A patient who has gastroesophageal reflux disease (GERD) is experiencing increasing discomfort.
Which patient statement to the nurse indicates that additional teaching about GERD is needed?
I quit smoking years ago, but I chew gum.
I sleep with the head of the bed elevated on 4-inch blocks.
I take antacids between meals and at bedtime each night.
I eat small meals and have a bedtime snack.
The Correct Answer is D
Choice A rationale
Chewing gum can increase salivary production, and while saliva may neutralize some stomach acid, the act of chewing can stimulate swallowing and possibly exacerbate symptoms by introducing excess air into the stomach. For GERD patients, avoiding gum may help reduce bloating and gas discomfort.
Choice B rationale
Elevating the head of the bed reduces the likelihood of acid reflux during sleep by using gravity to prevent stomach contents from flowing backward into the esophagus. This strategy aligns with GERD management guidelines and reduces nighttime symptoms.
Choice C rationale
Taking antacids between meals and at bedtime helps neutralize stomach acid temporarily, providing short-term relief of GERD symptoms. While effective, long-term use without addressing dietary and lifestyle factors is not ideal for managing GERD.
Choice D rationale
Eating small meals is beneficial for GERD, as it prevents overdistension of the stomach, but having a bedtime snack contradicts GERD management principles. Late-night eating may increase the risk of acid reflux when lying down, thus requiring more teaching.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Insulin lispro (Humalog) is a rapid-acting insulin that begins to lower blood glucose within 15 minutes of injection, with a peak effect occurring in 30 minutes to 1 hour. It mimics the insulin release following a meal, allowing for better postprandial glucose control.
Choice B rationale
Intermediate-acting insulin, such as NPH, has an onset of 1.5 to 4 hours and provides blood glucose control over an extended period. Insulin lispro does not fit this profile, as it acts quickly and is used for meal-time glucose management.
Choice C rationale
Long-acting insulins, such as glargine or detemir, have no peak and provide basal glucose control for 24 hours or more. Lispro is not suitable for basal control due to its rapid action and short duration.
Correct Answer is C
Explanation
Choice A rationale
Glyburide does not stimulate glucose uptake directly in skeletal muscles. Instead, it acts on pancreatic beta cells, affecting insulin release. Enhancing muscular glucose uptake occurs through insulin’s action downstream.
Choice B rationale
Glyburide does not primarily increase insulin sensitivity. Agents like metformin work to sensitize cells to insulin, but Glyburide functions by stimulating endogenous insulin release.
Choice C rationale
Glyburide stimulates insulin release from pancreatic beta cells by closing ATP-sensitive potassium channels, leading to calcium influx and insulin secretion. This increases circulating insulin, aiding glucose uptake and reducing blood glucose levels.
Choice D rationale
Glyburide does not inhibit carbohydrate breakdown in the intestines. Medications like alpha-glucosidase inhibitors target intestinal enzymes to slow carbohydrate digestion, unlike Glyburide’s pancreatic action.
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