Question

A nurse is reinforcing discharge teaching with a client who has a new diagnosis of gastroesophageal disease (GERD). Which of the following foods should the nurse include in the list of foods the client should avoid?

Answer 1

Correct Answers:

Chocolate

Rationale :

🍫Chocolate is high in fat, which slows gastric emptying and increases reflux risk.

☕It contains caffeine and theobromine, both of which relax the lower esophageal sphincter.

🔥Relaxation of the lower esophageal sphincter allows acidic gastric contents to move back into the esophagus, worsening GERD.

⚠️Avoiding fatty, caffeinated foods reduces episodes of reflux and esophageal irritation.

📌Core Message

Chocolate relaxes the lower esophageal sphincter due to its fat and caffeine content, exacerbating GERD.

Answer 2

Correct Answers:

Perform leg exercises every 2 hr.
irrigate the nasogastric tube every 4 to 8 hr.
Encourage hourly use of an incentive spirometer while awake.
Document the color, consistency, and amount of nasogastric drainage.

Rationale :

🦵Leg exercises every 2 hours promote venous return and reduce risk of deep vein thrombosis after surgery.

💧Irrigating the nasogastric tube every 4–8 hours maintains patency, preventing tube occlusion and ensuring effective decompression.

🫁Hourly use of an incentive spirometer enhances lung expansion, prevents atelectasis, and supports respiratory recovery.

📝Documenting the color, consistency, and amount of drainage provides essential data to monitor gastrointestinal status and detect complications.

📌Core Message

Combine mobility, respiratory exercises, and tube maintenance to prevent complications and ensure proper function.

Answer 3

Correct Answers:

Fatty stools

Rationale :

💩Obstruction of the common bile duct prevents bile from entering the small intestine, impairing fat emulsification.

🧈Without bile salts, lipase activity is reduced, causing incomplete lipid digestion and absorption.

📊This malabsorption results in undigested fat in the stool, known as steatorrhea or fatty stools.

🔍Fatty stools are a hallmark of biliary obstruction due to the lack of bile salts necessary for micelle formation.

📌Core Message

Biliary obstruction prevents bile delivery, impairing fat digestion and causing fatty stools.

Answer 4

Correct Answers:

Potassium 2.5 mEq/L

Rationale :

🔋A potassium level of 2.5 mEq/L indicates severe hypokalemia, risking cardiac dysrhythmias.

💓Hypokalemia also causes muscle weakness and may impair respiratory muscle function, leading to breathing difficulties.

⚖️Although dehydration signs like weight loss and high urine specific gravity are important, electrolyte imbalances pose a more immediate threat.

🩺Correcting potassium promptly prevents potentially life-threatening cardiovascular complications.

📌Core Message

Severe hypokalemia at 2.5 mEq/L poses a high risk for cardiac dysrhythmias, requiring immediate correction.

Answer 5

Correct Answers:

1110

Rationale :

🧮Eight-ounce coffee (8 oz × 30 mL/oz) equals 240 mL, three-ounce juice equals 90 mL, and twelve-ounce soda equals 360 mL.

💧From the water pitcher, the client consumed 100 mL (300 mL minus 200 mL remaining).

💉The IV infusion at 40 mL/hr for 8 hr provides 320 mL of fluid.

🧾Summing oral intake (240 + 90 + 360 + 100 = 790 mL) and IV fluids (320 mL) yields 1110 mL.

📌Core Message

Convert ounces to milliliters and sum all oral and IV fluids to total 1110 mL.

Answer 6

Correct Answers:

Albumin

Rationale :

🥚Albumin is a plasma protein produced by the liver and reflects overall protein nutritional status.

📉Chronic malnutrition leads to reduced albumin synthesis and hypoalbuminemia.

🩸Albumin’s long half-life makes it a reliable marker of long-term nutritional deficiency.

🔍Low albumin indicates protein depletion and increased risk for edema due to decreased oncotic pressure.

📌Core Message

Low albumin reflects protein depletion and reduced oncotic pressure, indicating malnutrition.

Answer 7

Correct Answers:

"l will consume less caffeine and spicy foods"
"l will sleep with the head of my bed elevated"
"l will drink less fluid"
"l will try not to gain weight"

Rationale :

☕Avoiding caffeine and spicy foods prevents lower esophageal sphincter relaxation and reduces acid reflux.

🛏️Elevating the head of the bed uses gravity to keep gastric contents from refluxing at night.

💧Reducing fluid intake at mealtimes prevents gastric distension and lessens esophageal pressure.

⚖️Maintaining a healthy weight decreases intra-abdominal pressure and minimizes reflux episodes.

📌Core Message

Minimize reflux triggers and reduce intra-abdominal pressure through diet, positioning, fluid management, and weight control.

Answer 8

Correct Answers:

Request a potassium replace

Rationale :

🔋A potassium level of 3.0 mEq/L signifies hypokalemia, which requires replacement.

💉Clients on TPN often develop electrolyte imbalances if the infusion does not meet all potassium needs.

⚠️Hypokalemia can precipitate cardiac dysrhythmias, muscle weakness, and respiratory compromise.

🩺Prompt potassium supplementation prevents complications and supports acid-base balance during TPN therapy.

📌Core Message

Hypokalemia necessitates potassium replacement to prevent cardiac dysrhythmias and muscle dysfunction.

Answer 9

Correct Answers:

Clarithromycin

Rationale :

🧫Clarithromycin is a macrolide antibiotic effective against Helicobacter pylori.

💊It forms part of triple therapy with acid-suppressing agents to eradicate the infection.

⚙️Eradicating H. pylori reduces gastric acid secretion and promotes ulcer healing.

🛡️Using clarithromycin helps prevent ulcer recurrence and complications.

📌Core Message

Include clarithromycin in triple therapy to eradicate H. pylori and heal gastric ulcers.

Answer 10

Correct Answers:

Obtain the clients vital signs.

Rationale :

💓Assessing vital signs first evaluates hemodynamic stability and detects early postoperative complications.

🩹While dressing changes and TPN administration are important, they follow an initial physiologic assessment.

💉Daily weight reflects fluid status but is secondary to verifying cardiovascular and respiratory stability.

💊Administering pain medication is necessary but should follow assessment data to guide safe dosing.

📌Core Message

First check vital signs to ensure hemodynamic stability before other nursing actions.

1 :
A nurse is reinforcing discharge teaching with a client who has a new diagnosis of gastroesophageal disease (GERD). Which of the following foods should the nurse include in the list of foods the client should avoid?

2 :
A nurse is assisting in the plan of care for a client who had surgery for a bowel obstruction. The client has a nasogastric tube in place. Which of the following actions should the nurse include in the clientS plan of care?
(Select all that apply.)

3 :
A nurse is collecting data from a client who has obstruction and inflammation of the common bile duct due to cholelithiasis. Which of the following findings is expected for this condition?

4 :
A nurse is collecting data from a client who has acute gastroenteritis. Which of the following data collection findings should the nurse identify as the priority?

6 :
A nurse is planning care for a client who has anorexia and has manifestations of malnutrition. When reviewing the clients laboratory values. which of the following test results should the nurse expect to be low?

7 :
A nurse is reinforcing teaching about dietary recommendations for a client who has a hiatal hernia. Which of the following client statements indicate understanding of the teaching? (Select all that apply)

8 :
A nurse is reviewing the laboratory values of a client who is receiving total parenteral nutrition (TPN): glucose 72 mg/dL, chloride 100 mEq/L sodium 138 mEq/L, and potassium 3.0 mEq/L. Which of the following actions should the nurse plan to take?

9 :
A nurse in a provider's office is caring for a client who has a gastric ulcer caused by Helicobacter pylori. The nurse should anticipate that in addition to cimetidine and sucralfate, the provider will prescribe which of the following?

1 : A nurse is reinforcing discharge teaching with a client who has a new diagnosis of gastroesophageal disease (GERD). Which of the following foods should the nurse include in the list of foods the client should avoid?

2 : A nurse is assisting in the plan of care for a client who had surgery for a bowel obstruction. The client has a nasogastric tube in place. Which of the following actions should the nurse include in the clientS plan of care?(Select all that apply.)

3 : A nurse is collecting data from a client who has obstruction and inflammation of the common bile duct due to cholelithiasis. Which of the following findings is expected for this condition?

4 : A nurse is collecting data from a client who has acute gastroenteritis. Which of the following data collection findings should the nurse identify as the priority?

6 : A nurse is planning care for a client who has anorexia and has manifestations of malnutrition. When reviewing the clients laboratory values. which of the following test results should the nurse expect to be low?

7 : A nurse is reinforcing teaching about dietary recommendations for a client who has a hiatal hernia. Which of the following client statements indicate understanding of the teaching? (Select all that apply)

8 : A nurse is reviewing the laboratory values of a client who is receiving total parenteral nutrition (TPN): glucose 72 mg/dL, chloride 100 mEq/L sodium 138 mEq/L, and potassium 3.0 mEq/L. Which of the following actions should the nurse plan to take?

9 : A nurse in a provider's office is caring for a client who has a gastric ulcer caused by Helicobacter pylori. The nurse should anticipate that in addition to cimetidine and sucralfate, the provider will prescribe which of the following?

1 :
A nurse is reinforcing discharge teaching with a client who has a new diagnosis of gastroesophageal disease (GERD). Which of the following foods should the nurse include in the list of foods the client should avoid?

2 :
A nurse is assisting in the plan of care for a client who had surgery for a bowel obstruction. The client has a nasogastric tube in place. Which of the following actions should the nurse include in the clientS plan of care?
(Select all that apply.)

3 :
A nurse is collecting data from a client who has obstruction and inflammation of the common bile duct due to cholelithiasis. Which of the following findings is expected for this condition?

4 :
A nurse is collecting data from a client who has acute gastroenteritis. Which of the following data collection findings should the nurse identify as the priority?

6 :
A nurse is planning care for a client who has anorexia and has manifestations of malnutrition. When reviewing the clients laboratory values. which of the following test results should the nurse expect to be low?

7 :
A nurse is reinforcing teaching about dietary recommendations for a client who has a hiatal hernia. Which of the following client statements indicate understanding of the teaching? (Select all that apply)

8 :
A nurse is reviewing the laboratory values of a client who is receiving total parenteral nutrition (TPN): glucose 72 mg/dL, chloride 100 mEq/L sodium 138 mEq/L, and potassium 3.0 mEq/L. Which of the following actions should the nurse plan to take?

9 :
A nurse in a provider's office is caring for a client who has a gastric ulcer caused by Helicobacter pylori. The nurse should anticipate that in addition to cimetidine and sucralfate, the provider will prescribe which of the following?