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b. Chew everything very thoroughly.

A client has been experiencing difficulty swallowing and undergoes esophagoscopy which reveals the client has a structure near the end of the client esophagus. To help improve the clients ability to swallow the best recommendation the nurse can make is to instruct the client to do which of the following. a. Avoid Drinking beverages while eating a meal. b. Chew Everything very thoroughly. c. Eat a variety of foods containing a thickener. d. Refrain from consuming milk and dairy products.

b. Consulting the primary provider about decreasing the infusion rate.

A client has diarrhea due to a high carbohydrate and electrolyte content of fluid in the tube feed. Which of the following nursing actions will be most appropriate. a. Instructing a client to remain in a semi-fowler position. b. Consulting the primary provider about decreasing the infusion rate. c. Administering the tube feedings continuously. d. Maintaining the tube patency.

b. "I will eliminate bothersome foods from my diet."

A client who has occasional gastric symptoms is receiving teaching on how to prevent gastroesophageal reflux disease (GERD). Which statement indicates the client understands the teaching? a. "I will eat two large meals a day, instead of three." b. "I will eliminate bothersome foods from my diet." c. "I will plan to sleep flat without pillows." d. "I will start taking a nap after meals, when possible."

a. Keeping the head of the bed elevated.

A client who has recovered from anesthesia following oral surgery for lip cancer is experiencing difficulty breathing deeply and coughing up secretions. Which measure 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.

a. Impaired Gas Exchange

A client who is recovering from bariatric surgery is returning from the postanesthesia care unit. Which nursing assessment finding is of greatest concern in the immediate postoperative period for this client? a. Impaired Gas Exchange b. Self-Care Deficit c. Impaired Mobility d. Diarrhea

d. Checking the placement and gastric residual prior to feedings.

A nurse is preparing an intervention plan for a client who is receiving tooth feedings after an oral surgery. Which of the following measures can prevent improper infusion and assist in preventing vomiting? a. Consulting the primary provider and dietitian. b. Administering feedings at room temperature. c. Changing the tube, feeding container and tubing. d. Checking the placement and gastric residual prior to feedings.

b. Avoiding oral nourishment until bowel sounds and are active.

A nurse is preparing an intervention plan for an older client who underwent esophageal surgery. The client frequently reports problems of gastric distention. Which of the following aspects will be the most essential in the clients intervention plan. a. Supporting the surgical incision for coughing and deep breathing. b. Avoiding oral nourishment until bowel sounds resume and are active c. Turning the client to perform deep breathing and coughing every two hours d. Discouraging lying down immediately after eating.

A,B,C

A nurse is providing discharge teaching for a client following Roux-En-Y (RYGB) surgery. What instruction(s) should the nurse include in the teaching? Select all that apply. a. Stop eating when you feel full. b. Avoid all sweets. c. Choose breads, cereals, and grains that provide less than 2 g of fiber per serving. d. Limit mealtimes to fewer than 45 minutes. e. Begin with five to six meals a day.

hiatal hernia

A protrusion of part of the stomach into the lower portion of the thorax

gastrostomy

A transabdominal opening into the stomach that provides long-term access for administering fluids and liquid nourishment

b. 15-30 mL

Administer _____ of water before and after medications ands feedings and every 4-6 hrs with continuous feedings to maintain tube patency. a. 5-10 mL b. 15-30 mL c. 40-60 mL

c. Ensure frequent small meals and discourage lying down immediately after eating.

After a esophageal surgery, a client exhibited the symptoms of dyspnea. What should a nurse do to minimize dyspnea? a. Ensure the intake of soft foods or high calorie, high protein semi liquid foods. b. Advise avoidance of foods that contain significant air or gas. c. Ensure frequent small meals and discouraged lying down immediately after eating. d. Instruct client to take liquid supplements between meals.

c. History of COPD

An older adult client presents with a complaint of 10-lb weight loss over the past month. Which assessment finding is most important in determining the care of this client? a. History of seasonal allergies b. History gallbladder removal c. History of COPD d. History of osteoarthritis

d. Esophageal tumor

An older adult client seeks medical attention for a report of general difficulty swallowing. Which assessment finding is most significant as related to this symptom? a. Hiatal hernia b. Gastroesophageal reflux disease c. Gastritis d. Esophageal tumor

Hypothalamus

Appetite center is located here

esophageal cancer

Clients usually do not experience symptoms until the disease has progressed to interfere with swallowing and passage of food, leading to weight loss.

c. Extreme obesity

Clients with ______ greater risk for diabetes, heart, disease, hypertension, stroke, osteoarthritis, gallbladder disease, and some forms of cancer, most notably colorectal, and kidney cancer. a. Esophageal cancer b. Cancer of the stomach c. Extreme obesity

Extreme obesity

Defined as a body mass index of 40 or higher for a bodyweight of more than 20% over ideal

anorexia

Lack of appetite, which is a common symptom of many diseases

Stomach malignancy

Most common among natives of Japan, as well as African-Americans and Latinos

enteric coated

Never crush and administer this type of medication through any type of enteral feeding tube

Glycogen

Provides energy through the process of glycogenolysis.

b. Esophageal diverticula

Signs and symptoms of _____ include foul breath, and difficulty or pain when swallowing, belching, regurgitating, or coughing. Auscultation of the middle to upper chest may reveal gurgling sounds. a. GERD b. Esophageal diverticula c. Peptic ulcer disease

b. Larger than

The gastrointestinal tube used to relieve abdominal distention caused by problems after surgery, episodes of acute upper G.I. bleeding, or symptoms associated with intestinal obstruction, or for diagnostic purposes is _____ see one used for tube feeding. a. Smaller than b. Larger than c. The same size as

GERD

The most common symptoms are epigastric, pain, or discomfort (dyspepsia), burning sensation in the esophagus (pyrosis), and regurgitation

a. Advancing the diet slowly.

The nurse assist the client experiencing nausea and vomiting to develop tolerance for foods and fluids. Which of the following nursing actions would help the client? a. Advancing the diet slowly. b. Discouraging caffeinated or carbonated beverages. c. Recommending commercial over-the-counter beverages d. Replacing dietary fat with medium chain triglycerides

6

The nurse fills a tube feeding bag with two 8-oz cans of commercially prepared formula. The client is to receive the formula at 80 mL/hour via continuous gastrostomy feeding tube and pump. How many hours will this bag of formula run before becoming empty? Record your answer using a whole number.

A,B,D,E,F

The nurse has placed a feeding tube for a client with a gastroesophageal disorder. What recommendation(s) should the nurse follow to confirm proper placement of the tube? Select all that apply. a. Observe for respiratory distress. b. Measure pH of feeding tube aspirates. c. Auscultate. d. Monitor aspirate for sudden change in amount. e. Mark the tube at the exit site. f. Obtain radiographic confirmation.

A,B,C

The nurse is caring for a client with a feeding tube in place who has been prescribed bolus tube feedings. Which instruction(s) should the nurse consider when administering the client's plan of care? Select all that apply. a. Allow introduction of between 8.5 and 13.5 oz (250 and 400 mL) formula through the tube in a short period (usually 15 to 30 minutes). b. Administered by syringe or gravity flow system attached to the distal end of the feeding tube. c. Administer usually three to four times daily. d. Allow delivery of between 8.5 and 13.5 oz (250 and 400 mL) formula over 30 to 60 minutes. e. Deliver by gravity flow system or an electronic feeding pump.

A,B,C,D

The nurse is caring for a client with anorexia and constipation due to reduced bulk in the diet and the use of liquid supplements. Which intervention(s) should the nurse include in the plan of care for the client? Select all that apply. a. Keep a record of the client's bowel movements. b. Consult with the health care provider and dietitian about changing the type of supplement. c. Dilute the formula until the client adjusts to the concentrated contents. d. Administer a prescribed stool softener. e. Assist the client and dietitian to decrease dietary fiber.

D,E

The nurse is caring for a client with hypovolemia related to prolonged vomiting and decreased intake of oral fluids. What activity(ies) should the nurse include in the client's plan of care? Select all that apply. a. Encourage the client to drink a 16 oz (480 mL) glass of water over the course of 15 minutes. b. Instruct the client to avoid beverages with additives such as electrolytes. c. Inform the primary provider if urine output is 3.5 oz (100 mL) per day or lower. d. Monitor weight daily. e. Assess skin turgor and mucous membranes.

A,C,D,E

The nurse is caring for a client with oral cancer who reports severe mouth sensitivity. The client asks the nurse what might be done about the condition. What should the nurse include in the response? a. "I can arrange a nutritional consultation." b. "Cold liquids may help soothe the sensitivity." c. "An anesthetic mouthwash may be used, but I will need to consult with the primary provider." d. "A special diet may be necessary based on your ability to chew and swallow." e. "Your doctor may prescribe a systemic analgesic for pain relief if necessary."

a. Eliminating tobacco use

The nurse is holding a teaching workshop on managing the symptoms of hiatal hernia in older adults. Which lifestyle modification should be included in the presentation? a. Eliminating tobacco use b. Aerobic exercising c. Avoiding excess stress d. Providing adequate rest

B,D,A,C

The nurse is managing the care of a client needing gastrointestinal suction and decompression with a Levin tube. Place the steps of initiating suction and decompression in the order the nurse should perform them. A. Insert the gastric decompression tube. B. Locate the suction source. C. Connect the decompression tube to the suction. D. Select suction according to health care provider prescription.

d. Assessing the vital signs and fluid status.

The nurse is monitoring a client diagnosed with peptic ulcer disease for any signs of medical complications. Which of the following assessment measures is most useful. a. Assessing the clients, bowel patterns and stool characteristics b. Evaluating the client scan for signs of infections. c. Evaluating the client emotional status. d. Assessing the vital signs and fluid status.

a. Do not allow client to take maximum dose for more than 2 weeks without medical consultation.

The nurse is preparing to administer famotidine to a client with gastroesophageal reflux disease. Which safety warning should the nurse consider when administering the medication? a. Do not allow client to take maximum dose for more than 2 weeks without medical consultation. b. Review client's cardiac status and sodium restrictions. c. Do not give other oral drugs within 1 to 2 hours of administering the medication. d. Be aware that long-term use may be associated with bone fractures

A,B,C

The nurse is preparing to administer ondansetron to an older adult client. Which safety warning(s) should the nurse consider when administering the medication? Select all that apply. a. Do not use if the client has a heart block or prolonged QT interval. b. Increases sedation if used with opiates. c. Emphasize prevention. The client must take consistently to prevent nausea and vomiting. d. Explain that it must be started before travel to be effective. e. Explain that there is a risk for dehydration.

A,C,B,E,D,H,I,F,G

The nurse is preparing to assess the pH of aspirated fluid for a client who has a nasogastric tube in place. Place the following steps in the order the nurse should perform them. A. Obtain a pH test kit. B. Verify that the distal tip of the client's nasogastric tube is in the stomach and has not migrated to the intestine. C. Put on gloves. D. Connect the syringe to the tube. E. Use a new syringe for withdrawing the test specimen. F. Drop a sample of the gastric fluid onto a pH color indicator strip. G. Compare the color on the test strip with the color guide supplied in the test kit and record the findings. H. Instill a small amount of air to clear fluid from the gastric tube just before aspirating. I. Aspirate a small amount of fluid.

A,B

The nurse is teaching a client with a family history of oral cancer about the early stage of the disease. Which statement(s) should the nurse include in the teaching? Select all that apply. a. "The early stage of oral cancer is characteristically asymptomatic." b. "A lesion, lump, or other abnormality may be present on the lips or mouth." c. "Difficulty eating or tasting food may occur." d. "Pain and numbness are typically present." e. "Persistent hoarseness is a hallmark sign."

A,B,D,E

The nurse is teaching a client with gastroesophageal reflux disease (GERD) about how to reduce reflux. What should the nurse include in the teaching? Select all that apply. 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. Encourage the client to eat later in the day before bedtime rather than early in the morning. d. Instruct the client to avoid alcohol or tobacco products. e. Instruct the client to eat slowly and chew the food thoroughly.

a. Administer feedings at room temperature.

The nurse needs to administer feedings to a client who has diarrhea due to gastroenteritis. What factor should the nurse consider? a. Administer feedings at room temperature. b. Administer cold feedings. c. Administer bolus feedings. d. Administer intermittent feedings.

c. Instructing to eat slowly and chew the food thoroughly.

The nurse needs to promote an easy passage of food to the stomach in an older adult client who is obese with hiatal hernia. Which of the following nursing action in the care plan would help the client? a. Encouraging, frequent, small well-balanced meals. b. Suggesting avoidance of foods that caused discomfort. c. Instructing to eat slowly and chew the food thoroughly. d. Instructing to avoid alcohol and tobacco products.

nasogastric intubation

The tube passes through the nose into the stomach via the esophagus

d. Weakness, diaphoresis, diarrhea 90 minutes after eating

Which assessment finding is most indicative of dumping syndrome in a postgastrectomy client? a. Abdominal distention, elevated temperature, weakness before eating b. Constipation, rectal bleeding following bowel movements c. Persistent loose stools, chills, hiccups after eating d. Weakness, diaphoresis, diarrhea 90 minutes after eating

b. Administering 15 to 30 ML of water before and after medication's and feedings.

Which nursing actions will ensure tube placement and decrease the risk of bacterial infection as well as crusting or blockage of the tube a. Administering 10 to 40 ML of water before and after medication's and feed. b. Administering 15 to 30 ML of water before and after medication and feedings. c. Administering 30 to 40 ML of water before and after medication and feeding. d. Administering 5 to 10 email of water before and after medication and feedings.

b. Prostaglandin E

_____ is secreted in the stomach and promotes mucus production. a. Bile b. Prostaglandin E c. Hydrochloric acid

a. Bolus

______ feedings are not administered through gastric tubes placed below the pylorus because abdominal cramping and diarrhea can occur. a. Bolus b. Intermittent c. Cyclic

c. GERD- Gastroesophageal reflux disease

_______ is a common disorder that develops when gastric contents flow upwards into the esophagus. a. Esophageal diverticulum b. Hiatal hernia c. GERD- Gastroesophageal reflux disease

a. Squamous cell

_______ is the most common oral cancer. a. Squamous cell b. Lymphatic c. Leukoplakia

C. peptic ulcer disease

_______ occurs when the normal balance between factors that promote mucosal injury and factors that protect the mucosa is disrupted. The single greatest risk factor for the development of this disease is infection with a gram negative bacterium H. pylori a. GERD b. Esophageal diverticula c. Peptic ulcer disease

jejunostomy

tube enters jejunum or small intestine through a surgically created opening into the abdominal wall

gastrostomy

tube enters the stomach through a surgically created opening into the abdominal wall

orogastric intubation

tube passes through mouth into the stomach

Nasoenteric intubation

tube passes through the nose, esophagus, and stomach to the small intestine