Chapter 41, Nursing Management: Esophageal Disorders

Which medication increases lower esophageal sphincter pressure? Diazepam Bethanechol Theophylline Morphine sulfate

Bethanechol

Which complication does the nurse expect in a patient with gastroesophageal reflux disease (GERD) who has been taking dexlansoprazole for one year? Syncope Dyskinesia Renal calculi Bone fracture

Bone fracture

The nurse explains to the patient with gastroesophageal reflux disease (GERD) that this is a disorder that can be aggravated by which of the following? Select all that apply. Caffeine Chocolate Dietary fiber Orange juice Cigarette smoking High-protein foods

Caffeine Chocolate Orange juice Cigarette smoking

Which medication has a side effect of milk-alkali syndrome? Misoprostol Metoclopramide Calcium carbonate Aluminum hydroxide

Calcium carbonate

Which otolaryngologic symptoms occur in gastroesophageal reflux disease (GERD)? Select all that apply. Choking Dyspnea Wheezing Hoarseness Sore throat

Choking Hoarseness Sore throat

Which medication does the nurse expect to be beneficial to the patient who reports difficulty swallowing and is diagnosed with achalasia? Cisplatin Nifedipine Prednisone Porfimer sodium

Nifedipine

Which side effect occurs in a patient with gastroesophageal reflux disease who is on bethanechol therapy? Syncope Flatulence Renal calculi Hallucinations

syncope

Which findings indicate that a patient with gastroesophageal reflux disease has aspirated gastric contents into the respiratory system? Select all that apply. Cough Asthma Pneumonia Bronchospasm Chronic bronchitis

Asthma Pneumonia Chronic bronchitis

Where does Zenker's diverticulum occur? At the wall of the esophagus Near the esophageal midpoint At the lower portion of the esophagus Above the upper esophageal sphincter

Above the upper esophageal sphincter

A patient diagnosed with Eosinophilic esophagitis (EE) may require a referral to which kind of specialist because of the underlying pathology and etiology of the condition? Allergist Cardiologist Pulmonologist Rheumatologist

Allergist

Which antacid used in the treatment of gastrointestinal reflux disease (GERD) causes phosphorus depletion with chronic use? Magnesium oxide Calcium carbonate Sodium bicarbonate Aluminum hydroxide

Aluminum hydroxide

Which medication is beneficial to a patient reporting coughing, dyspnea, and radiating pain to the back, neck, and jaw? Nifedipine Prednisone Isosorbide dinitrate Aluminum hydroxide

Aluminum hydroxide

Which factors increase intraabdominal pressure and lead to the development of a hiatal hernia? Select all that apply. Ascites Obesity Pregnancy Fatty foods Peppermint

Ascites Obesity Pregnancy

Which diagnostic study is used to stage esophageal cancer? Radionuclide tests Manometric studies Esophagram (barium swallow) Endoscopic ultrasonography (EUS)

Endoscopic ultrasonography (EUS)

A nurse is teaching an obese patient with gastroesophageal reflux disease (GERD) measures that should be taken to prevent complications. What instructions should the nurse give? Select all that apply. Avoid tea and coffee. Maintain a low-fat diet. Avoid smoking cigarettes. Lie down immediately after having food. Use anticholinergic drugs, as prescribed.

Avoid tea and coffee. Maintain a low-fat diet. Avoid smoking cigarettes.

Which is a common antireflux surgery for repair of a hiatal hernia? Cryotherapy Toupet fundoplication Photodynamic therapy Endoscopic mucosal resection

Toupet fundoplication

Which is the first indication of gastroesophageal reflux disease and a hiatal hernia in elderly patients? Halitosis Pernicious anemia Esophageal bleeding Epigastric tenderness

Esophageal bleeding

Which esophageal disorder does the nurse expect in a patient who has ingested a strong acid and is admitted to the emergency unit? Achalasia Esophageal varices Esophageal stricture Eosinophilic esophagitis (EE)

Esophageal stricture

Which medication used in gastroesophageal reflux disease decreases the conversion of pepsinogen to pepsin? Famotidine Misoprostol Rabeprazole Metoclopramide

Famotidine

Which surgery is used to attach the stomach subdiaphragmatically to prevent reherniation? Gastropexy Herniotomy Herniorrhaphy Heller myotomy

Gastropexy

The nurse is aware that the primary symptoms of a sliding hiatal hernia are associated with reflux and should assess the patient for which symptoms? Jaundice, ascites, and edema Heartburn, regurgitation, and dysphagia Abdominal cramps, diarrhea, and anorexia Pelvic pain, fever, and board-like abdominal rigidity

Heartburn, regurgitation, and dysphagia

Which complication occurs when cancer erodes through the esophagus and into the aorta? Choking Hoarseness Hemorrhage Blood-flecked regurgitation

Hemorrhage

Which treatment will the nurse expect will provide short-term relief to an elderly patient who has difficulty swallowing food and has chest pain immediately after meals? Heller myotomy Endoscopic pneumatic dilation Endoscopic stapling diverticulotomy Injection of botulinum toxin endoscopically

Injection of botulinum toxin endoscopically

Which treatment strategy does the nurse expect to be beneficial for an elderly patient with a hiatal hernia who has a cardiovascular complication? Antireflux surgery Laparoscopic surgery Calcium channel blocker therapy Nonsteroidal antiinflammatory drugs (NSAIDs)

Laparoscopic surgery

Which respiratory complication occurs due to irritation of the upper airway by gastric secretions? Asthma Pneumonia Laryngospasm Chronic bronchitis

Laryngospasm

After reviewing the medical reports of a patient with portal hypertension, the nurse concludes that the patient has esophageal varices. Which other finding supports the nurse's conclusion? Kyphosis Liver cirrhosis Throat lacerations Squamous cell cancer

Liver cirrhosis

Which medication used to treat nausea and vomiting may cause dyskinesia? Nizatidine Sucralfate Omeprazole Metoclopramide

Metoclopramide

The nurse is preparing a care plan for a patient who underwent an open high abdominal incision. Which necessary interventions should the nurse include in the care plan? Select all that apply. Monitoring pulse rate Monitoring bowel sounds Monitoring blood glucose Monitoring respiratory rate Monitoring serum creatinine

Monitoring pulse rate Monitoring respiratory rate

Which complications can occur due to long-term use of proton pump inhibitors in patients with gastroesophageal reflux disease (GERD)? Select all that apply. Pneumonia Renal calculi Uterine rupture Decreased bone density Chronic hypochlorhydria

Pneumonia Decreased bone density Chronic hypochlorhydria

The nurse finds that a patient with weight loss reports nausea, vomiting, difficulty swallowing, and a burning sensation in the chest. The biopsy and endoscopy reports reveal infiltration of eosinophils. Which medication does the nurse expect to be beneficial to the patient? Sucralfate Prednisone Misoprostol Methotrexate

Prednisone

Which diagnostic test detects reflux of gastric contents? Biopsy Endoscopy Radionuclide test Manometric studies

Radionuclide test

A patient with gastroesophageal reflux disease reports to the nurse, "I feel like there is a hot, bitter liquid in my mouth." What does the nurse document in the patient's medical record? Dysphagia Regurgitation Hypersalivation Hyperchlorhydria

Regurgitation

While caring for a patient with esophageal cancer, the nurse finds regurgitation of blood-flecked esophageal contents. What does the nurse expect to be the reason behind the patient's condition? Severe esophageal stenosis Tumor in the upper third of the esophagus Obstruction of the esophagus at the diaphragm Cancer eroding through the esophagus and into the aorta

Severe esophageal stenosis

A patient presents to the outpatient clinic with concerns over persistent signs and symptoms of heartburn (pyrosis) . What is the most appropriate response for the nurse? "Is your throat sore?" "Are you waking up during the night coughing and choking?" "Give the medication time to take effect. You will be feeling better really soon." "I know it is uncomfortable for you. Have you been taking your medication as prescribed and making the necessary dietary adjustments?"

"I know it is uncomfortable for you. Have you been taking your medication as prescribed and making the necessary dietary adjustments?"

Which statement made by the nurse to an achalasia patient about how to manage symptoms needs correction? "You should eat slowly." "You should only eat soft food." "You should drink fluids with meals." "You should sleep with your head elevated."

"You should only eat soft food."

Which teaching should the nurse include in the discharge instructions for a postgastrectomy patient? "You should consume only liquid foods." "You should be aware that heartburn occurs after the surgery." "You should report it to the primary health care provider if regurgitation occurs." "You should inform the primary health care provider if dysphagia occurs within one month of the surgery."

"You should report it to the primary health care provider if regurgitation occurs."

A patient is seeking emergency care after choking on a piece of steak. The nursing assessment reveals a history of alcoholism, cigarette smoking, and hemoptysis. Which diagnostic study is most likely to be performed on this patient? Barium swallow Endoscopic biopsy Capsule endoscopy Endoscopic ultrasonography

Endoscopic biopsy

A patient with gastroesophageal reflux disease (GERD) is on cimetidine therapy. Which parameter does the nurse monitor to provide effective care? Bowel sounds Motor movements Serum calcium levels Serum magnesium levels

Bowel sounds Cimetidine is a histamine receptor used in the treatment of peptic ulcer and GERD. Cimetidine decreases gastric motility and causes constipation. Therefore the nurse monitors the patient for any changes in bowel sounds. This may help with early detection of constipation.

Which medication is responsible for causing flatulence in a patient on medication therapy for gastroesophageal reflux disease (GERD)? Sucralfate Famotidine Misoprostol Dexlansoprazole

Dexlansoprazole

Which condition does the nurse suspect in a patient who reports pain and discomfort in the upper abdomen? Pyrosis Halitosis Dyspepsia Water brash

Dyspepsia

Which procedure involves the disruption of the lower esophageal sphincter using balloons? Heller myotomy Esophagectomy Esophagoenterostomy Endoscopic pneumatic dilation

Endoscopic pneumatic dilation

Which condition does the nurse expect in a patient with gastroesophageal reflux disease (GERD) who has esophagitis and stenosis? Achalasia Hiatal hernia Esophageal strictures Eosinophilic esophagitis

Hiatal hernia

Which antacid does the nurse expect the primary health care provider to prescribe to a patient who reports mild, intermittent chest pain after meals? Sodium citrate Calcium carbonate Aluminum carbonate Magnesium trisilicate

Magnesium trisilicate

The patient is having an esophagoenterostomy with anastomosis of a segment of the colon to replace the resected portion. What initial postoperative care should the nurse expect when this patient returns to the nursing unit? Turn, deep breathe, cough, and use spirometer every four hours Maintain an upright position for at least two hours after eating Nasogastric (NG) tube will have bloody drainage and it should not be repositioned Keep in a supine position to prevent movement of the anastomosis

Nasogastric (NG) tube will have bloody drainage and it should not be repositioned

Which medications decrease lower esophageal sphincter pressure in elderly patients with a hiatal hernia and gastroesophageal reflux disease (GERD)? Select all that apply. Aspirin Nifedipine Potassium Imipramine Isosorbide dinitrate

Nifedipine Imipramine Isosorbide dinitrate

A patient has had esophageal surgery, and a jejunostomy feeding tube is inserted to administer oral fluids. The nurse has been told to check for signs of intolerance and leakage of feeding into the mediastinum. Which signs should the nurse be observant for? Select all that apply. Pain Dyspnea Acid reflux Tachycardia Increased temperature

Pain Dyspnea Increased temperature

While providing fluids to a postgastrectomy patient, which symptoms support the nurse's suspicion that there is leakage from a jejunostomy feeding tube? Select all that apply. Pain Fever Cough Regurgitation Difficulty breathing

Pain Fever Difficulty breathing

The nurse is assessing a patient who has suspected esophageal cancer. Which of these is the most common symptom of esophageal cancer? Weight loss Regurgitation Progressive dysphagia Epigastric pain during swallowing.

Progressive dysphagia

The nurse finds that a patient taking a prescribed medication for gastroesophageal reflux disease (GERD) had a miscarriage. Which medication does the nurse expect to be responsible for the miscarriage? Cholinergics Prostaglandins Antiulcer agents Histamine (H 2) receptor blockers

Prostaglandins

The primary health care provider orders endoscopic nutrition via a nasogastric tube for a postsurgical patient whose nutrition is disrupted. Which interventions should the nurse perform for this patient? Select all that apply. Irrigating the tube Providing oral care Providing nasal care Assessing the drainage Repositioning the tube

Providing oral care Providing nasal care Assessing the drainage

Which medication for treating gastroesophageal reflux disease (GERD) may cause constipation? Sucralfate Misoprostol Bethanechol Esomeprazole

Sucralfate

The nurse is teaching care management to a patient with gastroesophageal reflux disease (GERD). In the follow-up visit, the patient complains of severe heartburn. Which actions indicate the need for further teaching? Select all that apply. The patient chews gum daily. The patient eats ginger daily. The patient eats oranges daily. The patient eats ice cream often. The patient drinks 2 L of water daily. The patient drinks a cup of milk at bedtime.

The patient eats oranges daily. The patient eats ice cream often. The patient drinks a cup of milk at bedtime.

Why does a primary health care provider place stents endoscopically while preparing a patient with esophageal cancer for surgery? To prevent regurgitation To improve nutrition status To improve gastric emptying To prevent respiratory complications

To improve nutrition status