The nurse is teaching a client with gastroesophageal reflux disease about dietary modifications. Which instruction should the nurse include?

Suggest that the client also plan to eat frequent small meals to reduce discomfort

Remind the client to switch to decaffeinated coffee and tea

Review with the client the need to avoid foods rich in milk and cream

Reinforce the teaching by asking the client to make a list of snack foods high in dairy content

Answer and Explanation

The Correct Answer is A

Choice A reason: Frequent small meals reduce gastroesophageal reflux by minimizing gastric distension, which decreases pressure on the lower esophageal sphincter. This prevents acid reflux into the esophagus, alleviating heartburn and irritation, making it an effective dietary strategy for managing GERD symptoms.

Choice B reason: Switching to decaffeinated coffee and tea may reduce reflux triggers, as caffeine relaxes the lower esophageal sphincter. However, small meals are more effective, as they directly reduce gastric volume and sphincter pressure, providing broader symptom relief than caffeine avoidance alone.

Choice C reason: Avoiding milk and cream is relevant for some GERD patients, as high-fat foods delay gastric emptying, increasing reflux. However, frequent small meals address the root cause of reflux by reducing gastric pressure, making this a more universally effective strategy than specific food avoidance.

Choice D reason: Listing high-dairy snack foods reinforces avoidance but is less direct than recommending small meals. Dairy may trigger reflux in some, but frequent small meals broadly reduce gastric distension and sphincter pressure, offering a more immediate and effective GERD management strategy.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is B

Explanation

Choice A reason: Promoting effective swallowing is relevant for dysphagia but not the primary goal for sliding hiatal hernia, where the stomach protrudes into the thorax, causing reflux. Preventing acid reflux into the esophagus is critical to reduce irritation and complications like esophagitis, making swallowing secondary.

Choice B reason: Preventing esophageal reflux is the primary goal for sliding hiatal hernia, as the stomach’s protrusion through the diaphragm allows gastric acid to reflux, causing heartburn and esophageal damage. Nursing actions like elevating the head of the bed and avoiding trigger foods minimize reflux, protecting the esophagus.

Choice C reason: Maintaining intact oral mucosa is unrelated to hiatal hernia, which affects the gastroesophageal junction. Reflux causes esophageal, not oral, irritation. The focus is on preventing acid reflux to protect the esophagus, making oral mucosa maintenance irrelevant to the condition’s pathophysiology.

Choice D reason: Increasing intestinal peristalsis is not a goal for hiatal hernia, which involves gastroesophageal reflux, not intestinal motility. Enhanced peristalsis may worsen reflux by increasing intra-abdominal pressure. Preventing reflux is prioritized to manage symptoms and prevent esophageal complications.

A. Difficulty with urination B. Recent oral intake C. Trouble sleeping D. Unexplained weight loss

Correct Answer is B

Explanation

Choice A reason: Difficulty with urination is not a primary concern for pyridostigmine, a cholinesterase inhibitor used in myasthenia gravis to enhance neuromuscular transmission. While cholinergic side effects may include urinary urgency, this is not a pre-administration priority compared to oral intake, which affects absorption and efficacy.

Choice B reason: Recent oral intake is critical before administering pyridostigmine, as food can delay its absorption, reducing effectiveness in myasthenia gravis. Taking it 30–60 minutes before or 2 hours after meals ensures optimal plasma levels, improving muscle strength, making this the priority information to obtain.

Choice C reason: Trouble sleeping is not directly relevant to pyridostigmine administration. While cholinergic side effects like diarrhea may disrupt sleep, this is a secondary concern. Ensuring proper timing with oral intake is critical for therapeutic efficacy, as absorption impacts symptom control in myasthenia gravis.

Choice D reason: Unexplained weight loss may indicate myasthenia gravis progression or other issues but is not a pre-administration concern for pyridostigmine. Timing with oral intake directly affects the drug’s pharmacokinetics, ensuring effective muscle strength improvement, making weight loss less urgent to assess before dosing.

View Question and Answer

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

The nurse is teaching a client with gastroesophageal reflux disease about dietary modifications. Which instruction should the nurse include?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is planning care for a client with a direct (sliding) hiatal hernia. Nursing actions should be planned to meet which goal?

Correct Answer is B

Explanation

A client with myasthenia gravis receives a new prescription for pyridostigmine. Which information should the nurse obtain prior to administering the medication?

Correct Answer is B

Explanation

The nurse is caring for a client with a history of multiple sclerosis. Which intervention should the nurse prioritize?

A client has been administered lactulose for several days. Which therapeutic response should the nurse expect for a client with hepatic encephalopathy?

The nurse is securing a tracheostomy tube for a client post-procedure. Which action should the nurse take to ensure proper tracheostomy care?

The nurse is assessing a client with suspected hepatitis. Which finding is most indicative of this condition?

A client with emphysema is reporting difficulty breathing and exhibiting audible wheezing. The nurse administers albuterol as prescribed for the third time within the last 12 hours. Which assessment finding warrants immediate intervention by the nurse?

The nurse is caring for a client with a history of deep vein thrombosis. Which intervention should the nurse include in the care plan?