Oral & Esophageal Disorders Flashcards
A patient has a new order for metoclopramide (Reglan). The nurse identifies this medication can be safely administered for which condition?
a.) Peptic ulcer with melena
b.) Diverticulitis with perforation
c.) Gastritis
d.) Gastroesophageal reflux disease
d.) Gastroesophageal reflux disease (GERD)
A nurse is inserting an NG tube in an alert patient. During the procedure, the patient begins to cough constantly & has difficulty breathing. The nurse suspects the NG tube is…
a.) Irritating the epiglottis
b.) Passing into the esophagus
c.) Coiling in the patient’s mouth
d.) Inserted into the lungs
d.) Inserted into the lungs
Which of the following assessment findings would be most important for indicating dumping syndrome in a post-gastrectomy patient?
a.) Weakness, diaphoresis, & diarrhea 90 minutes after eating
b.) Persistent loose stools, chills, & hiccups after eating
c.) Constipation & rectal bleeding following bowel movements
d.) Abdominal distention, elevated temperature, & weakness before eating
a.) Weakness, diaphoresis, & diarrhea 90 minutes after eating
Dumping Syndrome: symptoms (diarrhea, nausea, & feeling light-headed or tired) that occur after eating due to rapid gastric emptying
An older patient who has been living alone is diagnosed with parotitis. What causative bacteria does the nurse suspect is the cause of parotitis?
a.) Pneumococcus
b.) Streptococcus viridans
c.) Methicillin-resistant Staphylococcus aureus (MRSA)
d.) Staphylococcus aureus
d.) Staphylococcus aureus
The nurse is obtaining a history on the patient who comes to the clinic. What symptom described by the patient is one of the first symptoms associated with esophageal disease?
a.) Malnutrition
b.) Dysphagia
c.) Regurgitation of food
d.) Pain
b.) Dysphagia
The nurse is inserting an NG tube & the patient begins to cough & is unable to speak. What does the nurse suspect has occured?
a.) The nurse has inadvertently inserted the NG tube into the trachea
b.) The nurse has inserted an NG tube that is too large for the patient
c.) This is a normal occurence & the NG tube should be left in place
d.) The NG tube is most likely defective & should be removed immediately
a.) The nurse has inadvertently inserted the tube into the trachea
For a patient with salivary calculi, which procedure uses shock waves to disintegrate the stones?
a.) Lithotripsy
b.) Radiation
c.) Biopsy
d.) Chemotherapy
a.) Lithotripsy
A patient has a cheesy white plaque in the mouth. The plaque looks like milk curds & can be rubbed off. What is the nurse’s best intervention?
a.) Remove the plaque from the mouth by rubbing it with gauze.
b.) Provide saline rinses prior to meals.
c.) Instruct the patient to swish prescribed nystatin solution for 1 minute.
d.) Encourage the patient to eat a soft or bland diet.
c.) Instruct the patient to swish prescribed nystatin solution for 1 minute
The patient is experiencing swallowing difficulties & is now scheduled to receive a gastric feeding. THe patient has the following prescribed oral (PO) medicaitons: furosemide, digoxin, enteric coated aspirin, & vitamin E. Which medication shoudl the nurse withold?
a.) furosemide
b.) digoxin
c.) vitamin E
d.) enteric coated aspirin
d.) enteric coated aspirin
A patient receiving tube feedings to the duodenum develops nausea, cramping, & diarrhea. Which condition would the nurse base the patient’s care plan on given the symptoms the patient is experiencing?
a.) Diverticulosis
b.) Dumping syndrome
c.) Paralytic ileus
d.) Small bowel obstruction
b.) Dumping syndrome
Which of the following are functions of saliva? (Select all that apply)
a.) Protection against harmful bacteria
b.) Elimination
c.) Lubrication
d.) Digestion
e.) Metabolism
a.) Protection against harmful bacteria
c.) Lubrication
d.) Digestion
A patient is post-operative following a graft reconstruction of the neck. What intervention is most important for the nurse to complete with this patient?
a.) Reinforce the neck dressing when blood is present on the dressing.
b.) Cleanse around the drain using aseptic technique.
c.) Assess the color & temperature of the graft.
d.) Administer prescribed intravenous vancomycin at the correct time.
c.) Assess the color & temperature of the graft
**The nurse inserts an NG tube into the right nare of a patient. When testing the tube by aspirating for pH to confirm the placement, what does the nurse anticipate the pH will be if the NG tube is placed in the lungs?
a.) 4
b.) 6
c.) 1
d.) 3
b.) 6
What is the most significant complication related to continuous tube feeding?
a.) The interruption of GI integrity
b.) An interruption in fat metabolism & lipoprotein synthesis
c.) A disturbance of intestinal & hepatic metabolism
d.) The increased potential for aspiration
d.) The increased potential for aspiration
A patient who had hemiglossectomy earlier in the day is assessed postoperatively, reveealing a patent airway, stable vitals, and no bleeding or drainage from the surgical site. The nurse notes the patient is alert. What is the patient’s priority need at this time?
a.) Emotional support from visitors & staff
b.) Referral to a speech therapist
c.) An effective measn of communicating with the nurse
d.) Dietary teachign focused on consistency of food & frequency of feedings
c.) An effective means of communicating with the nurse
A patient who had oral cancer has had extensive surgery to excise the malignancy. Although surgery was deemed successful, it was quiet disfiguring & incapacitating. What is essential to this patient and their family?
a.) Time to mourn, accept, & adjust to the loss
b.) Knowing that everything will work out just fine
c.) Not giving in to anger
d.) Having a courageous attitude
a.) Time to mourn, accept, & adjust to the loss
Which of the following is the primary source of microorganisms for catheter-related skin infections?
a.) IV fluid bag
b.) Catheter tubing
c.) IV tubing
d.) Catheter hub
d.) Catheter hub
The nurse cares for a patient who receives continuous enteral tube feedings & who is at low risk for aspiration. The nurse assesses the gastric residual volume to be 350 mL. Which action should the nurse take next?
a.) Monitor the feeding closely
b.) Flush the feeding tube
c.) Lower the head of the bed
d.) Increase the feeding rate
a.) Monitor the feeding closely
Which of the following would the nurse include when teaching a patient about oral cancer?
a.) A typical lesion is soft & crater-like.
b.) Many oral cancers produce no symptoms in early stages.
c.) Blood testing is used to diagnose oral cancer.
d.) Most oral cancers are painful at the outset.
b.) Many oral cancers produce no symptoms in early stages
The nurse observes dry mucous membranes in a patient who is receiving tube feedings after an oral surgery. The patient also reports unpleasant tastes & odors. Which measure should the nurse include in the patient’s plan of care?
a.) Ensure adquate hydration with additional water.
b.) Flush the tube with water before adding the feedings.
c.) Provide frequent oral care.
d.) Keep the feeding formula refrigerated.
c.) Provide frequent oral care
Why are gastrostomy feedings preferred to NG feedings in patients who are comatose?
a.) The digestive process occurs more rapidly as a result of the feedings not having to pass through the esophagus.
b.) Gastroesophageal sphincter is intact, lessening the possibillity of regurgitation & aspiration.
c.) Feedings can be administered with the patient in a recumbent position.
d.) The patient cannot experience the deprevational stress of not swallowing.
b.) Gastroesophageal sphincter is intact, lessening the possibility of regurgitation & aspiration
A patient in the ER reports that a piece of meat became stuck in their throat while eating. The nurse notes the patient is anxious with respirations at 30 breaths per minute, frequent swallowing, & little saliva in the mouth. An esophagogastroscopy with removal of foreign body is scheduled for today. What would be the first activity performed by the nurse?
a.) Assess the patient’s lung sounds bilaterally.
b.) Suction the patient’s oral cavity.
c.) Obtain consent for the esophagogastroscopy.
d.) Administer prescribed morphine intravenously.
a.) Assess the patient’s lung sounds bilaterally
Which clinical manifestation is NOT associated with hemorrhage?
a.) Hypotension
b.) Tachypnea
c.) Tachycardia
d.) Bradycardia
d.) Bradycardia
The nurse is to discontinue an NG tube that has been used for decompression. What is the first action the nurse should take when removing the NG tube?
a.) Flush the tube with 10 mL of water.
b.) Withdraw the tube gently for 6-8 inches.
c.) Remove the tape from the patient’s nose.
d.) Provide the patient with oral care.
a.) Flush the tube with 10 mL of water
