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LEWIS MEDICAL SURGICAL NURSING: CHAP 46 UPPER GI PROBLEMS QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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LEWIS MEDICAL SURGICAL NURSING: CHAP 46 UPPER GI PROBLEMS QUESTIONS AND ANSWERS WITH SOLUTIONS 2024

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  • August 31, 2024
  • 14
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

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  • lewis medical surgical nursing chap 46 upper gi p

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LEWIS MEDICAL SURGICAL NURSING:
CHAP 46 UPPER GI PROBLEMS
QUESTIONS AND ANSWERS WITH
SOLUTIONS 2024
After change-of-shift report, which patient would the nurse assess first?

a. A 42-yr-old patient who has acute gastritis and ongoing epigastric pain

b. A 70-yr-old patient with a hiatal hernia who experiences frequent heartburn c. A 60-yr-old patient
with nausea and vomiting who is lethargic with dry mucosa

d. A 53-yr-old patient who has dumping syndrome after a recent partial gastrectomy - ANSWER ANS: C A
patient with nausea and vomiting who is lethargic with dry mucosa is at high risk for problems such as
aspiration, dehydration, and fluid and electrolyte disturbances. The other patients will also need to be
assessed, but the information about them indicates symptoms that are typical for their diagnoses and
are not life threatening.



Which item would the nurse offer to the patient restarting oral intake after being NPO due to nausea and
vomiting?

a. Glass of orange juice

b. Dish of lemon gelatin

c. Cup of coffee with cream

d. Bowl of hot chicken broth - ANSWER ANS: B Clear cool liquids are usually the first foods started after a
patient has been nauseated. Acidic foods such as orange juice, very hot foods, and coffee are poorly
tolerated when patients have been nauseated.



A woman receiving chemotherapy for breast cancer develops a Candida albicans oral infection. Which
intervention would the nurse anticipate?

a. Nystatin tablets

b. Antiviral agents

c. Referral to a dentist

d. Hydrogen peroxide rinses - ANSWER ANS: A C. albicans infections are treated with an antifungal such
as nystatin. Peroxide rinses would be painful. Oral saltwater rinses may be used but will not cure the
infection. Antiviral agents are used for viral infections such as herpes simplex. Referral to a dentist is
indicated for gingivitis but not for Candida infection

, Which finding in the mouth of a patient who uses smokeless tobacco is suggestive of oral cancer?

a. Bleeding during tooth brushing

b. Painful blisters at the lip border

c. Red patches on the buccal mucosa

d. Curdlike plaques on the posterior tongue - ANSWER ANS: C A red, velvety patch suggests
erythroplasia, which has a high incidence (>50%) of progression to squamous cell carcinoma. The other
lesions are suggestive of acute processes (e.g., gingivitis, oral candidiasis, herpes simplex).



Which information will the nurse include when teaching adults to decrease the risk for cancers of the
tongue and buccal mucosa?

a. Use sunscreen even on cloudy days.

b. Avoid cigarettes and smokeless tobacco.

c. Complete antibiotic courses used to treat throat infections.

d. Use antivirals to treat herpes simplex virus (HSV) infections - ANSWER ANS: B Tobacco use greatly
increases the risk for oral cancer. Acute throat infections do not increase the risk for oral cancer,
although chronic irritation of the oral mucosa does increase risk. Sun exposure does not increase the risk
for cancers of the buccal mucosa, although it increases risk for cancer of the lip. Human papillomavirus
(HPV) infection is associated with an increased risk, but HSV infection is not a risk factor for oral cancer



A patient who has gastroesophageal reflux disease (GERD) is experiencing increasing discomfort. Which
patient statement to the nurse indicates a need for additional teaching about GERD?

a. ―I quit smoking years ago, but I chew gum.‖

b. ―I eat small meals and have a bedtime snack.‖

c. ―I take antacids between meals and at bedtime each night.‖

d. ―I sleep with the head of the bed elevated on 4-inch blocks.‖ - ANSWER ANS: B GERD is exacerbated
by eating late at night, and the nurse would plan to teach the patient to avoid eating within 3 hours of
bedtime. Smoking cessation, taking antacids, and elevating the head of the bed are appropriate actions
to control symptoms of GERD.



A patient with a stroke is unconscious and unresponsive to stimuli. After learning that the patient has a
history of gastroesophageal reflux disease (GERD), which assessment would the nurse plan to make
more frequently than is routine?

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