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PNR 309- TEST 2 with Complete Solutions/ Correct-Verified Answers
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PNR 309- TEST 2 with Complete Solutions/Correct-Verified Answers
The nurse is caring for a client with a diagnosis of diverticulitis and a history of irritable bowel
disease and gastro-esophageal reflux disease (GERD) who has received a dose of Mylanta 30 mL
PO. The nurse would evaluate its effectiveness by questioning the client as to whether which of
the following symptoms has been resolved?
a) Diarrhea
b) Heartburn
c)constipation
d) Lower abdominal pain - ANSWER B
Hiatal hernia - ANSWER herniation of a portion of the stomach into the esophagus through an
opening (hiatus) in the diaphragm.
Two types of Hiatus Hernia are: - ANSWER sliding and paraesophageal (rolling).
Predisposing factors of herniation - ANSWER increased intra- abdominal pressure
(including obesity, pregnancy, ascites, tumours, tight corsets),
intense physical exertion,
heavy lifting on a continual basis, increased age,
trauma,
poor nutrition,
prolonged bed rest.
,**Occurs more often in women
Diagnosing a hiatal hernia - ANSWER xray, barium swallow, endoscopy
Complications with hiatal hernias - ANSWER hemorrhage,
stenosis of esophagus, regurgitation/aspiration,
ulcers in herniated portion of stomach,
strangulation of hernia.
H Hernia treatments: - ANSWER similar to GERD;
lifestyle modifications, elevate HOB, antacids/H2R blockers, surgical therapy (all variations of
fundoplication)
Esophageal cancer - ANSWER rare malignant neoplasm of the esophagus, of which there
are two types: squamous cell carcinoma and adenocarcinoma
The nurse is caring for a client who is receiving chemotherapy and rings the call bell to report
an onset of nausea. The nurse should prepare a prn dose of which of the following
prescribed medications?
a) Morphine sulphate
b) Zolpidem
c)Ondansetron
d) dexamethasone - ANSWER C
After administering a dose of promethazine to a client with nausea and vomiting, the
nurse explains that which of the following may be experienced as a common temporary
adverse effect of the medication?
,a) Drowsiness
b) Reduced hearing
c) Sensation of falling
d) Photosensitivity - ANSWER A - promethazine also has sedative and amnesic properties.
Gastritis - ANSWER inflammation of the gastric mucosa that may be acute or chronic, and
may be diffuse or localized.
Gastric cancer - ANSWER an adenocarcinoma of the stomach wall.
Peptic ulcer disease (PUD) - ANSWER condition characterized by erosion of the GI mucosa
resulting from the digestive action of HCl and pepsin. Peptic ulcers can be classified as acute
or chronic, depending on the degree and duration of mucosal involvement.
Types of PUD (3) - ANSWER gastric, duodenal, stress
Causes/etiology of PUD - ANSWER excess acid secretion,
antacid use,
NSAID use,
bacteria
Gastric ulcer etiology and risk factors: - ANSWER women,
elderly (>50yo)
risks: H pylori infection, medications, smoking, bile reflux
Duodenal ulcer etiology and risk factors: - ANSWER familial tendency,
most often between 35-45yo,
, type O blood (^ HCL production)
risks: COPD, cirrhosis, pancreatitis, renal failure, smoking/alcohol, hyperparathyroidism
Diagnosing PUD - ANSWER endoscopy w biopsy,
urea breath test,
xray,
CBC (anemia),
urinalysis,
liver enzymes,
serum amylase (pancreatic fxn),
stool collection (occult blood)
Treatment for PUD - ANSWER lifestyle modifications,
drug therapy,
nutritional therapy,
surgical therapy
What nutritional therapy is indicated for PUD? - ANSWER avoid irritating food/drinks,
bland diet recommended,
6 small meals a day,
only drink liquids between meals
The results of a client's recent endoscopy indicate the presence of peptic ulcer disease (PUD).
Which of the following teaching points should the nurse provide to the client in light of this
new diagnosis?
a) "You'll need to drink at least two to three glasses of milk daily."
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