1. 1 Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier, Inc. Nursing Management: Upper Gastrointestinal Problems Chapter 42

2. 2 Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier, Inc. 1.A patient with persistent vomiting of 3 days’ duration is seen at the urgent care center because of increasing weakness. Intravenous therapy with lactated Ringer’s solution is started, and arterial blood gases (ABGs) are ordered. Which of the following ABG results would the nurse expect? 1.pH 7.4; PaCO 2 40 mm Hg; HCO 3 - 25 mEq/L 2.pH 7.3; PaCO 2 50 mm Hg; HCO 3 - 20 mEq/L 3.pH 7.6; PaCO 2 30 mm Hg; HCO 3 - 40 mEq/L 4.pH 7.48; PaCO 2 40 mm Hg; HCO 3 - 30 mEq/L

3. 3 Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier, Inc. 2.After the nurse teaches a patient with gastroesophageal reflux disease (GERD) about recommended dietary modifications, which statement by the patient indicates that the teaching has been effective? 1.“I can have a glass of low-fat milk at bedtime.” 2.“I will have to eliminate all spicy foods from my diet.” 3.“I will have to use herbal teas instead of caffeinated drinks.” 4.“I should keep something in my stomach all the time to neutralize the excess acids.”

4. 4 Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier, Inc. 3.When teaching a patient with a history of upper GI bleeding to check the stools for blood, the nurse informs the patient that 1.if vomiting of bright red blood occurs, stools will not be black and sticky. 2.blood is never obvious in stools and must be detected by fecal occult blood testing. 3.acute bleeding in the upper GI tract will result in bright red blood in the stools. 4.stools that are black and tarry occur with prolonged bleeding from the stomach or small intestine.

5. 5 Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier, Inc. 4.Diagnostic testing is planned for a patient with a suspected peptic ulcer. The nurse explains to the patient that the most reliable test for determining the presence and location of an ulcer is a(n) 1.endoscopy. 2.gastric analysis. 3.barium swallow. 4.serologic test for Helicobacter pylori.