Nclex Gastrointestinal System Disorders Exam

Preview (11 of 35 Pages)

100%

Nclex Gastrointestinal System Disorders Exam - Page 1 preview image

Loading page ...

Nclex Gastrointestinal System Disorders Exam withverified solution■The client with GERD complains of a chronic cough. The nurse understands thatina clientwithGERD thissymptom may be indicative of which of thefollowingconditions?]A. Development of laryngeal cancer.iB.Irritation of the esophagus.iC. Esophageal scar tissue formation.•]D. Aspiration of gastric contents.Answer: D. Aspiration of gastric contentsClients with GERD can develop pulmonary symptoms such as coughing, wheezing,anddyspnea that arecaused by the aspiration of gastric contents. It is frequently thought that GERD plays a big role inchronic cough: there are reports that25% ormore of chronic cough cases are associated with GERD.Option A: GERDdoes not predispose the client to the development of laryngeal cancer. Themost intuitive theory is called the reflux theory, whereby reflux rises above the esophagus andupper esophageal sphincter, resulting in microaspiration as microdroplets landinthe larynx oroccasionally enter the bronchia tree, directly causing cough as a protective mechanismagainstreflux.Option B:Irritation of the esophagus can deve op as a result of GERD. However, GERD is morelikely to cause painful and difficult swallowing. In the reflex theory, because of the commonembryologic origin of the respiratory tract and the digestive tract, a little bit ofreflux,intheesophagus can lead to an esophagobronchial reflex that causes cough.Option C:Esophageal scar tissue formation can develop as a result of GERD.GERD occurs inapproximately 20K of Americans, and chronic cough is a very common problem, which patients

Nclex Gastrointestinal System Disorders Exam - Page 2 preview image

Loading page ...

with GERD are not immune to developing. Due to the baseline GERD rate of 20%, it is difficult toseparate the presence of the disorder from the causative effect of the disorder.■Which ofthe followingtasks should beincluded inthe immediate postoperative managementof a client who has undergone gastric resection?1 A. Monitoring gastric pH to detect complications.]B. Assessing for bowel sounds.1 C. Providing nutritional support.•1D. Monitoring for symptoms of hemorrhage.Answer: D. Monitoring for symptoms of hemorrhage.The client should be monitored closely for signs and symptoms of hemorrhage, such as bright red bloodin the nasogastric tube suction, tachycardia, or a drop in blood pressure. Identify signs and symptomsrequiring medical evaluation such as persistent nausea and vomiting or abdominal fullness; weight loss;diarrhea; foul-smelling fatty or tarry stools; bloody or coffee-ground vomitus or presence of bile, fever.Instruct the patient to report changes in pain characteristics.Option A:GastricpHmay be monitored to evaluate the need for histamine-2 receptorantagonists. Caution the patient to read labelsand avoidproducts containing ASA, ibuprofen.Thiscan cause gastric irritationandbleeding. Review medication purpose, dosage, andschedule,andpossible side effects.OptionE: Bowel sounds may not return for up to 72 hours postoperatively. Auscultate forresumptionofbowelsounds andnote passage of flatus. Peristalsis can be expectedtoreturnabout the third postoperative day, signaling readiness to resume oral intake.Option C:Nutritional needs should be addressed soon after surgery. Monitor tolerance to fluidand food intake, noting abdominal distension, reports of increased pain, cramping, nausea,and vomiting. Avoid milkandhigh-carbohydrate foods inthediet becausethismay triggerdumping syndrome.■Whichof thefollowingwould beanexpected nutritional outcome foraclient whohas undergone a subtotal gastrectomy for cancer?1A. Regain weight loss within 1 month after surgery.1B. Resume normal dietary intake of three meals per day.iC. Control nausea and vomiting through regular use of antiemetics.*2D. Achieve optimal nutritional status through oral or parenteral feedings.Answer: D. Achieve optimal nutritional status through oral or parenteral feedings.

Nclex Gastrointestinal System Disorders Exam - Page 3 preview image

Loading page ...

An appropriate expected outcome is for the client to achieve optimal nutritional status through the useof oral feedings or total parenteral nutrition (TPN). TPN may be used to supplement oral intake, or itmay be used alone if the client cannot tolerate oral feedings. Maintain patency of NG tube. Notify thephysicianifthetubebecomes dislodged. This provides rest for theGltract during the acutepostoperative phase until the return of normal function.OptionA:The client would not be expected to regain lost weight within1month after surgery.Note admission weight and compare with subsequent readings. This provides information aboutthe adequacy of dietary intake and determination of nutritional needs.Option B: The client would not be expected to tolerate a normal dietary Intake of three mealsper day. Monitor tolerance to fluid and food intake, noting abdominal distension, reports ofincreased pain, cramping, nausea, and vomiting. Complications of paralytic ileus, obstruction,delayed gastric emptying, and gastric dilation may occur, possibly requiring reinsertion of theNG tube.Option C: Nausea and vomiting would not be considered an expected outcome of gastricsurgery,andregular use of antiemetics would not be anticipated. Progress diet as tolerated,advancing from clear liquid to bland diet with several small feedings. Usually, the NG tube isclamped for specified periods of time when peristalsis returns to determine tolerance. After theNGtube isremoved,intakeis advanced gradually to prevent gastric irritation and distension.•The nurse would assess the client experiencinganacute episodeofcholecystitis forpainthatis located in the right’A. Upper quadrantandradiates to the left scapulaandshoulder.*jB. Upper quadrant and radiates to the right scapula and shoulder.1 C. Lower quadrantandradiates to the umbilicus.1D. Lower quadrant and radiates to the back.Answer: B. Upper quadrant and radiates to the right scapula and shoulderDuringan acute "gallbladder attack," theclientmay complain of severe right upperquadrant painthat radiates to the right scapulaandshoulder.Thisis governedbythe pattern on dermatomesinthebody. Acute cholecystitis is inflammation of the gallbladder that occurs due to occlusion of the cysticduct or impaired emptying of the gallbladder. Often this impaired emptying is due to stones or biliarysludge.OptionA:When cystic duct blockage is caused by a stone,itis called acute calculouscholecystitis. It is important to know, one can have pain due to temporary obstruction bygallstones,andthat is called biliary colic. The diagnosis of biliary colic is upgraded to acutecalculous cholecystitis if the pain does not resolve in six hours. If no stone is identified, it iscalled acute acalculous cholecystitis.Option C: Cases of chronic cholecystitis present with progressing right upper quadrantabdominal pain with bloating, food intolerances (especially greasy and spicy foods), increased

Nclex Gastrointestinal System Disorders Exam - Page 4 preview image

Loading page ...

gas, nausea, and vomiting. Pain in the mid-back or shoulder may also occur. This pain could bepresent for years until diagnosis.OptionD: The pathophysiologic mechanism of acute cholecystitis is blockage of the cystic duct.Cholecystitis is a condition best treated with surgery; however, it can be treated conservatively ifnecessary. This condition can be associated with or without the presence of gallstones and canalso be classified as acute or chronic.*After a subtotal gastrectomy, care of the client's nasogastric tube and drainage systemshould include which of the following nursing interventions?iA. Irrigate the tube with 30 ml of sterile water every hour if needed.1B. Reposition the tube if it is not draining we .•1 C. Monitor the client for N/V, and abdominal distention.|D. Turn the machine to high suction if the drainage is sluggish on low suction.Answer: C. Monitor the client for N/Vrand abdominal distention.Nausea, vomiting, or abdominal distention indicated that gas and secretions are accumulating within thegastric pouch due to impaired peristalsis or edema at the operative site and may indicate that thedrainage system is not working properly. Assess the comfort of the client. Check for presence of nauseaand vomiting, feeling of fullness, or pain. May indicate incorrect operation of NG suction or blockage inthe tube.Option A:Saline solution is used to irrigate nasogastric tubes. Hypotonic solutions such as waterincrease electrolyte loss. In addition, a physician's order is needed to irrigate the NG tube,because this procedure could disrupt the suture line. Irrigations are recorded as intake. Drainagefrom the NG tube is measured as output every 0 hours. If drainage is copious, more frequentemptying of the collection container will be necessary. Documentation provides an accuraterecord of the client's response to NG drainage.OptionB: After gastric surgery, only the surgeon repositions the NG tube because of the dangerof rupturing or dislodging the suture line. Always verify if the NG tube placed is in the stomachby aspirating a small amount of stomach contents. An X-ray study is the best way to verifyplacement.OptionD: The amount of suction varies with the type of tube used and is ordered by thephysician. High suction may create too much tension on the gastric suture line. Inspect suctionapparatus. Check that setting is correct for the type of suction (continuous or intermittent),range of suction (low. medium, high), and that movement of drainage through the tubing ispresent.•A client with a peptic ulcer is scheduled for a vagotomy. The client asks the nurse aboutthe purpose of this procedure. The nurse tells the client that the procedure:jA. Decreases food absorption in the stomach.

Nclex Gastrointestinal System Disorders Exam - Page 5 preview image

Loading page ...

!B. Heals the gastric mucosa.|C.Halts stress reactions.•1D. Reduces the stimulus to acid secretions.Answer: D, Reduces the stimulus to acid secretions,A vagotomy, or cutting the vagus nerve, is done to eliminate parasympathetic stimulation of gastricsecretion. A vagotomy is a type of surgery that removes all or part of the vagus nerve. This nerve runsfrom the bottom of the brain, through the neck, and along the esophagus, stomach, and intestines in thegastrointestinal (Gl) tract.OptionA: The indications for vagotomy are few with the advancements of medical therapy.Generally, acid-reducing operations are reserved for complicated ulcer disease in a stablepatient who has failed maximum medical therapy. The type of surgery performed depends onthe type of ulcer (duodenal versusgastric), the complication of PUD (bleeding, perforation,obstruction, intractability), and the location of the ulcer (types I to V gastric ulcers as describedby the Modified Johnson Classification system}.OptionB: The relevant physiology revolves around the mechanisms relating to stomach acidsecretion. Intraluminal gastric acid is released by the parietal cells, mainly located in the body ofthe stomach. Parietal cells are stimulated via 3 mechanisms: gastrin, acetylcholine, andhistamine. All 3 mechanisms activate the hydrogen-potasslum ATPase-releasing hydrogen ioninto the stomach lumen.OptionC: Vagotomy was once commonly performed to treat and prevent PUD; however,with the availability of excel ent acid secretion control with H2-receptor antagonists, protonpumpinhibitors,andanti-Helicobacterpylorimedications,theneedforsurgicalmanagement of this condition has greatly decreased.■After a subtotal gastrectomy, the nurse should anticipate that nasogastric tube drainage willbe what color for about 12 to 24 hours after surgery?•1A. Dark brown•E. Bile greeniC. Bright red|D. Cloudy whiteAnswer: A, Dark brownAbout 12 to 24 hours after a subtotal gastrectomy, gastric drainage is normally brown, which indicatesdigested blood. The aims of prophylactic drainage are to prevent repeated infection (for example bydischarging remnant blood and preventing abscess formation), control possible leakage from thesurgical seam (by drainage of the digestive closure, for example, a colonic anastomosis), and to providea warning of potential complications.

Nclex Gastrointestinal System Disorders Exam - Page 6 preview image

Loading page ...

OptionB:Bile green is not expected during the first 12 to 24 hours after subtotal gastrectomy.Bile-colored (greenish) drainage is characteristic when the tube is in the duodenum. Measureand record the amount of drainage. Dispose of measured drainage by flushing into the hopperor toilet.Option C:Drainage during the first6to 12 hours contains some bright red blood, but largeamounts of blood or excessively bloody drainage should be reported to the physician promptly.In gastrointestinal! drainage, blood varies in color-it may be dark red when fresh, dark brownish-red. orinbrown particles ("coffee ground drainage'1) if it has been partially digested.OptionD:Cloudy, pale-yellowish drainage is characteristic when the tube is in the stomach.However, this is not expected within 12 to 24 hours. Measure the contents and empty thedrainage bottle at the hours ordered by the physician, when the drainage bottle is two-thirdsfull or when suction is discontinued.■The client with peptic ulcer disease is scheduledfora pyloroplasty. The client asks thenurse about the procedure. The nurse plans to respond knowing that a pyloroplastyinvolves:IA.Cutting the vagus nerve,IB. Removing the distal portion of the stomach.1 C. Removal of the ulcer and a large portion of the ce Is that produce hydrochloric acid.•1D. Anincision andresuturing of the pylorusto relax the muscle and enlarge the openingfrom the stomach to the duodenum.Correct Answer:D, An incision and resuturingof the pylorus to relax the muscle and enlarge theopening from the stomach to the duodenum.Pyloroplasty is surgery towiden the openinginthe lower part of the stomach (pylorus) so thatstomach contents can empty into the small intestine (duodenum). The pylorus is a thick, musculararea. When it thickens, food cannot pass through.Option A:A vagotomy involves cutting the vagus nerve. A vagotomy is a type of surgery thatremoves all or part of the vagus nerve. This nerve runs from the bottom of the brain, throughthe neck,and alongthe esophagus, stomach, and intestinesinthe gastrointestinal (GI) tract.OptionB:A subtotal gastrectomy involves removing the distal portion of the stomach.Gastrectomy is a surgery that's done to treat stomach cancer. During gastrectomy, the surgeonmay remove part or all of the stomach. A subtotal gastrectomy includes removing the part of thestomach with cancer, nearby lymph nodes, and possibly parts of other organs near the tumor.Option C:A Billroth II procedure involves removal of the ulceranda large portion of the tissuethat produces hydrochloric acid. There aremanyvariations on the procedure, but they generallyinvolve resection of the diseased portion of the distal stomach and a side-to-side anastomosis ofthe residual stomach tojejunumthrough the transverse mesocolon. It can be performedwitheither an antecolic or a retrocolic anastomosis.

Nclex Gastrointestinal System Disorders Exam - Page 7 preview image

Loading page ...

A 40-year-old male client has been hospitalized with peptic ulcer disease. He is being t r e a t e dwith a histamine receptor antagonist (cimetidine), antacids, and diet. The nurse doingdischarge planning will teach him that the action of cimetidine is to:•1 A, Reduce gastric acid output.iB. Protect the ulcer surface.1C. Inhibit the production of hydrochloric acid (HCl).]D. Inhibit vagus nervestimulation.Answer: A. Reduce gastric acidoutput.These drugs inhibit the action of histamine on the H2 receptors of parietal cells, thus reducing gastricacid output. The H2-receptor antagonist cimetidine competitively blocks histamine from stimulatingthe H 2-receptors ocated on the gastric parietal cells (these cells are responsible for hydrochloric acidsecretion and secretion of the intrinsic factor). The effect results in reducing the volume of gastric acidsecretion from stimuli, including histamine, food, caffeine, and insulin.Option B:Sucralfate exhibits its action by forming a protective layer, increasing bicarbonateproduction, exhibiting anti-peptic effects, p r o m o t i n g tissue g r o w t h , regeneration, and repair.Sucralfate is a medication used to treat duodenal ulcers, epithelial wounds, chemotherapy-induced mucositis, radiation proctitis, ulcers in Behcet disease, and burn wounds.OptionC: Ultimately, PPIs function to decrease acid secretion in the stomach. The proximal smallbowel absorbs these drugs, and once in circulation, affects the parietal cells of the stomach. Theparietal cells contain the H+/K+ ATPase enzyme, the proton pump, that PPIs block. This enzymeserves as the final step of acid secretion into the stomach.OptionD: Atropine is an antimuscarinic that works t h r o u g h competitive inhibition ofpostganglionic acetylcho ine receptors and direct vagolytic action, which leads toparasympathetic inhibition of the acetylcholine receptors in smooth muscle. The end effect ofincreased parasympathetic inhibition aows for preexisting sympathetic stimulation topredominate, creating increased cardiac output and other associated antimuscarinic side effectsas described herein.•A client has been diagnosed with adenocarcinoma of the stomach and is scheduled to undergoa subtotal gastrectomy (Billroth II procedure). During preoperative teaching, the nurse isreinforcing i n f o r m a t i o n about the procedure. Which of the following explanationsismostaccurate?1A. The procedure will result in enlargement of the pyloric sphincter.•JB. The procedure will result in anastomosis of the gastric stump to the jejunum.iC. The procedure will result in removal of the duodenum.JD. The procedure will result in repositioning of the vagus nerve.

Nclex Gastrointestinal System Disorders Exam - Page 8 preview image

Loading page ...

Correct Answer: B. The procedure will result in anastomosis of the gastric stump to the jejunum.A Billroth II procedure bypasses the duodenum and connects the gastric stump directly to the jejunum.The pyloric sphincter is removed,alongwith someofthe stomach fundus.Ifthe stomach cannot bereconnected to the duodenum, a Billroth II is performed, in which an opening hole is made in the nextsection of the small intestine, the jejunum, and the stomach attached at that opening.Option A:A pyloromyotomy is an operation to loosen the tight muscle causing the blockagebetween the stomach and small intestine. During the operation, the surgeon cuts the tightmuscleb e t w e e n the stomachandsmall intestine. This loosens the muscle so the stomach canempty and food will be able to pass easily into the small intestine.Option C:The W h i p p l e procedure (pancreaticoduodenectomy) is an operation to remove thehead of the pancreas, the first part of the small intestine (duodenum), the gallbladder, and thebile duct. The remaining organs are reattached to allow the client to digest food normally aftersurgery.Option D:Billroth II gastrojejunostomy is a procedure that has been performed for tumor orsevere ulcer disease in the distal stomach. There are many variations on the procedure, but theygenerally involve resection of the diseased portion of the distal stomach and a side-to-sideanastomosis of the residual stomach to jejunum t h r o u g h the transverse mesocolon. It can beperformed with eitheranantecolic or a retro colic anastomosis.•The nurse provides medication instructions toaclient with peptic ulcer disease.Whichstatement,ifmade by the client, indicates thebest understanding ofthe medicationtherapy?A.•)"The cimetidine (Tagamet) will cause metoproduce less stomach acid."JB. "Sucralfate (Carafate) will change the fluid in my stomach."1C. "Antacidswillcoat my stomach."1D. "Omeprazole (Prilosec) will c o a t t h e ulcer and help it heal."Answer: A. "The cimetidine (Tagamet) will cause m e t o produce less stomach acid."Cimetidine (Tagamet), a histamine H2 receptor antagonist,willdecrease the secretion of gastric acid.The H2-receptor antagonist cimetidine competitively blocks histamine from stimulating the H2-receptors located on the gastric parietal cells (these cells are responsible for hydrochloric acid secretionand secretion of the intrinsic factor). The effect results in reducing the volume of gastric acid secretionfrom stimuli,includinghistamine, food, caffeine, andinsulin.Option B:Sucralfate (Carafate) promotes healing by coating the ulcer. By f o r m i n g a polyaniongel,itacts as a physical barrier between luminal contentsandmucosa. It also increases theproduction of mucus by increasing prostaglandin production. Sucralfate prevents thebreakdown of mucus by pepsin A, reducing ulcerogenesis.Option C:Antacids neutralize acid in the stomach. The antacids reduce the acid reaching theduodenum by neutralizing the acid presentinthe stomach. The salts' mechanism of

Nclex Gastrointestinal System Disorders Exam - Page 9 preview image

Loading page ...

neutralization of acid varies, and each salt has a different mechanism with the ultimate goal ofacid neutra ization.Option D:Omeprazole (Prilosec) inhibits gastric acid secretion. Omeprazole is a protonpumpinhibitor. It inhibits the parietal cellH-i- /K-+ ATPpumprthe final step of acid production.Inturn, omeprazole suppresses gastric basal and stimulated acid secretion. The inhibitory effectsof omeprazole occur rapidly within 1 hour of administration, with the maximum effectoccurringin2hours.•When a client has peptic ulcer disease, the nurse would expect a priority intervention to be:]A. Assisting in inserting a Miller-Abbott tube.iB. Assisting in inserting an arterial pressure line.•1 C. Inserting a nasogastric tube.jD. Inserting an I.V.Answer: C. Inserting a nasogastric tube.AnNGtube insertion is the most appropriate intervention because it will determine the presence ofactive Gl bleeding. Monitor the client's fluidintakeand urine output. Assess for the signs ofhematemesis or melena. The client with a bleeding ulcer may vomit bright red blood or coffeegroundsemesis. Melena occurs when there is bleeding intheupper Gl tract.Option A:A Miller-Abbott tube is a weighted, mercury-filled bal oon tube used to resolve bowelobstructions. The modifications of lifestyle behaviors such as alcohol use, coffee,andothercaffeinated beverages, and the overuse of aspirin or other nonsteroidal anti-inflammatory drugsis necessary to prevent recurrent ulcer deveopment andprevent complications during thehealing phase.Option B:There is no evidenceofshock or fluid overload in the client; therefore,anarteriallineis not appropriateatthistime.Monitor the client's vital signs,andobserve BP andHRfor signsof orthostatic changes.Option D:An IV is optional. Administer IV fluids, volume expanders, and blood products asordered. Isotonic fluids, volume expanders, and blood products can restore or expandintravascular vo ume.•A client with suspected gastric cancer undergoes an endoscopy of the stomach. Which of thefollowing assessments made after the procedure would indicate the development of apotential complication?3A. Theclientcomplains of a sore throat.1B. The client displays signs of sedation.*1 C. The client experiences a sudden increase in temperature.

Nclex Gastrointestinal System Disorders Exam - Page 10 preview image

Loading page ...

]D. The client demonstrates a lack of appetite.Correct Answer: C. The client experiences a sudden increase in temperature.The most likely complication of an endoscopic procedure is perforation. A sudden temperature spikewithin 1 to 2 hours after the procedure is indicative of perforationandshould be reported immediatelyto the physician. This most commonly occurs when additional procedures are carried out at the sametime. The infections are normally minor and treatable with a course of antibiotics.Option A:A sore throat is to be anticipated after an endoscopy. Risks of endoscopy may includepersistentpain inthe area of the endoscopyora numb throat for a few hoursduetotheuse of alocal anesthetic.Option B:Clients are given sedatives during the procedure, so it is expected that they 'will displaysigns of sedation after the procedure is completed. Risks of endoscopy may include over-sedation. although sedation is not always necessary.Option D:A lack of appetite could be the result of many factors,includingthe disease process.There may be some soreness. Withthistype of endoscopy, theremaybe bloating and soreness,but these usually resolve quickly.•The nurse is assessing aclient24 hours following a cholecystectomy. Thenursenotes that theT- tube has drained 750ml of green-brown drainage. Whichnursinginterventionismostappropriate?!A.Notifythe physician.1 B. Document the findings.'C. Irrigate the T-tube.iD. Clamp the T-tube.Answer: B. Document the findings.Following cholecystectomy, drainage from the T-tube is initially bloody and then turns green-brown.Fresh post-op (1-2 days): drainage starts out with some blood and then progresses to agreenish/yellow/ brown liquid drainage. The drainage is measured as output. The amount of expecteddrainage will range from 500 to 1000 ml per day. The nurse would document the output.Option A:Notifying the physician is unnecessary. Thefluidmay appear bloodyforthe first day or2. The color will eventually be go den yellow or greenish, depending on exactly where thecatheter is inside the body. There will be bile (yellow-greenfluid)flowing into the bag.Option C:Thereisno need to irrigate the T-tube. The clientwillneed to flush the catheter withnormal saline twice a day. If the doctor instructed to flush with less than 10 mL, squirt the extrasalineout before connecting the syringe. Push the plunger of the syringe to push 1/3 of thenormal saline into the catheter, and then pause. Pushinanother 1/3 of the normal saline, andpause again. Push in the rest of the normal salineintothe catheter.

Nclex Gastrointestinal System Disorders Exam - Page 11 preview image

Loading page ...

Option D:The doctor may order the t-tube to be damped at times so bile can drain to theduodenum so fats can be digested during meal times. Assess how well the patient toleratedthe t-tube being clamped. If a patient develops abdominal pain, nausea, vomiting, etc.unclamp it and notify the physician.■A female client complains of gnawing epigastric pain for a few hours after meals. At times,when the pain is severe, vomiting occurs. Specific tests are indicated to rule out:JA. Cancer of the stomach•1B. Peptic ulcer disease■C. Chronic gastritis]D. PylorospasmAnswer: B, Peptic ulcer diseasePeptic u cer disease is characteristically gnawing epigastric pain that may radiate to the back. Vomitingusually reflects pyloric spasm from muscular spasm or obstruction. Peptic ulcer disease is characterizedby discontinuation in the inner lining of the gastrointestinal (Gl) tract because of gastric acid secretionor pepsin. It extends into the muscularis propria layer of the gastric epithelium. It usually occurs in thestomach and proximal duodenum.Option A:Cancer would not evidence pain or vomiting unless the pylorus was obstructed. In theUnited States, most patients have symptoms of an advanced stage at the time of presentation.The most common presenting symptoms for gastric cancers are non-specific weight oss,persistent abdominal pain, dysphagia, hematemesis, anorexia, nausea, early satiety, anddyspepsia.Option C:The current classification of gastritis is based on time course (acute versus chronic),histologica features, anatomic distribution,andunderlying pathological mechanisms. Acutegastritis will evolve to chronic,ifnot treated. There are no typica clinical manifestations ofgastritis. Sudden onset of epigastric pain, nausea, and vomiting have been described toaccompany acute gastritis.OptionD:There has been much uncertainty about the concept of "pylorospasm'1. For manyyears radiologists considered pylorospasm to be due to spasm of the pyloric ring, where the ringwas equated with the pyloric sphincter. It was thought that spasm of thering(or "sphincter ')closed the pyloric aperture, thereby delaying gastric emptying and causing retention.■The nurse instructs the nursing assistant on how to provide oral hygiene for a client whocannot perform this task for himself. Which of the following techniques should the nurse tellthe assistant to incorporate into the client's daily care?1 A. Assess the oral cavity each time mouth care is given and record observations.*iB. Use a soft toothbrush to brush the client's teeth after each meal.

Preview Mode

This document has 35 pages. Sign in to access the full document!

Report

Study Now!

Document Details

Related Documents

NSG 3160 NCLEX Review Chapter 15

NSG 3160 NCLEX Review Chapter 14

NSG 3160 NCLEX Review Chapter 24

Lippincott Style NCLEX Questions

NCLEX PN Test Practice Questions

Lecture Notes NCLEX

NCLEX Study Guide

Comprehensive NCLEX Review

NCLEX Style Questions Nutrition

Key Concepts for NCLEX

Company

Explore

Study Tools