ATI Care of Patients
with Esophageal Problems, Questions and Answers with Explanations, 100%
Correct, Download to Score A
Test Bank
MULTIPLE CHOICE
1. What is the pH range of the distal esophagus?
a. 1.5 to
2.0
b. 3.0 to
4.5
c. 4.5 to
6.0
d. 6.0 to
7.0
ANS: D
The pH of the lower esophagus is neutral (normal).
DIF: Cognitive Level: Knowledge/Remembering REF: p. 1204
TOP: Client Needs Category: Physiological Integrity
(Physiological Adaptation—Pathophysiology)
MSC: Integrated Process: Nursing Process (Assessment)
2. An obese client has reflux and asks how being overweight
could cause this condition. Which response by the nurse is best?
a. “You eat
more food, more often, than nonobese people do.”
b. “The
weight adds extra pressure, which helps push stomach contents up.”
c. “Obese
people tend to eat more high-fat food, which presents a risk.”
d. “Obesity
is not related to reflux, but losing weight would be healthy.”
ANS: B
Esophageal reflux can occur when intra-abdominal pressure is
elevated, or when the sphincter tone of the lower esophageal sphincter (LES) is
decreased. Obesity can increase intra-abdominal pressure. The other statements
are not accurate explanations of the connection between obesity and reflux.
DIF: Cognitive Level: Comprehension/Understanding REF: p.
1204
TOP: Client Needs Category: Physiological Integrity
(Reduction of Risk Potential—Potential for Alterations in Body Systems) MSC:
Integrated Process: Teaching/Learning
3. Which client does the nurse assess most carefully for the
development of gastroesophageal reflux disease?
a. Client
with atrial fibrillation who drinks decaffeinated coffee
b. Client
who has lost 20 pounds through diet and exercise
c. Diabetic
client taking oral hypoglycemic agents
d. Postoperative
client who has a nasogastric (NG) tube
ANS: D
A nasogastric tube keeps the cardiac sphincter open,
allowing acidic contents from the stomach to enter the esophagus. The other
clients do not have increased risk for gastroesophageal reflux.
DIF: Cognitive Level: Application/Applying or higher REF:
N/A
TOP: Client Needs Category: Physiological Integrity
(Reduction of Risk Potential—Potential for Complications from Diagnostic
Tests/Treatments/Procedures)
MSC: Integrated Process: Nursing Process (Assessment)
4. A client with esophageal reflux who experiences
regurgitation while lying flat is at risk for which complication?
a. Erosion
b. Bleeding
c. Aspiration
d. Odynophagia
ANS: C
Regurgitation of stomach contents while the client is
recumbent poses a risk of aspiration for the client.
DIF: Cognitive Level: Knowledge/Remembering REF: p. 1205
TOP: Client Needs Category: Physiological Integrity
(Reduction of Risk Potential—Potential for Complications from Surgical
Procedures and Health Alterations)
MSC: Integrated Process: Nursing Process (Planning)
5. A client just experienced an episode of reflux with
regurgitation. What assessment by the nurse is the priority?
a. Auscultate
the lungs for crackles.
b. Inspect
the oral cavity.
c. Check
the oxygen saturation.
d. Teach the
client to sleep sitting up.
ANS: A
The client with regurgitation is at risk for aspiration,
pneumonia, and bronchitis. The nurse should auscultate the lungs for
crackles—an indication of aspiration. If abnormalities are found, the nurse can
then check the oxygen saturation. The nurse should teach the client to sleep
with the head of the bed elevated, however; this is not a priority action.
Inspecting the oral cavity probably is not needed.
DIF: Cognitive Level: Application/Applying or higher REF:
N/A
TOP: Client Needs Category: Safe and Effective Care
Environment (Management of Care—Establishing Priorities) MSC: Integrated
Process: Nursing Process (Assessment)
6. The health care provider is prescribing medication to
treat a client’s severe gastroesophageal reflux disease (GERD). Which
medication does the nurse anticipate teaching the client about?
a. Magnesium
hydroxide (Gaviscon)
b. Ranitidine
(Zantac)
c. Nizatidine
(Axid)
d. Omeprazole
(Prilosec)
ANS: D
Proton pump inhibitors such as omeprazole are the main
treatment for more severe cases of GERD. Gaviscon, Axid, and Zantac can be used
to treat less severe cases.
DIF: Cognitive Level: Application/Applying or higher REF:
N/A
TOP: Client Needs Category: Physiological Integrity
(Pharmacological and Parenteral Therapies—Expected Actions/Outcomes) MSC:
Integrated Process: Nursing Process (Planning)
7. A client is undergoing diagnostic testing for
gastroesophageal reflux disease (GERD). Which test does the nurse tell the
client is best for diagnosing this condition?
a. Endoscopy
b. Schilling
test
c. 24-Hour
ambulatory pH monitoring
d. Stool
testing for occult blood
ANS: C
The most accurate method of diagnosing gastroesophageal
reflux disease is 24-hour ambulatory pH monitoring.
DIF: Cognitive Level: Knowledge/Remembering REF: p. 1205
TOP: Client Needs Category: Physiological Integrity
(Reduction of Risk Potential—Diagnostic Tests) MSC: Integrated Process:
Teaching/Learning
8. A client has Barrett’s esophagus. Which client assessment
by the nurse requires consultation with the health care provider?
a. Sleeping
with the head of the bed elevated
b. Coughing
when eating or drinking
c. Wanting
to eat several small meals during the day
d. Chewing
antacid tablets frequently during the day
ANS: B
In Barrett’s esophagus (a complication of gastroesophageal
reflux disease [GERD]), fibrosis and scarring that accompany the healing
process can cause esophageal stricture, leading to difficulty in swallowing.
This can be manifested by coughing when the client eats or drinks and requires
consultation with the health care team. The other assessments are typical of
clients trying to control their GERD.
DIF: Cognitive Level: Application/Applying or higher REF:
N/A
TOP: Client Needs Category: Physiological Integrity
(Reduction of Risk Potential—Potential for Alterations in Body Systems) MSC:
Integrated Process: Nursing Process (Assessment)
9. The nurse is teaching a client about self-management of
gastroesophageal reflux. Which statement by the nurse is most appropriate?
a. “Eat four
to six small meals each day.”
b. “Eat a
small evening snack 1 to 2 hours before bed.”
c. “No
specific foods or spices need to be cut from your diet.”
d. “You may
include orange or tomato juice with your breakfast.”
ANS: A
The client is instructed to eat four to six small meals
daily rather than three larger meals to avoid pressure in the stomach and
delayed gastric emptying, which can increase reflux. Evening snacks and acidic
foods also should be avoided. The client should keep a diary to assess for foods
or spices that increase symptoms, and those items need to be avoided.
DIF: Cognitive Level: Comprehension/Understanding REF: Chart
57-2, p. 1206
TOP: Client Needs Category: Health Promotion and Maintenance
(Self-Care)
MSC: Integrated Process: Teaching/Learning
Category | ATI |
Release date | 2021-09-14 |
Pages | 16 |
Language | English |
Comments | 0 |
Sales | 0 |
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