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
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 2 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 3 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.
Question 4 of 5
Which assessment finding is most indicative of dumping syndrome in a postgastrectomy client?
Correct Answer: D
Rationale: Dumping syndrome produces weakness, dizziness, sweating, palpitations, abdominal cramping, and diarrhea from the rapid emptying of the chyme after eating. Elevated temperature and chills can be a significant finding for infection and should be reported. Constipation with rectal bleeding is not indicative of dumping syndrome.
Question 5 of 5
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?
Correct Answer: A
Rationale: The safety warning that the nurse should consider is that the client should not take the maximum dose of famotidine for more than 2 weeks without medical consultation, because it is a histamine H2 antagonist. Reviewing cardiac status and sodium restrictions is a consideration for sodium bicarbonate. Not giving oral drugs within 1 to 2 hours is a consideration for antacids. Long-term use being associated with bone fractures is a consideration for proton pump inhibitors.