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The nurse has instructed self-management strategies for a client diagnosed with gastroesophageal reflux disease (GERD). Which statement by the client would indicate a correct understanding of the teaching?
- A. It's much better for me to wear loose-fitting clothes right now.
- B. I stopped eating grilled chicken and now eat more ground hamburger.
- C. If I wake up with GERD symptoms, I should lower the head of my bed while sleeping.
- D. I should take my prescribed omeprazole after meals.
Correct Answer: A
Rationale: Loose-fitting clothes (A) reduce abdominal pressure, helping manage GERD. Hamburger (B) is high-fat and worsens reflux, lowering the bed (C) increases symptoms, and omeprazole (D) is taken before meals.
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The nurse is caring for a client receiving total parenteral nutrition (TPN), which was initiated twelve hours ago. The priority assessment for this client is which of the following?
- A. Urine output
- B. Oral temperature
- C. Weight
- D. Capillary blood glucose
Correct Answer: D
Rationale: TPN contains high concentrations of glucose, which can lead to hyperglycemia, especially in the early stages of administration. Monitoring capillary blood glucose is critical to detect and manage this potential complication.
A nurse is caring for a client diagnosed with a duodenal ulcer. Which medication facilitates healing by forming a protective lining over the client's ulcer?
- A. Famotidine
- B. Omeprazole
- C. Sucralfate
- D. Cimetidine
Correct Answer: C
Rationale: Sucralfate (C) forms a protective barrier over the ulcer, promoting healing by shielding it from stomach acid. Famotidine (A) and cimetidine (D) are H2 blockers, and omeprazole (B) is a proton pump inhibitor, which reduce acid but do not form a physical barrier.
A nurse is caring for a client with ulcerative colitis who has experienced severe diarrhea for the past 24 hours. When assessing the client, the nurse should watch for signs of which of the following?
- A. Metabolic acidosis
- B. Metabolic alkalosis
- C. Malnutrition
- D. Malabsorption
Correct Answer: C
Rationale: Severe diarrhea in ulcerative colitis leads to nutrient loss, increasing the risk of malnutrition (C). Acid-base imbalances (A, B) and malabsorption (D) are possible but less immediate concerns.
The nurse is caring for a client who is postprocedure following an endoscopy. Which priority action should the nurse take prior to resuming the client's diet?
- A. Assess the client's oxygenation level
- B. Assess for the return of the client's gag reflex
- C. Have the healthcare provider speak with the client regarding results of the procedure
- D. Start with a soft diet to see if the client will tolerate
Correct Answer: B
Rationale: Assessing the gag reflex (B) ensures safe swallowing post-endoscopy to prevent aspiration before resuming the diet.
The nurse is caring for a client with appendicitis. Which of the following statements are correct regarding this condition? Select all that apply.
- A. McBurney's point tenderness is a sign of appendicitis
- B. Appendicitis is more common among males
- C. A low carbohydrate diet is a risk factor for appendicitis
- D. Diagnosis of appendicitis is confirmed by endoscopic retrograde cholangiopancreatography
- E. The client may have an elevated white blood cell count (WBC)
Correct Answer: A,E
Rationale: McBurney's point tenderness (A) and elevated WBC (E) are hallmark signs of appendicitis. It is not more common in males (B), low-carb diets (C) are not a risk factor, and ERCP (D) is not used for diagnosis.