A nurse is providing education to a client with GERD (gastroesophageal reflux disease). The client asks what measures can be taken independently to help reduce the symptoms. Which interventions would the nurse recommend?

Reintroducing foods that intensify symptoms one at a time

Promoting intake of food and fluids 1 to 2 hours before bedtime

Maintaining an upright position following meals

Increasing the amount of carbonated beverages

Answer and Explanation

The Correct Answer is C

Choice A reason: Reintroducing foods that intensify symptoms one at a time is not an intervention that the nurse would recommend for a client with GERD. Foods that can trigger or worsen GERD symptoms include spicy, acidic, fatty, or fried foods, chocolate, coffee, alcohol, mint, garlic, and onion. The nurse would advise the client to avoid or limit these foods, not to reintroduce them.

Choice B reason: Promoting intake of food and fluids 1 to 2 hours before bedtime is not an intervention that the nurse would recommend for a client with GERD. Eating or drinking close to bedtime can increase the risk of acid reflux, as the stomach contents can flow back into the esophagus when the client lies down. The nurse would suggest the client to have smaller and more frequent meals, and to avoid eating or drinking at least 3 hours before bedtime.

Choice C reason: Maintaining an upright position following meals is an intervention that the nurse would recommend for a client with GERD. Keeping an upright posture can help prevent or reduce acid reflux, as gravity can help keep the stomach contents in place. The nurse would encourage the client to avoid bending, stooping, or lying down for at least 2 hours after eating.

Choice D reason: Increasing the amount of carbonated beverages is not an intervention that the nurse would recommend for a client with GERD. Carbonated beverages can increase the production of gas and stomach acid, which can cause bloating, belching, and acid reflux. The nurse would advise the client to drink water or other non-carbonated fluids, and to avoid drinking through a straw or chewing gum, which can also introduce air into the stomach.

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Correct Answer is C

Explanation

Choice A reason: Pale yellow is the normal color of urine, indicating adequate hydration and no bilirubin in the urine. Bilirubin is a pigment that is produced when red blood cells are broken down. It is normally excreted in the bile, but if the bile duct is obstructed, it can accumulate in the blood and urine, causing jaundice and dark urine.

Choice B reason: Red urine can indicate blood in the urine, which can be caused by various conditions such as urinary tract infection, kidney stones, trauma, or cancer. It is not related to bile duct obstruction or cholecystitis.

Choice C reason: Greenish-brown urine can indicate bilirubin in the urine, which can be caused by bile duct obstruction or liver disease. It is a sign of cholestasis, which is a reduced or stopped flow of bile. The nurse should monitor the client for other signs of cholestasis such as jaundice, clay-colored stools, pruritus, and abdominal pain.

Choice D reason: Dark and concentrated urine can indicate dehydration, which can be caused by various factors such as fluid loss, fever, vomiting, or diarrhea. It is not related to bile duct obstruction or cholecystitis.

A. Client who weighs 28% above ideal body weight B. Client who has a waist circumference of 81.3 cm (32 in) C. Client who has a BMI of 28 D. Client who has a body fat of 22%

Correct Answer is A

Explanation

Choice A reason: This is the correct answer because weighing 28% above ideal body weight is a sign of obesity. Ideal body weight is an estimate of the weight that corresponds to the lowest mortality for a given height and gender. Obesity is defined as having a body weight that is 20% or more above ideal body weight.

Choice B reason: This is not the correct answer because having a waist circumference of 81.3 cm (32 in) is not a manifestation of obesity. Waist circumference is a measure of abdominal fat, which is associated with increased health risks. However, the cut-off point for waist circumference varies by gender and ethnicity. For women, a waist circumference of more than 88 cm (35 in) is considered high.

Choice C reason: This is not the correct answer because having a BMI of 28 is not a manifestation of obesity. BMI is a measure of body mass index, which is calculated by dividing weight in kilograms by height in meters squared. BMI is used to classify weight status and health risks. For adults, a BMI of 18.5 to 24.9 is considered normal, 25 to 29.9 is considered overweight, and 30 or more is considered obese.

Choice D reason: This is not the correct answer because having a body fat of 22% is not a manifestation of obesity. Body fat is a measure of the percentage of fat in the body, which is determined by various methods such as skinfold thickness, bioelectrical impedance, or underwater weighing. Body fat is influenced by age, gender, and physical activity. For women, a body fat of 21 to 33% is considered normal, 33 to 39% is considered high, and more than 39% is considered very high.

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A nurse is providing education to a client with GERD (gastroesophageal reflux disease). The client asks what measures can be taken independently to help reduce the symptoms. Which interventions would the nurse recommend?

Nursing Test Bank

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