The nurse is providing discharge teaching for the client newly diagnosed with GERD. The teaching should Include Instructions to: (SELECT ALL THAT APPLY)

eat small frequent meals during the day.

enroll in smoking cessation classes as needed.

take omeprazole 30 minutes after meals when acid levels are highest.

elevate the head of the bed at night.

eat your largest meal at bedtime.

Answer and Explanation

Correct Answer : A,B,D

A. Eating smaller, more frequent meals can help reduce the likelihood of gastric distention and decrease the pressure on the lower esophageal sphincter (LES), which can help reduce reflux symptoms.
B. Smoking is a risk factor for GERD as it can weaken the LES and increase acid reflux. Therefore, quitting smoking can help alleviate symptoms and improve overall health.
D. Elevating the head of the bed by 6 to 8 inches can help reduce nighttime reflux symptoms by using gravity to prevent stomach acid from flowing back into the esophagus.
C. Proton pump inhibitors (PPIs) like omeprazole are typically taken before meals to inhibit acid production and prevent reflux symptoms. Taking omeprazole after meals may not provide optimal acid suppression when it is most needed.
E. Eating a large meal right before bedtime can increase the likelihood of reflux symptoms as lying down after eating can worsen reflux. It is recommended to avoid large meals, particularly before bedtime, to minimize GERD symptoms.

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Correct Answer is D

Explanation

D. Bloody diarrhea is a hallmark symptom of ulcerative colitis, particularly during disease flares. It typically presents as frequent and urgent bowel movements containing blood, mucus, and pus. Crohn's disease, on the other hand, may present with bloody diarrhea but usually involves less frequent bowel movements.
A. Both ulcerative colitis and Crohn's disease can manifest at various ages, including during adolescence and early adulthood.
B. Abdominal pain and cramping are common symptoms of both ulcerative colitis and Crohn's disease.
C. Weight loss can occur in both ulcerative colitis and Crohn's disease due to factors such as decreased appetite, malabsorption, and inflammation of the gastrointestinal tract.

A. Urine output 50 mL per hour B. Heart rate 60 beats/minute C. Heart rhythm regular D. Blood pressure 120/90

Correct Answer is B

Explanation

A. While it may have some impact on kidney function indirectly through its effects on blood pressure and heart function, urine output is not the primary parameter used to assess the effectiveness of carvedilol in a patient with a history of unstable angina.
B. Carvedilol, as a beta-blocker, helps reduce heart rate by blocking the effects of adrenaline on the heart. In unstable angina, lowering the heart rate can reduce myocardial oxygen demand, which is beneficial in managing ischemic symptoms
C. Carvedilol primarily affects heart rate and blood pressure but doesn't directly regulate heart rhythm. However, in patients with certain cardiac conditions, like heart failure or left ventricular dysfunction after a heart attack, carvedilol can sometimes help to stabilize heart rhythm indirectly by reducing stress on the heart.
D. Carvedilol is also effective in reducing blood pressure, which is beneficial in patients with unstable angina, as it decreases the workload on the heart and the oxygen demand of the myocardium. A blood pressure reading of 120/90 is within the normal range for an adult and indicates good control of blood pressure.

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The nurse is providing discharge teaching for the client newly diagnosed with GERD. The teaching should Include Instructions to: (SELECT ALL THAT APPLY)

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Naxlex Comprehensive Predictor Exams

While obtaining a nursing history from a client with inflammatory bowel disease, the nurse recognizes that the client most likely has ulcerative colitis rather than Crohn's disease when the client reports experiencing:

Correct Answer is D

Explanation

The nurse is evaluating the medical prescription of carvedilol 6.25 mg PO daily for a client with a history of unstable angina. Which of the following reflects that the medication's action has been effective?

Correct Answer is B

Explanation

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