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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: This is a correct answer because normal saline 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, and it can help restore the fluid balance and the blood pressure of the dehydrated client.
Choice B reason: This is not a correct answer because 1/2 normal saline 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 lead to cellular swelling and edema. It is not suitable for rapid infusion, as it can cause hemolysis and hypotension.
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. It causes fluid to shift from the extracellular to the intracellular compartment, which can lead to cellular swelling and edema. It is not suitable for rapid infusion, as it can cause hemolysis and hypotension.
Choice D reason: This is not a correct answer because D5 1/2 normal saline is a hypertonic solution, which means it has a higher osmolarity than the blood plasma. It causes fluid to shift from the intracellular to the extracellular compartment, which can lead to cellular shrinkage and dehydration. It is not suitable for rapid infusion, as it can cause hypernatremia and fluid overload.
Correct Answer is B
Explanation
Choice A reason: MRI is not a diagnostic procedure for Barrett esophagus. MRI is a type of imaging test that uses magnetic fields and radio waves to create detailed pictures of the internal organs and tissues. It is mainly used to diagnose problems in the brain, spine, joints, and blood vessels.
Choice B reason: EGD is a diagnostic procedure for Barrett esophagus. EGD is a type of endoscopy that uses a flexible tube with a light and a camera to examine the esophagus, stomach, and duodenum. It can detect changes in the lining of the esophagus that may indicate Barrett esophagus, a condition where the normal squamous cells are replaced by columnar cells due to chronic acid exposure.
Choice C reason: Colonoscopy is not a diagnostic procedure for Barrett esophagus. Colonoscopy is a type of endoscopy that uses a flexible tube with a light and a camera to examine the colon and rectum. It is mainly used to screen for colorectal cancer and polyps, as well as to diagnose inflammatory bowel disease and other conditions affecting the lower gastrointestinal tract.
Choice D reason: CT scan is not a diagnostic procedure for Barrett esophagus. CT scan is a type of imaging test that uses X-rays and a computer to create cross-sectional pictures of the body. It is mainly used to diagnose problems in the chest, abdomen, pelvis, and bones.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today