Test Bank Complete_ Lewis’s Medical-Surgical Nursing
in Canada, 5th Edition, Mariann M. Harding (Author),
Jane Tyerman (Author), Shelley Cobbett (Author) All
Chapter 1-72 (2024/2055) Latest Edition
After change-of-shift report, which patient would the nurse assess first?
a. A 42-yr-old patient who has acute gastritis and ongoing epigastric pain
b. A 70-yr-old patient with a hiatal hernia who experiences frequent heartburn
c. A 60-yr-old patient with nausea and vomiting who is lethargic with dry mucosa
d. A 53-yr-old patient who has dumping syndrome after a recent partial gastrectomy
- ANSWERANS: C
A patient with nausea and vomiting who is lethargic with dry mucosa is at high risk
for problems such as aspiration, dehydration, and fluid and electrolyte disturbances.
The other patients will also need to be assessed, but the information about them
indicates symptoms that are typical for their diagnoses and are not life threatening.
DIF:CognitiveLevel: Apply (Application) TOP: NursingProcess: Assessment
MSC:NCLEX: Safe and Effective Care Environment
Which item would the nurse offer to the patient restarting oral intake after being
NPO due to nausea and vomiting?
a. Glass of orange juice
b. Dish of lemon gelatin
c. Cup of coffee with cream
d. Bowl of hot chicken broth - ANSWERANS: B
Clear cool liquids are usually the first foods started after a patient has been
nauseated. Acidic foods such as orange juice, very hot foods, and coffee are poorly
tolerated when patients have been nauseated.
DIF:CognitiveLevel: Apply (Application) TOP: NursingProcess: Implementation
MSC:NCLEX: PhysiologicalIntegrity
A woman receiving chemotherapy for breast cancer develops a Candida albicans oral
infection. Which intervention would the nurse anticipate?
a. Nystatin tablets
b. Antiviral agents
c. Referral to a dentist
d. Hydrogen peroxide rinses - ANSWERANS: A
C. albicans infections are treated with an antifungal such as nystatin. Peroxide rinses
would be painful. Oral saltwater rinses may be used but will not cure the infection.
Antiviral agents are used for viral infections such as herpes simplex. Referral to a
dentist is indicated for gingivitis but not for Candida infection.
,DIF:CognitiveLevel: Apply (Application) MSC:NCLEX: PhysiologicalIntegrity TOP:
NursingProcess: Planning
A patient who has gastroesophageal reflux disease (GERD) is experiencing increasing
discomfort. Which patient statement to the nurse indicates a need for additional
teaching about GERD?
a. "I quit smoking years ago, but I chew gum."
b. "I eat small meals and have a bedtime snack."
[c. "I take antacids between meals and at bedtime each night."
d. "I sleep with the head of the bed elevated on 4-inch blocks." - ANSWERANS: B
GERD is exacerbated by eating late at night, and the nurse would plan to teach the
patient to avoid eating within 3 hours of bedtime. Smoking cessation, taking
antacids, and elevating the head of the bed are appropriate actions to control
symptoms of GERD.
DIF:CognitiveLevel: Apply (Application) MSC:NCLEX: PhysiologicalIntegrity TOP:
NursingProcess: Evaluation
A patient with a stroke is unconscious and unresponsive to stimuli. After learning
that the patient has a history of gastroesophageal reflux disease (GERD), which
assessment would the nurse plan to make more frequently than is routine?
a. Apical pulse
b. Bowel sounds
c. Breath sounds
d. Abdominal girth - ANSWERANS: C
Because GERD may cause aspiration, the unconscious patient is at risk for developing
aspiration pneumonia. Bowel sounds, abdominal girth, and apical pulse will not be
affected by the patient's stroke or GERD and do not require more frequent
monitoring than the routine.
How would the nurse explain esomeprazole (Nexium) to a patient who has recurring
heartburn?
a. "It reduces gastroesophageal reflux by increasing the rate of gastric emptying."
b. "It neutralizes stomach acid and provides relief of symptoms in a few minutes."
c. "It coats and protects the lining of the stomach and esophagus from gastric acid."
d. "It treats gastroesophageal reflux disease by decreasing stomach acid production."
- ANSWERANS: D
The proton pump inhibitors decrease the rate of gastric acid secretion. Promotility
drugs such as metoclopramide (Reglan) increase the rate of gastric emptying.
Cryoprotective medications such as sucralfate (Carafate) protect the stomach.
Antacids neutralize stomach acid and work rapidly.
, DIF:CognitiveLevel: Apply (Application) TOP: NursingProcess: Implementation
MSC:NCLEX: PhysiologicalIntegrity
Which patient choice for a snack 3 hours before bedtime indicates that the nurse's
teaching about gastroesophageal reflux disease (GERD) has been effective?
a. Chocolate pudding
b. Glass of low-fat milk
c. Cherry gelatin with fruit
d. Peanut butter and jelly sandwich - ANSWERANS: C
Gelatin and fruit are low fat and will not decrease lower esophageal sphincter (LES)
pressure. Foods such as chocolate are avoided because they lower LES pressure. Milk
products increase gastric acid secretion. High-fat foods such as peanut butter
decrease both gastric emptying and LES pressure.
DIF:CognitiveLevel: Apply (Application) MSC:NCLEX: PhysiologicalIntegrity TOP:
NursingProcess: Evaluation
Which topic would the nurse anticipate teaching to a patient who has a new report
of heartburn?
a. Radionuclide tests
b. Barium swallow exam
c. Endoscopy procedures
d. Proton pump inhibitors - ANSWERANS: D
Because diagnostic testing for heartburn that is probably caused by
gastroesophageal reflux disease (GERD) is expensive and uncomfortable, proton
pump inhibitors are frequently used for a short period as the first step in the
diagnosis of GERD. The other tests may be used but are not usually the first step in
diagnosis.
DIF:CognitiveLevel: Apply (Application) MSC:NCLEX: PhysiologicalIntegrity TOP:
NursingProcess: Planning
Which information will the nurse provide for a patient with newly diagnosed
gastroesophageal reflux disease (GERD)?
a. "Peppermint tea may reduce your symptoms."
b. "Keep the head of your bed elevated on blocks."
c. "Avoid eating between meals to reduce acid secretion."
d. "Vigorous exercise may increase the incidence of reflux." - ANSWERANS: B
Elevating the head of the bed will reduce the incidence of reflux while the patient is
sleeping. Peppermint will decrease lower esophageal sphincter (LES) pressure and
increase the chance for reflux. Small, frequent meals are recommended to avoid
abdominal distention. There is no need to make changes in physical activities
because of GERD.
in Canada, 5th Edition, Mariann M. Harding (Author),
Jane Tyerman (Author), Shelley Cobbett (Author) All
Chapter 1-72 (2024/2055) Latest Edition
After change-of-shift report, which patient would the nurse assess first?
a. A 42-yr-old patient who has acute gastritis and ongoing epigastric pain
b. A 70-yr-old patient with a hiatal hernia who experiences frequent heartburn
c. A 60-yr-old patient with nausea and vomiting who is lethargic with dry mucosa
d. A 53-yr-old patient who has dumping syndrome after a recent partial gastrectomy
- ANSWERANS: C
A patient with nausea and vomiting who is lethargic with dry mucosa is at high risk
for problems such as aspiration, dehydration, and fluid and electrolyte disturbances.
The other patients will also need to be assessed, but the information about them
indicates symptoms that are typical for their diagnoses and are not life threatening.
DIF:CognitiveLevel: Apply (Application) TOP: NursingProcess: Assessment
MSC:NCLEX: Safe and Effective Care Environment
Which item would the nurse offer to the patient restarting oral intake after being
NPO due to nausea and vomiting?
a. Glass of orange juice
b. Dish of lemon gelatin
c. Cup of coffee with cream
d. Bowl of hot chicken broth - ANSWERANS: B
Clear cool liquids are usually the first foods started after a patient has been
nauseated. Acidic foods such as orange juice, very hot foods, and coffee are poorly
tolerated when patients have been nauseated.
DIF:CognitiveLevel: Apply (Application) TOP: NursingProcess: Implementation
MSC:NCLEX: PhysiologicalIntegrity
A woman receiving chemotherapy for breast cancer develops a Candida albicans oral
infection. Which intervention would the nurse anticipate?
a. Nystatin tablets
b. Antiviral agents
c. Referral to a dentist
d. Hydrogen peroxide rinses - ANSWERANS: A
C. albicans infections are treated with an antifungal such as nystatin. Peroxide rinses
would be painful. Oral saltwater rinses may be used but will not cure the infection.
Antiviral agents are used for viral infections such as herpes simplex. Referral to a
dentist is indicated for gingivitis but not for Candida infection.
,DIF:CognitiveLevel: Apply (Application) MSC:NCLEX: PhysiologicalIntegrity TOP:
NursingProcess: Planning
A patient who has gastroesophageal reflux disease (GERD) is experiencing increasing
discomfort. Which patient statement to the nurse indicates a need for additional
teaching about GERD?
a. "I quit smoking years ago, but I chew gum."
b. "I eat small meals and have a bedtime snack."
[c. "I take antacids between meals and at bedtime each night."
d. "I sleep with the head of the bed elevated on 4-inch blocks." - ANSWERANS: B
GERD is exacerbated by eating late at night, and the nurse would plan to teach the
patient to avoid eating within 3 hours of bedtime. Smoking cessation, taking
antacids, and elevating the head of the bed are appropriate actions to control
symptoms of GERD.
DIF:CognitiveLevel: Apply (Application) MSC:NCLEX: PhysiologicalIntegrity TOP:
NursingProcess: Evaluation
A patient with a stroke is unconscious and unresponsive to stimuli. After learning
that the patient has a history of gastroesophageal reflux disease (GERD), which
assessment would the nurse plan to make more frequently than is routine?
a. Apical pulse
b. Bowel sounds
c. Breath sounds
d. Abdominal girth - ANSWERANS: C
Because GERD may cause aspiration, the unconscious patient is at risk for developing
aspiration pneumonia. Bowel sounds, abdominal girth, and apical pulse will not be
affected by the patient's stroke or GERD and do not require more frequent
monitoring than the routine.
How would the nurse explain esomeprazole (Nexium) to a patient who has recurring
heartburn?
a. "It reduces gastroesophageal reflux by increasing the rate of gastric emptying."
b. "It neutralizes stomach acid and provides relief of symptoms in a few minutes."
c. "It coats and protects the lining of the stomach and esophagus from gastric acid."
d. "It treats gastroesophageal reflux disease by decreasing stomach acid production."
- ANSWERANS: D
The proton pump inhibitors decrease the rate of gastric acid secretion. Promotility
drugs such as metoclopramide (Reglan) increase the rate of gastric emptying.
Cryoprotective medications such as sucralfate (Carafate) protect the stomach.
Antacids neutralize stomach acid and work rapidly.
, DIF:CognitiveLevel: Apply (Application) TOP: NursingProcess: Implementation
MSC:NCLEX: PhysiologicalIntegrity
Which patient choice for a snack 3 hours before bedtime indicates that the nurse's
teaching about gastroesophageal reflux disease (GERD) has been effective?
a. Chocolate pudding
b. Glass of low-fat milk
c. Cherry gelatin with fruit
d. Peanut butter and jelly sandwich - ANSWERANS: C
Gelatin and fruit are low fat and will not decrease lower esophageal sphincter (LES)
pressure. Foods such as chocolate are avoided because they lower LES pressure. Milk
products increase gastric acid secretion. High-fat foods such as peanut butter
decrease both gastric emptying and LES pressure.
DIF:CognitiveLevel: Apply (Application) MSC:NCLEX: PhysiologicalIntegrity TOP:
NursingProcess: Evaluation
Which topic would the nurse anticipate teaching to a patient who has a new report
of heartburn?
a. Radionuclide tests
b. Barium swallow exam
c. Endoscopy procedures
d. Proton pump inhibitors - ANSWERANS: D
Because diagnostic testing for heartburn that is probably caused by
gastroesophageal reflux disease (GERD) is expensive and uncomfortable, proton
pump inhibitors are frequently used for a short period as the first step in the
diagnosis of GERD. The other tests may be used but are not usually the first step in
diagnosis.
DIF:CognitiveLevel: Apply (Application) MSC:NCLEX: PhysiologicalIntegrity TOP:
NursingProcess: Planning
Which information will the nurse provide for a patient with newly diagnosed
gastroesophageal reflux disease (GERD)?
a. "Peppermint tea may reduce your symptoms."
b. "Keep the head of your bed elevated on blocks."
c. "Avoid eating between meals to reduce acid secretion."
d. "Vigorous exercise may increase the incidence of reflux." - ANSWERANS: B
Elevating the head of the bed will reduce the incidence of reflux while the patient is
sleeping. Peppermint will decrease lower esophageal sphincter (LES) pressure and
increase the chance for reflux. Small, frequent meals are recommended to avoid
abdominal distention. There is no need to make changes in physical activities
because of GERD.
