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Question 1: A patient diagnosed with peptic ulcer disease (PUD) reports sudden, sharp abdominal pain. Which of the following actions should the nurse take first?

A. Administer an antacid. B. Check the patient’s vital signs. C. Prepare the patient for an endoscopy. D. Administer a proton pump inhibitor (PPI). E. Encourage the patient to rest and monitor for further symptoms.

Correct Answer: B. Check the patient’s vital signs.

Rationale: Checking vital signs is a crucial first step in assessing the severity of the patient’s condition and potential complications such as perforation or bleeding. This action helps determine the urgency of the situation and guides subsequent interventions. Administering medications or procedures without assessing the patient’s current status could delay essential care for potentially life-threatening conditions. Vital signs provide immediate, valuable data to inform the nurse’s clinical decisions.

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Question 2: Which medication is most effective in reducing gastric acid secretion in a patient with Zollinger-Ellison Syndrome?

A. Aluminum hydroxide (antacid) B. Ranitidine (H2 receptor antagonist) C. Omeprazole (proton pump inhibitor) D. Metoclopramide (prokinetic agent) E. Sucralfate (mucosal protectant)

Correct Answer: C. Omeprazole (proton pump inhibitor)

Rationale: Zollinger-Ellison Syndrome is characterized by excessive gastric acid production due to gastrin-secreting tumors. Proton pump inhibitors (PPIs) like omeprazole are the most effective class of drugs in reducing gastric acid secretion by directly inhibiting the H+/K+ ATPase enzyme system of the gastric parietal cells. H2 receptor antagonists also reduce acid secretion but are less effective in the context of Zollinger-Ellison Syndrome. Antacids and mucosal protectants do not significantly reduce acid secretion, and prokinetic agents primarily affect gastrointestinal motility.

Question 3: A nurse is caring for a patient with acute gastritis. Which dietary recommendation is most appropriate for this patient?

A. High-fiber diet B. Clear liquid diet C. Gluten-free diet D. High-fat diet E. Bland diet

Correct Answer: E. Bland diet

Rationale: A bland diet is recommended for patients with acute gastritis as it consists of foods that are soft, not very spicy, and low in dietary fiber, which can help minimize gastric irritation and reduce symptoms. High-fiber diets may increase gastric motility and irritation, potentially worsening symptoms. Clear liquid diets are typically for initial management of acute conditions or pre-procedure but not specifically beneficial for gastritis recovery. Gluten-free and high-fat diets are not directly related to the management of acute gastritis and may, in some cases, exacerbate symptoms.

Question 4: For a patient with a history of NSAID-induced peptic ulcer, which of the following medications should the nurse anticipate administering to promote ulcer healing?

A. Ibuprofen B. Aspirin C. Misoprostol D. Naproxen E. Acetaminophen

Correct Answer: C. Misoprostol

Rationale: Misoprostol is a prostaglandin analogue that can help protect the gastric mucosa and promote healing of peptic ulcers, especially those induced by NSAIDs, by increasing mucous production and bicarbonate secretion. Ibuprofen, aspirin, and naproxen are NSAIDs that inhibit prostaglandin synthesis, potentially worsening or causing ulcers. Acetaminophen is not directly involved in the healing of gastric ulcers and, while a safer alternative for pain relief in patients with a history of ulcers, does not contribute to the healing process.

Question 5: A nurse is teaching a patient with gastritis about lifestyle modifications. Which of the following should the nurse include to reduce symptom flare-ups?

A. Increase caffeine intake. B. Consume small, frequent meals. C. Engage in high-intensity exercise. D. Increase alcohol consumption. E. Use NSAIDs for pain management.

Correct Answer: B. Consume small, frequent meals.

Rationale: Consuming small, frequent meals can help manage gastritis by preventing the stomach from becoming too full, which can increase pressure and lead to discomfort or exacerbation of symptoms. High caffeine and alcohol intake, high-intensity exercise, and the use of NSAIDs can all irritate the gastric lining and potentially worsen gastritis symptoms. Therefore, recommending small, frequent meals is a practical, evidence-based strategy to manage gastritis symptoms effectively.

Question 6: Which finding would a nurse expect in a patient with a diagnosis of gastric cancer?

A. Bradycardia B. Hypotension C. Weight loss D. Hyperglycemia E. Decreased serum amylase

Correct Answer: C. Weight loss

Rationale: Weight loss is a common finding in patients with gastric cancer due to decreased appetite, early satiety, or malabsorption associated with the disease process. Bradycardia, hypotension, hyperglycemia, and decreased serum amylase are not directly associated with gastric cancer and may relate to other conditions or complications. Weight loss in gastric cancer can be significant and is a result of both the physical obstruction caused by the tumor and the metabolic effects of cancer on the body.

Question 7: A patient with a duodenal ulcer is scheduled for a Helicobacter pylori breath test. The nurse explains that this test is used to:

A. Assess the presence of gastric bleeding. B. Measure the acidity of gastric secretions. C. Detect the presence of H. pylori bacteria. D. Evaluate gastric and duodenal motility. E. Determine the effectiveness of proton pump inhibitors.

Correct Answer: C. Detect the presence of H. pylori bacteria.

Rationale: The Helicobacter pylori breath test is a non-invasive diagnostic tool used specifically to detect the presence of H. pylori bacteria, a common cause of peptic ulcers. This test works by detecting urease produced by H. pylori in the stomach, which breaks down urea into carbon dioxide, detectable in the patient’s breath. It does not assess bleeding, measure gastric acidity, evaluate motility, or determine the effectiveness of medication, making it specifically tailored for H. pylori detection.

Question 8: In managing a patient with gastroparesis, which medication would the nurse anticipate administering to facilitate gastric emptying?

A. Omeprazole B. Loperamide C. Metoclopramide D. Calcium carbonate E. Docusate sodium

Correct Answer: C. Metoclopramide

Rationale: Metoclopramide is a prokinetic agent that facilitates gastric emptying by increasing the motility of the upper gastrointestinal tract without increasing the production of gastric acid. It is particularly useful in the management of gastroparesis, a condition characterized by delayed gastric emptying. Omeprazole is a proton pump inhibitor used to reduce acid production, loperamide is an anti-diarrheal, calcium carbonate is an antacid, and docusate sodium is a stool softener. None of these medications directly improve gastric motility like metoclopramide.

Question 9: A patient with a recent diagnosis of gastritis asks about the risk factors for developing this condition. The nurse should include which of the following in the explanation?

A. High calcium intake B. Chronic use of corticosteroids C. Low-fat diet D. Moderate alcohol use E. Regular use of NSAIDs

Correct Answer: E. Regular use of NSAIDs

Rationale: Regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) is a well-documented risk factor for the development of gastritis. NSAIDs can cause irritation and erosion of the gastric mucosa, leading to inflammation. High calcium intake and a low-fat diet are not directly linked to gastritis development. While moderate alcohol use can contribute to gastric irritation, it is less directly associated with gastritis than the chronic use of NSAIDs. Corticosteroids, though potentially contributing to peptic ulcer disease, are less commonly associated with gastritis compared to NSAIDs.

Question 10: When educating a patient about lifestyle modifications to manage gastroesophageal reflux disease (GERD), which of the following should the nurse recommend?

A. Lying down immediately after eating B. Increasing intake of spicy foods C. Wearing tight-fitting clothing around the abdomen D. Elevating the head of the bed during sleep E. Consuming large meals before bedtime

Correct Answer: D. Elevating the head of the bed during sleep

Rationale: Elevating the head of the bed helps prevent the backflow of stomach acids into the esophagus by utilizing gravity, thus reducing symptoms of GERD. Lying down immediately after eating, consuming large meals before bedtime, increasing intake of spicy foods, and wearing tight-fitting clothing can all exacerbate GERD symptoms by increasing abdominal pressure or triggering acid reflux. Therefore, recommending the elevation of the head of the bed is a practical and effective lifestyle modification for managing GERD symptoms.

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A 48-year-old male patient, presents to the emergency department, with complaints of abdominal pain, bloating, and vomiting four times today. He reports a history of drinking alcohol daily. The physical examination reveals epigastric tenderness. Laboratory tests reveal an elevated blood alcohol level. Which intervention should the nurse prioritize for this patient?
a) Administer antacids to neutralize gastric acid.
b) Provide intravenous fluids for rehydration.
c) Offer a high-protein, low-fat diet.
d) Schedule an upper gastrointestinal endoscopy.

LISTEN to the answer and explanation for Question 1. Click below.

A 32-year-old female patient presents to the primary care clinic with complaints of recurrent epigastric pain, heartburn, and bloating after meals. She reports a history of using nonsteroidal anti-inflammatory drugs (NSAIDs) for chronic knee pain. The physical examination is unremarkable. Which instruction should the nurse provide to this patient?
a) Avoid spicy and acidic foods.
b) Take NSAIDs with food or milk.
c) Eat smaller, more frequent meals.
d) Consume a high-fiber diet.

LISTEN to the answer and explanation for Question 2. Click below.

A 62-year-old male patient with a medical history of peptic ulcer disease presents to the clinic reporting worsening epigastric pain and black, tarry stools. The patient is currently taking aspirin for his chronic heart condition. Which intervention should the nurse implement for this patient?
a) Encourage the patient to stop taking aspirin.
b) Administer proton pump inhibitors (PPIs).
c) Assess for signs of gastrointestinal bleeding.
d) Schedule an abdominal ultrasound

LISTEN to the answer and explanation for Question 3. Click below.

A 70-year-old female patient with a history of chronic liver disease presents to the emergency department with sudden onset of hematemesis (vomiting blood) and melena (black, tarry stools). The patient appears pale and is hypotensive. Which intervention should the nurse prioritize for this patient?
a) Administer intravenous fluids and blood products.
b) Insert a nasogastric tube for gastric lavage.
c) Obtain an electrocardiogram (ECG) to assess cardiac function.
d) Prepare the patient for an upper gastrointestinal endoscopy.

LISTEN to the answer and explanation for Question 4. Click below.

 A 50-year-old male patient presents to the clinic with complaints of recurrent epigastric pain, dizziness, and fatigue. The patient reports a history of nonsteroidal anti-inflammatory drug (NSAID) use for chronic arthritis. On examination, the patient appears pale and has an elevated heart rate. Which laboratory test should the nurse anticipate for this patient?
a) Hemoglobin and hematocrit levels.
b) Prothrombin time (PT) and international normalized ratio (INR).
c) Serum amylase and lipase levels.
d) Liver function tests (LFTs)

LISTEN to the answer and explanation for Question 5. Click below.

A 60-year-old female patient with a medical history of peptic ulcer disease presents to the emergency department with complaints of severe abdominal pain, hematemesis, and hypotension. The patient’s blood pressure is 80/50 mmHg, heart rate is 110 beats per minute, and respiratory rate is 24 breaths per minute. Which intervention should the nurse implement first?
a) Initiate two large-bore intravenous lines.
b) Administer intravenous proton pump inhibitors (PPIs).
c) Prepare the patient for emergent surgery.
d) Administer a blood transfusion.

LISTEN to the answer and explanation for Question 6. Click below.

A 65-year-old male patient presents to the primary care clinic with complaints of persistent indigestion, unintentional weight loss, and abdominal pain. The patient reports a history of chronic gastritis. Upon physical examination, the nurse palpates an abdominal mass. Which diagnostic test should the nurse anticipate for this patient?
a) Upper gastrointestinal endoscopy with biopsy.
b) Abdominal ultrasound.
c) Complete blood count (CBC) with differential.
d) Stool test for occult blood.

LISTEN to the answer and explanation for Question 7. Click below.

A 50-year-old female patient with a family history of stomach cancer presents to the clinic for a routine check-up. The nurse assesses the patient’s risk factors for gastric malignancy. Which risk factor should the nurse prioritize during the assessment?
a) Helicobacter pylori infection.
b) Tobacco use.
c) Family history of stomach cancer.
d) High intake of processed meats.

LISTEN to the answer and explanation for Question 8. Click below.

A 70-year-old male patient with a confirmed diagnosis of stomach cancer is scheduled for surgical resection. The patient asks the nurse about the expected outcome of the surgery. Which response by the nurse is appropriate?
a) “The surgery aims to cure your cancer completely.”
b) “The surgery will prevent the spread of cancer to other organs.”
c) “The surgery will relieve your symptoms and improve your quality of life.”
d) “The surgery will remove the tumor but cannot guarantee a cure.”

A 45-year-old female patient with a body mass index (BMI) of 45 kg/m² is considering gastric bypass surgery as a treatment for obesity. The patient has a history of uncontrolled type 2 diabetes mellitus. Which information should the nurse provide to the patient regarding the potential benefits of gastric bypass surgery?
a) Resolution of type 2 diabetes.
b) Immediate and sustained weight loss.
c) Improved bone density and reduced fracture risk.
d) Elimination of the need for lifelong vitamin supplementation.

LISTEN to the answer and explanation for Question 10. Click below.