NEW
Font size
WorksheetsNCM 116 Lec Seatwork #1
Total questions: 15
Worksheet time: 11mins
A 54-year-old man presents with chronic heartburn for 8 years, worsened at night. He reports recent unintentional weight loss, dysphagia to solids, and intermittent regurgitation. He takes OTC antacids daily with minimal relief. Vital signs are stable. Which action is the nurse’s priority recommendation?
Initiate a high-dose proton pump inhibitor
Encourage head-of-bed elevation and dietary modification
Refer the patient for upper endoscopy
Educate the patient on avoiding late-night meals
A 63-year-old woman reports postprandial epigastric burning, early satiety, and regurgitation when lying flat. A barium swallow reveals a sliding hiatal hernia. She denies chest pain or GI bleeding. Which intervention is most appropriate initially?
Surgical fundoplication
Small frequent meals and upright positioning after eating
Continuous nasogastric decompression
Long-term H2-receptor antagonist therapy
A 71-year-old man with a known paraesophageal hiatal hernia presents with sudden severe chest pain, dyspnea, and vomiting. He appears pale and diaphoretic. Which nursing action is most critical?
Administer prescribed antiemetics
Prepare the patient for emergent surgical evaluation
Place the patient in reverse Trendelenburg position
Administer IV proton pump inhibitor
A 45-year-old patient reports progressive dysphagia to both solids and liquids, nocturnal regurgitation of undigested food, and chest discomfort. Manometry confirms achalasia. Which explanation best describes the cause of the patient’s symptoms?
Decreased gastric acid secretion
Failure of the lower esophageal sphincter to relax
Weak peristalsis in the stomach
Increased esophageal inflammation
A patient undergoes pneumatic dilation for achalasia. Four hours later, the patient reports chest pain and increasing shortness of breath. Which action should the nurse take first?
Administer prescribed analgesics
Assess for signs of esophageal perforation
Encourage oral intake of warm liquids
Reassure the patient that discomfort is expected
A 38-year-old patient presents with epigastric pain, nausea, and vomiting after several days of NSAID use and heavy alcohol intake. Which intervention is most appropriate to prevent recurrence?
Initiate antiemetic therapy
Discontinue NSAIDs and alcohol use
Administer IV fluids
Provide proton pump inhibitor therapy
A hospitalized patient with severe gastritis has persistent vomiting and decreased level of consciousness. Which nursing intervention is the priority?
Administer ondansetron as ordered
Place the patient in a side-lying position
Provide oral care
Monitor electrolyte levels
A patient with a history of GERD presents with coffee-ground emesis and black tarry stools. Blood pressure is 92/58 mmHg. Which action should the nurse perform first?
Insert a nasogastric tube
Establish large-bore IV access
Administer IV proton pump inhibitor
Prepare the patient for endoscopy
A patient with chronic gastritis reports fatigue and dizziness. Labs show hemoglobin of 8.2 g/dL. Which finding best explains the anemia?
Decreased iron absorption
Chronic occult gastrointestinal blood loss
Hemodilution from IV fluids
Bone marrow suppression
A patient with GERD asks which lifestyle change would provide the greatest symptom relief. Which recommendation is most effective?
Avoid citrus fruits
Eat smaller meals
Elevate the head of the bed during sleep
Avoid carbonated beverages
A patient with achalasia reports frequent regurgitation and weight loss. Which dietary instruction is most appropriate?
Eat quickly to promote esophageal clearance
Consume thickened liquids
Eat slowly and remain upright after meals
Avoid all solid foods
A patient with active upper GI bleeding secondary to erosive gastritis is admitted. Which medication order should the nurse anticipate as priority?
Oral antacids
IV proton pump inhibitor
H2-receptor antagonist
Sucralfate
A patient presents with chest pain that worsens after meals and improves with antacids. Cardiac workup is negative. Which diagnosis is most likely?
Stable angina
GERD
Esophageal rupture
Acute gastritis
A patient with a hiatal hernia asks which activity should be avoided to reduce symptoms. Which instruction is most appropriate?
Light walking after meals
Wearing loose-fitting clothing
Bending at the waist after eating
Sleeping on the left side
A patient with prolonged vomiting from gastritis develops muscle cramps and cardiac dysrhythmias. Which imbalance is most likely responsible?
Hypernatremia
Hypocalcemia
Hypokalemia
Hypermagnesemia
