Nokea
A client has gastroesophageal reflux disease (GERD). The provider prescribes a proton pump inhibitor. About what medication should the nurse anticipate teaching the client?
- A. Famotidine (Pepcid)
- B. Magnesium hydroxide
- C. Omeprazole (Prilosec)
- D. Ranitidine (Zantac)
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.
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A client has been discharged to an inpatient rehabilitation center after an esophagogastrectomy. What menu selections by the client at the rehabilitation center indicate a good understanding of dietary instructions? (Select all that apply.)
- A. Boost supplement
- B. Greek yogurt
- C. Scrambled eggs
- D. Whole milk shake
- E. Whole wheat toast
Correct Answer: A,B,C,D
Rationale: High-protein, high-calorie, easy-to-swallow foods like Boost, Greek yogurt, scrambled eggs, and whole milk shakes are appropriate post-esophagogastrectomy. Whole wheat toast is dry and harder to swallow, making it a poor choice.
The nurse has taught a client about lifestyle modifications for gastroesophageal reflux disease (GERD). What statements by the client indicate good understanding of the teaching? (Select all that apply.)
- A. I just joined a gym, so I hope that helps me lose weight.
- B. I sure hate to give up my coffee, but I guess I have to.
- C. I will eat three small meals and three small snacks a day.
- D. Sitting upright and not lying down after meals will help
- E. Smoking a pipe is not a problem and I don't have to stop
Correct Answer: A,B,C,D
Rationale: Weight loss, avoiding caffeine (e.g., coffee), eating smaller frequent meals, and staying upright post-meals help manage GERD. All tobacco use, including pipe smoking, is a risk factor and should be avoided.
A client is 1 day postoperative after having Zanders diverticula removed. The client has a nasogastric (NG) tube in place. The NG tube is not being used for suctioning drainage. There are no specific care orders for the NG tube in place. What action by the nurse is most appropriate?
- A. Document the findings as normal.
- B. Irrigate the NG tube with sterile saline.
- C. Notify the surgeon about this finding.
- D. Remove and reinsert the NG tube.
Correct Answer: C
Rationale: NG tubes placed during surgery should not be manipulated without surgeon orders. Lack of suction or drainage is not normal and requires notifying the surgeon for further evaluation, as irrigation or reinsertion could be harmful.
A client has been taught about alginic acid and sodium bicarbonate (Gaviscon). What statement by the client indicates that teaching has been effective?
- A. I can only take this medicine at night.
- B. I should take this on a full stomach.
- C. This drug decreases stomach acid.
- D. This should be taken 1 hour before meals.
Correct Answer: B
Rationale: Gaviscon should be taken with food in the stomach to form a protective barrier. It can be taken with meals at any time, and its mechanism of action is not to decrease stomach acid but to create a foam barrier to prevent reflux.
A client with an esophageal tumor is having extreme difficulty swallowing. For what procedure does the nurse prepare this client?
- A. Enteral tube feeding
- B. Esophageal dilation
- C. Nissen fundoplication
- D. Photodynamic therapy
Correct Answer: B
Rationale: Esophageal dilation provides immediate relief for strictures impairing swallowing. Enteral feeding may be used later if dilation fails, while Nissen fundoplication addresses reflux, and photodynamic therapy is for cancer treatment, not immediate swallowing relief.