Mary is diagnosed with gastroesophageal reflux disease. You need to teach Mary to

Correct Answer: D

Rationale: In teaching Mary about managing gastroesophageal reflux disease (GERD), selecting option D, "All of the above," is the most comprehensive approach. Option A, advising Mary to avoid caffeine-containing beverages, is crucial as caffeine can trigger acid reflux and worsen GERD symptoms. Option B, recommending histamine 2 blockers like ranitidine, is important for reducing stomach acid production and providing relief from GERD symptoms. Option C, suggesting Mary avoid acidic foods, is essential as these can irritate the esophagus and exacerbate reflux. Educationally, it is vital for Mary to understand that a multi-faceted approach, including dietary modifications, medication adherence, and lifestyle changes, is necessary to effectively manage GERD. By following all the recommendations (options A, B, and C), Mary can better control her symptoms and improve her quality of life. It is crucial for healthcare providers to emphasize the holistic nature of managing chronic conditions like GERD to empower patients in their self-care strategies.

Correct Answer: C

Rationale: In the treatment of pernicious anemia, the correct option is C) Parenteral vitamin B12. Pernicious anemia is caused by a deficiency in intrinsic factor, a protein necessary for the absorption of vitamin B12 in the gastrointestinal tract. Oral administration of vitamin B12 is ineffective in these cases due to the lack of intrinsic factor. Therefore, parenteral administration (intramuscular injection) of vitamin B12 is the preferred route of administration for patients with pernicious anemia. Option A) Oral iron is incorrect because pernicious anemia is not caused by an iron deficiency, but rather a vitamin B12 deficiency. Option B) Oral folic acid is also incorrect as folic acid supplementation is not the primary treatment for pernicious anemia. Option D) Oral prednisone is not indicated in the treatment of pernicious anemia. Educationally, understanding the specific treatment approach for pernicious anemia is crucial for nurses and healthcare providers to effectively manage patients with this condition. It is essential to differentiate between various types of anemia and tailor treatment based on the underlying cause to ensure optimal patient outcomes.

Correct Answer: A

Rationale: In patients with rheumatoid arthritis, pain is typically experienced with activity. This is because the inflammation in the joints is aggravated by movement, leading to increased pain during physical exertion. The correct answer, option A, aligns with the pathophysiology of rheumatoid arthritis where joint inflammation is triggered by movement and use of the affected joints. Option B, stating that pain is only upon awakening, is incorrect because rheumatoid arthritis pain is not limited to a specific time of day. Option C, suggesting pain late in the evening, is also incorrect as the pain experienced in rheumatoid arthritis is not restricted to a particular time but is more related to activity levels. Option D, stating that pain is present all day without remission, is too generalized and does not accurately reflect the characteristic pattern of pain in rheumatoid arthritis. In an educational context, understanding the patterns of pain in rheumatoid arthritis is crucial for healthcare providers to effectively manage and support patients with this condition. Educating patients about how their pain is related to activity can help them make informed decisions about managing their symptoms and improving their quality of life. It is essential for nurses and other healthcare professionals to have a comprehensive understanding of rheumatoid arthritis to provide holistic care to patients with this chronic condition.

Correct Answer: D

Rationale: In this scenario, the correct nursing intervention is to choose option D: report the findings to the provider. This is crucial because the patient is experiencing severe incisional pain along with elevated blood pressure, tachycardia, tachypnea, and pallor, which may indicate a potential complication post-spinal anesthesia. These vital signs and symptoms suggest a possible spinal headache, hypotension, or other complications that require immediate attention from the healthcare provider for further evaluation and management. Option A (medicating the patient for pain) is not appropriate at this time without further assessment and evaluation by the provider to determine the cause of the pain and the appropriate treatment. Administering pain medication without addressing the underlying issue can mask symptoms and delay necessary interventions. Option B (placing the patient in a high Fowler position and administering oxygen) is not the priority in this situation as the patient's oxygen saturation is not provided, and the primary concern is the severe incisional pain along with the abnormal vital signs. Option C (placing the patient in a reverse Trendelenburg position and opening the IV line) is not indicated based on the patient's symptoms and vital signs. This intervention does not address the underlying issue of severe incisional pain and abnormal vital signs, which require immediate attention and further evaluation by the healthcare provider. Educationally, this scenario emphasizes the importance of critical thinking and prioritization in nursing care. It highlights the need to assess and recognize abnormal findings, prioritize interventions based on the patient's condition, and collaborate with the healthcare team to ensure timely and appropriate management of postoperative complications. Reporting critical findings to the provider promptly is essential in ensuring patient safety and optimal outcomes.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) sensory deprivation. Sensory deprivation occurs when a person is deprived of normal sensory stimuli, leading to confusion, disorientation, and hallucinations. In the case of the 80-year-old patient with an MRSA infection in isolation, the lack of social interaction, limited stimuli, and restricted environment can contribute to sensory deprivation, resulting in the changes in mental status observed by the nurse. Option A) a fluid and electrolyte imbalance is incorrect because the patient's symptoms are not indicative of this imbalance. Option B) a stimulating environment is incorrect as an overly stimulating environment can exacerbate confusion and hallucinations in individuals experiencing sensory deprivation. Option D) sundowning refers to increased confusion and agitation in the late afternoon or evening, usually seen in patients with dementia, and is not applicable to this scenario. Educationally, understanding the impact of sensory deprivation on patients' mental status is crucial for nurses caring for individuals in isolation or restricted environments. Nurses must be vigilant in recognizing signs of sensory deprivation and implementing interventions to promote sensory stimulation and prevent its negative effects on patients' mental well-being.