HESI Patient Reviews–Adult Health-Gastrointestinal (Mr. Lewin)

1. You ask Mr. Lewin to describe his pain in more detail. Which symptom is consistent with peptic ulcer disease?
Burning epigastric pain

2. You read the healthcare provider’s (HCP) admission note, which describes Mr. Lewin as complaining of “pyrosis.” The layman’s term for this symptom is:

3. If Mr. Lewin has GI bleeding prior to endoscopy, gastric lavage may be needed. Which of the following should be available for gastric lavage?
Room-temperature saline

4. Mr. Lewin’s nasogastric (NG) tube is a vented (double lumen) type, attached to suction. The tube does not have an anti-reflux valve. You notice that gastric contents are leaking from the air vent (pigtail) port. What should you do initially?
Instill air into the air vent

5. You discuss the upper GI endoscopy procedure with Mr. Lewin. Which description is the most accurate?
“A tube will be passed through your mouth and advanced into

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your stomach and upper intestines.”

6. You prepare Mr. Lewin for the upper GI endoscopy procedure. Pre-procedure preparation involves which actions by the nurse? (select 5)
-Insuring that NPO status is maintained
-Advising Mr. Lewin that a sedative will be administered
-Obtaining written consent
-Removing any dentures
-Advising Mr. Lewin that a local anesthetic will be sprayed into his throat

7. An IV infusion of pantoprazole IV is prescribed for Mr. Lewin. He asks you why he has to take this medication. What is the correct response to give the client for the use of pantoprozole IV?
Suppress gastric acid secretions

8. Which nursing actions are appropriate for Mr. Lewin after his return from the endoscopy? (Select 2)
-Assessing vital signs
-Assessing for abdominal pain

9. What are major causes of peptic ulcer disease that are recognized in the current literature? (Select 3)
-Chronic H. pylori infection
-Use of nonsteroidal antiinflammatory drugs (NSAIDs)

10. Clarithromycin and amoxicillin are antibiotics, prescribed to eliminate H. pylori. Omeprazole is prescribed to:
Inhibit gastric acid secretion

11. Which suggestions do you include in your discharge plan for Mr. Lewin to prevent exacerbation of ulcer symptoms? (Select 3)
-Start a smoking cessation program
-Avoid aspirin
-Avoid nonsteroidal antiinflammatory drugs (NSAIDs)

12. Despite treatment and attention to his diet, Mr. Lewin could still experience complications of peptic ulcer disease. What are the complications of peptic ulcer disease? (Select 3)
-Bleeding from the ulcers
-Ulcer perforation through the GI tract wall
-Gastric outlet obstruction

13. Mr. Lewin is advised to watch for GI bleeding. Which sign could indicate a bleeding ulcer, and should be reported? (Select 2)
-Black bowel movement
-Vomiting dark brown or bloody fluid

14. You validate Mr. Lewin’s understanding of his upcoming surgical procedure (selective vagotomy and antrectomy with Billroth II anastamosis) when he tells you that the procedure involves: (Select 2)
-Surgical cutting of the vagus nerve
-Removal of part of the stomach

15. How will the patient-controlled analgesia (PCA) contribute to Mr. Lewin’s comfort? (Select 2)
-Provide a consistent level of pain relief
-Allow him to administer his own pain medication

16. Mr. Lewin has a Billroth II procedure, with general anesthesia. Which assessment should you perform first, after transferring Mr. Lewin from the OR stretcher to his bed?
Vital signs

17. You correctly advise Mr. Lewin that he can self-administer pain medication every ___ minutes

18. Which intervention regarding Mr. Lewin’s NG tube should be included in his care plan?
Keep vent (pigtail) lumen of NG tube positioned above the client’s waist.

19. Mr. Lewin is predisposed to dumping syndrome as a result of his surgery. Which of the following characterizes dumping syndrome?
Dizziness after eating

20. Your discharge plan for Mr. Lewin includes suggestions for preventing symptoms associated with dumping syndrome. What suggestion helps prevent symptoms of dumping syndrome?
Lie down for 20-30 minutes after meals

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