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A nurse is teaching clients with gastroesophageal reflux disease (GERD) about foods to avoid. Which foods should the nurse include in the teaching? (Select all that apply.)
- A. Chocolate
- B. Decaffeinated coffee
- C. Citrus fruits
- D. Peppermint
- E. Tomato sauce
Correct Answer: A,C,D,E
Rationale: Chocolate, citrus fruits, peppermint, and tomato-based products exacerbate GERD by promoting reflux. Decaffeinated coffee is less likely to trigger symptoms compared to caffeinated beverages.
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A client has a nasogastric (NG) tube. What action by the nursing student requires the registered nurse to intervene?
- A. Checking tube placement every 4 or 8 hours
- B. Monitoring and client listening drainage from the NG tube
- C. Pinning the tube to the gown so the client cannot turn the head
- D. Providing oral care every 4 to 8 hours
Correct Answer: C
Rationale: Pinning the NG tube to restrict head movement is incorrect, as it can cause discomfort or dislodge the tube. The client should have freedom to move their head. The other actions are appropriate for NG tube care.
A nurse works on the surgical unit. After receiving the hand-off report, which client should the nurse see first?
- A. Client who underwent diverticula removal with a pulse of 106/min
- B. Client who had esophageal dilation and is attempting first postprocedure oral intake.
- C. Client who had an esophagectomy with a respiratory rate of 32/min
- D. Client who underwent hernia repair, reporting incisional pain of 7/10
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.
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.
A client is scheduled for a traditional esophagogastrostomy. All preoperative teaching has been completed and the client and family show good understanding. What action by the nurse is best?
- A. Arrange an intensive care unit tour.
- B. Assess the client's psychosocial status.
- C. Document the teaching and response.
- D. Have the client begin nutritional supplements.
Correct Answer: B
Rationale: Clients facing esophagogastrostomy are often anxious due to the procedure's complexity. Assessing psychosocial status is critical to address anxiety and provide tailored support, making it the best action compared to the more limited scope of the other options.
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.