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

Answer and Explanation

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.

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Correct Answer is A

Explanation

Choice A reason: Priming an ipratropium inhaler typically requires 2 pumps, not 7, to ensure proper dosing. Excessive priming wastes medication and may reduce the inhaler’s lifespan. This action indicates misunderstanding of device preparation, necessitating further teaching to ensure effective administration and therapeutic outcomes.

Choice B reason: Attaching a spacer device enhances ipratropium delivery by improving aerosol deposition in the lungs, especially in COPD patients with poor inhalation technique. This is correct, as spacers reduce oropharyngeal deposition, minimizing side effects and maximizing bronchodilation, requiring no additional teaching.

Choice C reason: Storing ipratropium at room temperature is correct, as extreme temperatures can degrade the medication’s efficacy. This action aligns with manufacturer guidelines, ensuring the inhaler’s stability and effectiveness, indicating proper understanding and eliminating the need for further teaching on storage.

Choice D reason: Rinsing the mouth after ipratropium use is appropriate, as it reduces local side effects like dry mouth or throat irritation from residual medication. This correct action prevents complications, showing proper technique and understanding, so no additional teaching is required for this step.

A. Imbalanced nutrition less than body requirements B. Risk for aspiration related to difficulty swallowing C. Anxiety and grieving related to progression of disease D. Chronic pain related to tissue destruction by tumor

Correct Answer is D

Explanation

Choice A reason: Imbalanced nutrition due to anorexia and dysphagia is significant in esophageal cancer, as it risks weight loss and weakness. However, pain at 8/10 is an acute, distressing symptom requiring immediate relief to improve quality of life, making it the priority over nutritional deficits.

Choice B reason: Risk for aspiration from dysphagia is a concern in esophageal cancer, as tumor obstruction can cause swallowing issues. While serious, aspiration is a potential risk, whereas severe pain is an immediate, actual problem, making pain management the priority to alleviate current suffering.

Choice C reason: Anxiety and grieving are valid in esophageal cancer due to its prognosis, but a pain level of 8/10 is an urgent physiological need. Addressing pain first improves the client’s ability to cope with psychological distress, prioritizing physical comfort over emotional concerns.

Choice D reason: Chronic pain from tumor-related tissue destruction, rated 8/10, is the priority, as severe pain causes significant distress and impairs function. Effective pain management enhances comfort, facilitates other interventions, and addresses the client’s immediate suffering, making it the most urgent nursing problem.

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The nurse is teaching a client with gastroesophageal reflux disease about dietary modifications. Which instruction should the nurse include?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with chronic obstructive pulmonary disease receives a new prescription for an ipratropium inhaler. Which action indicates to the nurse that additional teaching is needed?

Correct Answer is A

Explanation

The nurse is caring for a client who has been admitted with a diagnosis of esophageal cancer. The client reports a pain level of 8 on a 0 to 10 scale, dysphagia, anorexia, anxiety, and a hoarse voice. Which nursing problem is the priority for this client?

Correct Answer is D

Explanation

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