Module 8 - Upper GI Disorders

Question 1

All of the following are signs and symptoms of periodontal disease EXCEPT:

a.	 gingivitis.

b.	 fruity smelling breath.

c.	 bad taste in the mouth.

d.	 painful chewing

Answer 1

fruity smelling breath.

Question 2

What is the primary reason why dysphagia is life-threatening?

a.	 causing strokes

b.	 food entering the esophagus

c.	 aspiration

d.	 food entering the stomach

Answer 2

aspiration

Question 3

What is dysphagia?

a.	 food entering the airways

b.	 difficulty swallowing

c.	 indigestion

d.	 malnutrition

Answer 3

difficulty swallowing

Question 4

Which of the following is likely to cause dysphagia? Select all that apply.

[mark all correct answers]
a.
Stroke

b.	 Tooth decay

c.	 Aging

d.	 Injuries

e.	 Diabetes

f.	 Developmental disabilities

Answer 4

stroke

aging

injuries

Developmental disabilities

Question 5

Which of the following is a symptom of dysphagia?

a.	 food and drink spilling down side of mouth

b.	 hiccups

c.	 sneezing

d.	 dizziness

Answer 5

food and drink spilling down side of mouth

Question 6

The most serious concern with dysphagia is aspiration, which can lead to:

a.	 malabsorption

b.	 lack of appetite

c.	 pneumonia

d.	 stroke

Answer 6

pneumonia

Question 7

Which of the following beverages is most appropriate for a client with dysphagia with an order for nectar-like liquids?

a.	 water

b.	 chicken broth

c.	 iced tea

d.	 tomato juice

Answer 7

tomato juice

Question 8

An example of a strategy used by dietitians to encourage clients on mechanically altered diets to eat is to

a.	 allow them to eat all desired foods.

b.	 identify a person's favorite foods and foods that have pleasant smells.

c.	 allow them to eat just one meal a day.

d.	 restrict all their favorite foods

Answer 8

identify a person’s favorite foods and foods that have pleasant smells.

Question 9

Which meal assistance techniques would you use when assisting a client who has dysphagia? Select all that apply.

[mark all correct answers]
a.
Encourage the client to drink water between bites of food.

b.	 Ensure the client is sitting upright with their head slightly titled forward.

c.	 Use utensils adapted with a large handle.

d.	 Encourage the client to take a 1/2 teaspoonful of food with each bite.

e.	 Encourage the client to swallow twice before eating the next spoonful.

f.	 Use the clock face method to identify food location.

g.	 Encourage the client to swallow by gently touching client's chin.

Answer 9

Ensure the client is sitting upright with their head slightly titled forward.

Encourage the client to take a 1/2 teaspoonful of food with each bite.

Encourage the client to swallow twice before eating the next spoonful.

Question 10

A client has right-sided weakness in their arm and leg. The client is right-handed. During breakfast, you noticed the client’s arm becomes lethargic and the client begins to struggle raising their arm to their mouth. The client still has half of their breakfast to eat, including yogurt and oatmeal. What should the nurse do first?

a.	 Offer to feed the client.

b.	 Begin to use the hand under hand technique with the client.

c.	 Encourage the client to eat with their non-dominant hand.

d.	 Encourage the client to rest

Answer 10

Encourage the client to eat with their non-dominant hand.

Question 11

You need to assist a client who is two months post cerebrovascular accident (CVA), with left-sided weakness and dysphagia. Which side of the client’s mouth should you place the food?

a.	 Left

b.	 Right

c.	 Center

d.	 Not at all

Answer 11

Right

Question 12

Which strategy reduces the risk of gastroesophageal reflux that could be aspirated?

a.	 Remain sitting upright for 30 minutes after a meal.

b.	 Drink water between each bite.

c.	 Tilt chin down while eating.

d.	 Swallow at least twice between mouthfuls.

Answer 12

Remain sitting upright for 30 minutes after a meal.

Question 13

What priority action should the nurse take when witnessing a client with dysphagia begin to choke during their meal?

a.	 Call for help and encourage the client to clear their airway by coughing.

b.	 Provide four back blows between the scapula.

c.	 Assess for pocketing of food in between coughing.

d.	 Run to get additional assistance for the client.

Answer 13

Call for help and encourage the client to clear their airway by coughing.

Question 14

A Speech-Language Pathologist ordered a thickened liquid diet for a client diagnosed with dysphagia. Which food items would you find on the client’s tray? Select all that apply.

[mark all correct answers]
a.
Coffee

b.	 Oatmeal

c.	 Yogurt

d.	 Broth

e.	 Hummus

Answer 14

Oatmeal

Yogurt

Hummus

Question 15

Which are the following signs of dysphagia? Select all that apply.

[mark all correct answers]
a.
Drooling during a meal.

b.	 Coughing while eating.

c.	 Food pocketing in the cheek.

d.	 Gurgling or change in voice.

e.	 Ability to clear throat

Answer 15

Drooling during a meal.

Coughing while eating.

Food pocketing in the cheek.

Gurgling or change in voice.

Question 16

Which of the following should be avoided with GERD? Select all that apply.

[mark all correct answers]
a.
Fried chicken

b.	 Apple juice

c.	 Peppermint

d.	 Alcoholic beverages

e.	 Bananas

f.	 Leafy greens

g.	 Coffee with caffeine

h.	 Chocolate

Answer 16

fried chicken

peppermint

alcoholic beverages

coffee w caffeine

chocolate

Question 17

What is the long term risk if GERD is left untreated?

a.	 rapid weight gain

b.	 poor digestion and constipation

c.	 vitamin B12 deficiency

d.	 esophageal cancer

Answer 17

esophageal cancer

Question 18

What is the main characteristic of GERD?

a.	 rapid digestion due to cell damage

b.	 inability of food to move throughout the stomach properly

c.	 acidic content of stomach backing up into the esophagus

d.	 lesions in the esophagus affecting the ability of consumed food to move to the stomach

Answer 18

acidic content of stomach backing up into the esophagus

Question 19

Which of the following foods would weaken the lower esophageal sphincter pressure?

a.	 Skim milk

b.	 Fried fish

c.	 Steamed carrots

d.	 Mashed potatoes

Answer 19

Fried fish

Question 20

What is the common cause of chronic gastroesophageal reflux?

a.	 hiatal hernia

b.	 frequent consumption of acidic foods

c.	 excess acidic production by the stomach

d.	 rapid weight loss

Answer 20

hiatal hernia

Question 21

Identify the potential causes of both gastritis and ulcers.

Select ALL that apply.

[mark all correct answers]
a.
h.pylori bacterial infection

b.	 frequent consumption of alcohol

c.	 consumption of acidic foods

d.	 use of anti-inflammatory pain medications

Answer 21

h.pylori bacterial infection

frequent consumption of alcohol

use of anti-inflammatory pain medications

Question 22

What is a common complication of ulcers and gastritis?

a.	 iron overload

b.	 anemia

c.	 vitamin C deficiency

d.	 impaired absorption of calcium

Answer 22

anemia

Question 23

What is a potential complication of gastritis?

a.	 Vitamin B12 deficiency

b.	 Weight gain

c.	 Periodontal disease

d.	 Dysphagia

Answer 23

Vitamin B12 deficiency

Question 24

A client with gastric ulcers receives the following items on his breakfast tray: scrambled eggs, toast, coffee, and apple juice. Which food/beverage should not be on the tray for someone with gastric ulcers?

a.	 scrambled eggs

b.	 toast

c.	 apple juice

d.	 coffee

Answer 24

coffee

Question 25

Which of the following should be avoided with peptic ulcers? Select all that apply.

[mark all correct answers]
a.
Orange juice

b.	 Whole chocolate milk

c.	 Tea

d.	 Sausage

e.	 Ice cream

f.	 Rice

g.	 Spinach

Answer 25

Whole chocolate milk

Tea

Sausage

Ice cream

Question 26

What is the main characteristic of gastritis?

a.	 chronic intestinal gas after eating

b.	 inability of the stomach to digest food

c.	 bleeding lesions in the esophagus

d.	 inflammation of the lining of the stomach

Answer 26

inflammation of the lining of the stomach

Question 27

What type of surgery to the stomach produces weight loss benefits?

a.	 gastrectomy

b.	 bariatric surgery

c.	 ostomy

d.	 adenectomy

Answer 27

bariatric surgery

Question 28

In what way does gastric bypass surgery help with weight loss?

a.	 decreases ghrelin production and there lowers appetite

b.	 improves serotonin production and less mental focus on food

c.	 removes all of the stomach so a person can only consume liquids

d.	 increases testosterone production and thereby increases metabolism

Answer 28

decreases ghrelin production and there lowers appetite

Question 29

What is a complication after gastric surgery?

a.	 excessive iron absorption

b.	 diabetes

c.	 weight gain

d.	 bone disease

Answer 29

bone disease

Question 30

In what way does gastric bypass surgery help with weight loss?

a.	 decreases ghrelin production and lowers appetite

b.	 improves serotonin production and less mental focus on food

c.	 removes all of the stomach so a person can only consume liquids

d.	 increases testosterone production and thereby increases metabolism

Answer 30

decreases ghrelin production and lowers appetite

Question 31

Which of the following supplements are usually recommended after gastric surgery?

a.	 Vitamin C and zinc

b.	 Potassium and magnesium

c.	 Calcium and vitamin D

d.	 Essential amino acids

Answer 31

Calcium and vitamin D

Question 32

A post gastrectomy diet is a

a.	 protein-controlled diet to prevent hypoglycemia.

b.	 fat-controlled diet to prevent dumping syndrome

c.	 simple carbohydrate-controlled diet to prevent dumping syndrome

d.	 protein- and fat-controlled diet to prevent

hypoglycemia.

Answer 32

simple carbohydrate-controlled diet to prevent dumping syndrome

Question 33

Which of the following are potential complications after gastric surgery? Select all that apply.

[mark all correct answers]
a.
Bone disease

b.	 Weight gain

c.	 Anemia

d.	 Malnutrition

e.	 Diabetes

f.	 Excessive iron absorption

g.	 Vitamin B12 deficiency

h.	 Lactose intolerance

Answer 33

bone disease

anemia

malnutrition

vitamin B12 deficiency

lactose intolerance

Question 34

Which of the following are recommended after gastric surgery to prevent dumping syndrome? Select all that apply.

[mark all correct answers]
a.
Consume fluids only with meals

b.	 Avoid concentrated sweets

c.	 Meals high in protein

d.	 Consume 3-6 small meals and snacks daily

e.	 Diet high in carbohydrate

f.	 Diet low in fat

Answer 34

Avoid concentrated sweets

Meals high in protein

Consume 3-6 small meals and snacks daily

Question 35

What is the best response to a client asking why it so important to avoid sugars and sweets after gastric bypass surgery?

a.	 Sugars and sweets provide empty calories.

b.	 Sugars increase risk of developing diabetes post surgery.

c.	 Sugars can draw water into the intestines and cause cramping and diarrhea.

d.	 Sugars will prevent you from losing weight.

Answer 35

Sugars can draw water into the intestines and cause cramping and diarrhea.

Question 36

Which nutrient deficiencies have an effect dental caries?

Select ALL that apply.

[mark all correct answers]
a.
Vitamin A

b.	 Carbohydrate

c.	 Vitamin D

d.	 Vitamin E

e.	 Calcium

f.	 Phosphorus

g.	 Sodium

h.	 Fluoride

Answer 36

vitamin A

Vitamin D

Calcium

Phosphorus

Fluoride

Question 37

Which of the following should be avoided after bariatric surgery? Select all that apply.

[mark all correct answers]
a.
Carbonated beverages

b.	 Fried foods

c.	 Cooked vegetables without skins or peels

d.	 Plain yogurt

e.	 Fruits canned in syrup

f.	 Caffeinated beverages

g.	 Bananas

h.	 Chocolate milk