NURS 111 Peptic Ulcer Disease Exam. Columbia University. Complete Solution.Assessment
Ms. Lewis arrives at her HCP's office, and the nurse escorts her to
... [Show More] the examination room. The nurse performs
the initial assessment. During the initial interview, Ms. Lewis requests that the nurse call her Gail.
1.
Which information is most significant when assessing a client suspected of having a peptic ulcer?
A) Amount of stress at work and in personal life.
INCORRECT
In the past, stress and emotions were thought to be a major cause of ulcers, but stress rarely causes an ulcer
although it probably can aggravate the symptoms.
B) Frequent use of aspirin or products containing aspirin.
CORRECT
Longterm use of antiinflammatory medications (NSAIDs) damages the stomach lining and causes ulcers.
NSAIDs inhibit the production of an enzyme (cyclooxygenase) that produces prostaglandins which help protect
the stomach lining from chemical and physical injury.
Gail reports that she occasionally takes aspirin or ibuprofen for low back pain and joint pains. During the
interview, Gail tells the nurse that she frequently has a gnawing, burning pain in her stomach. The nurse asks
Gail to explain the pain in more detail.
C) History of cigarette smoking and/or current cigarette smoking.
INCORRECT
Nicotine delays the healing of an ulcer, but it does not cause the development of a peptic ulcer.
D) Daily consumption of coffee or other caffeinated drinks.
INCORRECT
Although caffeine stimulates the secretion of gastric acid, ingestion of caffeine is not considered a risk factor in
developing gastric ulcers.
Points Earned: 1.0/1.0
Correct Answer(s): B
2.
Which response by Gail supports a peptic ulcer?
A) "The pain usually does not bother me at night."
INCORRECT
Because gastric acid production at night can cause extreme abdominal pain, individuals with ulcers may wake
up during the night.
B) "My pain is temporarily relieved when I drink milk."
CORRECT
Although antacids and milk usually provide temporary relief for the pain since they neutralize the gastric acid in
the stomach, milk can make an ulcer worse because it stimulates the stomach to produce more acid and
digestive juices that can aggravate an ulcer.
C) "My pain seems to be worse just before I eat a meal."
INCORRECT
The gnawing, burning pain frequently occurs several hours following a meal after the food leaves the stomach
but while acid production is still high.
D) "The pain is worse in the morning when I first wake up."
INCORRECT
Pain upon awakening is not a symptom experienced by clients diagnosed with PUD.
Points Earned: 1.0/1.0
Correct Answer(s): B
Diagnostic Tests
The HCP suspects that Gail has a peptic ulcer and schedules her for a Helicobacter pylori (H. pylori) breath
test. The nurse explains that this is a simple and safe test used to detect an active H. pylori infection which is
often the cause of PUD. The nurse discusses the preprocedure guidelines for the test.
3.
Which intervention should the nurse include?
A) Advise Gail of the need to sign an informed consent form prior to the test.
INCORRECT
An informed consent is needed for invasive procedures. The H. pylori breath test is not invasive.
B) Tell Gail to not eat or drink anything eight hours prior to the test.
INCORRECT
Food and drink are withheld for only one hour prior to the procedure.
C) Instruct Gail not to take any antibiotics for four weeks prior to the test.
CORRECT
Antibiotics and oral bismuth subsalicylate (Pepto Bismol) should be withheld for four weeks so that they do not
interfere with the results of the H. pylori breath test.
D) Explain that a protonpump inhibitor should be taken four hours prior to the test.
INCORRECT
Protonpump inhibitors are withheld for two weeks prior to the H. pylori breath test so that they do not interfere
with the results of the test.
Points Earned: 1.0/1.0
Correct Answer(s): C
Gail asks the nurse, "What happens during this test?"
4.
Which information should the nurse provide?
A) Some saliva is expectorated into a sterile specimen cup.
INCORRECT
This is not the correct procedure for this test.
B) The lining of the mouth is swabbed with a culture tube qtip.
INCORRECT
A swab is not used to perform the H. pylori breath test.
C) A machine is used that requires you to breathe into it for five minutes.
INCORRECT
Breathing into a machine is not part of this test.
D) A pleasanttasting solution is ingested and you breathe into a balloon.
CORRECT
Exhaling into a balloonlike bag is performed first to obtain a baseline sample. Then a small amount of a
pleasant lemonflavored solution is ingested, and 15 minutes later another balloon breath sample is obtained.
This sample is tested for an increase in carbon dioxide which indicates a positive H. pylori breath test. [Show Less]