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. This is an appropriate statement. Most patients with an ileostomy can resume physical activities and exercise, though they should be mindful of their stoma and pouch during activities.
B. This is a correct statement. The pouch should be emptied when it is about one-third to one-half full to prevent it from becoming too heavy or causing skin irritation.
C. This is also correct. Adhesive remover can be used to gently remove the pouch and adhesive, preventing irritation to the skin around the stoma.
D. This statement indicates a need for more teaching. While many foods can be eaten after an ileostomy, some foods may cause blockages or discomfort (e.g., nuts, seeds, and high-fiber vegetables). Patients need to be educated on dietary modifications and precautions post-ileostomy.

A. Jaundice B. Anorexia C. Stomatitis D. Pyrosis

Correct Answer is D

Explanation

A. Jaundice is typically related to liver dysfunction and would not be a primary symptom of a hiatal hernia.
B. Anorexia is not a primary symptom of a sliding hiatal hernia, although some patients may experience reduced appetite due to discomfort.
C. Stomatitis (inflammation of the mouth) is not typically associated with a hiatal hernia.
D. Pyrosis, or heartburn, is a primary symptom of a sliding hiatal hernia, which occurs when stomach acid refluxes into the esophagus due to the hernia. This can lead to the sensation of heartburn or acid reflux.

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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

The nurse is completing discharge teaching with a patient following an ileostomy. Which statement by the patient indicates the need for more teaching concerning the ileostomy?

Correct Answer is D

Explanation

The nurse understands that the primary symptoms of a sliding hiatal hernia are associated with reflux. Therefore, the nurse should assess the client with a hiatal hernia for which of the following symptoms?

Correct Answer is D

Explanation

A client comes to the clinic complaining of dysphagia and states that "he feels like food is stuck in his throat." The physician suspects esophageal cancer. Which of the following is a risk factor for esophageal cancer?

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