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?

Jaundice

Anorexia

Stomatitis

Pyrosis

Answer and Explanation

The Correct Answer is D

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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Correct Answer is B

Explanation

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.

A. Position head of bed at 10 degrees. B. Encourage fluid intake of 1500 mL/day. C. Cough and deep breathe every 8 hr. D. Obtain a sputum culture.

Correct Answer is D

Explanation

A. Positioning the head of the bed at 10 degrees is not sufficient for optimizing respiratory function. Typically, the head of the bed should be elevated to 30–45 degrees to help with breathing and reduce the risk of aspiration.
B. Encouraging fluid intake of 1500 mL/day may be too low for a client with pneumonia. Adequate hydration is important to thin mucus and help with expectoration, especially in the context of pneumonia. Typically, fluid intake should be higher unless contraindicated.
C. Coughing and deep breathing every 8 hours is insufficient. To prevent atelectasis and promote effective clearance of secretions in clients with pneumonia, coughing and deep breathing should be done more frequently, typically every 2 hours.
D. Obtaining a sputum culture is a priority for determining the specific pathogen causing the pneumonia and guiding antibiotic treatment. A sputum culture helps identify bacterial, viral, or fungal organisms that may be present, which is crucial for managing recurrent pneumonia, especially in an immunocompromised client with AIDS.

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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?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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