The patient is admitted with upper GI bleeding following an episode of forceful vomiting due to excessive alcohol intake. The nurse suspects a Mallory-Weiss tear. Which of the following is true of a Mallory-Weiss tear?
The bleeding occurs from peptic ulcers in the stomach.
This type of bleeding is treated by giving chewable aspirin.
The bleeding occurs from tears in the lining of the duodenum.
The bleeding occurs from a tear in the mucosal lining where the esophagus meets the stomach.
The Correct Answer is D
A. Peptic ulcers are sores that develop on the lining of the stomach, small intestine, or esophagus due to the erosion caused by stomach acid. A Mallory-Weiss tear is not related to peptic ulcers. Instead, it results from a different type of injury related to forceful vomiting or retching.
B. Chewable aspirin is not a treatment for Mallory-Weiss tears. In fact, aspirin can exacerbate bleeding and is typically avoided in situations where gastrointestinal bleeding is present. Mallory-Weiss tears are generally managed by supportive measures and sometimes endoscopic interventions, not with aspirin.
C. A Mallory-Weiss tear specifically affects the mucosal lining at the junction of the esophagus and the stomach, not the duodenum. The duodenum is part of the small intestine, and tears or bleeding here are not characteristic of Mallory-Weiss syndrome.
D. A Mallory-Weiss tear is a tear or laceration in the mucosal lining at the gastroesophageal junction (where the esophagus meets the stomach). It is typically caused by severe vomiting or retching, which can lead to the tear and subsequent upper gastrointestinal bleeding.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Chemotherapy often requires multiple infusions over a long period, and a CVAD provides a reliable and convenient access point for these treatments. It allows for the continuous or intermittent administration of chemotherapy drugs, which are often irritating to veins and require precise dosing.
B. While CVADs are used for administering chemotherapy and other treatments, they are not typically used to implant radioactive material for internal radiation (brachytherapy).
C. While CVADs reduce the need for repeated venipunctures and can help manage the complications of frequent injections, they do not eliminate the risk of infection. CVADs can themselves become a source of infection if not properly maintained, as they are open to the external environment.
D. The placement of a CVAD does not directly affect the side effects of chemotherapy, such as nausea and vomiting. The CVAD’s role is primarily related to the administration of medications and access to blood vessels.
Correct Answer is C
Explanation
A. Methylprednisolone is a corticosteroid used to reduce inflammation and suppress the immune system. While corticosteroids are sometimes used in critical care settings, they are not specifically used to prevent stress ulcers. In fact, corticosteroids can increase the risk of gastrointestinal bleeding and may require additional measures to protect the stomach lining.
B. Enoxaparin is a low molecular weight heparin (LMWH) used primarily for the prevention of deep vein thrombosis (DVT) and pulmonary embolism (PE). It works as an anticoagulant, preventing blood clots. While enoxaparin is important for preventing thromboembolic events in critically ill patients, it does not specifically address the prevention of stress ulcers.
C. Pantoprazole is a proton pump inhibitor (PPI) that reduces gastric acid production by inhibiting the proton pumps in the stomach lining. PPIs are commonly used to prevent and treat stress ulcers because they help decrease gastric acid secretion, thereby reducing the risk of ulcer formation and bleeding. This makes pantoprazole the appropriate medication to administer to prevent physiologic stress ulcers in a patient with sepsis on a ventilator.
D. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is used for pain relief and inflammation. NSAIDs can actually increase the risk of gastrointestinal bleeding and ulceration, especially in critically ill patients.
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