Which instruction should the nurse include in the discharge teaching for a client who has gastroesophageal reflux?

Encourage the client to lie down and rest after meals

Remind the client to avoid high-fiber foods

Teach the client to elevate the head of the bed on blocks

Instruct the client to use antacids only as a last resort

Answer and Explanation

The Correct Answer is C

Choice A reason: Encouraging the client to lie down and rest after meals is not advisable for someone with gastroesophageal reflux. Lying down after eating can exacerbate symptoms by allowing stomach acid to more easily flow back into the esophagus. It's recommended that clients stay upright for at least 2-3 hours after meals.

Choice B reason: Avoiding high-fiber foods is not a standard recommendation for managing gastroesophageal reflux. In fact, a diet high in fiber can benefit overall digestive health and help prevent constipation. The key dietary advice usually involves avoiding trigger foods such as spicy, fatty, or acidic foods.

Choice C reason: Elevating the head of the bed on blocks is an effective way to manage gastroesophageal reflux, especially at night. This position helps keep stomach acid in the stomach and prevents it from flowing back into the esophagus, reducing symptoms such as heartburn.

Choice D reason: Instructing the client to use antacids only as a last resort is not necessarily accurate advice. While antacids can provide symptomatic relief, they are often used as part of a comprehensive management plan for gastroesophageal reflux. However, lifestyle modifications and dietary changes are also crucial.

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Correct Answer is D

Explanation

Choice A reason: Obtaining a prostate-specific antigen (PSA) blood level test is important for screening and monitoring prostate health but does not directly reduce the risk factors for benign prostatic hyperplasia (BPH). PSA tests can help in early detection of prostate issues, but they are not preventive measures.

Choice B reason: Taking vitamin supplements is not specifically proven to reduce the risk of BPH. While maintaining overall nutritional health is important, there is no direct evidence that vitamin supplements alone can prevent BPH. It's better to focus on a balanced diet and healthy lifestyle choices.

Choice C reason: Consuming a high-protein diet does not specifically reduce the risk of BPH. While protein is an essential nutrient for overall health, there is no clear evidence that it has a direct impact on preventing BPH. A balanced diet that includes a variety of nutrients is more beneficial for general health and well-being.

Choice D reason: Increasing physical activity is one of the recommended lifestyle changes to reduce the risk of BPH. Regular physical activity can improve overall health, help maintain a healthy weight, and potentially reduce the risk of BPH. Physical activity is associated with better prostate health and can help mitigate some of the risk factors associated with BPH, such as obesity and sedentary lifestyle.

A. Fasting serum glucose 140 mg/dL (7.77 mmol/L). B. Glycosylated hemoglobin (A1c) 6.9%. C. Serum creatinine 1.6 mg/dL (141.44 umol/L). D. White blood cell (WBC) 11,000/mm3 (11 x 10^9/L).

Correct Answer is C

Explanation

Choice A reason: A fasting serum glucose level of 140 mg/dL (7.77 mmol/L) indicates hyperglycemia, which is elevated but not an immediate life-threatening complication. It suggests poor blood glucose control but does not directly indicate a complication specific to type 2 diabetes and hypertension. This value should prompt further evaluation and adjustments in diabetes management, but it is not as critical as other potential findings.

Choice B reason: A glycosylated hemoglobin (A1c) level of 6.9% is within the range of good diabetic control. While it indicates the client has been managing their blood glucose levels relatively well over the past few months, it does not suggest a current complication. This value is used to assess long-term glucose control rather than acute issues.

Choice C reason: A serum creatinine level of 1.6 mg/dL (141.44 umol/L) is elevated and indicates impaired kidney function. Clients with type 2 diabetes mellitus and hypertension are at increased risk for kidney disease, known as diabetic nephropathy or hypertensive nephropathy. Elevated creatinine levels suggest that the kidneys are not filtering waste products effectively, which is a significant complication that requires immediate attention and intervention.

Choice D reason: A white blood cell (WBC) count of 11,000/mm3 (11 x 10^9/L) is slightly elevated and may suggest an infection or inflammation. However, it is not a specific complication related to type 2 diabetes mellitus and hypertension. Elevated WBC counts warrant further investigation to identify any underlying infection or inflammatory process, but it is not as directly related to diabetic or hypertensive complications as elevated serum creatinine.

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Which instruction should the nurse include in the discharge teaching for a client who has gastroesophageal reflux?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

Correct Answer is C

Explanation

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