A patient with a history of Gastroesophageal Reflux Disease (GERD) comes to the clinic for a follow-up visit. The nurse is providing education on health prevention measures to manage GERD symptoms. Which of the following statements by the patient indicates a correct understanding of the nurse's teaching?

I should eat large meals to reduce the frequency of acid reflux.

I should drink peppermint tea after meals to help with digestion.

I should lie down immediately after eating to prevent heartburn.

I should avoid eating meals at least 2-3 hours before bedtime.

Answer and Explanation

The Correct Answer is D

A. I should eat large meals to reduce the frequency of acid reflux: Large meals can worsen GERD by increasing stomach pressure and acid production, leading to reflux. Small, frequent meals are recommended instead.

B. I should drink peppermint tea after meals to help with digestion: While peppermint may help with general digestion, it can relax the lower esophageal sphincter (LES), making GERD worse by allowing acid to reflux into the esophagus.

C. I should lie down immediately after eating to prevent heartburn: Lying down after meals increases the likelihood of acid reflux due to gravity, especially if the stomach is full, and should be avoided.

D. I should avoid eating meals at least 2-3 hours before bedtime. Avoiding meals 2-3 hours before bedtime helps reduce acid reflux by preventing the stomach from being full and producing excess acid when lying down.

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Correct Answer is D

Explanation

A. Encourage the patient to use an alcohol-based mouthwash to clean the oral cavity:
Alcohol-based mouthwashes can irritate the oral mucosa and worsen the pain of stomatitis. Instead, non-alcoholic, soothing mouth rinses are recommended.

B. Advise the patient to avoid all oral intake until the ulcers heal completely: Patients still need proper nutrition, and complete avoidance of food can lead to malnutrition. Soft, non-irritating foods are encouraged rather than full avoidance.

C. Suggest the patient brush their teeth vigorously to remove any bacteria from the mouth: Vigorous brushing can worsen oral ulcers and lead to further pain and bleeding. A gentle, soft-bristle toothbrush should be recommended.

D. Recommend the patient to consume soft, non-irritating foods and avoid acidic or spicy foods.
Consuming soft, bland, non-irritating foods and avoiding acidic or spicy foods helps reduce discomfort and prevent further irritation of oral ulcers, which is essential in managing stomatitis.

A. “Vomiting blood or material that looks like coffee grounds is a serious sign that I need to go to the emergency room.” B. “If experience severe abdominal pain, I should take an over-the-counter antacid and rest.” C. “I should avoid taking NSAIDs like ibuprofen as they can increase my risk of bleeding." D. “I should immediately report any black, tarry stools to my healthcare provider.”

Correct Answer is B

Explanation

A. "Vomiting blood or material that looks like coffee grounds is a serious sign that I need to go to the emergency room." This is a correct understanding. Vomiting blood or coffee-ground material is a sign of gastrointestinal bleeding and requires immediate medical attention.

B. "If I experience severe abdominal pain, I should take an over-the-counter antacid and rest."
Taking an over-the-counter antacid without contacting a healthcare provider for severe pain could mask serious complications, such as recurrent bleeding or perforation, that need immediate medical attention. This statement indicates a need for further teaching.

C. "I should avoid taking NSAIDs like ibuprofen as they can increase my risk of bleeding." This is a correct understanding, as NSAIDs can cause or worsen gastric ulcers and increase the risk of bleeding.

D. "I should immediately report any black, tarry stools to my healthcare provider."This is a correct understanding. Black, tarry stools (melena) indicate upper gastrointestinal bleeding.

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Naxlex Comprehensive Predictor Exams

A patient undergoing chemotherapy reports painful oral ulcers, difficulty eating, and a metallic taste in the mouth. The nurse suspects stomatitis. Which nursing intervention is most appropriate for this patient?

Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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