Question 1

The nursing instruction that would be included in a client's teaching plan to prevent or delay the development of hiatal hernia is

Accepted Answer

Health promotion behaviors to prevent or at least delay a hiatal hernia include avoiding any activities that increase intra-abdominal pressure, such as heavy lifting and wearing constrictive clothing.

Question 2

A client has undergone radiation therapy to reduce the size of an esophageal tumor. The nurse should be especially vigilant in assessing for

Accepted Answer

Because high-dose radiation may cause stenosis of the esophagus, treatments are usually administered over 6 to 8 weeks.

Question 3

Metoclopramide (Reglan) is prescribed for a client with GERD. The nurse realizes that teaching about this drug has been effective when the client says "I understand metoclopramide

Accepted Answer

Metoclopramide may be prescribed because it increases LES pressure by stimulating the smooth muscle of the gastrointestinal tract and increasing the rate of gastric emptying. It has no effect on gastric acidity, no anesthetic effects, and does not work in the esophagus.

Question 4

For a client with diverticula of the esophagus, the nurse would tell the client to avoid

Accepted Answer

To prevent reflux of food, the client should have the head of the bed raised for 2 hours after meals. Nocturnal reflux can often be prevented by sleeping with the head of the bed elevated. The client should avoid constrictive clothes and vigorous exercise after eating.

Question 5

A nurse is conducting smoking cessation clinics and educates the clients they should report which finding in their mouths to their physicians immediately?

Accepted Answer

Erythroplakias, which are frequently early squamous cell carcinomas, have a red, velvety appearance. These lesions are not well delineated and bleed easily. The yellow-white lesion is probably leukoplakia, a potentially precancerous lesion. "Milk curd" lesions are typical for candidiasis. The ulcer-like lesions is probably mucositis.

Question 6

A client with a rolling hiatal hernia complains of a feeling of fullness after eating and difficulty breathing. When the client says, "I think I should lie down for awhile," the nurse should remind the client

Accepted Answer

A client with a rolling hiatal hernia will experience greater discomfort when lying down.

Question 7

The nurse is conducting secondary prevention measures for a group of clients who smoke. Screening is aimed at early diagnosis of

Accepted Answer

Squamous cell carcinoma is the most common type of oral malignancy, accounting for about 95% of the cancers found on the tongue. Although common, hemangiomas and neurofibromas are benign. Smoking is the primary cause for all the lesions listed. Secondary prevention measures are those that provide screening and early diagnosis.

Question 8

A client has oral cancer and is scheduled for a radical neck dissection. The priority intervention to address this client's psychosocial needs is to

Accepted Answer

Clients who are rendered unable to speak by this surgical procedure are often fearful and anxious. Ensuring the client is able to signal for help and responding promptly will help diminish this anxiety. Once in the room with the client, use alternative means of communication to decrease frustration. Preferably, these methods were determined in advance of the operation. Visits from someone who has had this procedure and being aware of tendencies to treat people who cannot talk as if they are deaf are also good interventions, but not the priority.

Question 9

During a health interview, the nurse informs a client with GERD that of all the drugs the client is presently taking, the drug that will aggravate the clinical manifestations of GERD is

Accepted Answer

Anticholinergic drugs, calcium-channel blockers, and theophylline should be avoided, if possible, because they delay gastric emptying and can initiate manifestations of GERD.

Quiz 30: Management of Clients with Ingestive Disorders