ATI LPN
Timby's Introductory Medical-Surgical Nursing Thirteenth, North American Edition
Chapter 45 : Caring for Clients With Disorders of the Upper Gastrointestinal Tract Questions
Question 1 of 5
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?
Correct Answer: C
Rationale: Decreased appetite may be a result of diminished oxygenation to the appetite centers of the brain. With a history of chronic obstructive pulmonary disease, oxygen deprivation may be occurring, and this is a starting assessment for this client. Seasonal allergies can aggravate breathing difficulties but are not as significant as COPD. Removal of the gallbladder is not indicated in current weight loss issues. Osteoarthritis may make it more difficult for the client to shop for food but not is as significant as oxygen deprivation.
Question 2 of 5
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?
Correct Answer: B
Rationale: Irritating foods such as spices, caffeine, and alcohol should be avoided because doing so will assist in decreasing gastric acidity. Eating smaller meals is recommended to avoid lower pressure in the lower esophageal sphincter. Gastric reflux of acid is more likely to occur with positioning flat and lying down after a meal, so this should be avoided.
Question 3 of 5
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?
Correct Answer: A
Rationale: Approximately 60% of people older than 70 years of age will develop hiatal hernias. Because tobacco use reduces esophageal sphincter tone, which can result in reflux, tobacco should be avoided. Aerobic exercising, managing stress, and providing adequate rest are good for general health not specific to the management of hiatal hernias.
Question 4 of 5
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?
Correct Answer: D
Rationale: The finding of an esophageal tumor is most significant and can result in advancing cancer. Esophageal cancer is a serious condition that presents with a symptom of difficulty swallowing as the tumor grows. Hiatal hernia, gastritis, and GERD can lead to serious associated complications but are less likely to be as significant as esophageal tumor/cancer.
Question 5 of 5
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?
Correct Answer: A
Rationale: Extremely obese clients are at greater risk for complications related to anesthesia and surgery. Obstructive sleep apnea and impaired breathing can be a problem requiring continuous or positive airway pressure devices. Self-care deficit and impaired mobility are real problems that need to be addressed but less significant than airway issues. Diarrhea due to dumping syndrome is not an immediate post-op issue.