A nurse is providing teaching to a client who has long-term symptoms of GERD (gastroesophageal reflux disease). Which of the following statements should the nurse include in the educational materials?

“It is important to follow up with a GI specialist for recommended surveillance for Barrett’s esophagus.”

“You will need to monitor for manifestations of liver issues.”

“Follow up with an endocrinologist as your risk for diabetes increases.”

“It is important to watch for manifestations of pancreatic cancer.”

Answer and Explanation

The Correct Answer is A

Choice A Reason:

This is the correct answer. Long-term GERD can lead to Barrett’s esophagus, a condition where the esophageal lining changes and can increase the risk of developing esophageal cancer. Regular surveillance by a GI specialist is crucial for early detection and management of Barrett’s esophagus.

Choice B Reason:

Monitoring for liver issues is not directly related to GERD. While liver health is important, it is not a primary concern for patients with long-term GERD.

Choice C Reason:

There is no direct link between GERD and an increased risk of diabetes. Therefore, follow-up with an endocrinologist for diabetes risk is not specifically relevant to GERD management.

Choice D Reason:

Pancreatic cancer is not a known complication of GERD. The primary concerns with long-term GERD are esophageal complications, such as Barrett’s esophagus and esophageal cancer.

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Correct Answer is D

Explanation

Choice A Reason: The client should maintain systolic BP between 130 and 135 mm Hg

Maintaining a systolic BP between 130 and 135 mm Hg is higher than the recommended range for someone who has experienced a transient ischemic attack (TIA). According to the American Heart Association, the goal for systolic BP in patients with a history of TIA or stroke should be lower to reduce the risk of recurrent events. While this range is not extremely high, it is still above the optimal target for secondary prevention.

Choice B Reason: The client should maintain systolic BP between 141 and 145 mm Hg

This range is significantly higher than the recommended target for systolic BP in patients with hypertension and a history of TIA. Elevated BP in this range increases the risk of recurrent stroke and other cardiovascular events. Effective BP management is crucial in reducing these risks, and maintaining a systolic BP in this range would not be advisable.

Choice C Reason: The client should maintain systolic BP between 136 and 140 mm Hg

Although this range is slightly lower than choice B, it is still above the optimal target for patients with a history of TIA. Research indicates that tighter BP control can significantly reduce the risk of recurrent strokes. Therefore, maintaining a systolic BP in this range would not be ideal for secondary prevention.

Choice D Reason: The client should maintain systolic BP between 120 and 129 mm Hg

This range aligns with the current guidelines for BP management in patients with a history of TIA or stroke. Maintaining a systolic BP between 120 and 129 mm Hg helps reduce the risk of recurrent cerebrovascular events4. This target is considered optimal for secondary prevention and is supported by evidence from various studies and clinical guidelines.

A. Portal of entry B. Susceptible host C. Infectious agent D. Reservoir

Correct Answer is A

Explanation

Choice A Reason: Portal of entry

The client’s mouth serves as the portal of entry in the chain of infection. The portal of entry is the route through which an infectious agent enters the host. In the case of hepatitis A, the virus enters the body through the mouth when contaminated food or water is ingested. This link is crucial in the chain of infection as it determines how the pathogen gains access to the host’s body.

Choice B Reason: Susceptible host

A susceptible host is an individual who is at risk of infection due to factors such as a weakened immune system, age, or underlying health conditions. While the client in this scenario may be a susceptible host, the mouth specifically represents the portal of entry, not the host itself.

Choice C Reason: Infectious agent

The infectious agent is the pathogen that causes the disease. In this case, the infectious agent is the hepatitis A virus. The mouth is not the infectious agent but rather the entry point for the virus into the body.

Choice D Reason: Reservoir

A reservoir is the habitat in which the infectious agent normally lives, grows, and multiplies. Common reservoirs include humans, animals, and the environment. The client’s mouth is not a reservoir but the portal of entry for the hepatitis A virus.

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A nurse is providing teaching to a client who has long-term symptoms of GERD (gastroesophageal reflux disease). Which of the following statements should the nurse include in the educational materials?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing discharge instructions to a client who has hypertension that has resulted in a transient ischemic attack (TIA). Which of the following information should the nurse discuss with the client regarding blood pressure (BP) management?

Correct Answer is D

Explanation

A nurse is caring for a client who acquired hepatitis A from consuming contaminated food. The client’s mouth is an example of which of the following links in the chain of infection?

Correct Answer is A

Explanation

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