A patient who has gastroesophageal reflux disease (GERD) is experiencing increasing discomfort.
Which patient statement to the nurse indicates that additional teaching about GERD is needed?

I quit smoking years ago, but I chew gum.

I sleep with the head of the bed elevated on 4-inch blocks.

I take antacids between meals and at bedtime each night.

I eat small meals and have a bedtime snack.

Answer and Explanation

The Correct Answer is D

Choice A rationale

Chewing gum can increase salivary production, and while saliva may neutralize some stomach acid, the act of chewing can stimulate swallowing and possibly exacerbate symptoms by introducing excess air into the stomach. For GERD patients, avoiding gum may help reduce bloating and gas discomfort.

Choice B rationale

Elevating the head of the bed reduces the likelihood of acid reflux during sleep by using gravity to prevent stomach contents from flowing backward into the esophagus. This strategy aligns with GERD management guidelines and reduces nighttime symptoms.

Choice C rationale

Taking antacids between meals and at bedtime helps neutralize stomach acid temporarily, providing short-term relief of GERD symptoms. While effective, long-term use without addressing dietary and lifestyle factors is not ideal for managing GERD.

Choice D rationale

Eating small meals is beneficial for GERD, as it prevents overdistension of the stomach, but having a bedtime snack contradicts GERD management principles. Late-night eating may increase the risk of acid reflux when lying down, thus requiring more teaching.

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Correct Answer is A

Explanation

Choice A rationale

Using a Foley catheter can help prevent skin breakdown caused by prolonged contact with urine in incontinent patients, especially if they are confused or non-ambulatory and unable to use other urinary devices. Maintaining intact skin is crucial to avoiding infections and pressure injuries, making a Foley catheter a suitable intervention in specific cases when prescribed.

Choice B rationale

Foley catheters are not inherently inappropriate but must be prescribed judiciously due to risks like urinary tract infections. While alternative methods may be preferable, this intervention is justified for incontinent, immobile patients with compromised mental status to protect skin integrity. It aligns with clinical guidelines and patient-specific needs.

A. Lispro (Humalog). B. Glargine (Lantus). C. Detemir (Levemir). D. NPH (Humulin N).

Correct Answer is A

Explanation

Choice A rationale

Lispro (Humalog) is a rapid-acting insulin analog designed for mealtime glucose control. It begins action within 15 minutes, peaks in 1 hour, and lasts 2 to 4 hours. Its quick onset matches postprandial glucose spikes, enhancing glycemic control during meals and preventing hyperglycemia from carbohydrate intake.

Choice B rationale

Glargine (Lantus) is a long-acting basal insulin with no peak and prolonged action. It does not target mealtime spikes but provides steady glucose control over 24 hours. Its slow onset and constant release profile are unsuitable for immediate postprandial glucose management.

Choice C rationale

Detemir (Levemir) is a long-acting basal insulin, similar to glargine, with extended action for baseline glucose control. It lacks the rapid onset needed for mealtime management, making it inappropriate for postprandial hyperglycemia control, as observed in Lispro efficacy.

Choice D rationale

NPH (Humulin N) is an intermediate-acting insulin with delayed onset and peak activity. It supports baseline glucose regulation but fails to address mealtime glucose control promptly. Its time profile does not align with the immediate needs of postprandial hyperglycemia management.

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A patient who has gastroesophageal reflux disease (GERD) is experiencing increasing discomfort.Which patient statement to the nurse indicates that additional teaching about GERD is needed?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The student nurses ask the RN if a Foley catheter would be an appropriate intervention to protect intact skin for a patient who is not ambulatory, incontinent, and confused.The nurse knows that it would be appropriate to ask the physician for an order to place a Foley catheter for this patient.

Correct Answer is A

Explanation

A patient with diabetes is starting on insulin therapy.Which type of insulin will the nurse discuss using for mealtime coverage?

Correct Answer is A

Explanation

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A patient who has gastroesophageal reflux disease (GERD) is experiencing increasing discomfort.
Which patient statement to the nurse indicates that additional teaching about GERD is needed?