A client with active GERD presents to clinic. Which statement by the client indicates they need additional education?

"I will avoid alcohol and cigarettes."

I will have. small snack right before bedtime."

I will wear loose fitting clothes."

I will take all NSAIDs and steroids with food."

Answer and Explanation

The Correct Answer is B

A) "I will avoid alcohol and cigarettes.": This is a correct and important statement for a client with GERD. Both alcohol and cigarettes can relax the lower esophageal sphincter, increasing the likelihood of acid reflux and exacerbating GERD symptoms. Avoiding these substances is a standard recommendation for managing GERD.

B) "I will have a small snack right before bedtime.": This statement indicates the need for additional education. Eating a meal or snack right before bedtime can exacerbate GERD symptoms because lying down after eating can increase the likelihood of acid reflux. It is generally recommended for clients with GERD to avoid eating at least 2-3 hours before going to bed to reduce the risk of reflux.

C) "I will wear loose fitting clothes.": Wearing loose-fitting clothes is an appropriate measure for managing GERD. Tight clothing around the abdomen can increase pressure on the stomach, promoting acid reflux. Loose clothing helps avoid this additional pressure, which can alleviate symptoms.

D) "I will take all NSAIDs and steroids with food.": This is generally good advice for reducing the risk of stomach irritation caused by NSAIDs and steroids, which can worsen GERD symptoms or cause gastric ulcers. Taking these medications with food can help buffer the stomach lining and reduce irritation.

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Correct Answer is D

Explanation

A) Metoprolol XL: Metoprolol XL (extended-release) should not be crushed. Crushing extended-release formulations can result in the rapid release of the drug, leading to an overdose or adverse effects due to the immediate release of the full dose. The nurse should advise the client to swallow this medication whole.

B) Ibuprofen EC (enteric-coated): Enteric-coated medications should not be crushed. The enteric coating is designed to protect the stomach lining by preventing the medication from being released in the stomach. Crushing the tablet would destroy this protective mechanism and could irritate the stomach lining, leading to discomfort or ulceration.

C) Morphine ER (extended-release): Extended-release formulations of morphine should never be crushed. Crushing extended-release formulations can lead to a potentially fatal overdose because it releases the entire dose of medication at once. This can cause respiratory depression and other life-threatening effects.

D) Acetaminophen: Acetaminophen in its regular tablet form can be safely crushed if needed. Crushing acetaminophen does not affect its effectiveness or safety, and it is a non-extended-release formulation, making it safe for manipulation when necessary, such as for clients with difficulty swallowing. However, it's essential to verify with the specific prescription, as acetaminophen is also available in extended-release formulations, which should not be crushed.

Correct Answer is ["12"]

Explanation

1. Convert the child's weight from pounds to kilograms:

There are approximately 2.2 pounds in 1 kilogram.

33 pounds / 2.2 pounds/kg = 15 kg (approximately)

2. Calculate the total milligrams of amoxicillin needed per dose:

The order is for 20 mg/kg/dose.

The child weighs 15 kg.

20 mg/kg * 15 kg = 300 mg

3. Determine the concentration of the amoxicillin suspension:

The label shows the concentration is 125 mg/5 mL.

4. Set up a proportion to find the volume (in mL) needed:

125 mg / 5 mL = 300 mg / x mL

5. Solve for x:

Cross-multiply: 125x = 300 * 5

125x = 1500

x = 1500 / 125

x = 12 mL

Answer: You will administer 12 mL per dose.

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A client with active GERD presents to clinic. Which statement by the client indicates they need additional education?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which prescribed medication can the nurse instruct the client to crush if needed?

Correct Answer is D

Explanation

The order reads "amoxicillin 20mg/kg/dose PO every 8 hours." The child weighs 33 pounds. Using the label below, how many mL will you administer per dose? (Enter a number only, answer to the nearest tenths place)

Correct Answer is ["12"]

Explanation

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