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Nursing Board Exam Reviewer Part 3 of 5

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201. The nurse recognizes that the patient with a duodenal ulcer will likely experience

a)      pain 2-3 hours after a meal.
The patient with a gastric ulcer often awakens between 1-2 A.M. with pain and ingestion of food brings relief.

b)      vomiting.
Vomiting is uncommon in the patient with duodenal ulcer.

c)      hemorrhage.
Hemorrhage is less likely in the patient with duodenal ulcer than the patient with gastric ulcer.

d)      weight loss.
The patient with a duodenal ulcer may experience weight gain.

202. Of the following categories of medications, which is used in combination with bismuth salts to eradicate Helicobacter pylori?

a)      Antibiotics
Antibiotics and bismuth salts are given to eradicate H. pylori.

b)      Antacids
Antacids are given to manage gastric acidity.

c)      Proton pump inhibitors
Proton pump inhibitors are given to decrease acid secretion.

d)      Histamine-2 receptor antagonists
Histamine-2 receptor antagonists are given to decrease the acid secretion in the stomach.

 

203. Which of the following medications represents the category proton (gastric acid) pump inhibitors?

a)      Omeprazole (Prilosec)
Omeprazole decreases gastric acid by slowing the hydrogen-potassium-adenosine-triphosphatase pump on the surface of the parietal cells.

b)      Sucralfate (Carafate)
Sucralfate is a cytoprotective drug.

c)      Famotidine (Pepcid)
Famotidine is a histamine-2 receptor antagonist.

d)      Metronidazole (Flagyl)
Metronidazole is an antibiotic, specifically an amebicide.

204. Which of the following medications used for the treatment of obesity prevents the absorption of triglycerides?

a)      Orlistat (Xenical)
Orlistat (Xenical) prevents the absorption of triglycerides. Side effects of Xenical may include increased bowel movements, gas with oily discharge, decreased food absorption, decreased bile flow, and decreased absorption of some vitamins.

b)      bupropion hydrochloride (Wellbutrin)
buproprion hydrochloride (Wellbutrin) is an antidepressant medication.

c)      Sibutramine hydrochoride (Meridia)
Sibutramine hydrochloride (Meridia) inhibits the reuptake of serotonin and norepinephine. Meridia decreases appetite.

d)      Fluoxetine hydrochloride (Prozac)
Fluoxetine hydrochloride (Prozac) has not been approved by the FDA for use in the treatment of obesity.

205. Of the following bariatric surgical procedures, which is the best procedure for long-term weight loss?

a)      Roux-en-Y
The Roux-en-Y gastric bypass is the recommended procedure for long-term weight loss. In this procedure, a horizontal row of staples creates a stomach pouch with a 1-cm stoma that is anastomosed with a portion of distal jejunum, creating a gastroenterostomy.

b)      Vertical banded gastroplasty
In vertical banded gastroplasty, a double row of staples is applied vertically along the lesser curvature of the stomach, beginning at the angle of His. Over time, the gastric restriction may fail.

c)      Gastric ring application
Application of a silicone ring to the fundus of the stomach may fail.

d)      Jejuno-ileal bypass
The first surgical procedure to treat morbid obesity was the jejuno-ileal bypass. This procedure, which resulted in significant complications, has been largely replaced by gastric restriction procedures

206. Which of the following statements regarding gastric cancer is accurate?

a)      The incidence of cancer of the stomach continues to decrease in the United States.
While the incidence continues to decrease, gastric cancer still accounts for 12,800 deaths annually.

b)      Most gastric cancer deaths occur in people younger than 40 years.
While gastric cancer deaths occasionally occur in younger people, most occur in people older than 40 years.

c)      Females have a higher incidence of gastric cancers than males.
Males have a higher incidence of gastric cancers than females.

d)      A diet high in smoked foods and low in fruits and vegetables may decrease the risk of gastric cancer.
More accurately, a diet high in smoked foods and low in fruits and vegetables may increase the risk of gastric cancer.

207. Which of the following categories of laxatives draw water into the intestines by osmosis?

a)      Saline agents (milk of magnesia)
Saline agents use osmosis to stimulate peristalsis and act within 2 hours of consumption.

b)      Bulk-forming agents (Metamucil)
Bulk-forming agents mix with intestinal fluids, swell, and stimulate peristalsis.

c)      Stimulants (Dulcolax)
Stimulants irritate the colon epithelium.

d)      Fecal softeners (Colace)
Fecal softeners hydrate the stool by surfactant action on the colonic epithelium, resulting in mixing of aqueous and fatty substances.

208. Crohn’s disease is a condition of malabsorption caused by

a)      inflammation of all layers of intestinal mucosa.
Crohn’s disease is also known as regional enteritis and can occur anywhere along the GI tract, but most commonly at the distal ileum and in the colon.

b)      infectious disease.
Infectious disease causes problems such as small bowel bacterial overgrowth leading to malabsorption.

c)      disaccharidase deficiency.
Disaccharidase deficiency leads to lactose intolerance.

d)      gastric resection.
Postoperative malabsorption occurs after gastric or intestinal resection.

209. The nurse teaches the patient whose surgery will result in a sigmoid colostomy that the feces expelled through the colostomy will be

a)      solid.
With a sigmoid colostomy, the feces are solid.

b)      semi-mushy.
With a descending colostomy, the feces are semi-mushy.

c)      mushy.
With a transverse colostomy, the feces are mushy.

d)      fluid.
With an ascending colostomy, the feces are fluid.

210. When irrigating a colostomy, the nurse lubricates the catheter and gently inserts it into the stoma no more than _______ inches

a)      3”
The nurse should insert the catheter no more than 3 inches.

b)      2”
Insertion of the catheter 2 inches is inadequate.

c)      4”
Insertion of the catheter 4 inches is excessive and not recommended.

d)      5”
Insertion of the catheter 5 inches is excessive and not recommended.

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