Question 1

A nurse is constructing a teaching plan for a patient with a hiatal hernia.What should be included in this plan to help reduce the complaints of heartburn, regurgitation, and eructation?

Accepted Answer

Eating nothing for several hours before bedtime can help to reduce the symptoms of heartburn, regurgitation, and eructation in patients with a hiatal hernia. This allows the stomach time to empty before lying down, reducing the likelihood of acid reflux. Eating three well-balanced meals and avoiding lying down for at least 2-3 hours after eating can also be beneficial. Sleeping with the head elevated on pillows may also help to reduce symptoms. However, lying down without pillows may make symptoms worse, as it can increase intra-abdominal pressure and worsen acid reflux.

Question 2

A nurse is assessing a patient for risk factors that increase the chances of developing oral cancer.Which information from this patient's history indicates a risk factor?

Accepted Answer

Alcohol consumption is a known risk factor for oral cancer. Chewing gum, environmental pollution, and consumption of a high-fat diet are not recognized risk factors for this type of cancer.

Question 3

A nurse is caring for a patient with esophageal surgery who has had stents placed in the esophagus and instructs the patient how best to avoid regurgitation.What should the nurse include in this instruction?

Accepted Answer

Eating smaller meals can help prevent regurgitation and allow for better passage of food through the esophagus. Keeping the bed flat may increase the risk of regurgitation, lying on the right side may increase reflux, and drinking too much fluid with meals may also exacerbate regurgitation.

Question 4

A long-term care nurse is assisting a well-nourished, 80-year-old resident with the diagnosis of esophageal cancer on methods to deal with dysphagia.What nursing intervention will best help to improve the resident's condition?

Accepted Answer

Tilting the head slightly forward can help prevent aspiration and facilitate swallowing in patients with dysphagia.

Question 5

A home health nurse is assigned to follow-up on a patient recently diagnosed with gastroesophageal reflux disease (GERD).Which primary symptom should the nurse take into consideration when updating the nursing interventions on this patient's care plan?

Accepted Answer

The primary symptom of GERD is heartburn, which is caused by the reflux of stomach acid up into the esophagus. This symptom should be closely monitored and managed to prevent further complications. Nausea, vomiting, and anorexia may also be present but are secondary symptoms that may be related to the primary symptom of heartburn.

Question 6

A patient experiencing nausea reports to the nurse that she adds ginger root to her morning tea to calm her stomach.Which classification of medication in the patient history alerts the nurse to provide further education?

Accepted Answer

Ginger can increase the risk of bleeding, especially in patients taking anticoagulants (blood thinners). It's important for patients on such medications to consult with healthcare providers before using ginger as a supplement.

Question 7

A goal for a patient with gastritis who has experienced nausea, vomiting, and diarrhea is to have a return of normal elimination patterns.Which statement best reflects this goal in a measurable manner?

Accepted Answer

The goal is for the patient's bowel pattern to return to normal, which includes having normal frequency, consistency, and form of stools.

Question 8

When assisting with the admission of a new resident to a long-term care facility, a nurse notes a current history of peptic ulcer disease.What type of pain should the nurse expect the resident to describe?

Accepted Answer

Peptic ulcer disease typically causes a burning pain in the upper abdomen, often occurring after meals or in the middle of the night.

Question 9

A nurse is caring for a patient hemorrhaging from a peptic ulcer when the patient complains of a sharp sudden pain and has a rapidly deteriorating condition.What is the best first action of the nurse?

Accepted Answer

The sudden onset of sharp pain and rapid deterioration in the patient's condition could indicate a potential complication such as perforation, which would require immediate medical attention. The nurse should roll the patient flat and assess vital signs to quickly detect any signs of shock or other complications. The other actions may also be necessary, but assessing the patient's vital signs should be the top priority.

Question 10

A home health nurse observes a patient with esophageal cancer tilt his head back while eating.What might this cause?

Accepted Answer

Tilting the head back while eating can cause food or liquids to enter the airway, increasing the risk of aspiration, which can be dangerous for people with esophageal cancer.

Question 11

A nurse is caring for a patient with achalasia.What nursing actions should be implemented to help the patient reduce swallowing difficulty? (Select all that apply.)

Accepted Answer

Identifying foods that cause the problem, experimenting with different eating positions, and elevating the head of the bed at night are all nursing actions that can help reduce swallowing difficulty in a patient with achalasia. Suggesting eating more rapidly and offering small bites of fresh vegetables may actually worsen the condition.

Question 12

A 60-year-old patient who has just been diagnosed with cancer of the stomach says, "I feel blank and numb." What is the best nursing response?

Accepted Answer

The best nursing response is to ask the patient what they mean by feeling "blank and numb." This shows that the nurse is actively listening and attempting to understand the patient's feelings, which can help the patient feel heard and validated. It also allows the nurse to better understand the patient's emotional state and can guide further conversation or interventions. A) is dismissive and does not address the patient's specific feelings. B) assumes the patient is already considering their next steps, which may not be the case, and does not address the patient's current emotional state. C) offers medication without first exploring other interventions or the patient's feelings.

Question 13

When assessing the tongue of patient in the outpatient clinic, a nurse observes bluish-white lesions on the mucous membranes.When reviewing the patient history, the nurse notes the patient has been on long-term antibiotic therapy for chronic prostatitis.What should the nurse suspect?

Accepted Answer

The observation of bluish-white lesions on the mucous membranes is characteristic of thrush, which is a fungal infection of the mouth. Long-term antibiotic therapy can disrupt the normal oral flora and increase the risk of developing thrush. Aphthous stomatitis presents as painful ulcers on the oral mucosa, herpes simplex type I presents as vesicles on the lips, and oral cancer presents as a persistent sore or growth in the mouth.

Quiz 38: Upper Digestive Tract Disorders