PNR 309 TEST 2 QUESTIONS AND ANSWERS
Gastro-esophageal reflux disease (GERD) - CORRECT ANSWER✅✅Any clinically significant symptomatic
condition or histopathological alteration presumed to be secondary to reflux of gastric contents into the
lower esophagus.
What is onset for chronic thyroiditis and what causes this? - CORRECT ANSWER✅✅Often asymptomatic
for a long time. Caused by abnormal blood antibodies and WBC attacking/damaging thyroid cells
Predisposing conditions of GERD (4) - CORRECT ANSWER✅✅1. hiatal hernia
2. incompetent lower esophageal sphincter (LES)
3. decreased esophageal clearance from impaired esophageal motility
4. decreased gastric emptying
Complications of GERD - CORRECT ANSWER✅✅Esophagitis (inflammation of the esophagus),
Barrett's esophagus (esophageal metaplasia),
respiratory complications,
aspiration pneumonia,
dental erosion.
Risk factors for Esophagitis - CORRECT ANSWER✅✅hiatal hernia, chemical irritation from lye, and
physical irritants such as smoking, cold or hot liquids, and excessive alcoholic intake. Trauma to the
esophagus may also produce inflammation.
Diagnosing GERD - CORRECT ANSWER✅✅Endoscopy, barium swallow
GERD treatments - CORRECT ANSWER✅✅lifestyle modifications,
nutritional therapy,
drug therapy,
surgical/endoscopy therapy
,What lifestyle modifications are suggested? - CORRECT ANSWER✅✅smoking/alcohol cessation (or at
least avoidance), avoid caffeine, lose weight if able (maintain healthy wt)
What nutritional modifications? - CORRECT ANSWER✅✅decrease high-fat foods, milk products, mints,
carbonated beverages, acidic foods/drinks
Drug therapy for GERD targets what? - CORRECT ANSWER✅✅focused on improving LES function,
increasing esophageal clearance, decreasing volume and acidity of reflux, and protecting the esophageal
mucosa.
What drugs can treat GERD (give name, class)? - CORRECT ANSWER✅✅H2R blockers - Pepsid, Zantac;
PPIs - Losec, Pantoloc, Prevacid;
Antacids - Gaviscon, maalox (mylanta);
Prokinetic drugs - Metoclopramide
Following administration of a dose of metoclopramide to the client, the nurse determines that the
medication has been effective when which of the following is noted?
a) Decreased blood pressure
b) Absence of muscle tremors
c) Relief of nausea and vomiting
d) absence of diarrhea - CORRECT ANSWER✅✅C
The nurse administered a dose of metoclopramide to a client and the client has symptoms of nausea.
The nurse would teach the client to report which of the following potential adverse effects?
a) Tremors
b) Constipation
c) Double vision
d) Numbness in the fingers and nose - CORRECT ANSWER✅✅A - Extrapyramidal adverse effects,
including tremors and dyskinesias, may occur as a result of metoclopramide administration.
,The nurse is caring for a client with a diagnosis of diverticulitis and a history of irritable bowel disease
and gastro-esophageal reflux disease (GERD) who has received a dose of Mylanta 30 mL PO. The nurse
would evaluate its effectiveness by questioning the client as to whether which of the following
symptoms has been resolved?
a) Diarrhea
b) Heartburn
c)constipation
d) Lower abdominal pain - CORRECT ANSWER✅✅B
Hiatal hernia - CORRECT ANSWER✅✅herniation of a portion of the stomach into the esophagus
through an opening (hiatus) in the diaphragm.
Two types of Hiatus Hernia are: - CORRECT ANSWER✅✅sliding and paraesophageal (rolling).
Predisposing factors of herniation - CORRECT ANSWER✅✅increased intra- abdominal pressure
(including obesity, pregnancy, ascites, tumours, tight corsets),
intense physical exertion,
heavy lifting on a continual basis, increased age,
trauma,
poor nutrition,
prolonged bed rest.
**Occurs more often in women
Diagnosing a hiatal hernia - CORRECT ANSWER✅✅xray, barium swallow, endoscopy
Complications with hiatal hernias - CORRECT ANSWER✅✅hemorrhage,
stenosis of esophagus, regurgitation/aspiration,
ulcers in herniated portion of stomach,
, strangulation of hernia.
H Hernia treatments: - CORRECT ANSWER✅✅similar to GERD;
lifestyle modifications, elevate HOB, antacids/H2R blockers, surgical therapy (all variations of
fundoplication)
Esophageal cancer - CORRECT ANSWER✅✅rare malignant neoplasm of the esophagus, of which there
are two types: squamous cell carcinoma and adenocarcinoma
The nurse is caring for a client who is receiving chemotherapy and rings the call bell to report an onset
of nausea. The nurse should prepare a prn dose of which of the following prescribed medications?
a) Morphine sulphate
b) Zolpidem
c)Ondansetron
d) dexamethasone - CORRECT ANSWER✅✅C
After administering a dose of promethazine to a client with nausea and vomiting, the nurse explains that
which of the following may be experienced as a common temporary adverse effect of the medication?
a) Drowsiness
b) Reduced hearing
c) Sensation of falling
d) Photosensitivity - CORRECT ANSWER✅✅A - promethazine also has sedative and amnesic properties.
Gastritis - CORRECT ANSWER✅✅inflammation of the gastric mucosa that may be acute or chronic, and
may be diffuse or localized.
Gastric cancer - CORRECT ANSWER✅✅an adenocarcinoma of the stomach wall.
Gastro-esophageal reflux disease (GERD) - CORRECT ANSWER✅✅Any clinically significant symptomatic
condition or histopathological alteration presumed to be secondary to reflux of gastric contents into the
lower esophagus.
What is onset for chronic thyroiditis and what causes this? - CORRECT ANSWER✅✅Often asymptomatic
for a long time. Caused by abnormal blood antibodies and WBC attacking/damaging thyroid cells
Predisposing conditions of GERD (4) - CORRECT ANSWER✅✅1. hiatal hernia
2. incompetent lower esophageal sphincter (LES)
3. decreased esophageal clearance from impaired esophageal motility
4. decreased gastric emptying
Complications of GERD - CORRECT ANSWER✅✅Esophagitis (inflammation of the esophagus),
Barrett's esophagus (esophageal metaplasia),
respiratory complications,
aspiration pneumonia,
dental erosion.
Risk factors for Esophagitis - CORRECT ANSWER✅✅hiatal hernia, chemical irritation from lye, and
physical irritants such as smoking, cold or hot liquids, and excessive alcoholic intake. Trauma to the
esophagus may also produce inflammation.
Diagnosing GERD - CORRECT ANSWER✅✅Endoscopy, barium swallow
GERD treatments - CORRECT ANSWER✅✅lifestyle modifications,
nutritional therapy,
drug therapy,
surgical/endoscopy therapy
,What lifestyle modifications are suggested? - CORRECT ANSWER✅✅smoking/alcohol cessation (or at
least avoidance), avoid caffeine, lose weight if able (maintain healthy wt)
What nutritional modifications? - CORRECT ANSWER✅✅decrease high-fat foods, milk products, mints,
carbonated beverages, acidic foods/drinks
Drug therapy for GERD targets what? - CORRECT ANSWER✅✅focused on improving LES function,
increasing esophageal clearance, decreasing volume and acidity of reflux, and protecting the esophageal
mucosa.
What drugs can treat GERD (give name, class)? - CORRECT ANSWER✅✅H2R blockers - Pepsid, Zantac;
PPIs - Losec, Pantoloc, Prevacid;
Antacids - Gaviscon, maalox (mylanta);
Prokinetic drugs - Metoclopramide
Following administration of a dose of metoclopramide to the client, the nurse determines that the
medication has been effective when which of the following is noted?
a) Decreased blood pressure
b) Absence of muscle tremors
c) Relief of nausea and vomiting
d) absence of diarrhea - CORRECT ANSWER✅✅C
The nurse administered a dose of metoclopramide to a client and the client has symptoms of nausea.
The nurse would teach the client to report which of the following potential adverse effects?
a) Tremors
b) Constipation
c) Double vision
d) Numbness in the fingers and nose - CORRECT ANSWER✅✅A - Extrapyramidal adverse effects,
including tremors and dyskinesias, may occur as a result of metoclopramide administration.
,The nurse is caring for a client with a diagnosis of diverticulitis and a history of irritable bowel disease
and gastro-esophageal reflux disease (GERD) who has received a dose of Mylanta 30 mL PO. The nurse
would evaluate its effectiveness by questioning the client as to whether which of the following
symptoms has been resolved?
a) Diarrhea
b) Heartburn
c)constipation
d) Lower abdominal pain - CORRECT ANSWER✅✅B
Hiatal hernia - CORRECT ANSWER✅✅herniation of a portion of the stomach into the esophagus
through an opening (hiatus) in the diaphragm.
Two types of Hiatus Hernia are: - CORRECT ANSWER✅✅sliding and paraesophageal (rolling).
Predisposing factors of herniation - CORRECT ANSWER✅✅increased intra- abdominal pressure
(including obesity, pregnancy, ascites, tumours, tight corsets),
intense physical exertion,
heavy lifting on a continual basis, increased age,
trauma,
poor nutrition,
prolonged bed rest.
**Occurs more often in women
Diagnosing a hiatal hernia - CORRECT ANSWER✅✅xray, barium swallow, endoscopy
Complications with hiatal hernias - CORRECT ANSWER✅✅hemorrhage,
stenosis of esophagus, regurgitation/aspiration,
ulcers in herniated portion of stomach,
, strangulation of hernia.
H Hernia treatments: - CORRECT ANSWER✅✅similar to GERD;
lifestyle modifications, elevate HOB, antacids/H2R blockers, surgical therapy (all variations of
fundoplication)
Esophageal cancer - CORRECT ANSWER✅✅rare malignant neoplasm of the esophagus, of which there
are two types: squamous cell carcinoma and adenocarcinoma
The nurse is caring for a client who is receiving chemotherapy and rings the call bell to report an onset
of nausea. The nurse should prepare a prn dose of which of the following prescribed medications?
a) Morphine sulphate
b) Zolpidem
c)Ondansetron
d) dexamethasone - CORRECT ANSWER✅✅C
After administering a dose of promethazine to a client with nausea and vomiting, the nurse explains that
which of the following may be experienced as a common temporary adverse effect of the medication?
a) Drowsiness
b) Reduced hearing
c) Sensation of falling
d) Photosensitivity - CORRECT ANSWER✅✅A - promethazine also has sedative and amnesic properties.
Gastritis - CORRECT ANSWER✅✅inflammation of the gastric mucosa that may be acute or chronic, and
may be diffuse or localized.
Gastric cancer - CORRECT ANSWER✅✅an adenocarcinoma of the stomach wall.
