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The nurse explains to the patient with gastroesophageal reflux disease that this disorder

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This is a quiz that contains NCLEX review questions for GERD. As a nurse providing care to a patient with GERD, it is important to know the signs and symptoms, pathophysiology, medications, nursing management, diet education, and complications.

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In the previous NCLEX review series, I explained about other GI disorders you may be asked about on the NCLEX exam, so be sure to check out those reviews and quizzes as well.

GERD NCLEX Practice Questions

This quiz will test your knowledge on GERD in preparation for the NCLEX exam.

(NOTE: When you hit submit, it will refresh this same page. Scroll down to see your results.)

GERD NCLEX Questions

1. A patient reports frequent heartburn twice a week for the past 4 months. What other symptoms reported by the patient may indicate the patient has GERD? SELECT-ALL-THAT-APPLY:

A. Bitter taste in mouth

B. Dry cough

C. Melena

D. Difficulty swallowing

E. Smooth, red tongue

F. Murphy’s Sign

2. Your patient, who is presenting with signs and symptoms of GERD, is scheduled to have a test that assesses the function of the esophagus’ ability to squeeze food down into the stomach and the closer of the lower esophageal sphincter. The patient asks you, “What is the name of the test I’m having later today?” You tell the patient the name of the test is:

A. Lower Esophageal Gastrointestinal Series

B. Transesophageal echocardiogram

C. Esophageal manometry

D. Esophageal pH monitoring

3. After dinner time, during hourly rounding, a patient awakes to report they feel like “food is coming up” in the back of their throat and that there is a bitter taste in their mouth. What nursing intervention will you perform next?

A. Perform deep suctioning

B. Assist the patient into the Semi-Fowler’s position

C. Keep the patient NPO

D. Instruct the patient to avoid milk products

4. During a home health visit, you are helping a patient develop a list of foods they should avoid due to GERD. Which items in the patient’s pantry should be avoided? SELECT-ALL-THAT-APPLY:

A. Hot and Spicy Pork Rinds

B. Peppermint patties

C. Green Beans

D. Tomato Soup

E. Chocolate Fondue

F. Almonds

G. Oranges

5. After providing education to a patient with GERD. You ask the patient to list 4 things they can do to prevent or alleviate signs and symptoms of GERD. Which statement is INCORRECT?

A. “It is best to try to consume small meals throughout the day than eat 3 large ones.”

B. “I’m disappointed that I will have to limit my intake of peppermint and spearmint because I love eating those types of hard candies.”

C. “It is important I avoid eating right before bedtime.”

D. “I will try to lie down after eating a meal to help decrease pressure on the lower esophageal sphincter.”

6. You’re collecting a patient’s medication history that has GERD. Which medication below is NOT typically used to treat GERD?

A. Colesevelam “Welchol”

B. Omeprazole “Prilosec”

C. Metoclopramide “Reglan”

D. Ranitidine HCL “Zantac”

7. A patient is taking Bethanechol “Urecholine” for treatment of GERD. This is known as what type of drug?

A. Proton-pump inhibitor

B. Histamine receptor blocker

C. Prokinetic

D. Mucosal Healing Agent

8. Which of the following does NOT play a role in the development of GERD?

A. Pregnancy

B. Hiatal hernia

C. Usage of antihistamines or calcium channel blockers

D. All the above play a role in GERD

Answer Key:

1. A, B, D
2. C
3. B
4. A, B, D, E, G
5. D
6. A
7. C
8. D

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The nurse explains to the patient with gastroesophageal reflux disease that this disorder

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CE Connection

Sickle cell anemia

Best practices for patient-centered care

doi: 10.1097/01.NME.0000720280.28438.0b

  • Free

GENERAL PURPOSE: To provide information on patient-centered care best practices for treating vaso-occlusive crisis due to SCA. LEARNING OBJECTIVES/OUTCOMES: After completing this continuing-education activity, you should be able to: 1. Describe the prevalence, financial aspects, incidence, and pathophysiology of SCA. 2. Summarize patient-centered management strategies for patients with vaso-occlusive crisis due to SCA.

  1. When describing SCA to a patient, the nurse explains that it
    1. affects more than 1 million people in the US.
    2. causes RBCs to have longer life spans.
    3. is an inherited disorder causing a defect of the hemoglobin molecule in RBCs.
  2. The annual Medicare cost due to patients with SCA is estimated at
    1. $10 million.
    2. $100 million.
    3. $1 billion.
  3. The US occurrence rate for SCA is
    1. 1 out of every 365 births.
    2. 1 out of every 950 births.
    3. 1 out of every 1,000 births.
  4. The case study of Mr. E explains his symptoms when arriving at the ED. After an evaluation, the healthcare providers believe that he's experiencing
    1. drug-seeking behavior.
    2. a hypertensive crisis.
    3. a vaso-occlusive crisis.
  5. In the case study, the healthcare providers for Mr. E feel that his SCA crisis could be related to
    1. depression.
    2. dehydration.
    3. gastroesophageal reflux disease.
  6. In the case study, the hospitalist reviews Mr. E's existing medications and then addresses management of his present crisis, which includes providing
    1. esomeprazole.
    2. lisinopril.
    3. tramadol.
  7. In adults with SCA, one of the most common symptoms of vaso-occlusive crisis is
    1. fever.
    2. nausea.
    3. extremity pain.
  8. Patients with SCA have blood cells that contain an abnormal form of hemoglobin known as
    1. hemoglobin C.
    2. hemoglobin S.
    3. beta-globin hemoglobin.
  9. Patients with SCA have misshaped RBCs that cause an inadequate blood and oxygen supply by obstructing blood vessels, which leads to
    1. heavy bleeding.
    2. various malignancies.
    3. a vaso-occlusive crisis.
  10. The patient with SCA begins to show signs of jaundice. This is the result of rupturing sickle-shaped blood cells releasing hemoglobin into the
    1. liver.
    2. gallbladder.
    3. bloodstream.
  11. Darbari identified an intensification of stigma toward patients with SCA, including
    1. “drug seeking.”
    2. “hypochondriac.”
    3. “nonadherence.”
  12. The patient arrives at the hospital experiencing a vaso-occlusive crisis due to SCA. The standard first-line treatment is initiated, which includes
    1. an RBC transfusion.
    2. opioid administration.
    3. comfort measures and relaxation techniques.
  13. When a patient with SCA is experiencing a crisis, barriers to receiving care for symptom control in the ED include
    1. overcrowding.
    2. overtraining of healthcare providers.
    3. reduced turnover rates of healthcare providers.
  14. According to the Expert Panel Report released by the National Heart, Lung, and Blood Institute, the best route of medication administration for vaso-occlusive crisis is I.V. or
    1. oral.
    2. I.M.
    3. subcutaneous.
  15. The patient with SCA is experiencing vaso-occlusive pain and asks for meperidine. The healthcare provider explains that this medication
    1. should be avoided.
    2. needs to be increased by 25% until the pain is controlled.
    3. is usually combined with another medication to increase effectiveness.
  16. Within 30 minutes of triage in the ED, safe and effective relief of vaso-occulusive crisis includes
    1. strict fluid and food restrictions.
    2. rapid analgesia administration of opioids.
    3. avoidance of using heat to the affected area.
  17. Stat labs for vaso-occlusive crisis would most likely include
    1. drug toxicology.
    2. sedimentation rate.
    3. lactate dehydrogenase.
  18. After the patient with SCA is treated with first-line therapy for severe pain, a CAM therapy is initiated, which includes
    1. massage.
    2. meperidine.
    3. cold compresses.
  19. When using morphine for a vaso-occlusive crisis, it acts by increasing
    1. adverse reactions and shouldn't be used.
    2. blood flow to areas with less blood flow.
    3. the stiff sickle shape of RBCs.
  20. During treatment for SCA, patients are often
    1. instructed to restrict fluids.
    2. provided I.V. fluids due to dehydration.
    3. comforted with cold compresses on painful areas.
Wolters Kluwer Health, Inc. All rights reserved.

Which instruction should be discussed with the client diagnosed with gastroesophageal reflux disease GERD )?

Avoid foods that decrease the pressure in the lower esophagus, such as fatty foods, alcohol and peppermint. Avoid foods that affect peristalsis (the muscle movements in your digestive tract), such as coffee, alcohol and acidic liquids. Avoid foods that slow gastric emptying, including fatty foods. Avoid large meals.

What are common clinical findings associated with the presence of gastroesophageal reflux disease?

Findings include erosions and ulcerations, strictures, hiatal hernia, thickening of mucosal folds and poor distensibility. Only a minority of patients with documented abnormal pH have radiographically evident esophagitis. Consequently, a radiographic study is not the test of choice for the diagnosis of GERD.

What is the mechanism responsible for gastroesophageal reflux?

Gastroesophageal reflux occurs when contents in the stomach flow back into the esophagus. This happens when the valve between the stomach and the esophagus, known as the lower esophageal sphincter, does not close properly.

Which would be the proper nursing intervention for the disorder in GERD?

Nursing Management.
Eat a low-fat, high-fiber diet..
Avoid irritants, such as spicy or acidic foods, alcohol, caffeine, and tobacco, because they increase gastric acid production..
Avoid food or drink 2 hours before bedtime or lying down after eating..
Elevate the head of the bed on 6” to 8” bocks..
Lose weight if necessary..

nurse explains patient gastroesophageal reflux disease disorder Gastritis NCLEX questions GERD symptoms

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