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

Answer and Explanation

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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Correct Answer is C

Explanation

Choice A reason: The client quitting smoking 6 months ago is not a factor that would exclude her from being an appropriate surgical candidate. In fact, smoking cessation is a requirement for bariatric surgery, as smoking increases the risk of complications such as infection, thrombosis, and poor wound healing.

Choice B reason: The client having a strong family history of obesity is not a factor that would exclude her from being an appropriate surgical candidate. Family history is one of the genetic factors that can contribute to obesity, but it does not determine the eligibility for bariatric surgery. Other factors such as BMI, comorbidities, lifestyle, and motivation are more important.

Choice C reason: The client drinking six to eight cans of beer daily is a factor that would exclude her from being an appropriate surgical candidate. Alcohol abuse is a contraindication for bariatric surgery, as it can cause liver damage, malnutrition, dehydration, and addiction transfer. The client would need to abstain from alcohol for at least 6 months before and after the surgery.

Choice D reason: The client having poorly controlled type 2 diabetes is not a factor that would exclude her from being an appropriate surgical candidate. Type 2 diabetes is one of the comorbidities that can qualify a client for bariatric surgery, as it can improve or resolve after the surgery. However, the client would need to have a good glycemic control before the surgery to reduce the risk of complications.

A. Half-normal saline solution B. 10% dextrose in water C. 5% dextrose and half-normal saline solution D. Lactated Ringer's solution

Correct Answer is D

Explanation

Choice A reason: Half-normal saline solution is a hypotonic solution, which means it has a lower concentration of solutes than the blood plasma. It can cause fluid to shift from the blood vessels into the cells, leading to cellular swelling and edema.

Choice B reason: 10% dextrose in water is a hypertonic solution, which means it has a higher concentration of solutes than the blood plasma. It can cause fluid to shift from the cells into the blood vessels, leading to cellular shrinkage and dehydration.

Choice C reason: 5% dextrose and half-normal saline solution is a hypertonic solution, which has the same effects as choice B. The dextrose increases the osmolarity of the solution, while the half-normal saline provides some electrolytes.

Choice D reason: Lactated Ringer's solution is an isotonic solution, which means it has the same concentration of solutes as the blood plasma. It maintains fluid balance and provides electrolytes such as sodium, potassium, calcium, and lactate. It is commonly used for fluid resuscitation, dehydration, and acidosis.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is D

Explanation

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