Brunner and Suddarth's Textbook of
Medical-surgical Nursing- Chapter 40
multiple choice with clear and precise
explanation and answers
Multiple Choice with clear explanation
10. A client was treated in the emergency department and critical care unit after
ingesting bleach. What possible complication of the resulting gastritis should the
nurse recognize?
A. Esophageal or pyloric obstruction related to scarring
B. Uncontrolled proliferation of H. pylori
C. Gastric hyperacidity related to excessive gastrin secretion
D. Chronic referred pain in the lower abdomen - correct answerA
Rationale: A severe form of acute gastritis is caused by the ingestion of strong
acid or alkali, which may cause the mucosa to become gangrenous or to
perforate. Scarring can occur, resulting in pyloric stenosis (narrowing or
tightening) or obstruction. Chronic referred pain to the lower abdomen is a
symptom of peptic ulcer disease, but would not be an expected finding for a client
who has ingested a corrosive substance. Bacterial proliferation and hyperacidity
would not occur.
PTS: 1 REF: p. 1272
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 40: Management of Clients With Gastric and Duodenal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
,Multiple Choice
11. A client who underwent a gastric resection 3 weeks ago is having their diet
progressed on a daily basis. Following the latest meal, the client reports dizziness
and palpitations. Inspection reveals that the client is diaphoretic. What is the
nurse's best action?
A. Insert a nasogastric tube promptly.
B. Reposition the client supine.
C. Monitor the client closely for further signs of dumping syndrome.
D. Assess the client for signs and symptoms of aspiration. - correct answerC
Rationale: The client's symptoms are characteristic of dumping syndrome, which
results in a sensation of fullness, weakness, faintness, dizziness, palpitations,
diaphoresis, cramping pains, and diarrhea. Aspiration is a less likely cause for the
client's symptoms. Supine positioning will likely exacerbate the symptoms and
insertion of an NG tube is contraindicated due to the nature of the client's
surgery.
PTS: 1 REF: p. 1279
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 40: Management of Clients With Gastric and Duodenal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
Multiple Choice
12. A client is receiving education about an upcoming Billroth I procedure
(gastroduodenostomy). This client should be informed that the client may
experience which of the following adverse effects associated with this procedure?
A. Persistent feelings of hunger and thirst
B. Constipation or bowel incontinence
C. Diarrhea and feelings of fullness
D. Gastric reflux and belching - correct answerC
Rationale: Following a Billroth I, the client may have problems with feelings of
fullness, dumping syndrome, and diarrhea. Hunger and thirst, constipation, and
gastric reflux are not adverse effects associated with this procedure.
, PTS: 1 REF: p. 1274
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 40: Management of Clients With Gastric and Duodenal Disorders
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
Multiple Choice
13. A nurse is providing client education for a client with peptic ulcer disease
secondary to chronic nonsteroidal anti-inflammatory drug (NSAID) use. The client
has recently been prescribed misoprostol. What would the nurse be most
accurate in informing the client about the drug?
A. It reduces the stomach's volume of hydrochloric acid
B. It increases the speed of gastric emptying
C. It protects the stomach's lining
D. It increases lower esophageal sphincter pressure - correct answerC
Rationale: Misoprostol is a synthetic prostaglandin that, like prostaglandin,
protects the gastric mucosa. NSAIDs decrease prostaglandin production and
predispose the client to peptic ulceration. Misoprostol does not reduce gastric
acidity, improve emptying of the stomach, or increase lower esophageal sphincter
pressure.
PTS: 1 REF: p. 1269
NAT: Client Needs: Physiological Integrity: Pharmacological and Parenteral
Therapies
TOP: Chapter 40: Management of Clients With Gastric and Duodenal Disorders
KEY: Integrated Process: Communication and Documentation BLM: Cognitive
Level: Understand
Multiple Choice
14. A nurse is providing anticipatory guidance to a client who is preparing for a
total gastrectomy. The nurse learns that the client is anxious about numerous
aspects of the surgery. What intervention is most appropriate to alleviate the
client's anxiety?
A. Emphasize the fact that gastric surgery has a low risk of complications.
B. Encourage the client to focus on the benefits of the surgery.
Medical-surgical Nursing- Chapter 40
multiple choice with clear and precise
explanation and answers
Multiple Choice with clear explanation
10. A client was treated in the emergency department and critical care unit after
ingesting bleach. What possible complication of the resulting gastritis should the
nurse recognize?
A. Esophageal or pyloric obstruction related to scarring
B. Uncontrolled proliferation of H. pylori
C. Gastric hyperacidity related to excessive gastrin secretion
D. Chronic referred pain in the lower abdomen - correct answerA
Rationale: A severe form of acute gastritis is caused by the ingestion of strong
acid or alkali, which may cause the mucosa to become gangrenous or to
perforate. Scarring can occur, resulting in pyloric stenosis (narrowing or
tightening) or obstruction. Chronic referred pain to the lower abdomen is a
symptom of peptic ulcer disease, but would not be an expected finding for a client
who has ingested a corrosive substance. Bacterial proliferation and hyperacidity
would not occur.
PTS: 1 REF: p. 1272
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 40: Management of Clients With Gastric and Duodenal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
,Multiple Choice
11. A client who underwent a gastric resection 3 weeks ago is having their diet
progressed on a daily basis. Following the latest meal, the client reports dizziness
and palpitations. Inspection reveals that the client is diaphoretic. What is the
nurse's best action?
A. Insert a nasogastric tube promptly.
B. Reposition the client supine.
C. Monitor the client closely for further signs of dumping syndrome.
D. Assess the client for signs and symptoms of aspiration. - correct answerC
Rationale: The client's symptoms are characteristic of dumping syndrome, which
results in a sensation of fullness, weakness, faintness, dizziness, palpitations,
diaphoresis, cramping pains, and diarrhea. Aspiration is a less likely cause for the
client's symptoms. Supine positioning will likely exacerbate the symptoms and
insertion of an NG tube is contraindicated due to the nature of the client's
surgery.
PTS: 1 REF: p. 1279
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 40: Management of Clients With Gastric and Duodenal Disorders
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
Multiple Choice
12. A client is receiving education about an upcoming Billroth I procedure
(gastroduodenostomy). This client should be informed that the client may
experience which of the following adverse effects associated with this procedure?
A. Persistent feelings of hunger and thirst
B. Constipation or bowel incontinence
C. Diarrhea and feelings of fullness
D. Gastric reflux and belching - correct answerC
Rationale: Following a Billroth I, the client may have problems with feelings of
fullness, dumping syndrome, and diarrhea. Hunger and thirst, constipation, and
gastric reflux are not adverse effects associated with this procedure.
, PTS: 1 REF: p. 1274
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 40: Management of Clients With Gastric and Duodenal Disorders
KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply
Multiple Choice
13. A nurse is providing client education for a client with peptic ulcer disease
secondary to chronic nonsteroidal anti-inflammatory drug (NSAID) use. The client
has recently been prescribed misoprostol. What would the nurse be most
accurate in informing the client about the drug?
A. It reduces the stomach's volume of hydrochloric acid
B. It increases the speed of gastric emptying
C. It protects the stomach's lining
D. It increases lower esophageal sphincter pressure - correct answerC
Rationale: Misoprostol is a synthetic prostaglandin that, like prostaglandin,
protects the gastric mucosa. NSAIDs decrease prostaglandin production and
predispose the client to peptic ulceration. Misoprostol does not reduce gastric
acidity, improve emptying of the stomach, or increase lower esophageal sphincter
pressure.
PTS: 1 REF: p. 1269
NAT: Client Needs: Physiological Integrity: Pharmacological and Parenteral
Therapies
TOP: Chapter 40: Management of Clients With Gastric and Duodenal Disorders
KEY: Integrated Process: Communication and Documentation BLM: Cognitive
Level: Understand
Multiple Choice
14. A nurse is providing anticipatory guidance to a client who is preparing for a
total gastrectomy. The nurse learns that the client is anxious about numerous
aspects of the surgery. What intervention is most appropriate to alleviate the
client's anxiety?
A. Emphasize the fact that gastric surgery has a low risk of complications.
B. Encourage the client to focus on the benefits of the surgery.
