Upper Gastrointestinal Disorders

A nurse is caring for a patient with suspected GERD. Which diagnostic test provides the most definitive diagnosis?

Esophageal pH monitoring

A patient with a history of peptic ulcer disease (PUD) presents with a rigid abdomen, tachycardia, and severe epigastric pain. What is the nurse's priority action?

Notify the provider immediately

Which of the following medications is contraindicated in a patient with GERD?

Ibuprofen

The nurse is providing education to a patient with a newly diagnosed hiatal hernia. Which statement indicates a need for further teaching?

"I can take NSAIDs for pain relief."

A patient with PUD caused by H. pylori is prescribed a triple therapy regimen. Which of the following drugs is included?

Proton pump inhibitor, two antibiotics

Which of the following dietary recommendations is appropriate for a patient with GERD?

Avoid caffeine, chocolate, and fatty foods

What is the primary reason for administering a proton pump inhibitor (PPI) in a patient with gastritis?

To inhibit gastric acid secretion

A nurse is teaching a patient with dumping syndrome. Which statement by the patient requires further teaching?

"I should drink fluids with my meals to help digestion."

Which of the following complications is most concerning in a patient with chronic GERD?

Barrett's esophagus

The nurse is assessing a patient with an upper GI bleed. Which finding is most concerning?

Bright red blood in emesis

Which surgical procedure is commonly performed for severe GERD?

Nissen fundoplication

Which intervention is appropriate for a patient with an active GI bleed?

Administer IV fluids and blood products as ordered

Which symptom differentiates a gastric ulcer from a duodenal ulcer?

Pain immediately after meals (gastric)

Which of the following patients should the charge nurse assign to the most experienced nurse?

A) A patient with GERD reporting mild heartburn

B) A patient with a hiatal hernia scheduled for discharge

C) A patient with Barrett's esophagus requiring pre-op care for an endoscopy

D) A patient with dumping syndrome learning dietary changes

C) A patient with Barrett's esophagus requiring pre-op care for an endoscopy

Which laboratory test is most useful in diagnosing an H. pylori infection?

Urea breath test

What is a major risk factor for gastric cancer?

Chronic H. Pylori infection

Which postoperative complication should the nurse monitor for in a patient after a gastrectomy?

Dumping syndrome

Which intervention is essential in preventing aspiration pneumonia in a patient with GERD?

Elevate the head of the bed 6-8 inches

A patient is prescribed sucralfate for PUD. When should it be administered?

1 hour before meals

Which of the following is a symptom of gastric outlet obstruction?

Projectile vomiting undigested food

A patient with severe GERD is prescribed metoclopramide. What is the primary action of this medication?

Increases gastric motility

A nurse is assessing a patient with suspected esophageal perforation. Which symptom is most concerning?

Subcutaneous emphysema

Which dietary recommendation is most appropriate for a patient with PUD?

Small, frequent meals with avoidance of spicy foods

A patient with an upper GI bleed has a hemoglobin level of 7.2 g/dL. What is the nurse's priority intervention?

Administer IV fluids and prepare for a blood transfusion

What is the most common cause of duodenal ulcers?

H. pylori infection

Which of the following findings is most concerning in a patient recovering from a gastrectomy?

Tachycardia and hypotension

A patient with chronic gastritis is at increased risk for which of the following?

Vitamin B12 deficiency

The nurse is educating a patient on lifestyle changes to prevent GERD symptoms. Which statement by the patient indicates a need for further education?

"I should lie down after eating to help digestion."

A patient with a history of gastric ulcers presents with sudden severe abdominal pain and a rigid abdomen. What complication should the nurse suspect?

Gastric perforation

A patient diagnosed with Barrett's esophagus asks about their condition. What is the best explanation by the nurse?

"It is a precancerous condition that requires regular monitoring."

The RN charge nurse is making assignments. Staffing includes a registered nurse with 5 years of medical-surgical experience, a newly graduated registered nurse, and two unlicensed assistive personnel (UAPs). Which client should be assigned to the most experienced nurse?

The 46-year-old client diagnosed with gastroesophageal reflux disease wheezing in all five lobes

The nurse is planning care of a client diagnosed with lower esophageal sphincter dysfunction. Which dietary modifications should be included in the plan of care? Select all that apply.

- Eat four to six meals a day and limit fluids during mealtimes

- Maintain an ideal body weight with a healthy diet and exercise

A nurse in the emergency department is completing an assessment of a client who has suspected stomach perforation due to a peptic ulcer. Which of the following findings should the nurse expect? (Select all that Apply)

- rigid abdomen

- tachycardia

- rebound tenderness

A nurse is teaching a client who has a new diagnosis of dumping syndrome following gastric surgery. Which of the following information should the nurse include in the teaching?

Increase protein in the diet