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The nurse is caring for an adult client diagnosed with GERD. Which condition is the most common comorbid disease associated with GERD?
- A. Adult-onset asthma.
- B. Pancreatitis.
- C. Peptic ulcer disease.
- D. Increased gastric emptying.
Correct Answer: A
Rationale: GERD is commonly associated with adult-onset asthma due to acid reflux irritating the airways, leading to bronchospasm. Pancreatitis and peptic ulcer disease are less directly linked, and increased gastric emptying is not a typical comorbidity.
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A client is found to have colon cancer. An abdominoperineal resection and colostomy are scheduled. Neomycin is ordered. The nurse explains to the client that the primary purpose for administering this drug is to:
- A. decrease peristalsis in the intestines.
- B. decrease the bacterial content in the colon.
- C. reduce inflammation of the bowel.
- D. help prevent postoperative pneumonia.
Correct Answer: B
Rationale: Neomycin, a poorly absorbed antibiotic, reduces bacterial content in the colon to prevent postoperative infections like peritonitis.
The client is admitted to the hospital complaining of malaise, abdominal discomfort, and severe diarrhea. The diagnosis is possible Crohn's disease. The client says that he has lost 27 pounds in the last four months even though he has not been dieting. To plan nursing care, which assessment data are most essential for the nurse to obtain?
- A. Approximate number and characteristics of stools each day
- B. Amount of liquid consumed daily
- C. History of previous gastric surgery
- D. Bowel sounds in the right lower quadrant
Correct Answer: A
Rationale: Frequent stools are characteristic of Crohn’s disease, and their number and characteristics are critical for assessing dehydration and skin breakdown risks.
The nurse is administering a proton pump inhibitor to a client diagnosed with peptic ulcer disease. Which statement supports the rationale for administering this medication?
- A. It prevents the final transport of hydrogen ions into the gastric lumen.
- B. It blocks receptors controlling hydrochloric acid secretion by the parietal cells.
- C. It protects the ulcer from the destructive action of the digestive enzyme pepsin.
- D. It neutralizes the hydrochloric acid secreted by the stomach.
Correct Answer: A
Rationale: Proton pump inhibitors (PPIs) inhibit the H+/K+ ATPase pump, preventing hydrogen ion transport into the gastric lumen, thus reducing acid production to promote ulcer healing. Blocking receptors is for H2 antagonists, pepsin protection is for mucosal agents, and neutralization is for antacids.
The occupational health nurse is preparing a presentation to a group of factory workers about preventing colon cancer. Which information should be included in the presentation?
- A. Wear a high-filtration mask when around chemicals.
- B. Eat several servings of cruciferous vegetables daily.
- C. Take a multiple vitamin every day.
- D. Do not engage in high-risk sexual behaviors.
Correct Answer: B
Rationale: Cruciferous vegetables (e.g., broccoli, cauliflower) are high in fiber and antioxidants, which may reduce colon cancer risk. Masks, vitamins, and sexual behaviors are less directly linked to colon cancer prevention.
The client is admitted to a hospital for medical management of acute diverticulitis. The nurse should anticipate that this client’s treatment plan will include which component?
- A. NPO (nothing per mouth) status
- B. Frequent ambulation
- C. Prescribed antibiotics
- D. Antiemetic medication
- E. Deep breathing every 2 hours
Correct Answer: A, C
Rationale: The nurse should plan for the client to be NPO. Medical management for diverticulitis includes resting the bowel. NPO status will help to achieve this. B. Ambulation is not encouraged; resting the body promotes bowel rest. C. Broad-spectrum antibiotics effective against known enteric pathogens are used in treating every stage of diverticulitis. D. Nausea is not a concern with diverticulitis. E. The client did not have surgery; there is no need for deep breathing every 2 hours.