During a clinic visit the client provides all of the following health

Gastrointestinal NCLEX

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Question 1 of 5.

During a clinic visit the client provides all of the following health history information. Which client statement should be most concerning to the nurse because it could describe a symptom of esophageal cancer?

A. â€œI have been having a lot of indigestion lately.â€

B. â€œWhen I eat meat, it seems to get stuck halfway down.â€

C. â€œI have been waking up at night lately with chest pain.â€

D. â€œI gained weight, even though I have not changed my diet.â€

Explanation: A. Indigestion is not a symptom of esophageal cancer. B. Progressive dysphagia is the most common symptom associated with esophageal cancer, and it is initially experienced when eating meat. It is often described as a feeling that food is not passing. C. Chest pain is not a symptom of esophageal cancer. D. Weight loss rather than gain is a symptom of esophageal cancer.

Question 2 of 5.

The nurse caring for a client diagnosed with GERD writes the client problem of 'behavior modification.' Which intervention should be included for this problem?

A. Teach the client to sleep with a foam wedge under the head.

B. Encourage the client to decrease the amount of smoking.

C. Instruct the client to take over-the-counter medication for relief of pain.

D. Discuss the need to attend Alcoholics Anonymous to quit drinking.

Explanation: Sleeping with a foam wedge elevates the head, reducing reflux by preventing stomach acid from flowing into the esophagus during sleep, a key behavioral modification for GERD. Smoking cessation is beneficial but less specific to immediate symptom relief, and the other options are not directly related to behavior modification for GERD.

Question 3 of 5.

The nurse is administering morning medications at 0730. Which medication should have priority?

A. A proton pump inhibitor.

B. A nonnarcotic analgesic.

C. A histamine receptor antagonist.

D. A mucosal barrier agent.

Explanation: Proton pump inhibitors (PPIs) are the mainstay treatment for GERD, reducing acid production and preventing esophageal damage. They should be prioritized over analgesics, histamine receptor antagonists, or mucosal barrier agents, which are less critical for immediate symptom control and healing.

Question 4 of 5.

Which disease is the client diagnosed with GERD at greater risk for developing?

A. Hiatal hernia.

B. Gastroenteritis.

C. Esophageal cancer.

D. Gastric cancer.

Explanation: Chronic GERD increases the risk of esophageal cancer, particularly adenocarcinoma, due to prolonged acid exposure causing Barrett's esophagus, a precancerous condition. Hiatal hernia is a risk factor for GERD, not a consequence, and gastroenteritis and gastric cancer are less directly linked.

Question 5 of 5.

The client diagnosed with IBD is prescribed total parenteral nutrition (TPN). Which intervention should the nurse implement?

A. Check the client's glucose level.

B. Administer an oral hypoglycemic.

C. Assess the peripheral intravenous site.

D. Monitor the client's oral food intake.

Explanation: TPN, high in dextrose, can cause hyperglycemia, so monitoring glucose levels is essential, especially in IBD patients with potential metabolic stress. Oral hypoglycemics are inappropriate, TPN uses central lines, and oral intake is typically minimal.