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.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
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.
Correct Answer is A
Explanation
Choice A reason: Sudden abdominal pain is a sign of gastrointestinal perforation, which is a life-threatening complication of peptic ulcer disease. It occurs when the ulcer erodes through the wall of the stomach or duodenum, causing leakage of gastric contents into the peritoneal cavity. This causes inflammation, infection, and peritonitis.
Choice B reason: Hyperactive bowel sounds are not indicative of gastrointestinal perforation. They may be present in other conditions, such as gastroenteritis, intestinal obstruction, or diarrhea.
Choice C reason: Bradycardia is not indicative of gastrointestinal perforation. It may be caused by other factors, such as vagal stimulation, medication side effects, or cardiac disorders.
Choice D reason: Decreased blood pressure is not indicative of gastrointestinal perforation. It may be a result of other causes, such as hypovolemia, shock, or dehydration.
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