Therapies
14. For which patient would the NP suggest the provider not prescribe misoprostol
(Cytotec)?
a. Patient taking antacids
b. Patient taking antibiotics
c. Patient who is pregnant
d. Patient over 65 years of age
ANSWER: C
Misoprostol can cause abortion, so pregnant women should not take this drug. The other
victim have no
contraindications to taking misoprostol.
DIF: Remembering/Knowledge REF: 1106
KEY: Gastrointestinal disorders| prostaglandin
analogues MSC: Integrated Process:
Communication& Documentation
NOT: Patient Needs Category: Physiological Integrity: Pharmacological&Parenteral
Therapies
15. A patient has dumping syndrome after a partial gastrectomy. Which action by the
NP would be most helpful?
a. Arrange a dietary consult.
b. Increase fluid intake.
c. Limit the victim foods.
d. Make the patient NPO.
ANSWER: A
The patient with dumping syndrome after a gastrectomy has multiple dietary needs. A
referral to the registered dietitian will be extremely helpful. Food&fluid intake is
complicated&needs planning. The patient should not be NPO.
DIF: Applying/Application REF: 1117
KEY: Gastrointestinal disorders| referrals| nutrition
MSC: Integrated Process: Communication&Documentation
NOT: Patient Needs Category: Safe&Effective Care Environment: Management of Care
16. An older patient has gastric cancer&is scheduled to have a partial gastrectomy. The
family does not want the patient told about her diagnosis. What action by the NP is best?
a. Ask the family why they feel this way.
b. Assess family concerns&fears.
c. Refuse to go along with the familys wishes.
d. Tell the family that such secrets cannot be kept.
ANSWER: B
The NP should use open-ended questions&statements to fully assess the familys
concerns&fears. Asking why questions often puts people on the defensive&is considered
a barrier to therapeutic communication. Refusing to follow the familys wishes or keep
their confidence will not help move this family from their position&will set up an
adversarial relationship.
DIF: Applying/Application REF: 1119
KEY: Gastrointestinal disorders| ethics| communication
MSC: Integrated Process: Communication&Documentation
NOT: Patient Needs Category: Safe&Effective Care Environment: Management of Care
MULTIPLE RESPONSE
1. A patient has a gastrointestinal hemorrhage&is prescribed two units of packed red
blood cells. What actions should the NP perform prior to hanging the blood? (Select
all that apply.)
a. Ask a second NP to double-check the blood.
b. Prime the IV tubing with normal saline.
c. Prime the IV tubing with dextrose in water.
d. Take&record a set of vital signs.
e. Teach the patient about reaction manifestations.
ANSWER: A, B, D, E
Prior to starting a blood transfusion, the NP asks another NP to double-check the blood
(and patient identity), primes the IV tubing with normal saline, takes&records a baseline
set of vital signs,&teaches the patient about manifestations to report. The IV tubing is
not primed with dextrose in water.
DIF: Applying/Application REF:
1113 KEY: Patient safety| blood
transfusions
