Which snack selection indicates to the nurse that a school-age child with gastroesophageal reflux understands the dietary restrictions?
Tacos.
Chocolate milkshake.
Pizza.
Sugar cookies.
The Correct Answer is D
A. Tacos: Tacos are often spicy and greasy, both of which can relax the lower esophageal sphincter and aggravate GERD symptoms in children by increasing acid reflux episodes.
B. Chocolate milkshake: Chocolate and high-fat dairy both reduce LES pressure and increase gastric acid secretion, worsening reflux. The milkshake also adds volume, which can trigger symptoms.
C. Pizza: Pizza is acidic (due to tomato sauce), high in fat, and often spicy—an unhealthy combination for a child with GERD. It’s one of the most commonly reported reflux-triggering foods.
D. Sugar cookies: Sugar cookies are bland, low in fat, and non-acidic, making them a safe snack choice for children managing GERD symptoms through dietary adjustments.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Hydrocortisone: Addison’s disease is characterized by insufficient cortisol production. The client’s symptoms, including weakness, confusion, and dehydration, along with laboratory values indicating low sodium, low glucose, and elevated potassium, suggest an adrenal crisis. Hydrocortisone is the primary.
B. Regular insulin: Regular insulin is used to lower blood glucose levels, but the client’s glucose level is already low, not high. Insulin could worsen the client's hypoglycemia. The focus should be on correcting the cortisol deficiency rather than administering insulin.
C. Broad spectrum antibiotic: While antibiotics may be needed if there’s a concern for infection, there’s no evidence of active infection here. The priority is addressing the client's Addisonian crisis, which is primarily treated with hydrocortisone, not antibiotics.
D. Potassium chloride: The client's potassium is elevated (5.3 mEq/L), but potassium chloride is not indicated in this case. The priority is to manage the underlying adrenal crisis, which will address the electrolyte imbalance.
Correct Answer is B
Explanation
A. Morphine: Morphine is used to relieve chest pain and anxiety in acute coronary syndromes. It acts as a vasodilator and analgesic, and there are no direct contraindications with recent sildenafil use, although blood pressure should still be monitored.
B. Nitroglycerin: Nitroglycerin is absolutely contraindicated in clients who have taken sildenafil within the past 24–48 hours. Both drugs are vasodilators, and their combination can lead to severe, life-threatening hypotension due to additive effects on vascular smooth muscle relaxation.
C. Aspirin: Aspirin is recommended in acute chest pain cases as it reduces platelet aggregation and helps prevent clot extension. It has no interaction with sildenafil and should not be withheld when myocardial ischemia is suspected.
D. Heparin: Heparin is an anticoagulant used in suspected myocardial infarction to prevent further clot formation. It does not have any adverse interactions with sildenafil and remains safe and beneficial in this context.
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