GERD & Hiatal Hernia NCLEX Update Q&A 2024/2025
Solved 100%
Which of the following instructions should the nurse include in the teaching
plan for a client who is experiencing gastroesophageal reflux disease (GERD)?
1. Limit caffeine intake to two cups of coffee per day.
2. Do not lie down for 2 hours after eating.
3. Follow a low-protein diet.
4. Take medications with milk to decrease irritation.
2.
The nurse should instruct the client to not lie down for about 2 hours after eating to
prevent reflux. Caffeinated beverages decrease pressure in the lower esophageal
sphincter and milk increases gastric acid secretion, so these beverages should be
avoided. The client is encouraged to follow a high-protein, low-fat diet, and avoid
foods that are irritating.
The client is scheduled to have an upper gastrointestinal tract series of x-rays.
Following the x-rays, the nurse should instruct the client to:
1. Take a laxative.
2. Follow a clear liquid diet.
3. Administer an enema.
4. Take an antiemetic.
1.
The client should take a laxative after an upper gastrointestinal series to stimulate a
bowel movement. This examination involves the administration of barium, which
must be promptly eliminated from the body because it may harden and cause an
obstruction. A clear liquid diet would have no effect on stimulating removal of the
barium. The client should not have nausea and an antiemetic would not be
necessary; additionally, the antiemetic will decrease peristalsis and increase the
likelihood of eliminating the barium. An enema would be ineffective because the
barium is too high in the gastrointestinal tract.
A client who has been diagnosed with gastroesophageal reflux disease
(GERD) complains of heartburn. To decrease the heartburn, the nurse should
instruct the client to eliminate which of the following items from the diet?
1. Lean beef.
2. Air-popped popcorn.
3. Hot chocolate.
4. Raw vegetables.
3.
With GERD, eating substances that decrease lower esophageal sphincter pressure
causes heartburn. A decrease in the lower esophageal sphincter pressure allows
gastric contents to reflux into the lower end of the esophagus. Foods that can cause
a decrease in esophageal sphincter pressure include fatty foods, chocolate,
caffeinated beverages, peppermint, and alcohol. A diet high in protein and low in fat
is recommended for clients with GERD. Lean beef, popcorn, and raw vegetables
would be acceptable.
The client with gastroesophageal reflux disease (GERD) complains of a
chronic cough. The nurse understands that in a client with GERD this
symptom may be indicative of which of the following conditions?
, 1. Development of laryngeal cancer.
2. Irritation of the esophagus.
3. Esophageal scar tissue formation.
4. Aspiration of gastric contents.
4.
Clients with GERD can develop pulmonary symptoms, such as coughing, wheezing,
and dyspnea, that are caused by the aspiration of gastric contents. GERD does not
predispose the client to the development of laryngeal cancer. Irritation of the
esophagus and esophageal scar tissue formation can develop as a result of GERD.
However, GERD is more likely to cause painful and difficult swallowing.
Bethanechol (Urecholine) has been ordered for a client with gastroesophageal
reflux disease (GERD). The nurse should assess the client for which of the
following adverse effects?
1. Constipation.
2. Urinary urgency.
3. Hypertension.
4. Dry oral mucosa.
2.
Bethanechol (Urecholine), a cholinergic drug, may be used in GERD to increase
lower esophageal sphincter pressure and facilitate gastric emptying. Cholinergic
adverse effects may include urinary urgency, diarrhea, abdominal cramping,
hypotension, and increased salivation. To avoid these adverse effects, the client
should be closely monitored to establish the minimum effective dose.
The client attends two sessions with the dietitian to learn about diet
modifications to minimize gastroesophageal reflux. The teaching would be
considered successful if the client says that she will decrease her intake of
which of the following foods?
1. Fats.
2. High-sodium foods.
3. Carbohydrates.
4. High-calcium foods.
1.
Fats are associated with decreased esophageal sphincter tone, which increases
reflux. Obesity contributes to the development of hiatal hernia, and a low-fat diet
might also aid in weight loss. Carbohydrates and foods high in sodium or calcium do
not affect gastroesophageal reflux.
Which of the following dietary measures would be useful in preventing
esophageal reflux?
1. Eating small, frequent meals.
2. Increasing fluid intake.
3. Avoiding air swallowing with meals.
4. Adding a bedtime snack to the dietary plan.
1.
Esophageal reflux worsens when the stomach is overdistended with food. Therefore,
an important measure is to eat small, frequent meals. Fluid intake should be
decreased during meals to reduce abdominal distention. Avoiding air swallowing
does not prevent esophageal reflux. Food intake in the evening should be strictly
limited to reduce the incidence of nighttime reflux, so bedtime snacks are not
recommended.
Solved 100%
Which of the following instructions should the nurse include in the teaching
plan for a client who is experiencing gastroesophageal reflux disease (GERD)?
1. Limit caffeine intake to two cups of coffee per day.
2. Do not lie down for 2 hours after eating.
3. Follow a low-protein diet.
4. Take medications with milk to decrease irritation.
2.
The nurse should instruct the client to not lie down for about 2 hours after eating to
prevent reflux. Caffeinated beverages decrease pressure in the lower esophageal
sphincter and milk increases gastric acid secretion, so these beverages should be
avoided. The client is encouraged to follow a high-protein, low-fat diet, and avoid
foods that are irritating.
The client is scheduled to have an upper gastrointestinal tract series of x-rays.
Following the x-rays, the nurse should instruct the client to:
1. Take a laxative.
2. Follow a clear liquid diet.
3. Administer an enema.
4. Take an antiemetic.
1.
The client should take a laxative after an upper gastrointestinal series to stimulate a
bowel movement. This examination involves the administration of barium, which
must be promptly eliminated from the body because it may harden and cause an
obstruction. A clear liquid diet would have no effect on stimulating removal of the
barium. The client should not have nausea and an antiemetic would not be
necessary; additionally, the antiemetic will decrease peristalsis and increase the
likelihood of eliminating the barium. An enema would be ineffective because the
barium is too high in the gastrointestinal tract.
A client who has been diagnosed with gastroesophageal reflux disease
(GERD) complains of heartburn. To decrease the heartburn, the nurse should
instruct the client to eliminate which of the following items from the diet?
1. Lean beef.
2. Air-popped popcorn.
3. Hot chocolate.
4. Raw vegetables.
3.
With GERD, eating substances that decrease lower esophageal sphincter pressure
causes heartburn. A decrease in the lower esophageal sphincter pressure allows
gastric contents to reflux into the lower end of the esophagus. Foods that can cause
a decrease in esophageal sphincter pressure include fatty foods, chocolate,
caffeinated beverages, peppermint, and alcohol. A diet high in protein and low in fat
is recommended for clients with GERD. Lean beef, popcorn, and raw vegetables
would be acceptable.
The client with gastroesophageal reflux disease (GERD) complains of a
chronic cough. The nurse understands that in a client with GERD this
symptom may be indicative of which of the following conditions?
, 1. Development of laryngeal cancer.
2. Irritation of the esophagus.
3. Esophageal scar tissue formation.
4. Aspiration of gastric contents.
4.
Clients with GERD can develop pulmonary symptoms, such as coughing, wheezing,
and dyspnea, that are caused by the aspiration of gastric contents. GERD does not
predispose the client to the development of laryngeal cancer. Irritation of the
esophagus and esophageal scar tissue formation can develop as a result of GERD.
However, GERD is more likely to cause painful and difficult swallowing.
Bethanechol (Urecholine) has been ordered for a client with gastroesophageal
reflux disease (GERD). The nurse should assess the client for which of the
following adverse effects?
1. Constipation.
2. Urinary urgency.
3. Hypertension.
4. Dry oral mucosa.
2.
Bethanechol (Urecholine), a cholinergic drug, may be used in GERD to increase
lower esophageal sphincter pressure and facilitate gastric emptying. Cholinergic
adverse effects may include urinary urgency, diarrhea, abdominal cramping,
hypotension, and increased salivation. To avoid these adverse effects, the client
should be closely monitored to establish the minimum effective dose.
The client attends two sessions with the dietitian to learn about diet
modifications to minimize gastroesophageal reflux. The teaching would be
considered successful if the client says that she will decrease her intake of
which of the following foods?
1. Fats.
2. High-sodium foods.
3. Carbohydrates.
4. High-calcium foods.
1.
Fats are associated with decreased esophageal sphincter tone, which increases
reflux. Obesity contributes to the development of hiatal hernia, and a low-fat diet
might also aid in weight loss. Carbohydrates and foods high in sodium or calcium do
not affect gastroesophageal reflux.
Which of the following dietary measures would be useful in preventing
esophageal reflux?
1. Eating small, frequent meals.
2. Increasing fluid intake.
3. Avoiding air swallowing with meals.
4. Adding a bedtime snack to the dietary plan.
1.
Esophageal reflux worsens when the stomach is overdistended with food. Therefore,
an important measure is to eat small, frequent meals. Fluid intake should be
decreased during meals to reduce abdominal distention. Avoiding air swallowing
does not prevent esophageal reflux. Food intake in the evening should be strictly
limited to reduce the incidence of nighttime reflux, so bedtime snacks are not
recommended.
