ANSWERS 100% PASS
What is the pH range of the distal esophagus?
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).
An obese client has reflux and asks how being overweight could cause this condition.
Which response by the nurse is best?
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.
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,Which client does the nurse assess most carefully for the development of
gastroesophageal reflux disease?
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.
A client with esophageal reflux who experiences regurgitation while lying flat is at risk
for which complication?
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.
A client just experienced an episode of reflux with regurgitation. What assessment by
the nurse is the priority?
a. Auscultate the lungs for crackles.
b. Inspect the oral cavity.
c. Check the oxygen saturation.
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,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.
The health care provider is prescribing medication to treat a client's severe
gastroesophageal reflux disease (GERD). Which medication does the nurse anticipate
teaching the client about?
a. Magnesium hydroxide (Gaviscon)
b. Ranitidine (Zantac)
c. Nizatidine (Axid)
d. Omeprazole (Prilosec) - ✔✔ANS: D
Proton pump inhibitors such as omeprazole are the main treatment for more severe
cases of GERD. Gaviscon, Axid, and Zantac can be used to treat less severe cases.
A client is undergoing diagnostic testing for gastroesophageal reflux disease (GERD).
Which test does the nurse tell the client is best for diagnosing this condition?
a. Endoscopy
b. Schilling test
c. 24-Hour ambulatory pH monitoring
d. Stool testing for occult blood - ✔✔ANS: C
The most accurate method of diagnosing gastroesophageal reflux disease is 24-hour
ambulatory pH monitoring.
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, A client has Barrett's esophagus. Which client assessment by the nurse requires
consultation with the health care provider?
a. Sleeping with the head of the bed elevated
b. Coughing when eating or drinking
c. Wanting to eat several small meals during the day
d. Chewing antacid tablets frequently during the day - ✔✔ANS: B
In Barrett's esophagus (a complication of gastroesophageal reflux disease [GERD]),
fibrosis and scarring that accompany the healing process can cause esophageal stricture,
leading to difficulty in swallowing. This can be manifested by coughing when the client
eats or drinks and requires consultation with the health care team. The other
assessments are typical of clients trying to control their GERD.
The nurse is teaching a client about self-management of gastroesophageal reflux. Which
statement by the nurse is most appropriate?
a. "Eat four to six small meals each day."
b. "Eat a small evening snack 1 to 2 hours before bed."
c. "No specific foods or spices need to be cut from your diet."
d. "You may include orange or tomato juice with your breakfast." - ✔✔ANS: A
The client is instructed to eat four to six small meals daily rather than three larger meals
to avoid pressure in the stomach and delayed gastric emptying, which can increase
reflux. Evening snacks and acidic foods also should be avoided. The client should keep
a diary to assess for foods or spices that increase symptoms, and those items need to be
avoided.
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