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 D

Explanation

Choice A rationale
While it’s true that dentures and other oral appliances should be removed before an EGD to prevent damage or loss during the procedure, this information is not the most crucial for the patient to understand.
Choice B rationale
Although a sore throat can occur after an EGD due to the passage of the endoscope, it’s not the most important information. The patient should be aware that the sore throat is temporary and can be relieved with warm gargles or ice.
Choice C rationale

This choice is accurate. An EGD allows the doctor to directly visualize the esophagus, stomach, and part of the small intestine. However, this information, while important, is not the most critical aspect for the patient to understand about the post-procedure period.
Choice D rationale
This is the correct answer. After an EGD, it’s crucial for the patient to understand that they should not eat or drink until their gag reflex has returned. This is to prevent aspiration, which can occur if the patient tries to swallow food or liquid before the gag reflex is functioning properly.

A. “Can you share how you think having the ileostomy will affect you?” B. “Everyone worries about how they will manage their ileostomy at first.”. C. “This will cure your disease so you don’t spend so much time in the hospital.”. D. “Let’s discuss some strategies to help you adapt to life with an ileostomy.”. .

Correct Answer is A

Explanation

Choice A rationale

Asking the patient to share their concerns allows the nurse to understand the patient’s perspective and provide individualized care. It opens up a dialogue where the patient can express their fears and the nurse can provide reassurance and information.
Choice B rationale
While it’s true that many people worry about managing an ileostomy at first, this response does not address the patient’s specific concerns. It’s important to understand the patient’s individual fears and worries.

Choice C rationale
This response may be misleading. While an ileostomy can help manage the symptoms of ulcerative colitis, it does not cure the disease. It’s important to provide accurate information to the patient.

Choice D rationale
Discussing strategies to adapt to life with an ileostomy can be helpful, but it’s important to first understand the patient’s specific concerns. This response assumes what the patient needs without asking them.

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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

After a diagnostic work-up, a 56-year-old male client was diagnosed with a duodenal ulcer caused by Helicobacter pylori infection. After treatment, the client is to have an esophagogastroduodenoscopy (EGD). Which teaching should the nurse reinforce?

Correct Answer is D

Explanation

A nurse is providing care for a young adult patient who has ulcerative colitis and is scheduled for an ileostomy surgery. After a discussion with the healthcare provider, the patient expresses concern, “How will I ever be able to have a normal life after this?” How should the nurse respond?

Correct Answer is A

Explanation

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