Nokea
Which of the following information should the nurse plan to teach to a patient with newly diagnosed achalasia?
- A. A liquid or blenderized diet will be necessary.
- B. Drinking fluids with meals should be avoided.
- C. Endoscopic procedures may be used for treatment.
- D. Lying down and resting after meals is recommended.
Correct Answer: C
Rationale: Endoscopic and laparoscopic procedures are the most effective therapy for improving symptoms caused by achalasia. Patients are advised to drink fluid with meals. Keeping the head elevated after eating will improve esophageal emptying. A semisolid diet is recommended to improve esophageal emptying.
You may also like to solve these questions
The nurse is caring for an older-adult patient who has been diagnosed with esophageal cancer and the patient tells the nurse, 'I know that my chances are not very good, but I do not feel ready to die yet.' Which of the following responses by the nurse is best?
- A. You may have quite a few years still left to live.
- B. Thinking about dying will only make you feel worse.
- C. Having this new diagnosis must be very hard for you.
- D. It is important that you be realistic about your prognosis.
Correct Answer: C
Rationale: This response is open-ended and will encourage the patient to further discuss feelings of anxiety or sadness about the diagnosis. Patients with esophageal cancer have only a low survival rate, so the response 'You may have quite a few years still left to live' is misleading. The response beginning, 'Thinking about dying' indicates that the nurse is not open to discussing the patient's fears of dying. And the response beginning, 'It is important that you be realistic,' discourages the patient from feeling hopeful, which is important to patients with any life-threatening diagnosis.
The nurse is caring for a patient with peptic ulcer disease associated with the presence of Helicobacter pylori and is being treated with triple drug therapy. Which of the following medications should the nurse include in the patient teaching?
- A. Sucralfate, nystatin, and bismuth
- B. Amoxicillin, clarithromycin, and omeprazole
- C. Famotidine, magnesium hydroxide, and pantoprazole
- D. Metoclopramide, bethanechol, and promethazine
Correct Answer: B
Rationale: The drugs used in triple drug therapy include a proton pump inhibitor such as omeprazole and the antibiotics amoxicillin and clarithromycin. The other combinations listed are not included in the protocol for H. pylori infection.
The nurse is caring for a patient with stomach cancer who had a recent 9.1 kg unintended weight loss. Which of the following nursing actions should be included in the plan of care?
- A. Refer the patient for hospice services.
- B. Infuse IV fluids through a central line.
- C. Teach the patient about antiemetic therapy
- D. Offer supplemental feedings between meals.
Correct Answer: D
Rationale: The patient data indicate a poor nutritional state and improvement in nutrition will be helpful in improving response to therapies such as surgery, chemotherapy, or radiation. Nausea and vomiting are not common clinical manifestations of stomach cancer. There is no indication that the patient requires hospice or IV fluid infusions.
The nurse is caring for a patient who has just arrived on the postoperative unit after having a laparoscopic esophagectomy for treatment of esophageal cancer. Which of the following nursing actions should be included in the postoperative plan of care?
- A. Elevate the head of the bed to at least 30 degrees.
- B. Reposition the nasogastric (NG) tube if drainage stops or decreases.
- C. Notify the doctor immediately about bloody NG drainage.
- D. Start oral fluids when the patient has active bowel sounds.
Correct Answer: A
Rationale: Elevation of the head of the bed decreases the risk for reflux and aspiration of gastric secretions. The patient should be in the Fowler's or semi-Fowler's position. The NG tube should not be repositioned without consulting with the health care provider. Bloody NG drainage is expected for the first 8-12 hours. A swallowing study is needed before oral fluids are started.
The nurse is teaching a patient with gastroesophageal reflux disease (GERD) about recommended dietary modifications. Which of the following diet choices for a snack 2 hours before bedtime indicates that the teaching has been effective?
- A. Chocolate pudding
- B. Glass of low-fat milk
- C. Peanut butter sandwich
- D. Cherry gelatin and fruit
Correct Answer: D
Rationale: Cherry gelatin and fruit is a suitable choice as it is low in fat and not likely to trigger reflux, unlike chocolate, milk, or high-fat foods like peanut butter, which can exacerbate GERD symptoms.