The nurse is teaching a client with gastroesophageal reflux disease about dietary modifications. Which instruction should the nurse include?
Suggest that the client also plan to eat frequent small meals to reduce discomfort
Remind the client to switch to decaffeinated coffee and tea
Review with the client the need to avoid foods rich in milk and cream
Reinforce the teaching by asking the client to make a list of snack foods high in dairy content
The Correct Answer is A
Choice A reason: Frequent small meals reduce gastroesophageal reflux by minimizing gastric distension, which decreases pressure on the lower esophageal sphincter. This prevents acid reflux into the esophagus, alleviating heartburn and irritation, making it an effective dietary strategy for managing GERD symptoms.
Choice B reason: Switching to decaffeinated coffee and tea may reduce reflux triggers, as caffeine relaxes the lower esophageal sphincter. However, small meals are more effective, as they directly reduce gastric volume and sphincter pressure, providing broader symptom relief than caffeine avoidance alone.
Choice C reason: Avoiding milk and cream is relevant for some GERD patients, as high-fat foods delay gastric emptying, increasing reflux. However, frequent small meals address the root cause of reflux by reducing gastric pressure, making this a more universally effective strategy than specific food avoidance.
Choice D reason: Listing high-dairy snack foods reinforces avoidance but is less direct than recommending small meals. Dairy may trigger reflux in some, but frequent small meals broadly reduce gastric distension and sphincter pressure, offering a more immediate and effective GERD management strategy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Throat irritation is a common albuterol side effect due to its deposition in the oropharynx during inhalation. It is not life-threatening and can be managed with rinsing or spacer use. This does not require immediate intervention compared to cardiovascular effects, as it does not compromise vital organ function.
Choice B reason: Uncontrollable shaking (tremors) is a frequent albuterol side effect, resulting from beta-2 receptor stimulation in skeletal muscles. It is usually transient and benign, not requiring immediate intervention. Monitoring is sufficient unless severe, as it does not pose an acute threat compared to cardiac irregularities.
Choice C reason: An irregular rapid heart rate (tachycardia or arrhythmia) is a serious albuterol side effect, as beta-2 agonists can stimulate beta-1 receptors in the heart, causing cardiovascular instability. This warrants immediate intervention, as it risks cardiac compromise, especially in emphysema patients with compromised respiratory and cardiac reserves.
Choice D reason: Increased anxiety is a possible albuterol side effect due to its stimulatory effects on the central nervous system. While distressing, it is not immediately life-threatening. It requires monitoring but is secondary to cardiovascular complications, which pose a greater acute risk in emphysema patients with wheezing.
Correct Answer is B
Explanation
Choice A reason: Difficulty with urination is not a primary concern for pyridostigmine, a cholinesterase inhibitor used in myasthenia gravis to enhance neuromuscular transmission. While cholinergic side effects may include urinary urgency, this is not a pre-administration priority compared to oral intake, which affects absorption and efficacy.
Choice B reason: Recent oral intake is critical before administering pyridostigmine, as food can delay its absorption, reducing effectiveness in myasthenia gravis. Taking it 30–60 minutes before or 2 hours after meals ensures optimal plasma levels, improving muscle strength, making this the priority information to obtain.
Choice C reason: Trouble sleeping is not directly relevant to pyridostigmine administration. While cholinergic side effects like diarrhea may disrupt sleep, this is a secondary concern. Ensuring proper timing with oral intake is critical for therapeutic efficacy, as absorption impacts symptom control in myasthenia gravis.
Choice D reason: Unexplained weight loss may indicate myasthenia gravis progression or other issues but is not a pre-administration concern for pyridostigmine. Timing with oral intake directly affects the drug’s pharmacokinetics, ensuring effective muscle strength improvement, making weight loss less urgent to assess before dosing.
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