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
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 2 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.
Question 3 of 5
The nurse is teaching a client with gastroesophageal reflux disease (GERD) about how to reduce reflux. What should the nurse include in the teaching? Select all that apply.
Correct Answer: A,B,D,E
Rationale: The nurse should encourage the client to eat frequent, small, well-balanced meals, inform the client to remain upright for at least 2 hours after meals, instruct the client to avoid alcohol or tobacco products, and instruct the client to eat slowly and chew the food thoroughly when teaching the client how to reduce reflux. The nurse should discourage the client from eating before bedtime.
Question 4 of 5
A nurse is providing discharge teaching for a client following Roux-En-Y (RYGB) surgery. What instruction(s) should the nurse include in the teaching? Select all that apply.
Correct Answer: A,B,C
Rationale: The nurse should instruct the client to stop eating when the client feels full, avoid all sweets, and choose breads, cereals, and grains that provide less than 2 g of fiber per serving. The client should plan to take an hour to eat, chewing food slowly and thoroughly. The client should not begin with five to six meals a day but should instead gradually progress to this number of meals.
Question 5 of 5
The nurse is caring for a client with anorexia and constipation due to reduced bulk in the diet and the use of liquid supplements. Which intervention(s) should the nurse include in the plan of care for the client? Select all that apply.
Correct Answer: A,B,C,D
Rationale: The nurse should keep a record of the client's bowel movements, consult with the health care provider and dietitian about changing the type of supplement, dilute the formula until the client adjusts to the concentrated contents, and administer a prescribed stool softener. Dietary fiber should be increased, not decreased, as a decrease will further reduce the amount of bulk in the client's diet and contribute to further constipation.