GERD NCLEX Questions

Question 1

The male client tells the nurse he has been experiencing “heartburn” at night that awakens him. Which assessment question should the nurse ask?

1. How much weight have you gained recently?
2. What have you done to alleviate the heartburn?
3. Do you consume many milk and dairy products?
4. Have you been around anyone with a stomach virus?

Answer 1

2. Most clients with GERD have been self medicating with over the counter medications prior to seeking advice from a health-care provider. It is important to know what the client has been using to treat the problem.

Question 2

The nurse caring for a client diagnosed with GERD writes the client problem of “behavior modification.” Which intervention should be included for this problem?

1. Teach the client to sleep with a foam wedge under the head.
2. Encourage the client to decrease the amount of smoking.
3. Instruct the client to take over the counter medication for relief of pain.
4. Discuss the need to attend Alcoholics Anonymous to quit drinking.

Answer 2

1. The client should elevate the head of the bed on blocks or use a foam wedge to use gravity to help keep the gastric acid in the stomach and prevent reflux into the esophagus. behavior modification is changing ones behavior.

Question 3

The nurse is preparing a client diagnosed with GERD for discharge following an esophagogastroduodenoscopy. Which statement indicates the client understands the discharge instructions?

1. I should not eat for at least one day following this procedure.
2. I can lie down whenever I want after a meal. It won’t make a difference.
3. The stomach contents won’t bother my esophagus but will make me nauseous.
4. I should avoid orange juice and eating tomatoes until my esophagus heals

Answer 3

4. Orange juice and tomatoes are acidic, and the client diagnosed with GERD should avoid acidic foods u Tio the esophagus has had a chance to heal.

Question 4

The nurse is planning the care of a client diagnosed with lower esophageal sphincter dysfunction. Which dietary modifications should be included in the plan of care?

1. Allow any of the clients favorite foods as long as the amount is limited.
2. Have the client perform eructation exercises several times a day.
3. Eat four to six small meals a day and limit fluids during mealtimes.
4. Encourage the client to consume a glass of red wine with one meal a day.

Answer 4

3.clients should eat small frequent meals and limit fluids with the meals to prevent reflux into the esophagus from a distended stomach.

Question 5

The nurse is caring for a client diagnosed with GERD. Which nursing interventions should be implemented?

1. Place the client prone in bed and administer no steroidal anti-inflammatory medications.
2. Have the client remain upright at all times and walk from 30 minutes three (3) times a week.
3. Instruct the client to maintain a right lateral side lying position and take antacids before meals.
4. Elevate the head of the bed 30 degrees and discuss lifestyle modifications with the client.

Answer 5

4. The head of the bed should be elevated to allow gravity to help in preventing reflux. Lifestyle modifications of losing weight, making dietary modifications, attempting smoking cessation, discontinuing the use of alcohol, and not stooping or bending at the waist all help to decrease reflux.

Question 6

The nurse is caring for an adult client diagnosed with GERD. Which condition is the most common comorbid disease associated with GERD?

1. Adult onset asthma
2. Pancreatitis
3. Peptic ulcer disease
4. Increase gastric emptying.

Answer 6

1. Of adult onset asthma cases, 80% to 90% are caused by GERD.

Question 7

The nurses is administering morning medications at 0730. Which. Education should have priority?

1. A proton pump inhibitor
2. A non narcotic analgesic
3. A histamine receptor antagonist.
4. A mucosal barrier agent.

Answer 7

4. A mucosal barrier agent must be administered on an empty stomach for the medication to coat the stomach.

Question 8

The nurse is preparing a client diagnosed with GERD for surgery. Which information warrants notifying the HCP?

1. The clients Bernstein esophageal text wax positive.
2. The clients abdominal X-ray shows a hiatal hernia.
3. The clients WBC count is 14,000/mm3
4. The clients hemoglobin is 13.8 g/dL

Answer 8

3. The clients WBC count is elevated, indicating a possible infection, which warrants notifying the HCP.

Question 9

The charge nurse is making assignments. Staffing includes a registered nurse with five years of medical-surgical experience, a newly graduated registered nurse, and two unlicensed assistive personnel (UAP). Which client should be assigned to the most experienced nurse?

1. The 39 year old client diagnosed with lower esophageal dysfunction who is complaining of pyrosis.
2. The 54 year old client diagnosed with Barrett’s esophagus who is scheduled to have endoscopy this morning.
3. The 46 year old client diagnosed with gastroesophageal reflux disease who has wheezes in all five lobes.
4. The 68 year old client who is there day postoperative for hiatal hernia and needs to be ambulated four times today.

Answer 9

3. This client is exhibiting symptoms of asthma, a complication of GERD. This client should be assigned to the most experienced nurse.

Question 10

Which statement made by the client indicates to the nurse the client may be experiencing GERD?

1. My chest hurts when I walk up the stairs in my home.
2. I take antacid tablets with me wherever I go
3. My spouse tells me I snore very loudly at night
4. I drink six to seven soft drinks every day.

Answer 10

2. Frequent use of antacids indicates an acid reflux problem.

Question 11

The nurse is performing an admission assessment on a client diagnosed with GERD. Which signs and symptoms would indicate GERD?

1. Pyrosis, water brash, and flatulence.
2. Weight loss, dysarthria, and diarrhea.
3. Decreased abdominal fat, proteinuria, and constipation.
4. Midepigastric pain, positive H. Pylori test, and melena.

Answer 11

1. Pyrosis is heartburn, water brash is the feeling of saliva secretion as a result of reflux, and flatulence is gas-all symptoms of GERD.

Question 12

Which disease is the client diagnosed with GERD at greater risk for developing?

1. Hiatal hernia
2. Gastroenteritis
3. Esophageal cancer
4. Gastric cancer

Answer 12

3. Barrett’s esophagus results from long term erosion of the esophagus as a result of reflux of stomach contents secondary to GERD. This is a precursor to esophageal cancer.