may be a contraindication for bariatric surgery? Disturbed Body Image Related to Obesity Deficient Knowledge Related to Risks and Expectations of Surgery Anxiety Related to Surgery Chronic Low Self-Esteem Related to Obesity - ANSWER Ans: B