The nurse is providing discharge teaching for the client newly diagnosed with GERD. The teaching should Include Instructions to: (SELECT ALL THAT APPLY)

eat small frequent meals during the day.

enroll in smoking cessation classes as needed.

take omeprazole 30 minutes after meals when acid levels are highest.

elevate the head of the bed at night.

eat your largest meal at bedtime.

Answer and Explanation

Correct Answer : A,B,D

A. Eating smaller, more frequent meals can help reduce the likelihood of gastric distention and decrease the pressure on the lower esophageal sphincter (LES), which can help reduce reflux symptoms.
B. Smoking is a risk factor for GERD as it can weaken the LES and increase acid reflux. Therefore, quitting smoking can help alleviate symptoms and improve overall health.
D. Elevating the head of the bed by 6 to 8 inches can help reduce nighttime reflux symptoms by using gravity to prevent stomach acid from flowing back into the esophagus.
C. Proton pump inhibitors (PPIs) like omeprazole are typically taken before meals to inhibit acid production and prevent reflux symptoms. Taking omeprazole after meals may not provide optimal acid suppression when it is most needed.
E. Eating a large meal right before bedtime can increase the likelihood of reflux symptoms as lying down after eating can worsen reflux. It is recommended to avoid large meals, particularly before bedtime, to minimize GERD symptoms.

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Correct Answer is C

Explanation

C. The expected effect of TPN is to maintain or promote weight gain in clients who are unable to meet their nutritional needs orally. TPN provides essential nutrients directly into the bloodstream, allowing for adequate caloric intake to support energy needs and promote tissue repair and growth.
A. A serum white blood cell count of 16,000/mm3 indicates leukocytosis, which may suggest infection or inflammation rather than a direct effect of TPN.
B. Pre-albumin is a marker of nutritional status, and levels below 10 mg/dl typically indicate malnutrition rather than a positive response to TPN.
D. Negative nitrogen balance occurs when the body loses more nitrogen than it gains, typically due to inadequate protein intake or increased protein breakdown. TPN provides amino acids, which are the building blocks of protein, and aims to promote a positive nitrogen balance to support tissue repair and growth.

A. Attention-deficit/hyperactivity disorder B. Diabetes mellitus C. Rheumatoid arthritis D. Hypotension

Correct Answer is B

Explanation

B. Childhood obesity is a significant risk factor for the development of type 2 diabetes mellitus (T2DM) in children and adolescents. Excess adiposity can lead to insulin resistance, a key underlying mechanism in the development of T2DM.
A. While ADHD is a neurodevelopmental disorder that can affect children, it is not typically considered a direct consequence or complication of childhood obesity. However, there may be associations between obesity and ADHD, such as shared genetic factors or lifestyle factors, but causality is not clearly established.
C. Rheumatoid arthritis is an autoimmune disorder characterized by inflammation of the joints. While obesity is a known risk factor for osteoarthritis, particularly in weight-bearing joints, it is not typically associated with rheumatoid arthritis.
D. Hypotension, or low blood pressure, is not typically considered a complication of childhood obesity. In fact, obesity is more commonly associated with hypertension (high blood pressure) due to the increased strain on the cardiovascular system.

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The nurse is providing discharge teaching for the client newly diagnosed with GERD. The teaching should Include Instructions to: (SELECT ALL THAT APPLY)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client was started on total parenteral nutrition (TPN) ten days ago. The nurse recognizes that the expected effect of TPN is a:

Correct Answer is C

Explanation

A nurse is teaching a class about long-term effects of childhood obesity. The nurse should include which of the following conditions as a potential complication of childhood obesity?

Correct Answer is B

Explanation

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