Nursing Elites

1. The nurse is planning to teach the client with gastroesophageal reflux disease about substances that will increase the lower esophageal sphincter pressure. Which of the following items would the nurse include on this list?

• A. Fatty foods
• B. Nonfat milk
• C. Chocolate
• D. Coffee

Correct answer: B

Rationale: Foods that increase the lower esophageal sphincter (LES) pressure will decrease reflux, and lessen the symptoms of gastroesophageal reflux disease (GERD). The food substance that will increase the LES pressure is nonfat milk. The other substances listed decrease the LES pressure, thus increasing reflux symptoms. Aggravating substances include chocolate, coffee, fatty foods and alcohol.

2. The client with GERD complains of a chronic cough. The nurse understands that in a client with GERD this symptom may be indicative of which of the following conditions?

• A. Development of laryngeal cancer
• B. Irritation of the esophagus
• C. Esophageal scar tissue formation
• D. Aspiration of gastric contents

Correct answer: D

Rationale: Aspiration of gastric contents can lead to a chronic cough in clients with GERD.

3. The nurse is doing an admission assessment on a client with a history of duodenal ulcer. To determine whether the problem is currently active, the nurse would assess the client for which of the following most frequent symptom(s) of duodenal ulcer?

• A. Pain that is relieved by food intake
• B. Pain that radiated down the right arm
• C. N/V
• D. Weight loss

Correct answer: A

Rationale: Pain that is relieved by food intake is the most frequent symptom of duodenal ulcers because the food neutralizes the stomach acid.

4. What information is correct about stomach cancer?

• A. Stomach pain is often a late symptom.
• B. Surgery is often a successful treatment.
• C. Chemotherapy and radiation are often successful treatments.
• D. The patient can survive for an extended time with TPN.

Correct answer: A

Rationale: Stomach pain is often a late symptom of stomach cancer.

5. During the assessment of a client’s mouth, the nurse notes the absence of saliva. The client is also complaining of pain near the area of the ear. The client has been NPO for several days because of the insertion of an NG tube. Based on these findings, the nurse suspects that the client is developing which of the following mouth conditions?

• A. Stomatitis
• B. Oral candidiasis
• C. Parotitis
• D. Gingivitis

Correct answer: C

Rationale: The correct answer is C, Parotitis. Parotitis, inflammation of the parotid glands, can occur due to the absence of saliva and dehydration, often associated with being NPO and having an NG tube. Stomatitis (choice A) is inflammation of the oral mucosa, not specifically related to absent saliva. Oral candidiasis (choice B) is a fungal infection that can occur in the mouth, not directly related to the absence of saliva. Gingivitis (choice D) is inflammation of the gums and is not typically associated with the absence of saliva and dehydration.

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