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 A

Explanation

Choice A Reason: WBC Count 22,000/mm³

A white blood cell (WBC) count of 22,000/mm³ is significantly higher than the normal range, which is typically between 4,000 and 11,000/mm³. An elevated WBC count, known as leukocytosis, often indicates the presence of an infection as the body produces more white blood cells to fight off pathogens. This elevated count can also be seen in other conditions such as inflammation, stress, or bone marrow disorders, but it is a strong indicator of infection.

Choice B Reason: Hgb 15 g/dL

Hemoglobin (Hgb) levels of 15 g/dL fall within the normal range for adults, which is generally 13.8 to 17.2 g/dL for males and 12.1 to 15.1 g/dL for females. Normal hemoglobin levels indicate that the blood’s oxygen-carrying capacity is adequate and do not specifically point to an infection.

Choice C Reason: Creatine kinase 75 units/L

Creatine kinase (CK) levels of 75 units/L are within the normal range, which is typically 24 to 204 U/L. CK is an enzyme found in the heart, brain, and skeletal muscle, and elevated levels can indicate muscle damage, myocardial infarction, or other conditions affecting these tissues. However, normal CK levels do not indicate the presence of an infection.

Choice D Reason: Platelet count 200,000/mm³

A platelet count of 200,000/mm³ is within the normal range, which is generally between 150,000 and 450,000 platelets per microliter of blood. Platelets are involved in blood clotting, and normal levels do not indicate an infection. Abnormal platelet counts can be associated with bleeding disorders or thrombosis, but a normal count does not suggest an infection.

A. The client should maintain systolic BP between 130 and 135 mm Hg. B. The client should maintain systolic BP between 141 and 145 mm Hg. C. The client should maintain systolic BP between 136 and 140 mm Hg. D. The client should maintain systolic BP between 120 and 129 mm Hg.

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.

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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 reviewing laboratory values for a client. Which of the following findings indicates the presence of an infection?

Correct Answer is A

Explanation

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

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