Chapter 45: Caring for Clients with Disorders of the Upper Gastrointestinal Tract (NCLEX Review Questions/PrepU)

A client is diagnosed with a hiatal hernia. Which statement indicates effective client teaching about hiatal hernia and its treatment?

"I'll eat frequent, small, bland meals that are high in fiber."

The nurse is conducting a health instruction program on oral cancer. The nurse determines that the participants understand the instructions when they state

"Many oral cancers produce no symptoms in the early stages."

Which of the following actions by the nurse promotes safety for a client receiving bolus tube feedings via a nasogastric tube? Select all that apply.

Assess tube placement according to agency policy. Check the residual volume prior to the bolus feeding. Irrigate the nasogastric tube with 30 mL water following the bolus.

A client is scheduled for removal of the lower portion of the antrum of the stomach and a small portion of the duodenum and pylorus. What surgical procedure will the nurse prepare the client for?

Billroth I

Which of the following appears to be a significant factor in the development of gastric cancer?

Diet

The nurse is assisting a client following an episode of severe vomiting and dehydration. The client is now tolerating fluids. What food choice suggestion by the nurse is most appropriate as the client progresses with the diet?

Dry toast

A nurse has obtained an order to remove a client's NG tube that was placed for feeding. What is the nurse's best initial action?

Explain the process clearly to the client.

The nurse reviews the results of diagnostic tests for a client experiencing persistent indigestion, feeling of gastric fullness, and unexplained weight loss. Which finding best suggests that the client's symptoms are related to cancer of the stomach?

Gastric analysis shows absence of hydrochloric acid.

A patient describes a burning sensation in the esophagus, pain when swallowing, and frequent indigestion. What does the nurse suspect that these clinical manifestations indicate?

Gastroesophageal reflux disease

A nursing student is caring for a client with gastritis. Which of the following would the student recognize as a common cause of gastritis? Choose all that apply.

Ingestion of strong acids Irritating foods Overuse of aspirin

The nurse implements the teaching plan on dumping syndrome for the client who has recently undergone a gastrojejunostomy. After the nurse provides information about restricting carbohydrates, which additional information should the nurse plan to teach this client to help reduce the potential for experiencing the symptoms of dumping syndrome?

Lie down for a short time after eating.

A nurse is caring for a client who has a diagnosis of GI bleed. During shift assessment, the nurse finds the client to be tachycardic and hypotensive, and the client has an episode of hematemesis while the nurse is in the room. In addition to monitoring the client's vital signs and level of conscious, what would be a priority nursing action for this client?

Notify the health care provider.

The nurse is conducting a community education class on gastritis. The nurse includes that chronic gastritis caused by Helicobacter pylori is implicated in which disease/condition?

Peptic ulcers

A client has undergone surgery for oral cancer and has just been extubated in postanesthetic recovery. What nursing action best promotes comfort and facilitates spontaneous breathing for this client?

Placing the client in Fowler position

A client who underwent surgery for esophageal cancer is admitted to the critical care unit following postanesthetic recovery. What should the nurse include in the client's immediate postoperative plan of care?

Positioning the client to prevent gastric reflux

During a routine home visit, a client describes what the nurse believes may be symptoms related to a hiatal hernia. Which modification to the client's bed is most appropriate to recommend at this time?

Raise the head of the bed on 4-inch blocks.

A client who suffered a stroke had an NG tube inserted to facilitate feeding shortly after admission. The client has since become comatose and the client's family asks the nurse why the physician is recommending the removal of the client's NG tube and the insertion of a gastrostomy tube. What is the nurse's best response?

Regurgitation and aspiration are less likely.

An older adult patient who has been living at home alone is diagnosed with parotitis. What causative bacteria does the nurse suspect is the cause of the parotitis?

Staphylococcus aureus

A client has been diagnosed with Zenker's diverticulum. What treatment does the nurse include in the client education?

Surgical removal of the diverticulum

A client with gastroesophageal reflux disease (GERD) has a diagnosis of Barrett esophagus with minor cell changes. What principle should be integrated into the client's subsequent care?

The client will be monitored closely to detect malignant changes.

The nurse is inserting a Levin tube for a patient for gastric decompression. The tube should be inserted to 6 to 10 cm beyond what length?

The distance measured from the tip of the nose to the earlobe and from the earlobe to the xiphoid process

A nurse in an oral surgery practice is working with a client scheduled for removal of an abscessed tooth. When providing discharge education, the nurse should recommend what action?

Use warm saline to rinse the mouth as needed.

A client who can't tolerate oral feedings begins receiving intermittent enteral feedings. When monitoring for evidence of intolerance to these feedings, what must the nurse remain alert for?

diaphoresis, vomiting, and diarrhea

The nurse provides health teaching to inform the client with oral cancer that

many oral cancers produce no symptoms in the early stages.

The nurse teaches an unlicensed caregiver about bathing clients who are receiving tube feedings. The most significant complication related to continuous tube feedings is the

potential risk for aspiration.