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1. Which of the following drugs is a histamine blocker and reduces levels of gastric acid? a. Omeprazole (Prilosec) b. Metoclopramide (Reglan) {c.] Cimetidine (Tagamet) d. Magnesium Hydroxide (Maalox) 2. Which of the following drugs is an antacid? a. Omeprazole (Prilosec) b. Metoclopramide (Reglan) c. Cimetidine (Tagamet) d. Magnesium Hydroxide (Maalox) 3. What type of cell in the pancreas releases insulin? {a}Beta cells b. alpha cells c. delta cells d. plasma cells 4. What type of cell in the pancreas releases glucagon? {a)Alpha cells b. Beta cells c. Delta cells d. Plasma cells 5. The digestive enzymes secreted by the pancreas include: a. protease, ptyalin, pepsinogen [b lipase, amylase, trypsin c. amylase, lipase, ptyalin d. insulin, glucagon, somatostatin 6. A client with a peptic ulcer is scheduled for a vagotomy and the client asks the nurse about the purpose of this procedure. Which response by the nurse best describes the purpose of a vagotomy? a. Halts stress reactions b. Heals the gastric mucosa educes the stimulus to acid secretions d. Decreases food absorption in the stomach 7. A client who has had a gastrectomy is not producing sufficient intrinsic factor. The nurse interprets that the client has lost the ability to absorb cyanocobalamin in the: a. Stomach {b] Small intestine c. Large intestine d. Colon 8. The nurse is aware that the body’s attempts to compensate for excessive fluid losses associated with diarrhea are evident in an increased: a. temperature b. serum potassium level c. hematocrit |d. specific gravity Situation: A client has been diagnosed with adenocarcinoma of the stomach and is scheduled to undergo subtotal gastrectomy (Billroth IT procedure). 9. During the preoperative teaching, the nurse is reinforcing information about the surgical procedure. Which of the following explanations is accurate? a. the procedure will.result in enlargement of the pyloric sphincter thesprocedure will result in anastomosis of the gastric stump with the jejunum c. the procedure will result in removal of the duodenum d. thesprocedure will result in excision of portion of the vagus nerve 10.Which of the following signs/symptoms would besndicative of dumping syndrome? awdiaphoresis, diarrhea, dizziness b. diarrhea, widened pulse pressure, fever c. dizziness, bradycardia, constipation d. constipation, abdominal cramping, diaphoresis 11. Which measure helps prevent dumping syndrome? a. sitting up after meals {b.}drinking fluids between meals rather than with meals c. eating large amounts of carbohydrates d. eating four to six small low protein meals during the day 12. A client progresses to a regular diet after a gastrectomy for gastric cancer. After eating lunch he becomes diaphoretic and has palpitations. These symptoms are probably the result of: a. dehiscence of the surgical incision b.Jan intolerance to fatty foods c. an extracellular fluid shift in the bowel d. diminished peristalsis in the small intestines 13. What is the priority nursing diagnosis to a client who develops severe ascites due to liver cirrhosis? {a] ineffective breathing pattern b. impaired skin integrity c. body image disturbance d. risk for immobility Situation: A client experiences severe abdominal pain after a heavy alcoholic binge last night. He was brought to the emergency room because of persistent pain and cold clammy skin. The diagnosis is acute pancreatitis. 14. The pathophysiology of pancreatitis is understood by the nurse to be which of these: {a.JThere is edema and inflammation of the pancreas b. There is an autodigestion commonly by the enzyme ptyalin c. It can be caused by nightmares and bad dreams d. There is a possible hypercalcemia and fluid overload 15. Aside from the abdominal pain, which other manifestation(s) should the nurse monitor? a. esophageal varices, caput medusae b. Increased appetite to eat c. Tetany and muscle spasms [d}Hep atomegaly and hypoglycemia 16. What laboratory test(s) may be helpful for the nurse to validate the diagnosis and guide her intervention? _a. Sérum lipase and amylase b. Total albumin levels c. Blood lipid level d. Ammonia level 17. The nurse.will employ which appropriate measure(s) for Mr. Moselina during the acute phase of his disease? ajmaintain on NPO and insert NGT b. monitomweight gain c. refer the patient'to,the psychiatrist d. restrict him to bed without bathroom privileges 18. What is the priority nursing diagnosis to a client with severe ascites due to liver cirrhosis? ineffective breathing pattern b. impaired skin integrity c. body image disturbance d. risk for immobility Situation: Gino was admitted to the hospital with ascites and jaundice to rule out liver cirrhosis. 19. The biopsy confirms the diagnosis of cirrhosis. The client is at increased risk for excessive bleeding primarily due to: a. trauma for invasive procedure 'b.|esophageal varices c. inadequate nutrition d. impaired clotting mechanism 20. Esophageal varicesy caput medusae, and ascites in liveneitrhosis are primarily due to: nereased pressure in the portal circulation secondary to liver damage b. decreased production,of albumin leading to decreased oncotie pressure c. Vitamin K deficiency d. increased intraabdominal pressure 21. The tube mostlikely to be used for a client with bleeding esophageal varices would be: {a,!Minnesota tube b. Levine tube c. Penrose drain d. Salem tube 
