A patient was diagnosed with hiatal hernia. She frequently has regurgitation and a sour taste on his mouth especially after eating large meals. Which action by the client shows understanding of her treatment regimen?

Correct Answer: D

Rationale: Hiatal hernia is a condition where a part of the stomach pushes up through the diaphragm muscle. Symptoms often include regurgitation of stomach acid into the esophagus, leading to heartburn and a sour taste in the mouth. Avoiding triggers like caffeine, alcohol, and chocolate can help reduce acid reflux and alleviate symptoms. These substances can relax the lower esophageal sphincter and increase stomach acid production, worsening symptoms in patients with hiatal hernia. Therefore, avoiding caffeine, alcohol, and chocolate is a key aspect of managing hiatal hernia symptoms effectively. The other options provided do not directly address the underlying cause of the symptoms experienced by the patient with hiatal hernia.

Correct Answer: C

Rationale: Acute respiratory distress syndrome (ARDS) is a severe form of acute respiratory failure characterized by rapidly progressive dyspnea, hypoxemia, and noncardiogenic pulmonary edema. The key signs of ARDS include severe respiratory distress, low partial pressure of oxygen (paO2), and bilateral infiltrates on chest x-ray. In the given scenario, the client presenting with restlessness and suprasternal retractions along with a paO2 level of 62 indicates severe respiratory distress and hypoxemia, which are consistent with ARDS. Therefore, option C is the most indicative of ARDS among the choices provided.

Correct Answer: B

Rationale: Angina pectoris is chest pain or discomfort caused by a temporary lack of an adequate blood supply to the heart muscle (myocardium). This lack of blood supply results in a decreased supply of oxygen to the heart muscle, leading to chest pain. This condition is commonly associated with coronary artery disease, where the arteries that supply blood to the heart become narrowed or blocked, reducing the flow of oxygen-rich blood to the myocardium. This oxygen deficit can trigger chest pain, which is characteristic of angina pectoris. Therefore, the cause of angina pectoris is the inadequate supply of oxygen to the myocardium, making option B the correct answer.

Correct Answer: B

Rationale: Hyperkalemia is a common complication in patients with chronic renal failure due to the kidneys' inability to excrete potassium efficiently. The correct intervention for hyperkalemia includes assessing the patient for muscle weakness, diarrhea, and ECG changes. Muscle weakness is a common symptom of hyperkalemia due to its effects on neuromuscular function. Diarrhea can lead to potassium loss from the gastrointestinal tract, helping to lower potassium levels. ECG changes are essential to monitor in hyperkalemia as high potassium levels can result in life-threatening cardiac arrhythmias. By identifying these signs and symptoms early, appropriate interventions can be initiated promptly, such as administering medications to lower potassium levels or adjusting the patient's diet to limit potassium intake.

Correct Answer: D

Rationale: Addison's disease, also known as adrenal insufficiency, is a condition where the adrenal glands do not produce enough hormones. One of the primary functions of the adrenal glands is to regulate sodium and potassium levels in the body. In Addison's disease, the lack of adrenal hormones can lead to electrolyte imbalances, specifically low sodium levels (hyponatremia) and high potassium levels (hyperkalemia).