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Which will the nurse include when reinforcing the teaching plan for a patient with a hiatal hernia to reduce the frequency of heartburn?
- A. Drinking 10 oz of milk with every meal
- B. Lie down after eating
- C. Panting through mouth when symptoms begin
- D. Eating small meals
Correct Answer: D
Rationale: Taking care not to overeat is the best defense against pyrosis (heartburn) for the person with a hiatal hernia.
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The nurse caring for a patient with a peptic ulcer who has had a nasogastric tube inserted notes bright blood in the tube, the patient complains of pain and has become hypotensive. Which condition should the nurse recognize these as signs of?
- A. Hiatal hernia
- B. Gastritis
- C. Perforation
- D. Bowel obstruction
Correct Answer: C
Rationale: Perforation of the gastric wall causes pain, hypotension, and hematemesis. Immediate reporting to the charge nurse/physician is essential as peritonitis, potentially lethal, is the result of a perforation.
The nurse takes into consideration that a proton pump inhibitor drug, such as which drug, will completely eradicate gastric acid production?
- A. omeprazole
- B. misoprostol
- C. sucralfate
- D. olsalazine
Correct Answer: A
Rationale: Omeprazole is a proton pump inhibitor that interferes with the production of gastric acid.
Which recommendation is most appropriate for a patient who has had an esophageal dilation related to achalasia?
- A. Consume only liquid.
- B. Avoid fruit juices.
- C. Drink 10 oz of fluid with each meal.
- D. Lie down for 30 minutes after each meal.
Correct Answer: C
Rationale: The patient should drink fluid with each meal to increase lower esophageal pressure to push food into the stomach.
The home health nurse is caring for a patient who has frequent bouts of diverticulitis accompanied by increased flatulence, diarrhea, and nausea. Which is the most appropriate suggestion to lessen these symptoms?
- A. Eat a diet high in fiber content.
- B. Increase dietary fat intake.
- C. Exercise to increase intraabdominal pressure.
- D. Take daily laxatives.
Correct Answer: A
Rationale: The symptoms of diverticulitis can be reduced or prevented by eating a high-fiber diet, reduction of meat and fats in the diet, and avoiding activities that increase intraabdominal pressure. Although laxatives might be prescribed sparingly, daily laxatives are not recommended.
In reinforcing a teaching plan to present to a group of older adults regarding the prevention of esophageal cancer, the nurse would include which significant information?
- A. cessation of smoking.
- B. Frequent monitoring for Barrett's esophagus
- C. regular checkups if dysphagia is present.
- D. reducing excessive weight.
- E. limiting alcohol consumption.
- F. reduction of consumption of citrus fruits.
Correct Answer: A,B,C,E
Rationale: Preventive measures include cessation of smoking and alcohol consumption, monitoring for Barrett's esophagus, and medical evaluation of dysphagia. Weight and reduction of citrus fruits are noncontributory to prevention of esophageal cancer.