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 ["A","C","D","E"]

Explanation

A. Serum phosphorus is crucial to monitor in patients at risk for refeeding syndrome. Hypophosphatemia is a key sign of the syndrome and can lead to severe complications, such as respiratory failure and cardiac arrhythmias.
B. Serum blood glucose levels are important to monitor, especially since refeeding syndrome can cause rapid shifts in glucose metabolism. However, it is not a primary test to diagnose refeeding syndrome. Blood glucose monitoring will be part of the overall management, but not the core test for the syndrome.
C. Serum calcium should be monitored because it can also decrease in refeeding syndrome due to shifts in phosphate and magnesium levels, which may affect calcium metabolism.
D. Serum potassium is essential to monitor because hypokalemia often occurs in refeeding syndrome as the body shifts electrolytes into cells. This can cause muscle weakness, arrhythmias, and other serious complications.
E. Serum magnesium is also important to check, as hypomagnesemia is commonly seen in refeeding syndrome and can contribute to neurological and cardiac symptoms.

A. Chronic alcohol consumption B. High intake of spicy foods C. Inadequate fiber intake D. Nonsteroidal anti-inflammatory drugs

Correct Answer is D

Explanation

A. Chronic alcohol consumption can contribute to ulcers but is not the primary cause of duodenal ulcers. It can increase stomach acid and irritate the mucosal lining.
B. High intake of spicy foods is often blamed for ulcers, but it is not a direct cause. Spicy foods may exacerbate symptoms but do not cause ulcers.
C. Inadequate fiber intake is not a significant factor in the development of duodenal ulcers. Diet can influence overall digestive health but is not the main cause.
D. Nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin and ibuprofen, are a leading cause of duodenal ulcers. They inhibit prostaglandin production, which protects the mucosal lining of the stomach and duodenum, leading to ulcer formation and increased risk of bleeding.

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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 patient with anorexia nervosa shows signs of malnutrition and is prescribed parenteral nutrition. If the client develops refeeding syndrome, what laboratory tests does the nurse expect the healthcare provider to order? (Select all that apply.)

Correct Answer is ["A","C","D","E"]

Explanation

A 36-year-old patient with suspected gastrointestinal (GI) bleeding undergoes a diagnostic endoscopy which determines the site of bleeding is a duodenal ulcer. The nurse explains to the patient that bleeding ulcers are commonly related to which of the following:

Correct Answer is D

Explanation

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