ATI Care of Patients with Esophageal Problems, Questions and Answers with Explanations

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

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Category ATI
Release date 2021-09-14
Pages 16
Language English
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