A nurse is collecting data from a patient who has gastroesophageal reflux disease (GERD) and reports experiencing heartburn every night.
Which of the following actions should the nurse identify as a contributing factor to the patient’s heartburn?

Choice A rationale

While a bulge at the hernia site is a common symptom of an umbilical hernia, it is not typically a cause for immediate concern or a reason to alert the healthcare provider.
Choice B rationale
Mild discomfort may be associated with an umbilical hernia, but it is not typically a cause for immediate concern or a reason to alert the healthcare provider.
Choice C rationale
A bulge that disappears when lying down is a common characteristic of an umbilical hernia and is not typically a cause for immediate concern or a reason to alert the healthcare provider.
Choice D rationale
Nausea and vomiting could indicate that the hernia has become strangulated, which is a medical emergency. Strangulation occurs when the blood supply to the herniated tissue is cut off. This is a serious complication that requires immediate medical attention.
Question 50.

Choice A rationale
Famotidine is a histamine-2 blocker used to decrease the amount of acid the stomach produces. It is not typically associated with liver disease.
Choice B rationale
Levothyroxine is a thyroid hormone used to treat hypothyroidism. It is not typically associated with liver disease.
Choice C rationale
Furosemide is a diuretic used to treat fluid retention (edema) in people with congestive heart failure, liver disease, or a kidney disorder such as nephrotic syndrome. It is not typically associated with liver disease.
Choice D rationale
Acetaminophen is a common over-the-counter medication used to relieve pain and reduce fever. However, high doses or long-term use of acetaminophen can cause liver damage.