Nokea
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?
- A. Bacteria can often cause ulcers.
- B. This operation often causes ulcers.
- C. The medication keeps your blood pH.
- D. It prevents stress-related ulcers.
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.
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The nurse is working with clients who have esophageal disorders. The nurse should assess the clients for which assessment. (Select all that apply.)
- A. Aphasia
- B. Dysphagia
- C. Eructation
- D. Halitosis
- E. Weight gain
Correct Answer: B,C,D
Rationale: Esophageal disorders commonly cause dysphagia (difficulty swallowing), eructation (belching), halitosis (bad breath), and weight loss. Aphasia is unrelated, as it involves speech difficulties typically from neurological issues.
The nurse is caring for a client who had an esophagectomy 3 days ago and was extubated yesterday. What actions may the nurse delegate to the unlicensed assistive personnel (UAP)? (Select all that apply.)
- A. Assisting with position changes and getting out of bed
- B. Keeping the head of the bed elevated to at least 30
- C. Turning the client
- D. Reminding the client to use the spirometer every 4 hours
- E. Taking and recording vital signs per hospital protocol
- F. Titrating oxygen based on the client oxygen saturations
Correct Answer: A,B,D
Rationale: UAPs can assist with mobility, maintain bed elevation, and remind about spirometer use (though it should be every 1-2 hours). Oxygen titration requires nursing judgment and cannot be delegated.
The nurse is aware that which factors are related to the development of gastroesophageal reflux disease (GERD)? (Select all that apply.)
- A. Delayed gastric emptying
- B. Eating large meals
- C. Hiatal hernia
- D. Obesity
- E. Viral infections
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.
A client with an esophageal tumor has difficulty swallowing and has been working with a speech-language pathologist. What assessment finding by the nurse indicates that the priority goal for this problem is being met?
- A. Choosing foods that are easy to swallow
- B. A length of the swallowing is being
- C. Properly performing swallowing
- D. Weight unchanged after 2 weeks
Correct Answer: B
Rationale: The priority goal for a client with an esophageal tumor and difficulty swallowing is preventing aspiration. Clear lungs after eating (implied by 'A length of the swallowing is being' in the context) indicate no aspiration, which is the priority over other findings.
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.