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 C

Explanation

Rationale:
A. Stop the blood transfusion immediately: There is no need to stop the transfusion, as type B negative blood is compatible with AB positive recipients. AB positive individuals are universal recipients and can safely receive red blood cells from any ABO and Rh-negative or Rh-positive blood type.

B. Prepare to administer antipyretics: Antipyretics are not required unless the client shows signs of a febrile reaction. There is no indication from the question that the client is experiencing such symptoms.

C. Monitor the client for any adverse reactions: This is the appropriate action. Although the blood type is compatible, it is standard protocol to closely monitor all clients during transfusion for signs of adverse reactions, especially within the first 15 minutes.

D. Transfuse the blood over 6 hr: Blood transfusions should be completed within 4 hours to reduce the risk of bacterial growth and hemolysis. Extending the transfusion to 6 hours violates safety guidelines.

A. Vitiligo B. Osteoporosis C. Myxedema D. Heat intolerance

Correct Answer is B

Explanation

Rationale:
A. Vitiligo: Vitiligo is an autoimmune condition characterized by depigmented patches of skin due to melanocyte destruction. It is more commonly associated with Addison's disease, not Cushing’s syndrome, which involves cortisol excess rather than deficiency.

B. Osteoporosis: Cushing's syndrome causes prolonged exposure to high cortisol levels, which inhibits bone formation and accelerates bone resorption. This leads to decreased bone density, making osteoporosis a common and expected finding in affected clients.

C. Myxedema: Myxedema refers to the severe hypothyroid state marked by non-pitting edema, dry skin, and slowed metabolism. It is associated with thyroid hormone deficiency, not the glucocorticoid excess seen in Cushing's syndrome.

D. Heat intolerance: Heat intolerance is a symptom more commonly linked to hyperthyroidism, where an increased metabolic rate leads to overheating. Clients with Cushing’s syndrome typically experience weight gain, fatigue, and cold intolerance rather than heat sensitivity.

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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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