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 B

Explanation

B. Bowel sounds are typically present and indicate normal gastrointestinal motility. A change from normoactive (normal) to absent bowel sounds can indicate bowel obstruction, perforation, or peritonitis, which are serious complications of diverticulitis. This change warrants immediate reporting to the physician as it may indicate a worsening condition requiring urgent intervention.
A. A temperature of 101.2°F (38.4°C) is slightly elevated and may indicate the presence of infection, which is concerning in the context of diverticulitis. Fever is a common symptom of diverticulitis, but an elevated temperature may also suggest worsening infection or the development of complications such as abscess formation or perforation.
C. Left lower quadrant discomfort is a common symptom of diverticulitis due to inflammation in the sigmoid colon, where diverticula are most prevalent. While discomfort is expected in diverticulitis, the severity and persistence of pain should be assessed.
D. An elevated white blood cell (WBC) count is indicative of inflammation or infection and is commonly seen in diverticulitis. However, the significance of the elevation depends on the degree of increase and the presence of other clinical findings.

A. will urinate before and after sexual intercourse." B. will empty my bladder every 3 to 4 hours during the day." C. can use vaginal sprays and douches to reduce bacteria." D. will wipe from front to back after I urinate."

Correct Answer is C

Explanation

A. Emptying the bladder before and after sexual intercourse can help flush out bacteria that may have entered the urethra during sexual activity, reducing the risk of UTIs. Therefore, this statement indicates effective understanding of preventive measures.
B. Regularly emptying the bladder helps prevent the buildup of bacteria in the urinary tract, reducing the risk of UTIs. Therefore, this statement indicates effective understanding of preventive measures.
C. Using vaginal sprays and douches can disrupt the natural balance of bacteria in the vagina and increase the risk of UTIs and other vaginal infections. Therefore, this statement indicates a misunderstanding of preventive measures and could potentially contribute to an increased risk of UTIs.
D. Wiping from front to back after urination helps prevent the spread of bacteria from the anal area to the urethra, reducing the risk of UTIs. Therefore, this statement indicates effective understanding of preventive measures.

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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)

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Naxlex Comprehensive Predictor Exams

The nurse assesses a client admitted four hours ago with a diagnosis of diverticulitis. Which clinical manifestation must be reported immediately to the physician?

Correct Answer is B

Explanation

The nurse determines that instruction regarding prevention of future urinary tract Infections for a female client who has cystitis has not been effective when the client states, "I:

Correct Answer is C

Explanation

The nurse evaluates that an overweight client understands the need for a healthy weight loss pattern by Indicating an intention to lose:

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?

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?

The nurse is caring for a client who has a peptic ulcer that is actively bleeding. Which finding would the nurse Immediately report to the physician?

The nurse is caring for a client admitted with a first episode of acute cholecystitis. Which of the following may have contributed to this event? She:

Which of the following is a common symptom of diverticular disease?

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A client newly diagnosed with Crohn's disease asks the nurse what to expect in the future. The best response by the nurse would be: