Nokea
The nurse is planning to teach the client with gastroesophageal reflux disease about substances that will increase the lower esophageal sphincter pressure. Which of the following items would the nurse include on this list?
- A. Fatty foods
- B. Nonfat milk
- C. Chocolate
- D. Coffee
Correct Answer: B
Rationale: The correct answer is B: Nonfat milk. Nonfat milk is alkaline and can help increase lower esophageal sphincter pressure, reducing reflux symptoms. Fatty foods (A) can relax the sphincter and worsen symptoms. Chocolate (C) and coffee (D) are known triggers for reflux and can also decrease sphincter pressure. Therefore, the nurse would include nonfat milk in the teaching to help manage symptoms of gastroesophageal reflux disease.
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A client with viral hepatitis is discussing with the nurse the need to avoid alcohol and states, 'I'm not sure I can avoid alcohol.' The most appropriate response is
- A. Everything will be alright.
- B. I think you should talk more with the doctor about this.
- C. I don't believe that.
- D. I'm not sure that I don't understand. Would you please explain?
Correct Answer: D
Rationale: The correct answer is D because it shows active listening and empathy towards the client's concerns. By asking the client to explain, the nurse can gain a better understanding of the client's perspective and provide tailored support and information. Choice A is incorrect as it dismisses the client's concerns. Choice B is incorrect as it deflects responsibility from the nurse. Choice C is incorrect as it shows disbelief and lacks empathy.
A client has a nasogastric tube inserted at the time of abdominal perineal resection with permanent colostomy. This tube will most likely be removed when the client demonstrates:
- A. Absence of nausea and vomiting.
- B. Passage of mucus from the rectum.
- C. Passage of flatus and feces from the colostomy.
- D. Absence of stomach drainage for 24 hours.
Correct Answer: C
Rationale: The correct answer is C: Passage of flatus and feces from the colostomy. This indicates that the gastrointestinal tract is functioning properly post-operatively. The nasogastric tube is typically removed once the client's bowel function has returned, as evidenced by the passage of flatus and feces from the colostomy. This indicates that the client's bowels are working and there is no longer a need for the tube to decompress the stomach. Choices A, B, and D are incorrect because the absence of nausea and vomiting, passage of mucus from the rectum, and absence of stomach drainage do not directly indicate the return of normal bowel function, which is the key factor for removing the nasogastric tube in this scenario.
A nurse is caring for a client who has just returned from the operating room following the creation of a colostomy. The nurse is assessing the drainage in the pouch attached to the site where the colostomy was formed and notes serosanguineous drainage. Which nursing action is most appropriate based on this assessment?
- A. Notify the physician
- B. Document the amount and characteristics of the drainage
- C. Apply ice to the stoma site
- D. Apply pressure to the site
Correct Answer: B
Rationale: The correct answer is B: Document the amount and characteristics of the drainage. This is appropriate as serosanguineous drainage is expected after colostomy creation. Documenting helps monitor for any changes and provides crucial information for the healthcare team.
Choice A (Notify the physician) is not necessary at this point as serosanguineous drainage is normal postoperatively. Choice C (Apply ice to the stoma site) and Choice D (Apply pressure to the site) are both incorrect actions that are not indicated in this situation and could potentially harm the client.
Which of the following activities should the nurse encourage the client with a peptic ulcer to avoid?
- A. Chewing gum.
- B. Smoking cigarettes.
- C. Eating chocolate.
- D. Taking acetaminophen (Tylenol).
Correct Answer: B
Rationale: The correct answer is B: Smoking cigarettes. Smoking can increase stomach acid production and decrease blood flow to the stomach lining, which can worsen peptic ulcers. Chewing gum can actually help by increasing saliva production, which can neutralize stomach acid. Eating chocolate and taking acetaminophen are generally safe for peptic ulcer patients as long as they do not have specific allergies or sensitivities.
The home care nurse is visiting a client with a diagnosis of pernicious anemia that developed as a result of gastric surgery. The nurse instructs the client that because the stomach lining produces a decreased amount of intrinsic factor in this disorder, the client will need
- A. Vitamin B12 injections
- B. Vitamin B6 injections
- C. An antibiotic
- D. An antacid
Correct Answer: A
Rationale: The correct answer is A: Vitamin B12 injections. Pernicious anemia results from a lack of intrinsic factor, which is needed for Vitamin B12 absorption. Since the stomach lining produces less intrinsic factor after gastric surgery, the client cannot absorb B12 orally. Therefore, B12 injections are necessary to bypass the need for intrinsic factor. Vitamin B6 injections (B) are not indicated for pernicious anemia. Antibiotics (C) and antacids (D) are not relevant to the treatment of pernicious anemia.