A patient has been diagnosed with reflux esophagitis (GERD). What instruction by the nurse professional is most appropriate?
Exercise soon after eating to increase gastric emptying
Try these proton-pump inhibitors for 2 weeks
You need to schedule an upper Gl endoscopy soon
Over-the-counter antiemetics work well for this condition
The Correct Answer is B
A. Exercise soon after eating to increase gastric emptying: Physical activity immediately after meals may actually worsen reflux symptoms by increasing intra-abdominal pressure and promoting acid reflux.
B. Try these proton-pump inhibitors for 2 weeks: Proton-pump inhibitors (PPIs) are a first-line treatment for GERD. They reduce gastric acid production, promoting symptom relief and esophageal healing.
C. You need to schedule an upper GI endoscopy soon: Endoscopy is not immediately necessary unless there are alarm symptoms like dysphagia, weight loss, or bleeding. Initial management focuses on medication and lifestyle changes.
D. Over-the-counter antiemetics work well for this condition: Antiemetics are not effective in treating the underlying cause of GERD, which is acid reflux, not nausea or vomiting. They would not effectively treat the heartburn or esophageal inflammation associated with GERD.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Nausea: Nausea can occur with peptic ulcers, particularly if gastric emptying is delayed or if inflammation affects the stomach lining. However, it is not the most common or defining symptom.
B. Pain in the epigastric region: Epigastric pain is the hallmark symptom of peptic ulcers. It is typically described as burning or gnawing and may occur between meals or at night, often relieved by eating or antacids.
C. Melena: Melena, or black tarry stools, can occur if the ulcer bleeds, but this is more of a complication than a routine symptom. It indicates gastrointestinal bleeding and requires urgent evaluation.
D. Decreased appetite: Appetite changes may occur, especially if eating exacerbates pain in gastric ulcers. However, decreased appetite is not as frequent or specific a symptom as epigastric pain.
Correct Answer is C
Explanation
A. Hemorrhage: Hemorrhage leads to significant blood loss, resulting in decreased blood volume and reduced renal perfusion, which is a common cause of prerenal acute kidney injury (AKI).
B. Cirrhosis: Cirrhosis can cause systemic vasodilation and reduced effective circulating volume, leading to decreased renal blood flow and prerenal failure due to impaired kidney perfusion.
C. Kidney disease: Kidney disease itself is an intrinsic (renal) cause of kidney failure, involving direct damage to the kidney tissue, rather than prerenal failure caused by decreased perfusion.
D. Narrowing of the blood vessels leading to the kidneys: Renal artery stenosis reduces blood flow to the kidneys, causing prerenal failure by impairing kidney perfusion despite adequate circulating volume.
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