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

Accepted Answer

A

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.

Accepted Answer

Increasing dietary fiber can help alleviate constipation, as it adds bulk to the stool and helps it move through the digestive system more easily. Providing adequate food quantity may not necessarily address the issue of constipation, as the quality of the food and the amount of fiber it contains are also important factors. Obtaining medical and food histories are also important, but they may not directly address the client's immediate concern of constipation.

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

Accepted Answer

A history of GERD (gastroesophageal reflux disease) is not a known risk factor for oral cancer. The other choices are established risk factors.

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

Accepted Answer

Reduction in the number of taste buds can lead to a decreased sensation of taste, which can contribute to a decrease in appetite and anorexia in older adults. Increased salivary gland activity and increased oxygenation of the appetite center are not associated with anorexia in older adults. Decreased dysphagia may actually improve appetite, as it makes eating and swallowing easier.

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.

Accepted Answer

The answer of The nurse observes dry mucous membranes in...

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

Accepted Answer

A gastrostomy tube is a tube that is inserted through a surgically created opening in the abdominal wall directly into the stomach. A jejunostomy tube is inserted directly into the jejunum, and a nasogastric tube and orogastric tube are inserted through the nose or mouth respectively and travel down into the stomach.

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)

Accepted Answer

Omeprazole is a proton-pump inhibitor, which works by blocking the enzyme in the stomach that produces acid, reducing the amount of acid produced and relieving symptoms of reflux. Ranitidine is a histamine-2 (H2) blocker, sucralfate is a medication that coats and protects the stomach lining, and cisapride is a prokinetic agent that increases gastrointestinal motility.

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.

Accepted Answer

Enteric-coated medications are designed to dissolve in the small intestine, rather than the stomach. Crushing or dissolving the tablet can interfere with the enteric coating and cause the medication to be absorbed too quickly or not at all. Checking with the pharmacist for a liquid form is the best option to ensure proper administration and absorption of the medication.

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.

Accepted Answer

Keeping the head of the bed elevated will help improve the client's breathing by increasing lung expansion and reducing the risk of aspiration. Positioning the client flat on the abdomen or side may exacerbate breathing difficulties and increase the risk of aspiration. Providing a tracheostomy tray near the bed is not necessary unless the client's condition deteriorates and emergency interventions are required. Turning the client's head to the side may help prevent aspiration but is not sufficient to improve breathing difficulties.

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

Accepted Answer

Histamine-2 antagonist therapy is used to reduce stomach acid production. A pH of 5.0 indicates that the medication is effective in increasing the pH level of the gastric fluid, making it less acidic, which is beneficial for a client with peptic ulcer disease.

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

Accepted Answer

Upper endoscopy with biopsy is the most reliable test to diagnose esophagitis. It allows for direct visualization of the esophageal tissue and provides the opportunity for a biopsy to be taken for further examination.

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)

Accepted Answer

Prochlorperazine (Compazine) is an antiemetic that inhibits the vomiting center in the brain. Odansetron (Zofran) works by blocking serotonin receptors in the GI tract and central nervous system, and is typically used for nausea and vomiting related to chemotherapy or radiation therapy. Hydroxyzine (Vistaril) is an antihistamine that can be used for anxiety and itching, but is not typically used for antiemetic purposes. Promethazine (Phenergan) also works by blocking histamine receptors in the brain, but has significant sedative effects and is typically reserved for severe cases of nausea and vomiting.

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

Accepted Answer

A residual content of 120 mL is considered high and indicates delayed gastric emptying, which would lead the nurse to delay the feeding to prevent aspiration and other complications.

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.

Accepted Answer

GERD symptoms often improve after delivery due to the reduction of intra-abdominal pressure and hormonal changes that occur postpartum, making this a valid suggestion for the patient.

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.

Accepted Answer

The answer of A client is prescribed a magnesium and...

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

Accepted Answer

A urinary output of less than 500 mL/day may indicate severe dehydration and warrants immediate medical attention. Clients with deficient fluid volume may have decreased urine output due to decreased fluid intake or increased fluid loss. If the urine output is below 500 mL/day it may indicate renal failure or severe dehydration and requires medical intervention.

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

Accepted Answer

Abdominal cramps are a commonly reported symptom of dumping syndrome, which can occur in clients with gastrojejunostomy who start eating solid foods too quickly. Dry skin, constipation, and hypergylcemia are not typically associated with dumping syndrome.

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

Accepted Answer

Total gastrectomy results in the removal of the cells that produce intrinsic factor, which is essential for the absorption of vitamin B12. Therefore, lifelong vitamin B12 replacement is necessary. Combination antibiotic therapy, subcutaneous insulin therapy, and antiemetics may not necessarily be required for all clients who have undergone total gastrectomy.

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.

Accepted Answer

Keeping the client in a semi-Fowler's position at all times can help reduce the risk of aspiration during and after feedings by promoting proper digestion and preventing reflux. Options A and B are not recommended practices for reducing the risk of aspiration, and option C does not directly address the issue of aspiration.

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.

Accepted Answer

Remaining upright after meals can help prevent reflux of gastric secretions and reduce pain associated with a hiatal hernia. While the other interventions may be helpful in managing symptoms or preventing exacerbations, they do not directly address the acute pain related to reflux.

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

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

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

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 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?

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

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?

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 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 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?

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

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?

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?