Nokea
Following an esophagectomy with colon interposition (esophagoenterostomy) for esophageal cancer, the client is beginning to eat oral foods. The nurse monitors for aspiration because the client no longer has which structure?
- A. A stomach
- B. A pyloric sphincter
- C. A pharynx
- D. A lower esophageal sphincter
Correct Answer: D
Rationale: A. All or part of the stomach will remain intact following an esophagoenterostomy. B. The pyloric sphincter will remain intact following an esophagoenterostomy. C. The pharynx will remain intact following an esophagoenterostomy. D. An esophagectomy for cancer involves removal of the lower esophageal sphincter, which normally functions to keep food from refluxing back into the esophagus. The absence of the lower esophageal sphincter places the client at risk for aspiration.
You may also like to solve these questions
The client is admitted to a medical unit. The client’s medication list includes rifaximin, lactulose, and propranolol. Which assessment should be the nurse’s priority based on the client’s medication list?
- A. Assess the client for a history of PUD.
- B. Assess the client for abdominal pain.
- C. Place the client on airborne precautions.
- D. Assess neurological status and abdominal girth.
Correct Answer: D
Rationale: A. Antibiotics and acid-reducing medications are expected with the treatment of PUD, but propranolol (Inderal) would not be expected. Although these medications may cue the nurse to further explore a history of PUD, this is not the most likely conclusion. B. There is no indication that the client has abdominal pain, and there isn’t an analgesic on the medication list. C. There is no indication that the client has an infectious condition necessitating airborne precautions. D. All medications listed are used to treat liver cirrhosis and its complications of portal hypertension and hepatic encephalopathy. The antibiotic rifaximin (Xifaxan) and the laxative lactulose (Cephulac) are used for treating hepatic encephalopathy. Thus, assessing the client’s neurological status and measuring abdominal girth are most important.
The nurse is caring for the client who has a temporary colostomy following surgery for colon cancer. The nurse assesses that the client’s colostomy bag is empty and that there has been no stool since surgery 24 hours ago. What should the nurse do?
- A. Call the surgeon immediately.
- B. Place the client left side-lying.
- C. Document these findings.
- D. Give a laxative medication.
Correct Answer: C
Rationale: The nurse should document the findings; the absence of stool is expected 24 hours postsurgery.
The client of Chinese ethnicity has diarrhea and refuses to drink the prescribed oral hydration solution, insisting on having chicken broth instead. Which statement about clients of Chinese ethnicity should be the basis for the nurse’s intervention in this situation?
- A. They consider chicken a food with yang qualities.
- B. They believe extra protein is needed to treat diarrhea.
- C. They believe high-sodium foods are needed to treat diarrhea.
- D. They mistrust modern medicine and eat broth to treat disease.
Correct Answer: A
Rationale: A. Loose stools are a yin symptom, which should be treated with foods that have yang qualities, one of which is chicken. B. There is no belief in the Chinese culture related to consuming high-protein foods. C. There is no belief in the Chinese culture related to consuming high-sodium foods. D. The Chinese do not mistrust modern medicine but may combine Western medicine and Chinese herbal medicines to treat disease.
A low-residue diet is ordered for a client. Which food would be contraindicated for this person?
- A. Roast beef
- B. Fresh peas
- C. Mashed potatoes
- D. Baked chicken
Correct Answer: B
Rationale: Fresh peas are high in residue due to their fiber content, contraindicated for a low-residue diet. Roast beef, mashed potatoes, and baked chicken are low-residue.
The 85-year-old male client diagnosed with cancer of the colon asks the nurse, 'Why did I get this cancer?' Which statement is the nurse's best response?
- A. Research shows a lack of fiber in the diet can cause colon cancer.
- B. It is not common to get colon cancer at your age; it is usually in young people.
- C. No one knows why anyone gets cancer, it just happens to certain people.
- D. Women usually get colon cancer more often than men but not always.
Correct Answer: A
Rationale: Low dietary fiber is a known risk factor for colon cancer, as it slows bowel transit and increases exposure to carcinogens. Colon cancer is common in older adults, not younger ones, and gender differences are minimal.