Hernia

The client has a hiatal hernia. How does the nurse describe this to the client? 1 A part of the stomach has exited through the diaphragm 2 A part of the abdominal contents has exited the inguinal canal 3 A part of the abdominal contents has exited through the abdominal wall 4 A part of the abdominal contents has exited the femoral canal

1

The nurse instructs the client on health maintenance activities to help control symptoms from her hiatal hernia. Which of the following statements would indicate that the client has understood the instructions? 1. "I'll avoid lying down after a meal." 2. "I can still enjoy my potato chips and cola at bedtime." 3. "I wish I didn't have to give up swimming." 4. "If I wear a girdle, I'll have more support for my stomach."

1

The nurse is obtaining a health history from a client who has a sliding hiatal hernia associated with reflux. The nurse should ask the client about the presence of which of the following symptoms? 1. Heartburn. 2. Jaundice. 3. Anorexia. 4. Stomatitis.

1

The physician prescribes metoclopramide hydrochloride (Reglan) for the client with hiatal hernia. The nurse plans to instruct the client that this drug is used in hiatal hernia therapy to accomplish which of the following objectives? 1. Increase tone of the esophageal sphincter. 2. Neutralize gastric secretions. 3. Delay gastric emptying. 4. Reduce secretion of digestive juices.

1

You have been assigned to care for a patient who was recently diagnosed with a hiatal hernia. The patient is experiencing chronic heartburn when eating a meal. You will teach the patient to avoid which of the following situations? 1. Lying flat after eating a meal 2. Ingesting small, frequent meals 3. Raising the head of the bed on 6- to 8-inch blocks 4. Taking the prescribed histamine receptor antagonist medications

1

The nurse is caring for a client with a hiatal hernia. Which of the following is an appropriate treatment? Select all that apply. Teach the client to avoid straining Recommend eating large meals Teach the client to avoid anticholinergics Recommend a high fat diet Administer antacids

1,3,5

In developing a teaching plan for the client with a hiatal hernia, the nurse's assessment of which work-related factors would be most useful? 1. Number and length of breaks. 2. Body mechanics used in lifting. 3. Temperature in the work area. 4. Cleaning solvents used.

2

The client asks the nurse whether he will need surgery to correct his hiatal hernia. Which reply by the nurse would be most accurate? 1. "Surgery is usually required, although medical treatment is attempted first." 2. "Hiatal hernia symptoms can usually be successfully managed with diet modifications, medications, and lifestyle changes." 3. "Surgery is not performed for this type of hernia." 4. "A minor surgical procedure to reduce the size of the diaphragmatic opening will probably be planned."

2

Which of the following factors would most likely contribute to the development of a client's hiatal hernia? 1. Having a sedentary desk job. 2. Being 5 feet, 3 inches tall and weighing 190 lb. 3. Using laxatives frequently. 4. Being 40 years old.

2

Which of the following lifestyle modifications should the nurse encourage the client with a hiatal hernia to include in activities of daily living? 1. Daily aerobic exercise. 2. Eliminating smoking and alcohol use. 3. Balancing activity and rest. 4. Avoiding high-stress situations.

2

A 45-year-old client is preparing to undergo hernia surgery. What information would the nurse provide for this client during the pre-operative teaching session? Select all that apply. 1 Do not bathe or shower for three days before the surgery 2 Avoid eating or drinking anything for eight hours before surgery 3 Stop taking insulin on the morning of the surgery 4 Remove all jewelry and body piercings 5 Leave valuables at home when coming to the hospital

2,4,5

Cimetidine (Tagamet) may also be used to treat hiatal hernia. The nurse should understand that this drug is used to prevent which of the following? 1. Esophageal reflux. 2. Dysphagia. 3. Esophagitis. 4. Ulcer formation.

3

The client has been taking magnesium hydroxide (milk of magnesia) at home in an attempt to control hiatal hernia symptoms. The nurse should assess the client for which of the following conditions most commonly associated with the ongoing use of magnesium-based antacids? 1. Anorexia. 2. Weight gain. 3. Diarrhea. 4. Constipation.

3

Which of the following nursing interventions would most likely promote self-care behaviors in the client with a hiatal hernia? 1. Introduce the client to other people who are successfully managing their care. 2. Include the client's daughter in the teaching so that she can help implement the plan. 3. Ask the client to identify other situations in which he demonstrated responsibility for himself. 4. Reassure the client that he will be able to implement all aspects of the plan successfully.

3

Risk factors for the development of hiatal hernias are those that lead to increased abdominal pressure. Which of the following complications can cause increased abdominal pressure? A. Obesity B. Volvulus C. Constipation D. Intestinal obstruction

A

The nurse is instructing the male client who has an inguinal hernia repair how to reduce postoperative swelling following the procedure. What should the nurse tell the client? A. Limit oral fluid B. Elevate the scrotum C. Apply heat to the abdomen D. Remain in a low-fiber diet

B

The nurse is preparing a discharge teaching plan for the male client who had umbilical hernia repair. What should the nurse include in the plan? A. Irrigating the drain B. Avoiding coughing C. Maintaining bed rest D. Restricting pain medication

B

A female patient has a sliding hiatal hernia. What nursing interventions will prevent the symptoms of heartburn and dyspepsia that she is experiencing? a. Keep the patient NPO. b. Put the bed in the Trendelenberg position. c. Have the patient eat 4 to 6 smaller meals each day. d. Give various antacids to determine which one works for the patient.

C

A patient returned from a laparoscopic Nissen fundoplication for hiatal hernia 4 hours ago. Which assessment finding is most important for the nurse to address immediately? a. The patient is experiencing intermittent waves of nausea. b. The patient complains of 7/10 (0 to 10 scale) abdominal pain. c. The patient has absent breath sounds in the left anterior chest. d. The patient has hypoactive bowel sounds in all four quadrants.

C

Which of the following symptoms is common with a hiatal hernia? A. Left arm pain B. Lower back pain C. Esophageal reflux D. Abdominal cramping

C

Which of the following tests can be performed to diagnose a hiatal hernia? A. Colonoscopy B. Lower GI series C. Barium swallow D. Abdominal x-rays

C

A patient seeking care because of recurrent heartburn and regurgitation is subsequently diagnosed with a hiatal hernia. Which of the following should the nurse include in health education? A) Drinking beverages after your meal, rather than with your meal, may bring some relief. B) It's best to avoid dry foods, such as rice and chicken, because they're harder to swallow. C) Many patients obtain relief by taking over-the-counter antacids 30 minutes before eating. D) Instead of eating three meals a day, try eating smaller amounts more often.

D

Which of the following conditions can cause a hiatal hernia? A. Increased intrathoracic pressure B. Weakness of the esophageal muscle C. Increased esophageal muscle pressure D. Weakness of the diaphragmatic muscle

D