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Evolve NCLEX test – gi with Questions & 100% Correct Answers
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Evolve NCLEX test – gi with Questions &100% Correct Answers
A client with gastroesophageal reflux disease (GERD) is prescribed to start pantoprazole
(Protonix) 40 mg every day. Which statement by the client requires further teaching by
the nurse?
A. "When I feel better, I can stop taking this drug."
B. "I'll take this drug at 8 AM every morning."
C. "This drug can cause headache and dizziness."
D. "I should not crush the drug because it has a delayed release." - ANSWER Answer: A
Rationale: Treatment for GERD should be continued even if a client begins to feel better.
Discontinuation of therapy can result in return of original GERD symptoms, which can further
damage esophageal tissues. Side effects of pantoprazole (Protonix) can include headache and
dizziness, which should immediately be reported to the client's health care provider. This
medication should be taken on a regular, predictable schedule because proton pump
inhibitors provide effective, long-acting inhibition of gastric acid secretion by affecting the
proton pump of the gastric parietal cells. This medication should not be crushed because of its
delayed release properties.
Over the past 3 months, a client with a history of gastroesophageal reflux disease and
obesity has implemented lifestyle changes. What lifestyle changes does the nurse recognize
as important for the client to decrease chances of development of cancer of the esophagus?
Select all that apply.
A. Lost 10 pounds
, B. Sleeps with two pillows
C. Has quit eating processed foods
D. Drinks a glass of wine every night
E. Uses a nicotine patch instead of smoking - ANSWER Answer: A, B, C, E
Rationale: Losing weight can result in a decrease in intra-abdominal pressure, which can reduce
the symptoms of reflux that are associated with an increased risk for development of
esophageal cancer. Nocturnal reflux can be reduced by sleeping with the head of the bed
elevated or with the use of two pillows. Chemicals used in processed foods, as well as smoking,
can contribute to an increased risk for esophageal (and other types of) cancer. Excessive alcohol
intake is associated with esophageal cancer.
The nurse has been assigned to provide care for four clients at the beginning of the day shift.
In what order does the nurse assess these clients?
A. A client planned for an esophagogastroduodenoscopy (EGD) at 1 PM (1300)
B. A client requesting pain medication 2 days after a partial gastrectomy
C. A client with peptic ulcer disease experiencing a sudden onset of acute stomach pain
D. A client who is NPO for tests to rule out gastric cancer - ANSWER Answer: C, B, A, D
Rationale: A client with peptic ulcer disease experiencing a sudden onset of acute stomach
pain is at risk for local gastric mucosal injury. Peptic ulcer perforation is a surgical emergency
and can be life threatening; therefore, this client should be seen first. The client who had a
gastrectomy is not expected to have moderate to severe pain 2 days after surgery and may be
experiencing a complication. Therefore, this client should be assessed next. Although the client
scheduled for an EGD and the client who is NPO are both scheduled for testing and do not
require immediate attention, the client having an EGD needs to receive pretest care in
preparation for this invasive procedure for which moderate sedation will be required. The last
client to be assessed is the one who is not yet scheduled for testing at a specific time.
When taking a history of a client diagnosed with a gastric ulcer, which assessment findings does
the nurse expect? Select all that apply.
A. Vomiting
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