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 ["A","B","C","E"]

Explanation

A. Chocolate can relax the lower esophageal sphincter (LES), allowing stomach acid to reflux into the esophagus and exacerbate symptoms. Therefore, it is advisable for clients with GERD to avoid chocolate.
B. Tomato-based products are acidic and can aggravate GERD symptoms. Tomatoes are naturally acidic, which can contribute to increased acidity in the stomach and exacerbate reflux symptoms.
C. Spicy and high-fat foods, such as hot and spicy pork rinds, can trigger GERD symptoms by increasing stomach acid production and relaxing the LES. Spicy foods can irritate the esophagus and exacerbate symptoms such as heartburn and reflux.
E. Oranges and other citrus fruits are acidic and can irritate the esophagus, exacerbating GERD symptoms. The acidity in oranges can increase stomach acid production and contribute to reflux.
D. Green beans are generally considered safe for individuals with GERD. They are low in fat and acidity, making them less likely to trigger reflux symptoms.

A. Fluid overload B. Altered body image C. Imbalanced nutrition - less than body requirements D. Social isolation

Correct Answer is C

Explanation

C. Crohn's disease exacerbation often leads to malnutrition due to decreased oral intake, malabsorption, and increased nutrient losses through diarrhea. Addressing imbalanced nutrition is crucial to replenish depleted nutrient stores, support healing, and prevent further complications.
A. While fluid overload can be a concern in certain situations, such as when administering intravenous fluids or in clients with renal impairment, it is not typically a primary concern in clients hospitalized with Crohn's disease exacerbation. Crohn's disease is more commonly associated with dehydration due to diarrhea and malabsorption rather than fluid overload.
B. In the acute phase of Crohn's disease exacerbation, addressing immediate physiological needs and stabilizing the client's condition typically take precedence over psychosocial concerns.
D. Social isolation can be a concern for clients with chronic illnesses, including Crohn's disease, as it may impact their quality of life and emotional well-being. However, in the acute phase of exacerbation, addressing physiological needs and stabilizing the client's condition typically takes precedence over psychosocial concerns such as social isolation.

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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 with a new diagnosis of GERD is preparing for discharge from the hospital. Which foods will the nurse teach this client to avoid? (SELECT ALL THAT APPLY)

Correct Answer is ["A","B","C","E"]

Explanation

The nurse is writing a care plan for a client who was diagnosed with Crohn's disease a year ago and is now hospitalized with a fourth acute exacerbation. Which client problem should receive the highest priority?

Correct Answer is C

Explanation

The nurse is caring for a hospitalized client who is attempting to pass a kidney stone. Which clinical manifestation should the nurse recognize as Indicating a potential emergency situation?

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