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: This is not a correct sign of hypervolemia. Increased thirst and dry mucous membranes are signs of dehydration or fluid volume deficit, which can occur due to excessive fluid loss or inadequate fluid intake.

Choice B reason: This is not a correct sign of hypervolemia. Low blood pressure and increased heart rate are signs of hypovolemic shock, which can occur due to severe fluid loss or hemorrhage.

Choice C reason: This is a correct sign of hypervolemia. Difficulty breathing and weight gain are signs of fluid overload, which can occur due to excessive fluid retention or impaired cardiac function. Difficulty breathing can be caused by pulmonary edema, which is the accumulation of fluid in the lungs. Weight gain can be caused by the increase in total body fluid.

Choice D reason: This is not a correct sign of hypervolemia. Dry cough and poor skin turgor are signs of dehydration or fluid volume deficit, which can occur due to excessive fluid loss or inadequate fluid intake.

A. An obese client whose parents and siblings are not obese B. A client with long-standing obesity who has recently been diagnosed with type 2 diabetes C. A client whose obesity has been attributed to a reversible endocrine disorder like hypothyroidism D. A client whose obesity is characterized as android rather than gynoid

Correct Answer is C

Explanation

Choice A reason: An obese client whose parents and siblings are not obese may have obesity due to environmental or behavioral factors, such as diet, physical activity, or stress. Medication may not be effective for this type of obesity, and lifestyle changes may be more appropriate.

Choice B reason: A client with long-standing obesity who has recently been diagnosed with type 2 diabetes may have obesity due to insulin resistance, which impairs the body's ability to use glucose and increases fat storage. Medication may help with glucose control, but it may not resolve the obesity. The client may also need to follow a diabetic diet and exercise regimen.

Choice C reason: A client whose obesity has been attributed to a reversible endocrine disorder like hypothyroidism may have obesity due to hormonal imbalance, which affects the metabolism and energy expenditure. Medication may be effective for this type of obesity, as it can restore the normal function of the thyroid gland and increase the metabolic rate.

Choice D reason: A client whose obesity is characterized as android rather than gynoid may have obesity due to genetic or gender factors, such as the distribution of fat in the upper body or the influence of male hormones. Medication may not be effective for this type of obesity, and the client may benefit from other interventions such as surgery or counseling.

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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?

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