A nurse is providing discharge teaching to a client who has gastroesophageal reflux disease (GERD). Which of the following statements by the client indicates an understanding of the teaching?

"I will eat a snack just before going to bed."

"I will sleep with the head of the bed elevated."

"The types of foods I eat do not affect this condition."

"I will eat bigger meals, that way I don't have frequent episodes."

Answer and Explanation

The Correct Answer is B

Choice A reason: Eating a snack just before going to bed is incorrect because it can exacerbate GERD symptoms. Lying down shortly after eating increases the likelihood of acid reflux, as gravity no longer helps keep stomach contents in the stomach.

Choice B reason: This is the correct answer. Sleeping with the head of the bed elevated helps reduce GERD symptoms by utilizing gravity to prevent stomach acids from flowing back into the esophagus. This position aids in minimizing nighttime reflux and discomfort.

Choice C reason: Stating that the types of foods eaten do not affect GERD is incorrect because certain foods can trigger or worsen symptoms. Clients with GERD are typically advised to avoid foods that are spicy, acidic, or high in fat to manage their condition better.

Choice D reason: Eating bigger meals is counterproductive in managing GERD. Larger meals increase stomach pressure and can lead to more frequent reflux episodes. Smaller, more frequent meals are recommended to help control symptoms.

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Correct Answer is C

Explanation

Choice A reason: A hemorrhagic stroke occurs due to bleeding in the brain, often from a burst blood vessel. While individuals with cardiovascular disease might have risk factors, atrial fibrillation primarily increases the risk for strokes caused by clots, not bleeding.

Choice B reason: A thrombotic stroke is caused by a clot that forms within the blood vessels of the brain. While cardiovascular disease can contribute to thrombosis, atrial fibrillation more commonly leads to embolic strokes due to clots forming in the heart and traveling to the brain.

Choice C reason: This is the correct answer. Atrial fibrillation increases the risk of embolic strokes because it can cause blood clots to form in the heart. These clots can travel to the brain and cause an embolic stroke, which is why patients with atrial fibrillation are often on anticoagulant therapy.

Choice D reason: A subarachnoid stroke involves bleeding in the space between the brain and the surrounding membrane. It is typically associated with aneurysms or head injury, rather than atrial fibrillation. This choice does not align with the client’s condition.

A. Prepare to take the client for a STAT CT of the head. B. Prepare to administer recombinant tissue plasminogen activator (rtPA). C. Notify speech pathologist for an emergency consult. D. Discuss the precipitating factors that caused the symptoms.

Correct Answer is A

Explanation

Choice A reason:

Preparing to take the client for a STAT CT of the head is crucial to quickly diagnose a possible stroke. Rapid imaging is essential to determine the type of stroke (ischemic or hemorrhagic), guiding appropriate treatment and improving outcomes. This immediate action is key in stroke management.

Choice B reason:

Administering rtPA is an appropriate intervention for an ischemic stroke but only after confirmation through imaging. Without imaging, there is a risk of worsening a potential hemorrhagic stroke. Hence, it is not the initial priority before confirming the diagnosis.

Choice C reason:

Notifying a speech pathologist for an emergency consult is relevant for assessing and managing speech and swallowing issues but is not the immediate priority. The primary focus should be on diagnosing and addressing the cause of the acute symptoms.

Choice D reason:

Discussing precipitating factors that caused the symptoms can be part of the assessment but is not the priority in the acute phase. Immediate imaging and medical intervention take precedence to mitigate the effects of a potential stroke.

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A nurse is providing discharge teaching to a client who has gastroesophageal reflux disease (GERD). Which of the following statements by the client indicates an understanding of the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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