How should the nurse teach the patient with a hiatal hernia or GERD to control symptoms?

Correct Answer: C

Rationale: In the context of teaching a patient with a hiatal hernia or GERD to control symptoms, the correct answer is C) Sleep with the head of the bed elevated on 4- to 6-inch blocks. Elevating the head of the bed helps prevent gastric reflux by using gravity to keep stomach acid from moving up into the esophagus while sleeping. This position can reduce symptoms such as heartburn and regurgitation. Option A) Drink 10 to 12 oz of water with each meal may exacerbate symptoms as consuming large amounts of liquid with meals can distend the stomach and increase pressure on the lower esophageal sphincter, leading to reflux. Option B) Spacing six small meals a day may be beneficial for some individuals with GERD to prevent overeating, but it may not directly address symptom control as effectively as elevating the head of the bed. Option D) Performing daily exercises of toe-touching, sit-ups, and weight lifting is not recommended for symptom control in patients with hiatal hernia or GERD. Vigorous exercises and certain movements like bending at the waist can worsen symptoms by increasing intra-abdominal pressure and promoting acid reflux. Educationally, it's important to teach patients evidence-based strategies backed by scientific rationale to effectively manage their condition. Understanding the physiological mechanisms behind each recommendation helps patients make informed decisions about their health and empowers them to take an active role in managing their gastrointestinal disorders.

Correct Answer: A

Rationale: The correct answer is A) Pallor and hair loss. This assessment data support the nursing diagnosis of imbalanced nutrition in a patient with inflammatory bowel disease because pallor indicates decreased hemoglobin levels due to nutritional deficiency, and hair loss can be a sign of malnutrition. These physical manifestations are directly related to inadequate nutritional intake and absorption in the gastrointestinal system. Option B) Frequent diarrhea stools may lead to dehydration and electrolyte imbalances, but it does not directly support the nursing diagnosis of imbalanced nutrition. Option C) Anorectal excoriation and pain are more indicative of complications related to diarrhea or inflammation in the anal area, rather than specifically pointing to imbalanced nutrition. Option D) Hypotension and low urine output suggest possible dehydration or renal issues, which are not directly linked to the nursing diagnosis of imbalanced nutrition. In an educational context, understanding how to assess and interpret data related to nutritional status in patients with gastrointestinal disorders is crucial for providing effective nursing care. Recognizing the signs and symptoms of malnutrition can help nurses develop appropriate interventions to address the patient's nutritional needs and improve their overall health outcomes.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Human papillomavirus (HPV). The rationale behind this is that HPV infection is a significant risk factor for anal cancer. HPV is a sexually transmitted infection that can lead to the development of various cancers, including anal cancer. Studies have shown a strong association between HPV infection and anal cancer, particularly in certain high-risk populations like older African American individuals. Option A) Alcohol use is not directly linked to an increased risk of anal cancer. While excessive alcohol consumption can contribute to other health issues, it is not a known risk factor for anal cancer. Option C) Having only one sexual partner does not influence the risk of anal cancer directly. The risk of HPV infection and subsequent anal cancer is more related to exposure to the virus rather than the number of sexual partners. Option D) Using a condom with sexual intercourse can reduce the risk of sexually transmitted infections, including HPV. However, condoms do not provide complete protection against HPV, so the individual can still be at risk for anal cancer if infected with the virus. From an educational perspective, understanding the risk factors associated with anal cancer is crucial for healthcare professionals to provide appropriate care and guidance to patients. By knowing the significant role of HPV in the development of anal cancer, healthcare providers can emphasize the importance of HPV vaccination and safe sexual practices to reduce the risk of this potentially serious condition.

Correct Answer: C

Rationale: The correct answer is C) Development of collateral channels of circulation in inelastic, fragile esophageal veins as a result of portal hypertension. In cirrhosis, portal hypertension causes increased pressure in the portal vein system, leading to the development of collateral circulation to bypass the blockage. Esophageal varices are dilated, fragile veins that develop in response to this increased pressure, and they serve as collateral channels. These varices are prone to rupture, leading to potentially life-threatening hemorrhage. Option A is incorrect because jaundice, peripheral edema, and ascites are manifestations of increased intrahepatic pressure and dysfunction, but they are not directly related to esophageal varices in cirrhosis. Option B is incorrect as it describes primary biliary cirrhosis, which is a different condition from cirrhosis related to esophageal varices. Option D is incorrect as it describes the pathophysiology of cirrhosis in general, but it does not specifically address the development of esophageal varices. Understanding the manifestations and complications of cirrhosis, including esophageal varices, is crucial in the management of patients with liver disease. Recognizing the signs and symptoms of esophageal varices can help healthcare providers intervene promptly to prevent catastrophic bleeding events. It is essential for healthcare professionals, especially those in gastroenterology and hepatology, to have a comprehensive understanding of gastrointestinal disorders like cirrhosis and its associated complications to provide optimal care for patients.

Correct Answer: D

Rationale: The correct answer is D) Duodenum adjoining the pancreas. In a Whipple procedure, the surgeon removes the head of the pancreas, the duodenum, a portion of the stomach, the gallbladder, and the common bile duct. The duodenum plays a critical role in nutrient absorption as it is the initial segment of the small intestine where most digestion occurs. Option A) Stomach is incorrect because only a portion of the stomach, not the entire stomach, is removed during a Whipple procedure. Option B) Pancreas is incorrect as only a part of the pancreas is resected, not the entire organ. Option C) Common bile duct is incorrect as it is removed but its absence does not have a direct impact on the patient's nutritional status. Educationally, understanding the implications of gastrointestinal surgeries like the Whipple procedure is crucial for healthcare professionals managing patients postoperatively. Knowing the specific anatomical changes and their effects on digestion and nutrient absorption can help in providing appropriate nutritional support and monitoring for these patients to prevent malnutrition and other complications.