What information is correct about stomach cancer?

Correct Answer: A

Rationale: In the context of stomach cancer, the correct information that stomach pain is often a late symptom is crucial for nursing students to understand. This is because stomach cancer can progress silently without causing noticeable symptoms in its early stages, making early detection challenging. By the time stomach pain manifests, the cancer may have already advanced to a more serious stage, impacting treatment outcomes. Option B, stating that surgery is often a successful treatment, while sometimes true, is not always the case for stomach cancer. The success of surgery depends on various factors such as the stage of cancer, location, and whether it has metastasized. Therefore, it is not a universally successful treatment for all cases of stomach cancer. Option C, suggesting that chemotherapy and radiation are often successful treatments, is also partially correct. These treatments can be part of a comprehensive treatment plan for stomach cancer, but their success rates vary depending on the stage of cancer, the patient's overall health, and other individual factors. They may not always lead to a cure. Option D, stating that the patient can survive for an extended time with TPN (total parenteral nutrition), is incorrect in the context of stomach cancer. TPN may be used to provide nutrition support in certain situations, but it is not a curative treatment for stomach cancer. It is essential for nursing students to understand that TPN does not address the underlying cancer and cannot be considered a primary treatment modality for stomach cancer. In conclusion, understanding that stomach pain is often a late symptom of stomach cancer is critical for early detection and timely intervention. Nursing students need to grasp the nuances of various treatment modalities and their effectiveness in managing stomach cancer to provide comprehensive care to patients with this condition.

Correct Answer: D

Rationale: In the context of a patient with an acute upper GI hemorrhage, the correct intervention of treating shock and diagnosing the bleeding source (Option D) is crucial. This intervention prioritizes stabilizing the patient's condition by addressing shock, which can result from significant blood loss. Promptly identifying and managing shock is essential to prevent further complications and improve patient outcomes. Additionally, diagnosing the bleeding source is essential for determining the appropriate treatment plan, whether it involves endoscopic interventions, medications, or surgical measures. Treating hypovolemia (Option A) is important in managing acute hemorrhage, as restoring intravascular volume helps maintain tissue perfusion. However, simply focusing on hypovolemia without addressing shock and identifying the bleeding source may lead to inadequate management of the patient's condition. Treating hypervolemia (Option B) is not indicated in the context of acute upper GI hemorrhage, as it can exacerbate the situation by increasing the risk of further bleeding and complications. While controlling the bleeding source (Option C) is a necessary intervention, it is not the initial priority when managing a patient with an acute upper GI hemorrhage. Stabilizing the patient, treating shock, and identifying the source of bleeding take precedence in ensuring a comprehensive and effective approach to care. In an educational context, understanding the hierarchy of interventions in managing acute upper GI hemorrhage is crucial for nursing students. Emphasizing the importance of prompt assessment, prioritization, and intervention can help students develop critical thinking skills and clinical reasoning abilities necessary for providing safe and effective patient care in high-acuity situations.

Correct Answer: D

Rationale: In managing a patient with upper GI bleeding, promoting hemodynamic stability is crucial to prevent further complications. The correct answer, "D) Giving blood, electrolyte, and fluid replacement," is the most appropriate action to address the underlying issue of blood loss and maintain hemodynamic stability. Blood transfusion helps replenish lost blood volume, ensuring adequate tissue perfusion and oxygen delivery. Electrolyte and fluid replacement are essential to maintain intravascular volume and electrolyte balance, supporting cardiovascular function. Option A, "Encouraging oral fluid intake," is incorrect as it may worsen the bleeding and lead to further hemodynamic instability. Option B, "Monitoring central venous pressure," while important in some cases, does not directly address the immediate need to replace lost blood and fluids. Option C, "Monitoring laboratory test results and vital signs," is a general nursing intervention and does not specifically target hemodynamic stability in a patient with active GI bleeding. In an educational context, understanding the rationale behind managing upper GI bleeding is essential for nurses caring for these patients. By selecting the correct answer, nurses demonstrate their ability to prioritize interventions that directly impact patient outcomes and prevent complications associated with hemorrhage. This question highlights the critical thinking skills required in medical-surgical nursing to provide safe and effective care to patients experiencing GI bleeding.

Correct Answer: A

Rationale: In preparing a patient with a malignant tumor for colorectal surgery and subsequent colostomy, the initial step should be to determine what the patient already knows about colostomies (Option A). This is crucial for assessing the patient's baseline knowledge, addressing any misconceptions, and tailoring education to meet their specific needs and concerns. Option B, showing pictures of colostomies, may be overwhelming for a patient experiencing anxiety and could potentially increase their distress. Option C, arranging for someone with a colostomy to visit the patient, may not always be feasible and might not address the patient's individual questions and fears. Option D, providing written material, may not be effective if the patient is too anxious to read or comprehend the information. In an educational context, effective patient education involves assessing the patient's knowledge, addressing their concerns, and providing information in a way that is tailored to their needs and preferences. By starting with what the patient already knows, healthcare providers can build upon existing knowledge, correct misunderstandings, and ensure that the patient is well-prepared and supported for the upcoming surgery and colostomy.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Bowel perforation. Christopher's presentation with severe abdominal pain aggravated by movement, rebound tenderness, fever, nausea, and decreased urine output is concerning for a bowel perforation. A bowel perforation is a serious complication of ulcerative colitis where there is a hole in the wall of the intestine. This leads to leakage of bowel contents into the abdominal cavity, causing severe pain, tenderness, fever, and signs of peritonitis like rebound tenderness. The decreased urine output may indicate hypovolemia due to fluid shifting into the peritoneal cavity. Option A) Fistula is incorrect as fistulas are abnormal connections between organs or vessels, not indicative of a bowel perforation in this context. Option C) Bowel obstruction typically presents with different signs and symptoms such as abdominal distension, constipation, and vomiting, which are not prominent in this case. Option D) Abscess would present with localized pain, swelling, and possibly a palpable mass, which are not described in Christopher's case. Educationally, understanding the complications of ulcerative colitis is crucial for nurses to provide timely and appropriate interventions to prevent further deterioration in patients like Christopher. Recognizing the signs and symptoms of bowel perforation can help nurses advocate for prompt medical attention and potentially life-saving interventions.