A patient who has undergone an esophagectomy for esophageal cancer develops increasing pain, fever, and dyspnea when a full liquid diet is started postoperatively. The nurse recognizes that these symptoms are most indicative of:

An intolerance to the feedings

Esophageal perforation with fistula formation into the lung

Extension of the tumor into the aorta

Leakage of fluids into the mediastinum

Answer and Explanation

The Correct Answer is B

A. An intolerance to the feedings might cause discomfort, but it would not typically cause increasing pain, fever, and dyspnea. These symptoms are more indicative of a serious complication.
B. Esophageal perforation with fistula formation into the lung is the most likely cause of these symptoms. A perforation can lead to leakage of gastric contents into the pleural space or mediastinum, causing fever, pain, and respiratory distress. The formation of a fistula between the esophagus and the lung would lead to dyspnea.
C. Extension of the tumor into the aorta is a rare complication that would typically manifest with symptoms related to cardiovascular issues, not gastrointestinal symptoms like fever and dyspnea.
D. Leakage of fluids into the mediastinum is a possible cause of the symptoms, but esophageal perforation with a fistula into the lung is more directly linked to these specific symptoms, especially dyspnea.

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Correct Answer is D

Explanation

A. Elevated serum potassium levels are not a specific finding related to gastric ulcers. They may be seen with other conditions such as kidney dysfunction or the use of certain medications (e.g., diuretics).
B. An increased white blood cell count is often associated with infection or inflammation but is not specific to gastric ulcers.
C. Mid epigastric pain that worsens with eating is more characteristic of duodenal ulcers, not gastric ulcers.
D. Epigastric pain that worsens with eating is a hallmark symptom of a gastric ulcer. This pain is typically aggravated by food intake due to the increased acid production in the stomach during digestion.

A. The patient's white blood cell (WBC) count is 6000/μL. B. Bronchial breath sounds are heard at the right base. C. Increased tactile fremitus is palpable over the right chest. D. The patient coughs up small amounts of green mucus.

Correct Answer is A

Explanation

A. A decrease in the white blood cell count toward normal levels indicates that the infection is responding to antibiotic treatment. A WBC count of 6000/μL is within the normal range for adults (usually 4,000–11,000/μL), which suggests that the body is no longer fighting a significant infection.
B. Bronchial breath sounds heard at the right base indicate consolidation, a sign of ongoing pneumonia or unresolved infection. This would suggest that the infection is not yet controlled, rather than an improvement.
C. Increased tactile fremitus indicates consolidation, which is commonly seen in pneumonia. It suggests that the infection is still present and has not resolved with treatment.
D. Green mucus can indicate the presence of purulent sputum and ongoing infection. Although the color of the mucus may change during the course of pneumonia, the presence of green mucus does not confirm that the infection is resolving, especially after three days of antibiotics.

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A patient who has undergone an esophagectomy for esophageal cancer develops increasing pain, fever, and dyspnea when a full liquid diet is started postoperatively. The nurse recognizes that these symptoms are most indicative of:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is admitted to the nursing unit with a diagnosis of gastric ulcer. Which assessment finding by the nurse supports the client's diagnosis of gastric ulcer?

Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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