A nurse is assessing a client who has a sliding hiatal hernia.
Which of the following findings should the nurse expect?

Choice A rationale

A corn tortilla with black beans is an excellent recommendation for a child with celiac disease. Corn is a naturally gluten-free grain, making corn tortillas a safe choice. Black beans are also gluten-free and provide essential protein, fiber, and iron, which are often deficient in a gluten-free diet. This meal provides a balanced and safe option for the child.

Choice B rationale

Low sodium vegetable soup with barley is an inappropriate recommendation because barley is a grain that contains gluten. Celiac disease is an autoimmune disorder where the ingestion of gluten leads to damage in the small intestine. Barley, along with wheat and rye, must be completely avoided to prevent an immune response and associated symptoms and intestinal damage.

Choice C rationale

Whole wheat pasta with shrimp is contraindicated for a child with celiac disease. Whole wheat is a form of wheat, which is a major source of gluten. Consuming whole wheat pasta would trigger an autoimmune reaction, causing inflammation and damage to the small intestinal villi, leading to malabsorption and a range of gastrointestinal symptoms.

Choice D rationale

A bologna sandwich on rye bread is a harmful choice for a child with celiac disease. Rye bread is made from rye grain, which is a source of gluten and must be avoided. The consumption of rye bread, like other gluten-containing grains, will provoke an immune response that damages the lining of the small intestine in individuals with this condition. *.

Choice A rationale

Administering a vasoconstrictor is a potential intervention for shock but it is not the first action. The client's hypotension and tachycardia are indicative of hypovolemic shock due to profuse vomiting, leading to fluid loss. The body's initial compensatory mechanism involves vasoconstriction to maintain blood pressure, so further constriction without addressing the volume deficit can worsen tissue perfusion.

Choice B rationale

The client is exhibiting signs of hypovolemic shock, including a low blood pressure of 86/58 mmHg, a high pulse of 114/min, and a high respiratory rate of 27/min. These are physiological compensations for reduced circulating blood volume. Increasing the intravenous infusion rate directly addresses the primary problem by rapidly replacing lost fluid volume, thereby increasing preload, stroke volume, cardiac output, and ultimately, blood pressure.

Choice C rationale

Elevating the client's feet can temporarily increase venous return to the heart and improve blood pressure. However, this is a passive measure that does not address the underlying fluid deficit causing the hypovolemic shock. It is a helpful adjunctive action but is not the definitive first-line intervention required to correct the circulatory collapse in this scenario.

Choice D rationale

Initiating oxygen therapy is a supportive measure for shock because it helps improve tissue oxygenation, which is compromised due to poor perfusion. While beneficial, it does not correct the root cause of the shock, which is the lack of circulating fluid volume. The most immediate and life-saving intervention is to restore fluid volume to improve cardiac output and blood pressure