GERD NCLEX questions and answers 2023/2024

GERD NCLEX questions The nurse explains to the patient with gastroesophageal reflux disease that this disorder: A. results in acid erosion and ulceration of the esophagus caused by frequent vomiting, B. will require surgical wrapping or repair of the pyloric sphincter to control the symptoms, C. is the protrusion of a portion of the stomach into to esophagus through an opening in the diaphragm, D. often involves relaxation of the lower esophageal sphincter, allowing stomach contents to back up into the espophagus - ANSWER D. The acidic contents of the stomach touching the inside of the esophagus are responsible for the physical sensation known as "heart-burn" that is a cardinal symptom of GERD "Which of the following types of gastritis is associated with Helicobacter pylori and duodenal ulcers? 1. Erosive (hemorrhagic) gastritis 2. Fundic gland gastritis (type A) 3. Antral gland gastritis (type B) 4.Aspiring-induced gastric ulcer - ANSWER 3 - Erosive (hemorrhagic) gastritis can be caused by ingestion of substances that irritate the gastric mucosa. Fundic gland gastritis (type A) is associated with diffuse severe mucosal atrophy and the presence of pernicious anemia. Antral gland gastritis (type B) is the most common form of gastritis, and is associated with Helicobacter pylori and duodenal ulcers Gastroesophageal reflux disease (GERD) weakens the lower esophageal sphincter, predisposing older persons to risk for impaired swallowing. In managing the symptoms associated with GERD, the nurse should assign the highest priority to which of the following interventions? 1. Decrease daily intake of vegetables and water, and ambulate frequently 2. Drink coffee diluted with milk at each meal, and remain in an upright position for 30 minutes. 3. Eat small, frequent meals, and remain in an upright position for at least 30 minutes after eating 4. Avoid over-the-counter drugs that have antacids in them - ANSWER Answer 3, Eating small and frequent meals requires less release of hydrochloric acid. Remaining in an upright position for 30 minutes after meals prevents reflux into the esophagus which is often exacerbated when lying down, expecially after a large meal which makes the patient tired The client with a hiatal hernia chronically experiences heartburn following meals. The nurse plans to teach the client to avoid which action because it is contraindicated with hiatal hernia? 1. Lying recumbent following meals 2. Taking in small, frequent, bland meals 3. Raising the head of the bed on 6-inch blocks 4. Taking H2-receptor antagonist medication - ANSWER Correct answer: 1 Laying recumbant following meals or at night will cause reflux and pain. Relief is usually achieved with the intake of small, bland meals, use of H2 receptor antagonists and antacids, and elevation of the thorax after meals and during sleep What response should a nurse offer to a client who asks why he's having a vagotomy to treat his ulcer? 1. To repair a hole in the stomach 2. to reduce the ability of the stomach to produce acid 3. to prevent the stomach from sliding into the chest 4. to remove a potentially malignant lesion in the stomach - ANSWER Answer 2: A vagotomy is perfomred to elimniate the acid-secreting stimulus to gastric cells. a perforation would be repaired with a gastric resection. Repair of hiatal hernia (fundoplication) prevents the stomach from sliding through the diaphragm. Removal of a potentially malignant tumor wouldn't reduce the entire acid-producing mechanism Which assessment data support the client's diagnosis of gastric ulcer? 1. Presence of blood in the client's stool for the past month. 2.Complaints of a burning sensation that moves like a wave. 3.Sharp pain in the upper abdomen after eating a heavy meal. 4.Comparison of complaints of pain with ingestion of food and sleep - ANSWER "1. The presence of blood does not specifically indicate diagnosis of an ulcer. The client could have hemorrhoids or cancer that would result in the presence of blood. 2. A wavelike burning sensation is a symptom of gastroesophageal reflus. 3. Sharp pain in the upper abdomen after eating a heavy meal is a symptom of gallbladder disease. 4. (CORRECT) In a client diagosed with a gastric ulcer, pain usually occurs 30-60 minutes after eating, but not at night. In contrast, a client with duodenal ulcer has pain durin ghte night that is often relieved by eating food. Pain occurs 1-3 hours after meals When assessing the client with the diagnosis of peptic ulcer disease, which physical examination should the nurse implement first? 1. Auscultate the client's bowel sounds in all four quadrants. 2.Palpate the abdominal area for tenderness. 3.Percuss the abdominal borders to identify organs. 4.Assess the tender area progressing to nontender - ANSWER Correct answer: #1. Auscultation should be used prior to palpa-tion or percussion when assessing the abdomen. If the nurse manipulates the abdomen, the bowel sounds can be altered and give false information The nurse is monitoring a client with a diagnosis of peptic ulcer. Which assessment finding would most likely indicate perforation of the ulcer? 1. Bradycardia 2. Numbness in the legs 3. Nausea and vomiting 4. A rigid, board-like abdomen - ANSWER Answer 4, Perforation of an ulcer is a surgical emergency and is characterized by sudden, sharp, intolerable severe pain beginning in the midepigastric area and spreading over the abdomen, which become rigid and board-like. Nausea and vomiting may occur. Tachycardia may occur as hypovolemic shock develops. Numbness in the legs is not an associated finding Which of the following nursing interventions should the nurse perform for a female client receiving enteral feedings through a gastrostomy tube? a. Change the tube feeding solutions and tubing at least every 24 hours b. Maintain the head of the bed at a 15-degree elevation continuously. c. Check the gastrostomy tube for position every 2 days. d. Maintain the client on bed rest during the feedings - ANSWER Answer A, Answer A. Tube feeding solutions and tubing should be changed every 24 hours, or more frequently if the feeding requires it. Doing so prevents contamination and bacterial growth. The head of the bed should be elevated 30 to 45 degrees continuously to prevent aspiration. Checking for gastrostomy tube placement is performed before initiating the feedings and every 4 hours during continuous feedings. Clients may ambulate during feedings The nurse is teaching the patient a client with a peptic ulcer discharge instructions. The client asks the nurse which type of analgesic he may take. Which of the following responses by the nurse would be most accurate? 1. Aspirin 2. Acetaminophen 3. Naproxen 4. Ibuprofen - ANSWER 2.Acetaminophen is recommended for pain relief because it does no promote irritation of the mucosa. Aspirin, and nonsteroidal antiinflammatory drugs suchs as naproxen and ibuprofen, may cause irritation of the mucosa and subsequent bleeding