Which instruction should the nurse include in the discharge teaching for a client who has gastroesophageal reflux?

Encourage the client to lie down and rest after meals

Remind the client to avoid high-fiber foods

Teach the client to elevate the head of the bed on blocks

Instruct the client to use antacids only as a last resort

Answer and Explanation

The Correct Answer is C

Choice A reason: Encouraging the client to lie down and rest after meals is not advisable for someone with gastroesophageal reflux. Lying down after eating can exacerbate symptoms by allowing stomach acid to more easily flow back into the esophagus. It's recommended that clients stay upright for at least 2-3 hours after meals.

Choice B reason: Avoiding high-fiber foods is not a standard recommendation for managing gastroesophageal reflux. In fact, a diet high in fiber can benefit overall digestive health and help prevent constipation. The key dietary advice usually involves avoiding trigger foods such as spicy, fatty, or acidic foods.

Choice C reason: Elevating the head of the bed on blocks is an effective way to manage gastroesophageal reflux, especially at night. This position helps keep stomach acid in the stomach and prevents it from flowing back into the esophagus, reducing symptoms such as heartburn.

Choice D reason: Instructing the client to use antacids only as a last resort is not necessarily accurate advice. While antacids can provide symptomatic relief, they are often used as part of a comprehensive management plan for gastroesophageal reflux. However, lifestyle modifications and dietary changes are also crucial.

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Correct Answer is B

Explanation

Choice A reason: A cerebrovascular accident (CVA), commonly known as a stroke, occurs when the blood supply to part of the brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients. Although a severe headache might be a symptom of a stroke, it does not typically present with fever, nuchal rigidity, and a petechial rash, which are more indicative of an infection or inflammatory process.

Choice B reason: Meningococcal meningitis is a bacterial infection that causes inflammation of the membranes covering the brain and spinal cord. Symptoms often include a severe headache, fever, neck stiffness (nuchal rigidity), and a petechial rash, which is a distinguishing feature. This condition is a medical emergency and requires prompt antibiotic treatment to prevent serious complications or death.

Choice C reason: Intracerebral hemorrhage is bleeding within the brain tissue itself, which can be caused by various factors such as hypertension, aneurysms, or trauma. While it can cause a severe headache and neurological symptoms, it does not typically present with fever, nuchal rigidity, and a petechial rash, which suggest an infectious etiology rather than a hemorrhagic one.

Choice D reason: Rocky Mountain spotted fever is a tick-borne illness caused by the bacterium Rickettsia rickettsii. It can present with fever, headache, and a rash, but the rash is typically more generalized and not petechial. Additionally, the presence of nuchal rigidity and severe headache are more characteristic of meningitis rather than Rocky Mountain spotted fever.

A. Jugular vein distension B. Lower extremity edema C. Hepatomegaly D. Fatigue

Correct Answer is B

Explanation

Choice A reason: Jugular vein distension is often associated with right-sided heart failure, where the right ventricle fails to pump effectively, leading to increased pressure in the veins and fluid backup. While it can occur in advanced cases of left ventricular dysfunction, it is not as directly indicative as lower extremity edema.

Choice B reason: Lower extremity edema is a common finding in left ventricular dysfunction. When the left ventricle fails to pump blood efficiently, it leads to a buildup of fluid in the lungs and eventually in the extremities. This results in swelling, particularly in the lower legs and feet. This symptom is a key indicator of congestive heart failure.

Choice C reason: Hepatomegaly, or enlargement of the liver, is more commonly associated with right-sided heart failure due to congestion of blood flow in the liver. While it can occur in severe cases of left ventricular dysfunction, it is not as typical an initial finding as lower extremity edema.

Choice D reason: Fatigue is a non-specific symptom that can be associated with various conditions, including heart failure. However, it is not as immediately indicative of left ventricular dysfunction as lower extremity edema, which is more directly related to the underlying issue of fluid retention and heart failure.

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Which instruction should the nurse include in the discharge teaching for a client who has gastroesophageal reflux?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client presents with the onset of a severe headache, fever, nuchal rigidity, and a petechial rash on arms and legs. The nurse recognizes the client is exhibiting symptoms of which condition?a) Cerebrovascular accident (CV

Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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