The nurse is providing discharge instructions for a slightly overweight client seen in the Emergency Department with gastroesophageal reflux disease (GERD). Which instruction should the nurse give for management of this disease process?
Drink a carbonated beverage before bed
Increase fatty foods one at a time
Elevate the head of the bed when sleeping
Eat dinner late in the evening
The Correct Answer is C
Choice A reason: This is not a correct instruction because drinking a carbonated beverage before bed can worsen the reflux symptoms by increasing the gastric pressure and the production of gas.
Choice B reason: This is not a correct instruction because increasing fatty foods can worsen the reflux symptoms by delaying the gastric emptying and relaxing the lower esophageal sphincter (LES), which allows the stomach acid to flow back into the esophagus.
Choice C reason: This is a correct instruction because elevating the head of the bed when sleeping can help prevent the reflux symptoms by using gravity to keep the stomach contents from flowing back into the esophagus.
Choice D reason: This is not a correct instruction because eating dinner late in the evening can worsen the reflux symptoms by increasing the amount and acidity of the stomach contents, which can easily flow back into the esophagus when lying down. The client should avoid eating within 3 hours of bedtime.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Pyuria, or pus in the urine, is not a direct sign of fluid volume overload. It may indicate a urinary tract infection, kidney stones, or other renal problems.
Choice B reason: Weight loss is not a typical finding of fluid volume overload. In fact, weight gain is a common symptom of fluid retention, as the body holds more fluid than it excretes.
Choice C reason: Jugular vein distention, or the bulging of the neck veins, is a serious indicator of fluid volume overload. It reflects increased pressure in the right side of the heart and the systemic circulation. It may also signal heart failure, pulmonary hypertension, or pericardial tamponade.
Choice D reason: Muscle contractions are not directly related to fluid volume overload. They may be caused by electrolyte imbalances, dehydration, muscle fatigue, or nerve disorders.
Correct Answer is B
Explanation
Choice A reason: Active transport is not the process that allows fluid to pass through a membrane from a dilute to a more concentrated area. Active transport is the process that moves solutes across a membrane against their concentration gradient, using energy from ATP. Active transport can create or maintain a concentration difference between two sides of a membrane.
Choice B reason: Osmosis is the process that allows fluid to pass through a membrane from a dilute to a more concentrated area. Osmosis is the movement of water across a selectively permeable membrane from an area of low solute concentration to an area of high solute concentration. Osmosis can equalize the concentration of solutes on both sides of a membrane.
Choice C reason: Filtration is not the process that allows fluid to pass through a membrane from a dilute to a more concentrated area. Filtration is the movement of fluid and solutes across a membrane due to a pressure difference between two sides of a membrane. Filtration can separate solutes from fluid based on their size and charge.
Choice D reason: Diffusion is not the process that allows fluid to pass through a membrane from a dilute to a more concentrated area. Diffusion is the movement of solutes across a membrane from an area of high solute concentration to an area of low solute concentration. Diffusion can also equalize the concentration of solutes on both sides of a membrane.

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