Which statement by the patient with chronic gastroesophageal reflux disease (GERD) indicates a need for further teaching?

"I have learned to sleep with the head of the bed elevated on blocks."

"I use antacids between meals and at bedtime."

"I enjoy eating large rich meals and snacks before bedtime.

"I quit smoking several years ago, but I still chew a lot of gum."

Answer and Explanation

The Correct Answer is C

A.   Elevating the head of the bed is a recommended practice for individuals with GERD, as it helps prevent stomach acid from flowing back into the esophagus during sleep. This shows the patient is taking proactive steps to manage their condition.
B.   Using antacids can provide symptomatic relief from heartburn and discomfort associated with GERD. Taking them between meals and at bedtime can help neutralize stomach acid, which is a common practice for managing GERD symptoms.
C.   Eating large meals, especially rich or fatty foods, and snacking before bedtime can exacerbate GERD symptoms by increasing stomach pressure and acid production. Patients with GERD are typically advised to eat smaller meals and avoid eating close to bedtime to reduce reflux episodes.
D.   Chewing gum can actually be beneficial for some GERD patients as it stimulates saliva production, which can help neutralize stomach acid.

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Correct Answer is C

Explanation

A. Sucralfate works by forming a protective barrier over the ulcer and is best taken on an empty stomach. Antacids can interfere with the effectiveness of sucralfate if taken simultaneously. It’s usually recommended to wait at least 30 minutes to 1 hour after taking sucralfate before taking an antacid.
B. Sucralfate should be stored at room temperature, away from moisture and heat, but it does not need to be refrigerated. This guidance is essential to ensure that the medication maintains its effectiveness.
C. Sucralfate is typically taken 1 hour before meals and at bedtime to optimize its protective effect on the stomach lining and ulcers. This timing allows it to coat the ulcer effectively before food intake.
D. Sucralfate tablets should be swallowed whole and not crushed or chewed, as doing so may affect how the medication works. This instruction helps ensure that the sucralfate can properly adhere to the ulcer surface.

A. History of bulimia B. Drinks green tea C. Has a glass of wine with dinner each day D. History of NSAID use

Correct Answer is D

Explanation

A. Bulimia involves episodes of binge eating followed by purging and can lead to a range of gastrointestinal issues, including esophageal damage and electrolyte imbalances. However, it is not a direct risk factor for the development of peptic ulcers. While it can affect the digestive system, it does not inherently increase the risk of ulcers.
B. Green tea is generally considered to have health benefits and is not typically associated with an increased risk of peptic ulcers. In some cases, it may even provide protective effects against gastric ulcers due to its antioxidant properties.
C. Moderate alcohol consumption can have varying effects on gastric mucosa. While excessive alcohol consumption is a risk factor for developing ulcers, moderate consumption, such as a glass of wine with dinner, is not typically considered a significant risk factor.
D. This is a well-established risk factor for peptic ulcer disease. Nonsteroidal anti-inflammatory drugs (NSAIDs) can irritate the gastric lining and inhibit the production of protective mucus, leading to an increased risk of developing ulcers.

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Which statement by the patient with chronic gastroesophageal reflux disease (GERD) indicates a need for further teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing teaching to a client who has peptic ulcer disease and a new prescription for sucralfate tablets. Which of the following information should the nurse provide?

Correct Answer is C

Explanation

A nurse is reviewing the medical record of a client who has a peptic ulcer. Which of the following findings should the nurse recognize as a risk factor for this condition?

Correct Answer is D

Explanation

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