This is a quiz that contains NCLEX review questions for GERD. As a nurse providing care to a patient with GERD, it is important to know the signs and symptoms, pathophysiology, medications, nursing management, diet education, and complications. In the previous
NCLEX review series, I explained about other GI disorders you may be asked about on the NCLEX exam, so be sure to check out those reviews and quizzes as well. This quiz will test your knowledge on GERD in preparation for the NCLEX exam. (NOTE: When you hit submit, it will refresh this same page. Scroll down to
see your results.) 1. A patient reports frequent heartburn twice a week for the past 4 months. What other symptoms reported by the patient may indicate the patient has GERD? SELECT-ALL-THAT-APPLY: A. Bitter taste in mouth B. Dry cough C. Melena D. Difficulty swallowing E.
Smooth, red tongue F. Murphy’s Sign 2. Your patient, who is presenting with signs and symptoms of GERD, is scheduled to have a test that assesses the function of the esophagus’ ability to squeeze food down into the stomach and the closer of the lower esophageal sphincter. The patient asks you, “What is the name of the test I’m having later today?” You tell the patient the name of the test is: A. Lower Esophageal Gastrointestinal Series B. Transesophageal echocardiogram C. Esophageal manometry D. Esophageal pH monitoring 3. After dinner time, during hourly rounding, a patient awakes to report they feel like “food is coming up” in the back of their throat and that there is a bitter taste in their mouth. What nursing intervention will you perform next? A. Perform deep suctioning B. Assist the patient into the Semi-Fowler’s position C. Keep the patient NPO D. Instruct the patient to avoid milk products 4. During a home health visit, you are helping a patient develop a list of foods they should avoid due to GERD. Which items in the patient’s pantry should be avoided? SELECT-ALL-THAT-APPLY: A. Hot and Spicy Pork Rinds B. Peppermint patties C. Green Beans D. Tomato Soup E. Chocolate Fondue F. Almonds G. Oranges 5. After providing education to a patient with GERD. You ask the patient to list 4 things they can do to prevent or alleviate signs and symptoms of GERD. Which statement is INCORRECT? A. “It is best to try to consume small meals throughout the day than eat 3 large ones.” B. “I’m disappointed that I will have to limit my intake of peppermint and spearmint because I love eating those types of hard candies.” C. “It is important I avoid eating right before bedtime.” D. “I will try to lie down after eating a meal to help decrease pressure on the lower esophageal sphincter.” 6. You’re collecting a patient’s medication history that has GERD. Which medication below is NOT typically used to treat GERD? A. Colesevelam “Welchol” B. Omeprazole “Prilosec” C. Metoclopramide “Reglan” D. Ranitidine HCL “Zantac” 7. A patient is taking Bethanechol “Urecholine” for treatment of GERD. This is known as what type of drug? A. Proton-pump inhibitor B. Histamine receptor blocker C. Prokinetic D. Mucosal Healing Agent 8. Which of the following does NOT play a role in the development of GERD? A. Pregnancy B. Hiatal hernia C. Usage of antihistamines or calcium channel blockers D. All the above play a role in GERD Answer Key: 1. A, B, D More NCLEX Quizzes Don’t forget to tell your friends about this quiz by sharing it your Facebook, Twitter, and other social media. You can also take more fun nursing quizzes. *Disclaimer: While we do our best to provide students with accurate and in-depth study quizzes, this quiz/test is for educational and entertainment purposes only. Please refer to the latest NCLEX review books for the latest updates in nursing. This quiz is copyright RegisteredNurseRn.com. Please do not copy this quiz directly; however, please feel free to share a link to this page with students, friends, and others. DiagnosisPhysical examYour doctor will perform a physical exam to rule out other possible conditions, such as a respiratory infection or chronic obstructive pulmonary disease (COPD). Your doctor will also ask you questions about your signs and symptoms and about any other health problems. Tests to measure lung functionYou may be given lung function tests to determine how much air moves in and out as you breathe. These tests may include:
Lung function tests often are done before and after taking a medication to open your airways called a bronchodilator (brong-koh-DIE-lay-tur), such as albuterol. If your lung function improves with use of a bronchodilator, it's likely you have asthma. Additional testsOther tests to diagnose asthma include:
How asthma is classifiedTo classify your asthma severity, your doctor will consider how often you have signs and symptoms and how severe they are. Your doctor will also consider the results of your physical exam and diagnostic tests. Determining your asthma severity helps your doctor choose the best treatment. Asthma severity often changes over time, requiring treatment adjustments. Asthma is classified into four general categories:
TreatmentPrevention and long-term control are key to stopping asthma attacks before they start. Treatment usually involves learning to recognize your triggers, taking steps to avoid triggers and tracking your breathing to make sure your medications are keeping symptoms under control. In case of an asthma flare-up, you may need to use a quick-relief inhaler. MedicationsThe right medications for you depend on a number of things — your age, symptoms, asthma triggers and what works best to keep your asthma under control. Preventive, long-term control medications reduce the swelling (inflammation) in your airways that leads to symptoms. Quick-relief inhalers (bronchodilators) quickly open swollen airways that are limiting breathing. In some cases, allergy medications are necessary. Long-term asthma control medications, generally taken daily, are the cornerstone of asthma treatment. These medications keep asthma under control on a day-to-day basis and make it less likely you'll have an asthma attack. Types of long-term control medications include:
Quick-relief (rescue) medications are used as needed for rapid, short-term symptom relief during an asthma attack. They may also be used before exercise if your doctor recommends it. Types of quick-relief medications include:
If you have an asthma flare-up, a quick-relief inhaler can ease your symptoms right away. But you shouldn't need to use your quick-relief inhaler very often if your long-term control medications are working properly. Keep a record of how many puffs you use each week. If you need to use your quick-relief inhaler more often than your doctor recommends, see your doctor. You probably need to adjust your long-term control medication. Allergy medications may help if your asthma is triggered or worsened by allergies. These include:
Bronchial thermoplastyThis treatment is used for severe asthma that doesn't improve with inhaled corticosteroids or other long-term asthma medications. It isn't widely available nor right for everyone. During bronchial thermoplasty, your doctor heats the insides of the airways in the lungs with an electrode. The heat reduces the smooth muscle inside the airways. This limits the ability of the airways to tighten, making breathing easier and possibly reducing asthma attacks. The therapy is generally done over three outpatient visits. Treat by severity for better control: A stepwise approachYour treatment should be flexible and based on changes in your symptoms. Your doctor should ask about your symptoms at each visit. Based on your signs and symptoms, your doctor can adjust your treatment accordingly. For example, if your asthma is well controlled, your doctor may prescribe less medication. If your asthma isn't well controlled or is getting worse, your doctor may increase your medication and recommend more-frequent visits. Asthma action planWork with your doctor to create an asthma action plan that outlines in writing when to take certain medications or when to increase or decrease the dose of your medications based on your symptoms. Also include a list of your triggers and the steps you need to take to avoid them. Your doctor may also recommend tracking your asthma symptoms or using a peak flow meter on a regular basis to monitor how well your treatment is controlling your asthma. More Information
Clinical trialsExplore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition. Lifestyle and home remediesAlthough many people with asthma rely on medications to prevent and relieve symptoms, you can do several things on your own to maintain your health and lessen the possibility of asthma attacks. Avoid your triggersTaking steps to reduce your exposure to asthma triggers is a key part of asthma control. To reduce your exposure, you should:
Stay healthyTaking care of yourself can help keep your symptoms under control, including:
Alternative medicineCertain alternative treatments may help with asthma symptoms. However, keep in mind that these treatments are not a replacement for medical treatment, especially if you have severe asthma. Talk to your doctor before taking any herbs or supplements, as some may interact with the medications you take. In most cases, more research is needed to see how well alternative remedies work and to measure the extent of possible side effects. Alternative asthma treatments include:
Coping and supportAsthma can be challenging and stressful. You may sometimes become frustrated, angry or depressed because you need to cut back on your usual activities to avoid environmental triggers. You may also feel limited or embarrassed by the symptoms of the disease and by complicated management routines. But asthma doesn't have to be a limiting condition. The best way to overcome anxiety and a feeling of helplessness is to understand your condition and take control of your treatment. Here are some suggestions that may help:
Preparing for your appointmentYou're likely to start by seeing your family doctor or a general practitioner. However, when you call to set up an appointment, you may be referred to an allergist or a pulmonologist. Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well prepared. Here's some information to help you get ready for your appointment, as well as what to expect from your doctor. What you can doThese steps can help you make the most of your appointment:
Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. For asthma, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask other questions during your appointment. What to expect from your doctorYour doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:
Which information would the nurse include in discharge instructions for a patient with a new diagnosis of gastroesophageal?Discharge Instructions for Gastroesophageal Reflux Disease (GERD). Stay at a healthy weight. ... . Don't lie down after meals.. Don't eat late at night.. Raise the head of your bed by 4 to 6 inches. ... . Don't wear tight-fitting clothes.. Don't eat foods that might bother your stomach, such as:. Which instruction should be discussed with the client diagnosed with gastroesophageal reflux disease?Avoid foods that decrease the pressure in the lower esophagus, such as fatty foods, alcohol and peppermint. Avoid foods that affect peristalsis (the muscle movements in your digestive tract), such as coffee, alcohol and acidic liquids. Avoid foods that slow gastric emptying, including fatty foods. Avoid large meals.
Which instruction will be helpful to a client who has gastroesophageal reflux?Weight loss, smoking cessation, avoiding trigger foods, decreased alcohol use, avoiding late night meals and elevating the head of the bed have all been shown to reduce GERD symptoms and improve QOL[24].
Which interventions should the nurse initiate to lessen acid reflux in a client diagnosed with gastroesophageal reflux disease?Encourage small frequent meals of high calories and high protein foods. Small and frequent meals are easier to digest. Instruct to remain in upright position at least 2 hours after meals; avoiding eating 3 hours before bedtime. Helps control reflux and causes less irritation from reflux action into esophagus.
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