Deck 23: Upper Gastrointestinal Disorders

Question 1

Which level of the National Dysphagia Diet is for patients with mild dysphagia?

A)Level 1
B)Level 2
C)Level 3

Answer 1

C

Question 2

A degenerative nerve condition affecting the esophagus, characterized by impaired peristalsis and incomplete relaxation of the lower esophageal sphincter when swallowing, is:

A)achalasia.
B)achlorhydria.
C)hypochlorhydria.
D)stricture.

Answer 2

A

Question 3

Louis has been diagnosed with dysphagia.Which diet order would not be potentially appropriate for him?

A)NPO
B)Pureed diet
C)Regular
D)Mechanical soft with nectar-thick liquids

Answer 3

C

Question 4

All of the following may cause dysphagia except

A)heart disease.
B)thyroid enlargement.
C)strokes.
D)brainstem tumors.

Question 5

The home health care nurse is visiting Paul Cantu, an 82-year-old man recovering from a stroke.Upon assessment, the nurse observes that Mr.Cantu has lost weight, has a hoarse voice, and exhibits a gurgling noise after swallowing.In this situation, the nurse should suspect

A)reduced saliva flow.
B)dysphagia.
C)reflux esophagitis.
D)peptic ulcer disease.

Question 6

An example of a strategy used by dietitians to encourage clients on mechanically altered diets to eat is to

A)allow them to eat all desired foods.
B)identify a person's favorite foods and foods that have pleasant smells.
C)restrict all their favorite foods.
D)allow them to eat just one meal a day.

Question 7

What is used to diagnose the cause of dysphagia?

A)Barium swallow study
B)Endoscopy in the esophageal lumen
C)Neurological examination
D)a and b
E)a, b, and c

Question 8

Brandi is a 93 year old with high blood pressure and diabetes.She is newly diagnosed with severe dysphagia.Which diet is most appropriate for Brandi?

A)No concentrated sweets
B)2 g sodium
C)Pureed
D)4 g Na, no concentrated sweets, Dysphagia Level one

Question 9

Foods that are pureed, homogenous, and cohesive would be appropriate for which level of the National Dysphagia Diet?

A)Level 1
B)Level 2
C)Level 3

Question 10

Which of the following beverages is most appropriate for a client with dysphagia with an order for nectar-like liquids?

A)Water
B)Chicken broth
C)Iced tea
D)Tomato juice

Question 11

All of the following conditions may lead to dysphagia except

A)esophageal tumor.
B)brain tumor.
C)poliomyelitis.
D)T7 fracture.

Question 12

Sam has been diagnosed with esophageal dysphagia.This means that he has:

A)difficulty passing a bolus of food through the esophagus into the stomach.
B)coughing during swallowing.
C)an inability to initiate swallowing.
D)all of the above

Question 13

Which of the following liquid consistencies would include fluids that can be eaten with a spoon but do not hold their shape?

A)Thin
B)Nectar-like
C)Honey-like
D)Spoon-thick

Question 14

When dysphagia impairs the passage of solid foods but not liquids, the cause is usually:

A)achalasia.
B)a stroke.
C)a motility disorder.
D)an obstruction of the esophagus.

Question 15

What do the following three conditions have in common: goiter, stroke, and Parkinson's disease?

A)They require a person to be placed on a diet containing pureed foods.
B)They affect a person's ability to communicate.
C)They affect a person's ability to swallow food.
D)They require a person to avoid salty foods.

Question 16

A sign of oropharyngeal dysphagia is

A)a sensation of food "sticking" in the throat.
B)nasal regurgitation.
C)achalasia.
D)all of the above

Question 17

Examples of liquids that can be incorporated into a diet for a client with an order for spoon-thick liquids include all of the following except

A)pudding.
B)custard.
C)yogurt.
D)thickened applesauce.

Question 18

Dorothy had a stroke 3 weeks ago.She has been diagnosed with oropharyngeal dysphagia.Which statement does not describe Dorothy's condition?

A)She has an impairment that affects the transfer of food from the mouth and pharynx to the esophagus.
B)She has an inability to initiate swallowing.
C)She has a neuromuscular condition that affects the tongue or the swallowing reflex.
D)She has an esophageal stricture that interferes with normal swallowing.

Question 19

What is the primary reason why dysphagia is life-threatening?

A)Causing strokes
B)Food entering the esophagus
C)Aspiration
D)None of the above

Question 20

Which of the following conditions is likely to impair a person's ability to swallow?

A)Achalasia
B)Multiple sclerosis
C)Myasthenia gravis
D)All of the above
E)None of the above

Question 21

Which of the following professionals is usually responsible for teaching dysphagia patients alternate feeding techniques?

A)Speech and language therapist
B)Occupational therapist
C)Registered dietitian
D)Registered nurse

Question 22

Bob has been eating pureed food for six months.The nurses have noticed that his skin is pale, he has lost 5 lbs., and he complains constantly about the food.What strategies can the dietitian use to improve Bob's feelings about eating a pureed diet?

A)Order larger portions to be given.
B)Use brightly colored foods.
C)Prepare the food for serving using molds.
D)b and c
E)a and c

Question 23

Examples of substances that cause the lower esophageal sphincter to weaken include

A)caffeine-free soft drinks.
B)high-fat foods.
C)decaffeinated coffee.
D)all of the above

Question 24

Pain, bloating, or discomfort in the upper abdominal area is termed

A)dysphagia.
B)dyspepsia.
C)epigastric.
D)none of the above

Question 25

Techniques to help patients learn how to compensate for dysphagia include all of the following except:

A)learning exercises that can strengthen the jaws, tongue, or larynx.
B)relying strictly on tube feedings for nutrition.
C)learning new methods of swallowing.
D)changing head and neck posture while eating.

Question 26

All of the following are consequences of untreated GERD except:

A)reflux esophagitis.
B)esophageal ulcers.
C)Barrett's esophagus.
D)hiatal hernia.

Question 27

Which of the following conditions does not increase the risk of GERD?

A)Pregnancy
B)Asthma
C)Hiatal hernia
D)Dehydration

Question 28

To minimize symptoms of dyspepsia, patients might be advised to do which of the following?

A)Consume large meals
B)Eat only raw foods
C)Avoid overly seasoned foods
D)Drink coffee rather than fruit juice
E)All of the above

Question 29

All of the following may cause symptoms of dyspepsia except:

A)aspirin and other NSAIDs.
B)antibiotics.
C)high-dose iron supplements.
D)a low-fat diet.

Question 30

Mr.Brown has been suffering from GERD.He is 25% above his ideal body weight.Health care professionals may prescribe a medication to treat Mr.Brown's esophageal reflux.An example of such a medication would be

A)proton-pump inhibitors.
B)histamine-2 receptor blocking agents.
C)antacids.
D)a and c
E)a, b, and c

Question 31

Frequent reflux of highly acidic gastric fluids results in

A)inflammation and scarring of the esophagus.
B)stomach ulcers.
C)the inability to swallow.
D)use of medications.

Question 32

The main barrier to gastric reflux is the

A)upper esophageal sphincter.
B)sphincter of Oddi.
C)pyloric sphincter.
D)lower esophageal sphincter.

Question 33

Indigestion is also called

A)dysphagia.
B)dyspnea.
C)dysgeusia.
D)dyspepsia.

Question 34

A technique to help ease the task of swallowing is

A)doing exercises to strengthen the tongue.
B)limiting fluids during the meal.
C)serving cold foods.
D)limiting sugars in the diet.

Question 35

Mr.Brown has been suffering from GERD.He is 25% above his ideal body weight.Substances that Mr.Brown should avoid include all of the following except

A)alcohol.
B)yogurt.
C)fried chicken.
D)chocolate.

Question 36

GERD most frequently develops from

A)aging.
B)pregnancy.
C)use of feeding tubes.
D)medications.

Question 37

Which of the following medical conditions can cause symptoms of dyspepsia?

A)GERD
B)Tumors
C)Malabsorptive disorders
D)Gallbladder disease
E)All of the above

Question 38

The backflow of gastric contents from the stomach into the mouth is

A)an esophageal stricture.
B)heartburn.
C)reflux.
D)all of the above

Question 39

Which of the following foods does not affect lower esophageal sphincter pressure?

A)Chocolate
B)Coffee
C)Peppermint candy
D)Whole-wheat bread

Question 40

Which statement is true?

A)A "one size fits all" approach applies to the dietary modifications for people suffering from GERD.
B)Proton-pump inhibitors are the most effective antisecretory agents used to treat GERD.
C)Antacids are appropriate for treating GERD and have no long-term side effects.
D)Fundoplication, a surgical procedure that raises pressure in the stomach, is used to treat severe GERD.

Question 41

Dietary interventions for nausea include consuming all of the following except

A)ice cream.
B)clear, cold fluids.
C)crackers.
D)small meals.

Question 42

Severe gastrointestinal bleeding or hemorrhage, a complication of peptic ulcer disease, may be evidenced by:

A)black, tarry stools.
B)vomit that resembles coffee grounds.
C)bright red blood in the stool.
D)a and b
E)b and c

Question 43

A postgastrectomy diet is a

A)protein-controlled diet to prevent hypoglycemia.
B)fat-controlled diet to prevent dumping syndrome.
C)simple carbohydrate-controlled diet to prevent hypoglycemia.
D)protein- and fat-controlled diet to prevent dumping syndrome.

Question 44

Trevor complains of bloating and stomach gas.Which of the following should be omitted to resolve this problem?

A)Eating slowly
B)Drinking iced tea
C)Chewing gum
D)Sipping from a cup

Question 45

Which of the following can cause nausea and vomiting?

A)Lactose intolerance
B)Peptic ulcer
C)Esophageal stricture
D)All of the above

Question 46

_____ refers to a group of symptoms that results from abnormally rapid gastric emptying and is a common complication of both gastrectomy and gastric bypass surgery.

A)Sjogren's syndrome
B)Steven-Johnson's syndrome
C)Dumping syndrome
D)Zollinger-Ellison syndrome

Question 47

Continuous vomiting can lead to which of the following?

A)Fluid and electrolyte imbalance
B)Reduced food intake
C)Malnutrition
D)All of the above

Question 48

In a vagotomy, the vagus nerve is severed in order to suppress gastric acid secretion.This procedure is often followed by a _____, which widens the pyloric sphincter.

A)gastrectomy
B)gastric resection
C)pyloroplasty
D)bariatric surgery

Question 49

Susan has recently been diagnosed with Zollinger-Ellison syndrome.If surgery is recommended for Susan, what is the primary desired outcome?

A)Decrease gastric acid production
B)Increase gastric acid production
C)Reduce inflammation
D)Control gastric bleeding

Question 50

A client suffering from chronic nausea should eat

A)a hot breakfast in the morning.
B)a tuna salad sandwich at lunch.
C)dry toast or crackers.
D)bagels with jalapeño cream cheese.

Question 51

All of the following are used in the management of peptic ulcer disease except

A)medications that coat the gastrointestinal lining.
B)antibiotics.
C)aspirin.
D)antisecretory agents.

Question 52

Acute gastritis may be caused by all of the following except:

A)viral infection.
B)chemotherapy.
C)genetics.
D)food allergy.

Question 53

Which of the following is known as a major cause of peptic ulcer disease?

A)Bacterial infection
B)Nonsteroidal anti-inflammatory agents
C)Alcohol abuse
D)a and b
E)b and c

Question 54

Physiological effects of stress vary among individuals, but may include which of the following?

A)Rapid stomach emptying
B)Hormonal changes that impair wound healing
C)An increase in acid and pepsin secretions
D)All of the above
E)None of the above

Question 55

Karen has intractable vomiting.Which type of diet would be most appropriate for her?

A)Gastric tube feeding
B)Intestinal tube feeding
C)Parenteral nutrition
D)Clear liquid

Question 56

Susan has recently been diagnosed with Zollinger-Ellison syndrome.What characteristics are associated with this condition?

A)Tumors in the pancreas or duodenum
B)Patient history of NSAID use
C)Infection by H.pylori
D)All of the above

Question 57

All of the following meet the guidelines for a post-gastrectomy diet except

A)unlimited liquids with meals.
B)limited simple sugar intake.
C)small, frequent meals.
D)pectin added to meals.

Question 58

The postgastrectomy diet includes

A)fluid with meals.
B)refined carbohydrates.
C)foods high in fat.
D)an emphasis on foods high in complex carbohydrates.

Question 59

The dietary management of acute gastritis includes

A)avoiding antacids.
B)dry crackers.
C)increasing aspirin for pain.
D)avoiding alcohol.

Question 60

Dumping syndrome may occur after

A)the nerves of the stomach are severed.
B)gastrectomy or gastric bypass surgery.
C)a and b
D)none of the above

Question 61

A sign of dumping syndrome is

A)rapid heart rate.
B)hyperglycemia.
C)feelings of satiety.
D)fluid retention.

Question 62

Which of the following nutrients is often needed in supplemental amounts after gastric surgeries?

A)Vitamin D
B)Selenium
C)Magnesium
D)Vitamin C
E)All of the above

Question 63

Anemia may develop after a gastrectomy because

A)surgery alters B₆ absorption.
B)folate-rich foods are avoided.
C)iron is absorbed poorly.
D)lactose is absorbed poorly.

Question 64

All of the following are signs and symptoms of periodontal disease except:

A)gingivitis.
B)fruity smelling breath.
C)bad taste in the mouth.
D)painful chewing.

Question 65

Case Studies
Cassandra Lyons is a 73-year-old retired administrative assistant.She has had recurrent episodes of pneumonia with weight loss for the past 5 months.Her past medical history includes high cholesterol and diabetes.Once again she is admitted to the hospital.
The nurse documents that Cassandra has a productive cough and a hoarse voice.She most likely has:

A)oropharyngeal dysphagia.
B)esophageal dysphagia.
C)achalasia.
D)strictures.

Question 66

Steatorrhea or fat malabsorption occurs as a result of which of the following?

A)Accelerated transit of food material
B)The duodenum has been removed or bypassed
C)Bacterial overgrowth occurs
D)all of the above
E)b and c only

Question 67

Why is a person with diabetes mellitus at higher risk for periodontal disease?

A)Impaired immune response
B)Increased rigidity of the collagen structure of tissues
C)Tendency for higher arterial plaque accumulations
D)All of the above

Question 68

Which of the following may have caused Cassandra's diagnosis to be delayed?

A)Respiratory infection
B)Abnormal cough reflux
C)Dehydration
D)Weight loss

Question 69

All of the following may be caused by dumping syndrome except

A)a surge of energy.
B)rapid heart rate.
C)dizziness.
D)sweating.

Question 70

A characteristic of dumping syndrome is rapid digestion.Which of the following would be an expected outcome?

A)Increased blood volume
B)Diarrhea
C)Hyperglycemia
D)All of the above

Question 71

The nurse suspects a swallowing problem and recommends an evaluation.All of the following can be used to evaluate Cassandra except:

A)a barium swallow test.
B)an endoscopy.
C)a neurological exam.
D)surgery.

Question 72

Which of the following is useful for managing dry mouth?

A)Sucking on sugarless candy
B)Chewing gum
C)Using over-the-counter saliva substitutes
D)b and c
E)a, b, and c

Question 73

Which of the following helps to decrease the incidence of oral infections in persons with HIV?

A)Antiretroviral therapy
B)Smoking
C)Regular use of mouthwash
D)All of the above

Question 74

Austin is a 42-year-old obese male.He is researching surgical options to lose weight.Which of the following surgeries is reversible?

A)Gastric banding
B)Gastric bypass
C)Vagotomy
D)Total gastrectomy

Question 75

Which of the following is a risk factor for the development of periodontal disease?

A)Wearing dentures
B)Tobacco smoking
C)History of cardiovascular disease
D)All of the above

Question 76

All of the following types of medications can be the cause of the development of dry mouth except:

A)antihistamines.
B)antihypertensive agents.
C)antibiotics.
D)antidepressants.

Question 77

Which of the following conditions is often associated with the development of dry mouth?

A)Poorly controlled diabetes
B)Sjögren's syndrome
C)Radiation therapy for neck and head cancers
D)Mouth breathing
E)All of the above

Question 78

Anemia after a gastrectomy is usually associated with all of the following except

A)reduced gastric secretions.
B)deficiency of vitamin B₁₂.
C)iron deficiencies.
D)deficiency of vitamin B₆.

Question 79

Possible causes of her condition include all of the following except:

A)stroke.
B)Alzheimer's disease.
C)emphysema.
D)Parkinson's disease.

Question 80

Todd has recently had gastric bypass surgery.What is not a post-surgical concern for him?

A)Kidney stones
B)Fat malabsorption
C)Multiple nutrient deficiencies
D)Increased risk of developing gallbladder disease