Deck 45: Caring Forclients With Disorders of the Upper Gastrointestinal Tract

Question 1

A client with esophageal cancer has difficulty in swallowing. Which of the following would be appropriate to help the client achieve improved nutrition?

A) Give high-protein, semiliquid foods
B) Provide oral liquids through a straw
C) Give liquid supplements for meals
D) Encourage small, frequent meals

Answer 1

Give high-protein, semiliquid foods

Question 2

A client with anorexia complains of constipation. Which of the following nursing measures would be most effective in helping the client reduce constipation?

A) Provide adequate quantity of food.
B) Obtain medical and allergy history.
C) Assist client to increase dietary fiber.
D) Obtain complete food history.

Answer 2

Assist client to increase dietary fiber.

Question 3

A group of students is reviewing information about oral cancers in preparation for an examination. The students demonstrate a need for additional review when they identify which of the following as a risk factor?

A) Pipe smoking
B) Excess alcohol use
C) Prolonged exposure to sun
D) History of GERD

Answer 3

History of GERD

Question 4

A nurse is preparing a presentation for a local community group for older adults on nutrition and anorexia in this population. Which of the following would the nurse include in the presentation as a possible contributing factor for anorexia in the older adult?

A) Increased salivary gland activity
B) Reduction in number of taste buds
C) Increased oxygenation of appetite center
D) Decreased dysphagia

Question 5

The nurse observes dry mucous membranes in a client who is receiving tube feedings after an oral surgery. The client also complains of unpleasant tastes and odors. Which of the following measures should be included in the client's plan of care?

A) Ensure adequate hydration with additional water.
B) Provide frequent mouth care.
C) Keep the feeding formula refrigerated.
D) Flush the tube with water before adding the feedings.

Question 6

A client has a gastrointestinal tube that enters the stomach through a surgically created opening in the abdominal wall. The nurse documents this as which of the following?

A) Jejunostomy tube
B) Gastrostomy tube
C) Nasogastric tube
D) Orogastric tube

Question 7

A group of students is reviewing the medications that may be used to treat esophageal reflux. The students demonstrate understanding of the information when they identify which of the following as an example of a proton-pump inhibitor?

A) Ranitidine (Zantac)
B) Sucralfate (Carafate)
C) Omeprazole (Prilosec)
D) Cisapride (Propulsid)

Question 8

A client with a feeding tube is to receive medication. The medication supplied is an enteric-coated tablet. Which of the following would be most appropriate?

A) Check with the pharmacist to see of a liquid form is available.
B) Dissolve the tablet in water after crushing it.
C) Sprinkle the contents of the opened tablet into the tube.
D) Give the tablet as is in its original state.

Question 9

A client who is recovering from anesthesia following oral surgery for lip cancer is experiencing difficulty breathing deeply and coughing up secretions. Which of the following measures will help ease the client's discomfort?

A) Keeping the head of the bed elevated.
B) Positioning the client flat on the abdomen or side.
C) Providing a tracheostomy tray near the bed.
D) Turning the client's head to the side.

Question 10

A client with peptic ulcer disease, who is receiving histamine-2 antagonist therapy, has a nasogastric tube in place. The nurse tests the pHof aspirated gastric fluid. Which pH finding would the nurse interpret as indicating effectiveness of the client's medication therapy?

A) 3.0
B) 5.0
C) 7.0
D) 9.0

Question 11

A client with GERD develops espophagitis. Which diagnostic test would the nurse expect the physician to order to confirm the diagnosis?

A) Barium swallow
B) Upper endoscopy with biopsy
C) Stool testing for occult blood
D) 24-hour esophageal pH monitoringAdd Question Here

Question 12

A client with nausea and vomiting is to receive an antiemetic that inhibits the vomiting center in the brain. Which of the following would the nurse expect the physician to order most likely?

A) Odansetron (Zofran)
B) Hydroxyzine (Vistaril)
C) Prochlorperazine (Compazine)
D) Promethazine (Phenergan)

Question 13

The nurse is checking the residual content for a client who is receiving intermittent feedings. Which residual content, if obtained, would lead the nurse to delay the feeding?

A) 30 mL
B) 60 mL
C) 90 mL
D) 120 mL

Question 14

A pregnant woman with gastroesophageal reflux disease (GERD) complains of a burning sensation in the esophagus. Which of the following suggestions should the nurse give her?

A) Ingesting food and drink that lowers pressure in the lower esophageal sphincter (LES).
B) Inform the physician because this is an unusual occurrence.
C) Symptoms of GERD usually resolve after delivery.
D) Drinking increased amounts of fluid for several hours before bedtime.

Question 15

A client is prescribed a magnesium and aluminum hydroxide antacid to treat gastroesophageal reflux disease (GERD). The nurse cautions this client to do which of the following?

A) Take it at the same time as other prescribed drugs.
B) Limit the frequency of use to two times per day.
C) Watch for possible antacid-related diarrhea.
D) Report any complaints of sore throat or fever to the physician.

Question 16

The nurse is caring for a client with deficient fluid volume. The nurse would notify the physician if the client's output is below which of the following?

A) 500 mL/day
B) 600 mL/day
C) 700 mL/day
D) 800 mL/day

Question 17

A client with a gastrojejunostomy is beginning to take solid food. Which finding would lead the nurse to suspect that the client is experiencing dumping syndrome?

A) Dry skin
B) Constipation
C) Abdominal cramps
D) Hyperglycemia

Question 18

A client has undergone a total gastrectomy for refractory ulcers. The nurse would explain the need for lifelong treatment with which of the following?

A) Vitamin B12replacement
B) Combination antibiotic therapy
C) Subcutaneous insulin therapy
D) Antiemetics such as odansetron

Question 19

When assisting with the plan of care for a client receiving tube feedings, which of the following would the nurse include to reduce the client's risk for aspiration?

A) Aspirating for residual contents every 4 to 8 hours.
B) Administering 15 to 30 mL of water every 4 hours.
C) Giving the feedings at room temperature.
D) Keeping the client in a semi-Fowler's position at all times.

Question 20

Which of the following interventions would be most appropriate for a client with a hiatal hernia and nursing diagnosis of acute pain related to reflux of gastric secretions?

A) Encourage the client to eat frequent, small, well-balanced meals.
B) Inform the client to remain upright for at least 2 hours after meals.
C) Instruct the client to avoid alcohol or tobacco products.
D) Instruct the client to eat slowly and chew the food thoroughly.

Question 21

The physician orders the insertion of a single lumen nasogastric tube. When gathering the equipment for the insertion, the nurse would select which of the following?

A) Salem sump tube
B) Miller-Abbott tube
C) Sengsten-Blakemore tube
D) Levin tube

Question 22

After teaching a client who has had a Roux-en-Y gastric bypass, which client statement indicates the need for additional teaching?

A) "I need to chew my food slowly and thoroughly."
B) "I need to drink 8 ounces of water before eating."
C) "A total serving should amount to be less than one cup."
D) "I should pick cereals with less than 2 g of fiber per serving."

Question 23

A client weighs 215 lbs and is 5' 8" tall. The nurse would calculate this client's body mass index (BMI) as which of the following?

A) 19.5
B) 24.8
C) 32.7
D) 44.9

Question 24

The nurse is reviewing the laboratory test results of a client who has been experiencing prolonged episodes of vomiting. Which of the following would the nurse most likely find?

A) Increased bicarbonate levels
B) Hypernatremia
C) Hyperchloremia
D) Increased white blood cell count

Question 25

The nurse is explaining orlistat (Xenical), prescribed for a client who is morbidly obese. Which of the following would the nurse include about this drug?

A) "You will probably have more bowel movements."
B) "There might be a greenish discharger from the rectum."
C) "This drug might cause your blood pressure to rise."
D) "You won't need to take your multivitamin anymore."