Medical Surgical Nursing Patient Centered Collaborative Care, 7th Edition by Donna D.
Medical Surgical Nursing Patient Centered Collaborative Care, 7th Edition by Donna D.
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Chapter 57: Care of Patients with Esophageal Problems
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
MULTIPLE CHOICE
| a. | 1.5 to 2.0 |
| b. | 3.0 to 4.5 |
| c. | 4.5 to 6.0 |
| d. | 6.0 to 7.0 |
ANS: D
The pH of the lower esophagus is neutral (normal).
DIF: Cognitive Level: Knowledge/Remembering REF: p. 1204
TOP: Client Needs Category: Physiological Integrity (Physiological Adaptation—Pathophysiology)
MSC: Integrated Process: Nursing Process (Assessment)
| a. | “You eat more food, more often, than nonobese people do.” |
| b. | “The weight adds extra pressure, which helps push stomach contents up.” |
| c. | “Obese people tend to eat more high-fat food, which presents a risk.” |
| d. | “Obesity is not related to reflux, but losing weight would be healthy.” |
ANS: B
Esophageal reflux can occur when intra-abdominal pressure is elevated, or when the sphincter tone of the lower esophageal sphincter (LES) is decreased. Obesity can increase intra-abdominal pressure. The other statements are not accurate explanations of the connection between obesity and reflux.
DIF: Cognitive Level: Comprehension/Understanding REF: p. 1204
TOP: Client Needs Category: Physiological Integrity (Reduction of Risk Potential—Potential for Alterations in Body Systems) MSC: Integrated Process: Teaching/Learning
| a. | Client with atrial fibrillation who drinks decaffeinated coffee |
| b. | Client who has lost 20 pounds through diet and exercise |
| c. | Diabetic client taking oral hypoglycemic agents |
| d. | Postoperative client who has a nasogastric (NG) tube |
ANS: D
A nasogastric tube keeps the cardiac sphincter open, allowing acidic contents from the stomach to enter the esophagus. The other clients do not have increased risk for gastroesophageal reflux.
DIF: Cognitive Level: Application/Applying or higher REF: N/A
TOP: Client Needs Category: Physiological Integrity (Reduction of Risk Potential—Potential for Complications from Diagnostic Tests/Treatments/Procedures)
MSC: Integrated Process: Nursing Process (Assessment)
| a. | Erosion |
| b. | Bleeding |
| c. | Aspiration |
| d. | Odynophagia |
ANS: C
Regurgitation of stomach contents while the client is recumbent poses a risk of aspiration for the client.
DIF: Cognitive Level: Knowledge/Remembering REF: p. 1205
TOP: Client Needs Category: Physiological Integrity (Reduction of Risk Potential—Potential for Complications from Surgical Procedures and Health Alterations)
MSC: Integrated Process: Nursing Process (Planning)
| a. | Auscultate the lungs for crackles. |
| b. | Inspect the oral cavity. |
| c. | Check the oxygen saturation. |
| d. | Teach the client to sleep sitting up. |
ANS: A
The client with regurgitation is at risk for aspiration, pneumonia, and bronchitis. The nurse should auscultate the lungs for crackles—an indication of aspiration. If abnormalities are found, the nurse can then check the oxygen saturation. The nurse should teach the client to sleep with the head of the bed elevated, however; this is not a priority action. Inspecting the oral cavity probably is not needed.
DIF: Cognitive Level: Application/Applying or higher REF: N/A
TOP: Client Needs Category: Safe and Effective Care Environment (Management of Care—Establishing Priorities) MSC: Integrated Process: Nursing Process (Assessment)
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