GI GERD

Question 1

The male client tells the nurse he has been experiencing “heartburn” at night that awakens him. Which assessment question should the nurse ask?

1. “How much weight have you gained recently?”
2. “What have you done to alleviate the heartburn?”
3. “Do you consume many milk and dairy
   products?”
4. “Have you been around anyone with a stomach
   virus?”

Answer 1

2. “What have you done to alleviate the heartburn?”

Question 2

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

1. Teach the client to sleep with a foam wedge under the head.
2. Encourage the client to decrease the amount of smoking.
3. Instruct the client to take over-the-counter medication for relief of pain.
4. Discuss the need to attend Alcoholics Anonymous to quit drinking.

Answer 2

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

Question 3

The nurse is preparing a client diagnosed
with GERD for discharge following an esophagogastroduodenoscopy (EGD). Which statement indicates the client understands the discharge instructions?

1. “I should not eat for at least one (1) day following this procedure.”
2. “I can lie down whenever I want after a meal. It won’t make a difference.”
3. “The stomach contents won’t bother my esophagus but will make me nauseous.”
4. “I should avoid orange juice and eating
   tomatoes until my esophagus heals.”

Answer 3

4. “I should avoid orange juice and eating
   tomatoes until my esophagus heals.”

Question 4

The nurse is planning the care of a client diagnosed with lower esophageal sphincter dysfunction. Which dietary modifications should be included in the plan of care?

1. Allow any of the client’s favorite foods as long as the amount is limited.
2. Have the client perform eructation exercises several times a day.
3. Eat four (4) to six (6) small meals a day and limit fluids during mealtimes.
4. Encourage the client to consume a glass of red wine with one (1) meal a day.

Answer 4

Eat four (4) to six (6) small meals a day and limit fluids during mealtimes.

Question 5

The nurse is caring for a client diagnosed with GERD. Which nursing interventions should be implemented?

1. Place the client prone in bed and administer
   nonsteroidal anti-inflammatory medications.
2. Have the client remain upright at all times and
   walk for 30 minutes three (3) times a week.
3. Instruct the client to maintain a right lateral
   side-lying position and take antacids before
   meals.
4. Elevate the head of the bed (HOB) 30 degrees
   and discuss lifestyle modifications with the client.

Answer 5

4. Elevate the head of the bed (HOB) 30 degrees
   and discuss lifestyle modifications with the client.

Question 6

The nurse is caring for an adult client diagnosed with GERD. Which condition is the most common comorbid disease associated with GERD?

1. Adult-onset asthma.
2. Pancreatitis.
3. Peptic ulcer disease.
4. Increased gastric emptying.

Answer 6

1. Adult-onset asthma.

Question 7

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

1. A proton pump inhibitor.
2. A nonnarcotic analgesic.
3. A histamine receptor antagonist.
4. A mucosal barrier agent.

Answer 7

4. A mucosal barrier agent.

Question 8

The nurse is preparing a client diagnosed with GERD for surgery. Which information warrants notifying the HCP?

1. The client’s Bernstein esophageal test was
   positive.
2. The client’s abdominal x-ray shows a hiatal
   hernia.
3. The client’s WBC count is 14,000/mm3.
4. The client’s hemoglobin is 13.8 g/dL.

Answer 8

3. The client’s WBC count is 14,000/mm3.

Question 9

The charge nurse is making assignments. Staffing includes a registered nurse with five (5) years of medical-surgical experience, a newly graduated registered nurse, and two (2) unlicensed assistive personnel (UAPs). Which client should be assigned to the most experienced nurse?

1. The 39-year-old client diagnosed with lower esophageal dysfunction who is complaining of pyrosis.
2. The 54-year-old client diagnosed with Barrett’s esophagus who is scheduled to have an endoscopy this morning.
3. The 46-year-old client diagnosed with gastroesophageal reflux disease who has wheezes in all five (5) lobes.
4. The 68-year-old client who is three (3) days postoperative for hiatal hernia and needs to be ambulated four (4) times today.

Answer 9

3. The 46-year-old client diagnosed with gastroesophageal reflux disease who has wheezes in all five (5) lobes.

Question 10

Which statement made by the client indicates to the nurse the client may be experiencing GERD?

1. “My chest hurts when I walk up the stairs in
   my home.”
2. “I take antacid tablets with me wherever I go.”
3. “My spouse tells me I snore very loudly at
   night.”
4. “I drink six (6) to seven (7) soft drinks every day.”

Answer 10

2. “I take antacid tablets with me wherever I go.”

Question 11

The nurse is performing an admission assessment on a client diagnosed with GERD. Which signs and symptoms would indicate GERD?

1. Pyrosis, water brash, and flatulence.
2. Weight loss, dysarthria, and diarrhea.
3. Decreased abdominal fat, proteinuria, and
   constipation.
4. Midepigastric pain, positive H. pylori test, and
   melena.

Answer 11

1. Pyrosis, water brash, and flatulence.

Question 12

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

1. Hiatal hernia.
2. Gastroenteritis.
3. Esophageal cancer.
4. Gastric cancer.

Answer 12

3. Esophageal cancer.