Question

Which interventions should the nurse implement for a patient with acute gastritis? Select all that apply.

Answer 1

Correct Answers:

Explain that aspirin frequently causes gastritis.
Administer sucralfate to control pain.
Administer antacids or H2-receptor antagonists.

Rationale :

💎 Aspirin explanation: Aspirin irritates the gastric mucosa by inhibiting prostaglandins, leading to inflammation and ulceration.

💎 Sucralfate: Forms a protective coating over the gastric lining, shielding mucosa from acid and pepsin.

💎 Antacids/H2 blockers: Neutralize or reduce acid secretion, relieving symptoms and promoting healing.

💎 Diet modification: Regular diet is avoided during the acute phase to prevent worsening irritation.

💎 Observation: Monitoring for GI bleeding and avoiding gastric irritants (NSAIDs, alcohol) are essential parts of management.

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Answer 2

Correct Answers:

Rifaximin (Xifaxan)

Rationale :

🔷 Asterixis & fetor hepaticus: Indicate hepatic encephalopathy from ammonia buildup.

🔷 Rifaximin: A non-absorbable antibiotic that reduces ammonia-producing gut bacteria.

🔷 Mechanism: Decreases bacterial load, improving mental status and confusion.

🔷 Propranolol: Used for variceal bleeding prevention, not encephalopathy.

🔷 Supportive care: Include lactulose therapy and low-protein diet to manage ammonia levels.

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Answer 3

Correct Answers:

"You will have stomas on your abdomen that can be returned to your abdomen after your bowel has healed."

Rationale :

🔶 Double-barrel colostomy: Temporary with two stomas — proximal for feces, distal for mucus.

🔶 Purpose: Allows healing of diseased bowel segment.

🔶 Reversal: Once bowel heals, stomas can be reconnected surgically.

🔶 Output: Stool exits through proximal stoma only.

🔶 Education: Involves stoma care, appliance management, and temporary nature of procedure.

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Answer 4

Correct Answers:

Coffee and glazed doughnut

Rationale :

💠 Simple sugars: Cause rapid gastric emptying → fluid shift → hypoglycemia & discomfort.

💠 High-carb foods: Worsen symptoms like dizziness, cramping, and diarrhea.

💠 Coffee: Increases gastric motility and secretion, aggravating dumping.

💠 Dietary plan: High-protein, moderate-fat, low-sugar meals best tolerated.

💠 Teaching: Small, frequent meals and no fluids with meals help control symptoms.

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Answer 5

Correct Answers:

"To prevent choking."

Rationale :

💎 Sedation effect: Procedure uses anesthetic spray that numbs the throat.

💎 Swallow reflex: Must return before oral intake to prevent aspiration.

💎 Priority: Airway protection until gag reflex returns.

💎 Assessment: Nurse checks gag reflex before giving food or fluids.

💎 Patient education: Delaying intake ensures safety and prevents aspiration pneumonia.

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Answer 6

Correct Answers:

"Your airways are inflamed and spastic."

Rationale :

🔷 Pathophysiology: Asthma is chronic inflammation leading to bronchial hyperresponsiveness and airway narrowing.

🔷 Spasm: Smooth muscles constrict, producing wheezing and dyspnea.

🔷 Inflammation: Causes mucosal edema and increased mucus production.

🔷 Triggers: Include allergens, cold air, exercise, and stress.

🔷 Education: Focus on avoiding triggers and using bronchodilators correctly.

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Answer 7

Correct Answers:

"Be sure to protect your tracheostomy from pollutants such as powders or hair."

Rationale :

🔶 Pollutants: Can obstruct airway, causing infection or difficulty breathing.

🔶 Tracheostomy: Bypasses upper airway filtration; hence, cleanliness is crucial.

🔶 Prevent infection: Maintain sterile dressing changes and avoid irritants.

🔶 Protection: Use trach covers when outdoors or near dust.

🔶 Education: Includes cleaning inner cannula and recognizing infection signs.

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Answer 8

Correct Answers:

Wheezes

Rationale :

💠 Wheezes: High-pitched, musical (violin-like) sounds from narrowed airways.

💠 Associated with: Asthma, COPD, or bronchospasm.

💠 Mechanism: Airflow through constricted passages creates vibration.

💠 Inspiration/Expiration: Can occur during both, often louder in expiration.

💠 Nursing care: Administer bronchodilators and assess breath sounds post-treatment.

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Answer 9

Correct Answers:

"You do not have enough hemoglobin to carry oxygen to your tissues."

Rationale :

💎 Hemoglobin function: Transports oxygen from lungs to body cells.

💎 Anemia: Reduces oxygen-carrying capacity → tissue hypoxia.

💎 Symptoms: Dyspnea, fatigue, pallor, tachycardia.

💎 Low Hb (6 g/dL): Indicates severe anemia requiring transfusion.

💎 Goal: Increase oxygen delivery and treat bleeding source.

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Answer 10

Correct Answers:

Administer an analgesic to the patient.

Rationale :

🔷 Pre-procedure pain management: Reduces anxiety and discomfort during aspiration.

🔷 Bone marrow biopsy: Involves puncture into bone (usually iliac crest), causing pain.

🔷 Analgesic: Given before procedure, not after, for optimal relief.

🔷 Nurse role: Verify consent, explain steps, and monitor for post-procedure bleeding.

🔷 Aftercare: Apply pressure dressing and assess for signs of infection or hematoma.

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VNSG202 Med-Surg 1 Summer 2025 (NS) Final Exam

No.

1 :
Which interventions should the nurse implement for a patient with acute gastritis? Select all that apply.

2 :
A patient with cirrhosis has asterixis and fetor hepaticus and is confused. The patient has all of these medications ordered. Which medication would be most appropriate to be given now?

3 :
Which of the following explanations by the nurse to reinforce the patient's preoperative education for a double-barrel colostomy would be correct?

4 :
The nurse is reinforcing teaching about food choices to a patient with dumping syndrome. Which foods would the nurse instruct the patient to avoid?

5 :
The nurse evaluates the patient as understanding the primary reason that food and fluids are held until the gag reflex returns after an esophagogastroduodenoscopy procedure if the patient states which of these?

6 :
A newly diagnosed patient asks the nurse to explain asthma. Which of the following explanations by the nurse is correct?

7 :
The nurse teaches a patient how to live with a new tracheostomy. Which of the following instructions is appropriate?

8 :
Which of the following adventitious lung sounds is a violin-like sound?

9 :
A nurse is caring for a patient admitted with gastrointestinal tract bleeding and a hemoglobin level of 6 g/dL. The patient asks the nurse why the low hemoglobin causes shortness of breath. Which response is best?

10 :
The nurse is preparing to assist the physician with a bone marrow biopsy. Which intervention is most important for the nurse to carry out before the procedure?

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VNSG202 Med-Surg 1 Summer 2025 (NS) Final Exam

No.

1 : Which interventions should the nurse implement for a patient with acute gastritis? Select all that apply.

2 : A patient with cirrhosis has asterixis and fetor hepaticus and is confused. The patient has all of these medications ordered. Which medication would be most appropriate to be given now?

3 : Which of the following explanations by the nurse to reinforce the patient's preoperative education for a double-barrel colostomy would be correct?

4 : The nurse is reinforcing teaching about food choices to a patient with dumping syndrome. Which foods would the nurse instruct the patient to avoid?

5 : The nurse evaluates the patient as understanding the primary reason that food and fluids are held until the gag reflex returns after an esophagogastroduodenoscopy procedure if the patient states which of these?

6 : A newly diagnosed patient asks the nurse to explain asthma. Which of the following explanations by the nurse is correct?

7 : The nurse teaches a patient how to live with a new tracheostomy. Which of the following instructions is appropriate?

8 : Which of the following adventitious lung sounds is a violin-like sound?

9 : A nurse is caring for a patient admitted with gastrointestinal tract bleeding and a hemoglobin level of 6 g/dL. The patient asks the nurse why the low hemoglobin causes shortness of breath. Which response is best?

10 : The nurse is preparing to assist the physician with a bone marrow biopsy. Which intervention is most important for the nurse to carry out before the procedure?

1 :
Which interventions should the nurse implement for a patient with acute gastritis? Select all that apply.

2 :
A patient with cirrhosis has asterixis and fetor hepaticus and is confused. The patient has all of these medications ordered. Which medication would be most appropriate to be given now?

3 :
Which of the following explanations by the nurse to reinforce the patient's preoperative education for a double-barrel colostomy would be correct?

4 :
The nurse is reinforcing teaching about food choices to a patient with dumping syndrome. Which foods would the nurse instruct the patient to avoid?

5 :
The nurse evaluates the patient as understanding the primary reason that food and fluids are held until the gag reflex returns after an esophagogastroduodenoscopy procedure if the patient states which of these?

6 :
A newly diagnosed patient asks the nurse to explain asthma. Which of the following explanations by the nurse is correct?

7 :
The nurse teaches a patient how to live with a new tracheostomy. Which of the following instructions is appropriate?

8 :
Which of the following adventitious lung sounds is a violin-like sound?

9 :
A nurse is caring for a patient admitted with gastrointestinal tract bleeding and a hemoglobin level of 6 g/dL. The patient asks the nurse why the low hemoglobin causes shortness of breath. Which response is best?

10 :
The nurse is preparing to assist the physician with a bone marrow biopsy. Which intervention is most important for the nurse to carry out before the procedure?