The nurse is providing discharge instructions for a slightly overweight client seen in the Emergency Department with gastroesophageal reflux disease (GERD). Which instruction should the nurse give for management of this disease process?

Drink a carbonated beverage before bed

Increase fatty foods one at a time

Elevate the head of the bed when sleeping

Eat dinner late in the evening

Answer and Explanation

The Correct Answer is C

Choice A reason: This is not a correct instruction because drinking a carbonated beverage before bed can worsen the reflux symptoms by increasing the gastric pressure and the production of gas.

Choice B reason: This is not a correct instruction because increasing fatty foods can worsen the reflux symptoms by delaying the gastric emptying and relaxing the lower esophageal sphincter (LES), which allows the stomach acid to flow back into the esophagus.

Choice C reason: This is a correct instruction because elevating the head of the bed when sleeping can help prevent the reflux symptoms by using gravity to keep the stomach contents from flowing back into the esophagus.

Choice D reason: This is not a correct instruction because eating dinner late in the evening can worsen the reflux symptoms by increasing the amount and acidity of the stomach contents, which can easily flow back into the esophagus when lying down. The client should avoid eating within 3 hours of bedtime.

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Correct Answer is D

Explanation

Choice A reason: This is not a correct answer because 0.9% Sodium Chloride is an isotonic solution, which means it has the same osmolarity as the blood plasma. It does not cause any fluid shifts between the intracellular and extracellular compartments.

Choice B reason: This is not a correct answer because Lactated Ringer's is an isotonic solution, which means it has the same osmolarity as the blood plasma. It does not cause any fluid shifts between the intracellular and extracellular compartments.

Choice C reason: This is not a correct answer because D5W (5% Dextrose in Water) is an isotonic solution when it is in the IV bag, but it becomes hypotonic once it enters the body, as the dextrose is rapidly metabolized and only water remains. However, it is not a preferred solution for a patient with critically high sodium, as it can cause cerebral edema and worsen the neurological status.

Choice D reason: This is a correct answer because 0.45% Sodium Chloride is a hypotonic solution, which means it has a lower osmolarity than the blood plasma. It causes fluid to shift from the extracellular to the intracellular compartment, which can help lower the sodium level and correct the fluid imbalance.

A. Fatty stools B. Tenderness in the left upper abdomen C. Ecchymosis of the extremities D. Pale-colored urine

Correct Answer is A

Explanation

Choice A reason: This is a correct finding for a client with an obstruction of the common bile duct. Fatty stools are caused by the reduced or absent flow of bile into the intestine, which impairs the digestion and absorption of fats.

Choice B reason: This is not a correct finding for a client with an obstruction of the common bile duct. Tenderness in the left upper abdomen may indicate a problem with the spleen, the stomach, or the pancreas, but not the bile duct.

Choice C reason: This is not a correct finding for a client with an obstruction of the common bile duct. Ecchymosis of the extremities is a bruising of the skin due to bleeding under the surface. It may be caused by trauma, medication, or bleeding disorders, but not by bile duct obstruction.

Choice D reason: This is not a correct finding for a client with an obstruction of the common bile duct. Pale-colored urine is a sign of dilute or low concentration of urine, which may be caused by excessive fluid intake, diabetes insipidus, or kidney failure, but not by bile duct obstruction.

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The nurse is providing discharge instructions for a slightly overweight client seen in the Emergency Department with gastroesophageal reflux disease (GERD). Which instruction should the nurse give for management of this disease process?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is to administer a hypotonic solution to a patient with a critically high sodium. Which solution is hypotonic?

Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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