A nurse is teaching a client who has a new diagnosis of gastroesophageal reflux disease. Which of the following instructions should the nurse include?

"Lie down after meals."

"Elevate the head of the bed while sleeping."

"Eat a snack 1 hour before going to bed."

"Eat three large meals each day."

Answer and Explanation

The Correct Answer is B

Rationale:
A. "Lie down after meals.": Lying down after eating increases the risk of gastric contents refluxing into the esophagus due to gravity. Clients with GERD should remain upright for at least 2 to 3 hours after meals to minimize symptoms.
B. "Elevate the head of the bed while sleeping.": Elevating the head of the bed by 6 to 8 inches helps prevent nighttime reflux by using gravity to reduce backward flow of stomach acid into the esophagus, which is a key strategy in GERD management.
C. "Eat a snack 1 hour before going to bed.": Eating close to bedtime can exacerbate GERD symptoms by increasing gastric volume and acid production, especially when the client lies down soon after eating. A longer gap between the last meal and sleep is advised.
D. "Eat three large meals each day.": Large meals increase gastric pressure and acid production, worsening reflux symptoms. Clients with GERD should eat smaller, more frequent meals to reduce gastric distension and minimize acid reflux episodes.

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Correct Answer is A

Explanation

Rationale:
A. Blurred vision: Ethambutol is known to cause optic neuritis, which can lead to blurred vision, decreased visual acuity, and impaired red-green color discrimination. Clients on ethambutol should be monitored for changes in vision and advised to report any visual disturbances immediately.

B. Tinnitus: Tinnitus is not a typical adverse effect of ethambutol. It is more commonly associated with other anti-tuberculosis drugs such as streptomycin, which can cause ototoxicity, especially affecting the auditory and vestibular systems.

C. Peripheral edema: Peripheral edema is not commonly linked to ethambutol use. It may occur with certain cardiovascular medications or conditions but is not an expected side effect of this antitubercular drug.

D. Bradycardia: Bradycardia is not a recognized adverse effect of ethambutol. This medication primarily affects the eyes rather than the cardiovascular system. Monitoring for vision changes is a higher priority when assessing for side effects.

A. Use a 3 mL syringe to flush the PICC following infusions. B. Assess the PICC infusion system systematically. C. Change the needleless connector device on the IV tubing after each infusion. D. Provide daily dressing changes to the PICC insertion site.

Correct Answer is B

Explanation

Rationale:
A. Use a 3 mL syringe to flush the PICC following infusions: A syringe smaller than 10 mL creates excessive pressure, which can damage the catheter. A 10 mL syringe or larger should always be used to flush a PICC to maintain catheter integrity.

B. Assess the PICC infusion system systematically: Systematic assessment of the PICC line, including the site, tubing, and connections, is essential for detecting complications such as infiltration, infection, or occlusion. This promotes safe and effective use of the catheter.

C. Change the needleless connector device on the IV tubing after each infusion: The needleless connector device does not need to be changed after each infusion. It is typically changed every 7 days or if contamination, leakage, or other issues are noted.

D. Provide daily dressing changes to the PICC insertion site: PICC dressings should be changed every 7 days if using a transparent dressing, or sooner if the dressing becomes damp, loose, or visibly soiled. Daily dressing changes increase infection risk unnecessarily.

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A nurse is teaching a client who has a new diagnosis of gastroesophageal reflux disease. Which of the following instructions should the nurse include?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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