ATI LPN
Test Bank for Medical Surgical Nursing: Concepts for Interprofessional Collaborative Care 10th Edition
Chapter 54 : Care of Patients with Esophageal Problems Questions
Question 1 of 5
A client has gastroesophageal reflux disease (GERD). The provider prescribes a proton pump inhibitor. About what medication should the nurse anticipate teaching the client?
Correct Answer: C
Rationale: Omeprazole is a proton pump inhibitor used for GERD. Famotidine and ranitidine are histamine blockers, and magnesium hydroxide is an antacid, none of which are proton pump inhibitors.
Question 2 of 5
After hiatal hernia repair surgery, a client is on IV pantoprazole (Protonix). The client asks the nurse why this medication is given since there is no history of ulcers. What response by the nurse is best?
Correct Answer: D
Rationale: Pantoprazole is given post-surgery to prevent stress-related ulcers, which can occur due to surgical stress, not because of bacteria, the operation itself, or blood pH regulation.
Question 3 of 5
A nurse works on the surgical unit. After receiving the hand-off report, which client should the nurse see first?
Correct Answer: C
Rationale: A respiratory rate of 32/min post-esophagectomy suggests possible sepsis, a life-threatening condition requiring immediate assessment. The other clients' conditions (elevated pulse, oral intake, pain) are less urgent.
Question 4 of 5
The following data relate to an older client who is 2 hours postoperative after an esophagogastrostomy: Physical Assessment: Skin dry, Urine output 20/ml/hr, NG tube patent with 100/ml, brown drainage/hr, Restless; Vital Signs: Pulse: 128 beats/min, Blood pressure: 85/50 mm Hg, Respiratory rate: 20 on ventilator, Cardiac output: 2.1 l/min; Physician Orders: Normal saline at 75/ml/hr, Morphine sulfate 2 mg IV push every 1 hr, Vancomycin (Vancocin) 1 g IV every 8 hr. What action by the nurse is best?
Correct Answer: C
Rationale: The client's vital signs, low urine output, dry skin, and low cardiac output indicate hypovolemia. Consulting the surgeon to increase IV fluids is the priority to address hypotension, rather than pain, antibiotics, or respiratory rate adjustments.
Question 5 of 5
The nurse is aware that which factors are related to the development of gastroesophageal reflux disease (GERD)? (Select all that apply.)
Correct Answer: A,B,C,D
Rationale: Delayed gastric emptying, large meals, hiatal hernia, and obesity are known risk factors for GERD. Viral infections are not associated with GERD, though Helicobacter pylori infection is.