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 B
Explanation
Choice A rationale
Checking plantar and dorsiflexion assesses neurological status requiring nursing expertise and cannot be delegated to UAP.
Choice B rationale
Log rolling every 2 hours maintains spinal alignment post-laminectomy, a straightforward, standardized task suitable for experienced UAP.
Choice C rationale
PCA assessment involves evaluating pain control methods, which require critical nursing judgments and is not appropriate to delegate.
Choice D rationale
Determining readiness to ambulate involves comprehensive assessment skills, evaluating multiple factors like pain, strength, and hemodynamic stability, beyond UAP’s scope of practice. .
Correct Answer is A
Explanation
Choice A rationale
Twelve hours without voiding indicates potential acute urinary retention due to ureteral obstruction, risking hydronephrosis or kidney damage, which requires immediate attention to preserve renal function.
Choice B rationale
Hematuria is common with kidney stones and generally not urgent unless accompanied by clots causing retention or excessive bleeding causing hemodynamic instability.
Choice C rationale
Fever indicates infection but at 37.7°C, it is considered low-grade and less urgent compared to obstruction. Normal body temperature is typically 36.1-37.2°C.
Choice D rationale
Cloudy urine suggests infection but lacks the immediacy of urinary retention or acute obstruction, which are potentially life-threatening.
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