Nokea
To prevent gastroesophageal reflux in a male client with a hiatal hernia, the nurse should provide which of the following discharge instructions?
- A. "Lie down after meals to promote digestion."
- B. "Avoid coffee and alcoholic beverages."
- C. "Take antacids with meals."
- D. "Limit fluid intake with meals."
Correct Answer: B
Rationale: The correct answer is B: "Avoid coffee and alcoholic beverages." This is because both coffee and alcohol can relax the lower esophageal sphincter, leading to increased likelihood of gastroesophageal reflux.
A: "Lie down after meals" can worsen reflux symptoms as gravity helps keep stomach contents down.
C: "Take antacids with meals" may provide temporary relief but does not address the underlying cause of reflux.
D: "Limit fluid intake with meals" can help reduce bloating but has no direct impact on preventing reflux.
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You are caring for a client with a nasogastric (NG) tube. Which task can be delegated to the experienced nursing assistant?
- A. Remove the NG tube per physician order.
- B. Secure the tape if the client accidentally dislodges the tube.
- C. Disconnect the suction to allow ambulation to the toilet.
- D. Reconnect the suction after the client has ambulated.
Correct Answer: B
Rationale: Securing the tape is a non-invasive task within the scope of a nursing assistant. Removing or reconnecting requires nursing assessment and should be done by licensed staff.
Which of these is most associated with bile?
- A. liver
- B. pancreas
- C. gallbladder
- D. small intestine
Correct Answer: A
Rationale: The correct answer is A: liver. Bile is produced in the liver and stored in the gallbladder before being released into the small intestine to aid in digestion. The liver plays a crucial role in bile production, whereas the pancreas is primarily responsible for producing digestive enzymes. The gallbladder stores and concentrates bile but does not produce it. The small intestine is where bile acts to break down fats. Therefore, the liver is most associated with bile due to its production and regulation of bile.
Concerning HCL secretion:
- A. it is secreted by chief cells.
- B. it is secreted by parietal cells.
- C. it is inhibited by gastrin secretion.
- D. it is inhibited by Ach secretion.
Correct Answer: B
Rationale: The correct answer is B because HCl secretion is primarily carried out by parietal cells in the stomach lining. Parietal cells contain proton pumps that actively secrete HCl to aid in digestion. Chief cells secrete pepsinogen, not HCl (A is incorrect). Gastrin actually stimulates HCl secretion, so it doesn't inhibit it (C is incorrect). Acetylcholine (Ach) is a neurotransmitter that can stimulate, not inhibit, HCl secretion (D is incorrect). Therefore, option B is the correct choice based on the roles of parietal cells in HCl secretion.
A patient diagnosed with chronic hepatitis B asks about drug therapy to treat the disease. What is the most appropriate response by the nurse?
- A. Only chronic hepatitis C is treatable and primarily with antiviral agents and interferon.'
- B. There are no specific drug therapies that are effective for treating acute viral hepatitis.'
- C. Interferon combined with lamivudine (Epivir) will decrease viral load and prevent complications.'
- D. There are no drugs used for the treatment of viral hepatitis because of the risk of additional liver damage.'
Correct Answer: C
Rationale: For chronic hepatitis B, antiviral therapy such as interferon and lamivudine (Epivir) is used to reduce the viral load and prevent complications like cirrhosis.
Ondansetron (Zofran) is prescribed for a patient with cancer chemotherapy'“induced vomiting. What should the nurse understand about this drug?
- A. It is a derivative of cannabis and has a potential for abuse.
- B. It has a strong antihistamine effect that provides sedation and induces sleep.
- C. It is used only when other therapies are ineffective because of side effects of anxiety and hallucinations.
- D. It relieves vomiting centrally by action in the vomiting center and peripherally by promoting gastric emptying.
Correct Answer: D
Rationale: Ondansetron works centrally to block serotonin receptors in the vomiting center and peripherally by improving gastric motility.