A nurse is reinforcing teaching about dietary recommendations for a client who has a hiatal hernia. Which of the following client statements indicate understanding of the teaching? (Select all that apply)

“I will consume less caffeine and spicy foods"

"I will sleep with the head of my bed elevated”

"I will lie down for one half hour after meals”

“I will drink less fluid"

"I will try not to gain weight”

Answer and Explanation

Correct Answer : A,B,E

A. "I will consume less caffeine and spicy foods":
Spicy foods and caffeine can irritate the esophagus, exacerbating symptoms of hiatal hernia. Avoiding these can help in managing symptoms.

B. "I will sleep with the head of my bed elevated”:
Keeping the head elevated can prevent stomach acid from flowing back into the esophagus, reducing symptoms like heartburn. This is a helpful strategy for managing hiatal hernia.

C. "I will lie down for one half hour after meals”:
Lying down after meals can worsen symptoms because gravity can't help keep stomach acid in the stomach. Staying upright after eating helps prevent acid reflux.

D. "I will drink less fluid":There is no need to reduce fluid intake. Staying hydrated is important, and fluids do not typically contribute to hiatal hernia symptoms. However, drinking large amounts of fluid with meals should be avoided as it can increase stomach pressure.

E. "I will try not to gain weight”:
Maintaining a healthy weight is important. Excess weight can increase pressure on the abdomen, potentially worsening hiatal hernia symptoms.

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Correct Answer is D

Explanation

A. Ecchymosis of the extremities: Ecchymosis refers to the medical term for a bruise. It's characterized by a discoloration of the skin resulting from bleeding underneath, typically caused by trauma to the blood vessels. This is not directly related to cholelithiasis.

B. Tenderness in the left upper abdomen: Tenderness in the left upper abdomen might be associated with conditions such as pancreatitis or splenic issues, not directly with obstruction and inflammation of the common bile duct due to cholelithiasis.

C. Straw-colored urine: Straw-colored urine is normal and healthy. Dark-colored or cloudy urine might indicate underlying issues, but straw-colored urine is generally a sign of proper hydration.

D. Fatty stools: When the common bile duct is obstructed due to cholelithiasis, proper digestion of fats doesn't occur, leading to the passage of fatty stools. This is due to the inability to properly digest and absorb fats, leading to their presence in the stool.

A. Prior to percussing the abdomen B. Prior to inspecting the abdomen C. After checking for kidney tenderness D. After palpating the abdomen

Correct Answer is A

Explanation

A. Prior to percussing the abdomen:Auscultation should be performed before percussing or palpating the abdomen. Percussion and palpation can alter bowel activity, potentially leading to inaccurate assessment of bowel sounds.

B. Prior to inspecting the abdomen:Inspection should always be performed before auscultation when assessing the abdomen. This allows the nurse to observe any visible abnormalities, such as distention or skin changes, without altering bowel activity. Auscultation should follow inspection.

C. After checking for kidney tenderness:Checking for kidney tenderness (e.g., costovertebral angle tenderness) involves percussing the back and is not part of the sequence of a standard abdominal exam. It does not precede auscultation.

D. After palpating the abdomen:
Palpation can stimulate or alter bowel sounds, potentially leading to an inaccurate assessment. Therefore, auscultation should always occur before palpation.

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A nurse is reinforcing teaching about dietary recommendations for a client who has a hiatal hernia. Which of the following client statements indicate understanding of the teaching? (Select all that apply)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting data from a client who has obstruction and inflammation of the common bile duct due to cholelithiasis. Which of the following findings is expected for this condition?

Correct Answer is D

Explanation

A nurse is checking a client's bowel sounds. At which of the following times should the nurse auscultate the client's abdomen?

Correct Answer is A

Explanation

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