A nurse is reinforcing teaching with a client who has a duodenal ulcer and a new prescription for cimetidine. Which of the following instructions should the nurse include?

"Drinking grapefruit juice while taking cimetidine can lead to toxicity."

"Avoid taking the medication at bedtime."

“Take an antacid 30 min prior to taking cimetidine to minimize stomach upset."

“You will need to continue taking this medication for up to 6 weeks."

Answer and Explanation

Correct Answer : B,D

When reinforcing teaching with a client who has a duodenal ulcer and a new prescription for cimetidine, the nurse should include the following instructions:

"Avoid taking the medication at bedtime.": Cimetidine is most effective when taken during waking hours to help control gastric acid secretion. Taking it at bedtime may not provide optimal therapeutic benefits.

"You will need to continue taking this medication for up to 6 weeks.": Cimetidine is often prescribed for the treatment of duodenal ulcers and may require several weeks of continuous use to promote healing. It is important for the client to understand the duration of treatment and the need for adherence to the prescribed regimen.

The following statements are incorrect or not applicable:

"Drinking grapefruit juice while taking cimetidine can lead to toxicity.": Cimetidine does not have a known interaction with grapefruit juice. However, it is always important to consult the healthcare provider or pharmacist about potential drug interactions, including those related to specific foods or beverages.

"Take an antacid 30 minutes prior to taking cimetidine to minimize stomach upset.": Cimetidine is an H2 receptor antagonist that works by reducing stomach acid production. It is not necessary to take an antacid prior to taking cimetidine to minimize stomach upset. However, if the client experiences stomach upset or discomfort, they should consult their healthcare provider for further guidance on managing these symptoms.

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Correct Answer is A

Explanation

Elevating the head of the bed can help reduce the symptoms of GERD during sleep. By elevating the head, gravity can help prevent stomach acid from flowing back into the esophagus, reducing the occurrence of reflux.

The other statements do not demonstrate an understanding of the teaching: "I will sleep on my stomach with my head flat": Sleeping on the stomach can actually worsen the symptoms of GERD as it can increase the likelihood of stomach acid flowing back into the esophagus. It is generally recommended to sleep on the left side or back to minimize reflux.

"I will have a snack 1 hour before going to bed": Consuming a snack close to bedtime can increase the likelihood of reflux during sleep. It is generally recommended to avoid eating at least 2 to 3 hours before lying down to minimize reflux symptoms.

"I can have 6 ounces of alcohol before bed, to help me sleep": Alcohol can relax the lower esophageal sphincter (LES) and increase the risk of reflux. It is best to avoid alcohol before bedtime, especially for individuals with GERD.

A. Lower the height of the solution container. B. Stop the enema and document that the client did not tolerate the procedure. C. Encourage the client to bear down D. Allow the client to expel some fluid before continuing

Correct Answer is D

Explanation

When the client experiences cramping during the enema administration, it indicates that the colon is becoming distended. By allowing the client to expel some of the fluid, the pressure in the colon is reduced, which can help alleviate the discomfort and cramping. The nurse should pause the administration of the enema and allow the client to release some fluid before continuing.

The other options mentioned are not appropriate or effective actions to relieve the client's discomfort:

Lowering the height of the solution container: Lowering the height of the solution container will decrease the force of the fluid flow but may not address the underlying cause of the cramping. Allowing the client to expel some fluid is a more appropriate intervention.

Stopping the enema and documenting that the client did not tolerate the procedure: While it is important to monitor the client's tolerance during the procedure, abruptly stopping the enema and documenting intolerance may not be necessary if the discomfort can be relieved by allowing the client to expel some fluid. The nurse should prioritize relieving the discomfort before deciding to stop the procedure.

Encouraging the client to bear down: Bearing down or pushing can increase intra-abdominal pressure and exacerbate the cramping. This action is not recommended in this situation.

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A nurse is reinforcing teaching with a client who has a duodenal ulcer and a new prescription for cimetidine. Which of the following instructions should the nurse include?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching with a client who has gastroesophageal reflux disease (GERD) about minimizing the effects of reflux during sleep. Which of the following client statements indicates an understanding of the teaching?

Correct Answer is A

Explanation

A nurse is administering a tap-water enema to a client. The client reports cramping as the nurse instills the irrigating solution. Which of the following actions should the nurse take to relieve the client's discomfort?

Correct Answer is D

Explanation

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