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The nurse is performing an admission assessment on a client diagnosed with GERD. Which signs and symptoms would indicate GERD?
- A. Pyrosis, water brash, and flatulence.
- B. Weight loss, dysarthria, and diarrhea.
- C. Decreased abdominal fat, proteinuria, and constipation.
- D. Midepigastric pain, positive H. pylori test, and melena.
Correct Answer: A
Rationale: Pyrosis (heartburn), water brash (regurgitation of sour fluid), and flatulence are classic symptoms of GERD due to acid reflux and gas buildup. The other options include symptoms more associated with other conditions like peptic ulcer disease or systemic disorders.
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The client has end-stage liver failure secondary to alcoholic cirrhosis. Which complication indicates the client is at risk for developing hepatic encephalopathy?
- A. Gastrointestinal bleeding.
- B. Hypoalbuminemia.
- C. Splenomegaly.
- D. Hyperaldosteronism.
Correct Answer: A
Rationale: GI bleeding increases ammonia levels (from blood protein breakdown), a key trigger for hepatic encephalopathy. Other complications are less directly linked to this risk.
The client at the eating disorder clinic weighs 35 kg and is 5 ft 7 inches tall. Which would the nurse document as the Body Mass Index (BMI)?
Correct Answer: 11.5
Rationale: BMI = weight (kg) / height (m)^2. Height = 5'7 = 1.73 m. BMI = 35 / (1.73)^2 = 35 / 2.9929 ≈ 11.5.
The nurse is facilitating a support group for clients diagnosed with Crohn's disease. Which information is most important for the nurse to discuss with the clients?
- A. Discuss coping skills to assist with adaptation to lifestyle modifications.
- B. Teach about drug administration, dosages, and scheduled times.
- C. Teach dietary changes necessary to control symptoms.
- D. Explain the care of the ileostomy and necessary equipment.
Correct Answer: A
Rationale: Coping skills help clients adapt to the chronic, unpredictable nature of Crohn’s disease, addressing psychosocial needs in a support group. Medications, diet, and ileostomy care are secondary.
The nurse is discussing the therapeutic diet for the client diagnosed with diverticulosis. Which meal indicates the client understands the discharge teaching?
- A. Fried fish, mashed potatoes, and iced tea.
- B. Ham sandwich, applesauce, and whole milk.
- C. Chicken salad on whole-wheat bread and water.
- D. Lettuce, tomato, and cucumber salad and coffee.
Correct Answer: C
Rationale: A high-fiber diet, like whole-wheat bread, prevents constipation and flare-ups in diverticulosis. Fried foods, low-fiber applesauce, and salads with seeds (e.g., tomatoes) are less appropriate.
The nurse is caring for an adult client diagnosed with GERD. Which condition is the most common comorbid disease associated with GERD?
- A. Adult-onset asthma.
- B. Pancreatitis.
- C. Peptic ulcer disease.
- D. Increased gastric emptying.
Correct Answer: A
Rationale: GERD is commonly associated with adult-onset asthma due to acid reflux irritating the airways, leading to bronchospasm. Pancreatitis and peptic ulcer disease are less directly linked, and increased gastric emptying is not a typical comorbidity.