The nurse is providing care for a patient who had surgical repair of a paraesophageal (rolling) hernia. The nurse observes that the patient is having difficulty swallowing during the first postoperative meal.What action should the nurse take?

Assure the patient the problem is temporary.

Cut the food into small pieces.

Report the observation to the healthcare provider (HCP).

Offer the patient liquids instead.

Answer and Explanation

The Correct Answer is C

Choice A rationale
Assuring the patient that the problem is temporary may not be accurate. Postoperative dysphagia could indicate a complication from the surgery, such as the stomach fundus being wrapped too tight around the esophagus, causing food obstruction. It’s important to not dismiss the patient’s concerns without proper assessment.
Choice B rationale
Cutting the food into small pieces might help the patient swallow easier, but it does not address the underlying issue. The patient’s difficulty in swallowing could be a sign of a serious problem that needs medical attention.
Choice C rationale
Reporting the observation to the healthcare provider (HCP) is the correct action. After the repair of a paraesophageal hernia, dysphagia should be reported to the HCP. The corrective fundoplication surgery may have the stomach fundus wrapped too tight around the esophagus, causing food obstruction.
Choice D rationale

Offering the patient liquids instead might alleviate the symptom temporarily, but it does not solve the potential problem. The healthcare provider needs to be informed about the dysphagia to assess and treat the possible complication.

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Correct Answer is B

Explanation

Choice A rationale

While it’s important to ensure the feeding bag contains enough formula for the feeding period, it’s not recommended to fill the bag with more than 4-6 hours’ worth of formula at a time due to the risk of bacterial growth.
Choice B rationale
This is the correct answer. Flushing the gastrostomy tube with water every 4 hours helps maintain tube patency and hydrates the patient.
Choice C rationale
Changing the feeding bag and tubing every 72 hours is a common practice, but it’s not the most critical intervention in this scenario.
Choice D rationale
Keeping the head of the bed elevated at 30 to 45 degrees during feeding and for 1 to 2 hours afterward is recommended to minimize the risk of aspiration. However, 15 degrees may not be sufficient.

A. Sleeping on a large wedge-style pillow B. Consuming low-fat meats C. Eating dinner early in the evening D. Regularly drinking orange juice

Correct Answer is D

Explanation

Choice A rationale
Sleeping on a large wedge-style pillow can actually help reduce heartburn symptoms by elevating the head and preventing stomach acid from flowing back into the esophagus.
Choice B rationale
Consuming low-fat meats is generally recommended for patients with GERD as fatty foods can trigger heartburn symptoms.
Choice C rationale
Eating dinner early in the evening can help prevent heartburn as it allows the stomach to empty before lying down, reducing the risk of acid reflux.
Choice D rationale
Regularly drinking orange juice can contribute to heartburn in patients with GERD. Orange juice is acidic and can lower the pH of the stomach, triggering symptoms of heartburn.

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The nurse is providing care for a patient who had surgical repair of a paraesophageal (rolling) hernia. The nurse observes that the patient is having difficulty swallowing during the first postoperative meal.What action should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is contributing to the plan of care for a client who has a gastrostomy tube through which he is receiving continuous enteral feedings. Which of the following interventions should the nurse include in the plan?

Correct Answer is B

Explanation

A nurse is collecting data from a patient who has gastroesophageal reflux disease (GERD) and reports experiencing heartburn every night. Which of the following actions should the nurse identify as a contributing factor to the patient’s heartburn?

Correct Answer is D

Explanation

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