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The nurse is providing dietary education to a client with gastroesophageal reflux disease (GERD). The nurse indicates that the client understands the teaching if the client states a plan to avoid which foods to prevent symptom exacerbation? (Select all that apply)

Tea.

Beer.

Cheese.

Oatmeal.

Chocolate.

Sweet potatoes.

Alcohol.

French fries.

Answer and Explanation

Correct Answer : A,B,E,G,H

Choice A reason: Tea, especially caffeinated, relaxes the lower esophageal sphincter, worsening GERD symptoms. Avoiding it shows understanding, making this a correct food the nurse would expect the client to avoid based on dietary education to prevent GERD exacerbation.

Choice B reason: Beer, an alcoholic beverage, irritates the esophagus and relaxes the sphincter, triggering GERD symptoms. Avoiding it reflects correct understanding, making this a correct food the nurse would include in teaching for the client to prevent GERD flare-ups.

Choice C reason: Cheese, while high-fat, is less likely to trigger GERD than alcohol or chocolate. Oatmeal is GERD-friendly, making this incorrect, as it’s not a primary trigger compared to the nurse’s teaching on foods to avoid for GERD symptom management.

Choice D reason: Oatmeal is a bland, high-fiber food that soothes GERD symptoms, not exacerbating them. Avoiding chocolate is correct, making this incorrect, as it’s a beneficial food, unlike the triggers the nurse teaches the client to avoid in GERD management.

Choice E reason: Chocolate contains caffeine and fat, relaxing the esophageal sphincter and worsening GERD. Avoiding it shows understanding, making this a correct food the nurse would expect the client to avoid to prevent symptom exacerbation based on GERD dietary teaching.

Choice F reason: Sweet potatoes are low-fat and non-irritating, not triggering GERD symptoms. Avoiding alcohol is correct, making this incorrect, as it’s a safe food, unlike the nurse’s teaching on foods the client should avoid to manage GERD effectively.

Choice G reason: Alcohol, including beer, relaxes the esophageal sphincter and irritates the mucosa, exacerbating GERD. Avoiding it reflects understanding, making this a correct food the nurse would include in teaching for the client to prevent GERD symptom flare-ups.

Choice H reason: French fries, high in fat, delay gastric emptying and worsen GERD symptoms. Avoiding them shows understanding, making this a correct food the nurse would expect the client to avoid based on dietary education to manage GERD effectively.

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Correct Answer is C

Explanation

Choice A reason: Leg exercises prevent thrombosis post-gastrojejunostomy, a standard order. Irrigating the NG tube risks anastomosis disruption, making this incorrect, as it’s a safe prescription the nurse wouldn’t question in the client’s postoperative care plan.

Choice B reason: Early ambulation reduces complications like pneumonia after Billroth II surgery. Irrigating the NG tube is risky, making this incorrect, as it’s a standard order the nurse wouldn’t need to verify in the postoperative period.

Choice C reason: Irrigating the nasogastric tube post-gastrojejunostomy risks disrupting the surgical anastomosis, causing leakage. This requires verification, aligning with surgical safety, making it the correct prescription the nurse would question in the client’s postoperative care.

Choice D reason: Coughing and deep-breathing exercises prevent atelectasis post-surgery, a routine order. Irrigating the NG tube is concerning, making this incorrect, as it’s a safe prescription the nurse wouldn’t question in the client’s recovery plan.

A. The nurse discusses the pulse oximetry findings with the client. B. The client has the pulse oximeter and automatic blood pressure cuff on the same arm. C. The pulse oximeter is placed on the ring finger of the client’s right hand. D. The nurse instructs nursing assistive personnel to obtain a pulse oximetry reading.

Correct Answer is B

Explanation

Choice A reason: Discussing pulse oximetry findings with the client is appropriate and promotes understanding, not requiring intervention. A blood pressure cuff on the same arm affects readings, making this incorrect, as it’s a correct nursing action for the client with Raynaud’s and diabetes.

Choice B reason: A blood pressure cuff on the same arm as the pulse oximeter disrupts blood flow, causing inaccurate readings, especially in Raynaud’s disease. This requires intervention, aligning with monitoring accuracy standards, making it the correct situation for the nurse to address immediately.

Choice C reason: Placing the pulse oximeter on the ring finger is appropriate, avoiding Raynaud’s-affected areas. A cuff on the same arm is problematic, making this incorrect, as it’s a standard placement not requiring intervention in the client’s monitoring setup.

Choice D reason: Instructing assistive personnel to obtain readings is acceptable if within their scope. A cuff on the same arm affects accuracy, making this incorrect, as it’s not an issue compared to the intervention needed for the pulse oximeter placement error.

Choice E reason: An LPN recording the pulse from the oximeter is within their role and not problematic. A cuff on the same arm requires intervention, making this incorrect, as it’s a correct action unlike the inaccurate monitoring setup needing nurse correction.

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The nurse is providing dietary education to a client with gastroesophageal reflux disease (GERD). The nurse indicates that the client understands the teaching if the client states a plan to avoid which foods to prevent symptom exacerbation? (Select all that apply)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with severe ulcer disease in the distal stomach undergoes a gastrojejunostomy (Billroth II procedure). Which postoperative prescription would the nurse question and verify?

Correct Answer is C

Explanation

The nurse cares for a client diagnosed with Type 1 diabetes and Raynaud’s disease. The orders include continuous pulse oximetry monitoring. Which situation requires an intervention by the nurse?

Correct Answer is B

Explanation

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