Nursing Elites

1. What are the dietary recommendations for a patient with GERD?

• A. Avoid mint and spicy foods
• B. Eat large meals before bedtime
• C. Consume liquids with meals
• D. Avoid NSAIDs

Correct answer: A

Rationale: The correct answer is to avoid mint and spicy foods for a patient with GERD. These foods can increase gastric acid secretion and worsen symptoms of GERD. Choice B is incorrect because eating large meals before bedtime can exacerbate GERD symptoms due to increased gastric pressure when lying down. Choice C is also incorrect as consuming liquids with meals can lead to increased gastric distention, potentially triggering GERD symptoms. Choice D, avoiding NSAIDs, though important for some patients with GERD due to their potential to irritate the stomach lining, is not a general dietary recommendation for all GERD patients.

2. What dietary changes should a patient with GERD make to manage their symptoms?

• A. Avoid mint and spicy foods
• B. Eat large, frequent meals
• C. Consume liquids with meals
• D. Eat small, frequent meals

Correct answer: A

Rationale: The correct answer is A: Avoid mint and spicy foods. Patients with GERD should avoid foods like mint and spicy dishes as they can trigger symptoms by increasing gastric acid secretion. Choices B, C, and D are incorrect. Eating large, frequent meals can exacerbate GERD symptoms by putting more pressure on the lower esophageal sphincter, consuming liquids with meals can lead to increased reflux, and eating small, frequent meals is the recommended approach to reduce symptoms and manage GERD.

3. A patient is admitted with chest pain, possible acute coronary syndrome. What should the nurse do first?

• A. Administer sublingual nitroglycerin
• B. Get IV access
• C. Obtain cardiac enzymes
• D. Auscultate heart sounds

Correct answer: A

Rationale: In a patient with chest pain, possible acute coronary syndrome, the nurse should administer sublingual nitroglycerin first. Nitroglycerin helps to vasodilate coronary arteries, improving blood flow to the heart, and reducing cardiac workload. This can alleviate chest pain and decrease cardiac tissue damage in acute coronary syndrome. Getting IV access, obtaining cardiac enzymes, and auscultating heart sounds are important steps in the assessment and management of acute coronary syndrome, but administering nitroglycerin to relieve chest pain and improve blood flow takes precedence as it directly addresses the patient's symptoms and aims to prevent further cardiac damage.

4. What is the priority nursing action when a patient with chest pain presents with possible acute coronary syndrome?

• A. Administer sublingual nitroglycerin
• B. Obtain IV access
• C. Check the patient's cardiac enzymes
• D. Administer aspirin

Correct answer: A

Rationale: The priority nursing action when a patient with chest pain presents with possible acute coronary syndrome is to administer sublingual nitroglycerin. Sublingual nitroglycerin helps dilate blood vessels, reducing cardiac workload, and improving blood supply to the heart muscle, thus relieving pain and enhancing blood flow to the heart. While obtaining IV access is important for administering medications and fluids, it is not the priority over addressing pain and improving blood flow. Checking the patient's cardiac enzymes is crucial for diagnosis and ongoing management but not the immediate priority when the patient is in pain. Administering aspirin is also a vital intervention in acute coronary syndrome, but in this scenario, it is not the priority action compared to providing immediate pain relief and enhancing blood flow to the heart.

5. What is the primary nursing action for a patient experiencing continuous bubbling in the chest tube water seal chamber?

• A. Tighten the connections of the chest tube system
• B. Clamp the chest tube
• C. Continue monitoring the chest tube
• D. Replace the chest tube system

Correct answer: A

Rationale: The correct answer is to tighten the connections of the chest tube system. Continuous bubbling in the chest tube water seal chamber indicates an air leak. By tightening the connections of the chest tube system, the nurse can often resolve the issue by ensuring there are no loose connections allowing air to enter. Clamping the chest tube or replacing the chest tube system are not appropriate actions in this situation. Clamping the tube can cause a dangerous buildup of pressure, while replacing the system should only be considered if tightening the connections does not resolve the air leak.

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