Which situations are early signs of an ethical dilemma? (Select all that apply)

Choice A reason: Coffee, caffeinated or decaf, relaxes the esophageal sphincter and irritates the mucosa, worsening GERD. This aligns with dietary restrictions, making it a correct substance the nurse would teach the client to avoid to prevent GERD symptom exacerbation.

Choice B reason: Chocolate contains methylxanthines and fat, relaxing the esophageal sphincter and triggering GERD symptoms. This aligns with GERD dietary guidelines, making it a correct item the nurse would include for the client to avoid to reduce reflux.

Choice C reason: Peppermint relaxes the lower esophageal sphincter, increasing acid reflux in GERD. This aligns with dietary teaching, making it a correct substance the nurse would advise the client to avoid to minimize GERD symptom flare-ups effectively.

Choice D reason: Nonfat milk is less likely to trigger GERD, as high-fat dairy worsens reflux. Coffee is a stronger trigger, making this incorrect, as it’s not a primary substance the nurse would include on the GERD avoidance list.

Choice E reason: Fried chicken, high in fat, delays gastric emptying and exacerbates GERD symptoms. This aligns with dietary restrictions, making it a correct item the nurse would teach the client to avoid to prevent GERD symptom exacerbation.

Choice F reason: Scrambled eggs are low-fat and unlikely to trigger GERD compared to chocolate or coffee. This is incorrect, as it’s not a primary substance the nurse would include on the list of items to avoid for GERD management.

Choice A reason: Hypercalcemia is not associated with ulcerative colitis, which affects the colon and causes diarrhea. Bloody stools are typical, making this incorrect, as it’s unrelated to the nurse’s expected findings in a client with ulcerative colitis during assessment.

Choice B reason: Hypernatremia may occur with dehydration but isn’t specific to ulcerative colitis. Frequent bloody stools are hallmark signs, making this incorrect, as it’s not a primary finding compared to the nurse’s expected manifestations in ulcerative colitis diagnosis.

Choice C reason: Frothy, fatty stools indicate malabsorption, typical in Crohn’s or pancreatic issues, not ulcerative colitis. Bloody stools are correct, making this incorrect, as it doesn’t align with the nurse’s anticipated findings in a client with ulcerative colitis.

Choice D reason: Bloody stool is a classic finding in ulcerative colitis due to mucosal inflammation and ulceration. This aligns with gastrointestinal assessment, making it a correct finding the nurse would determine is consistent with the client’s ulcerative colitis diagnosis.

Choice E reason: 10 to 20 liquid stools daily reflect severe diarrhea, a key feature of ulcerative colitis exacerbations. This aligns with clinical manifestations, making it a correct finding the nurse would identify in a client diagnosed with ulcerative colitis during assessment.

Choice F reason: Right lower quadrant pain is more typical of Crohn’s or appendicitis, not ulcerative colitis, which affects the left colon. Left quadrant pain is correct, making this incorrect, as it doesn’t support the nurse’s findings for ulcerative colitis diagnosis.

Choice G reason: Left lower quadrant pain is consistent with ulcerative colitis, as inflammation often affects the sigmoid colon. This aligns with abdominal assessment, making it a correct finding the nurse would expect in a client with ulcerative colitis during evaluation.