The nurse assists the client experiencing nausea and vomiting to develop tolerance for fluids and foods. Which of the following nursing actions would help the client?

Correct Answer: A

Rationale: The correct answer is A: Advancing the diet slowly. This helps the client gradually build tolerance for fluids and foods, reducing the likelihood of exacerbating nausea and vomiting. Advancing the diet slowly allows the digestive system to adjust and minimizes gastrointestinal distress. Choice B (Discouraging caffeinated or carbonated beverages) can help reduce gastric irritation but does not directly address developing tolerance for fluids and foods. Choice C (Recommending commercial over-the-counter beverages) is not specific to helping the client develop tolerance. Choice D (Replacing dietary fat with MCTs) may be beneficial for some clients, but it does not directly address the client's ability to tolerate fluids and foods.

Correct Answer: B

Rationale: The correct answer is B: Pepsin. Pepsin is an enzyme produced in the stomach that breaks down proteins into smaller peptides. It is activated by the acidic environment in the stomach. Bile (A) is produced in the liver and stored in the gallbladder, not active in the stomach. Gastrin (C) is a hormone that stimulates gastric acid secretion but is not a digestive substance. Maltase (D) is an enzyme produced in the small intestine that breaks down maltose into glucose, not active in the stomach. Thus, the only substance active or activated in the stomach is Pepsin.

Correct Answer: A

Rationale: Step-by-step rationale for why option A is correct: 1. Gastrostomy tube is inserted directly into the stomach, bypassing the esophagus, reducing irritation to nasal and esophageal mucosa. 2. NG tube goes through the nose, potentially causing irritation and discomfort to the mucosa. 3. In severe protein-calorie malnutrition, preservation of mucosal integrity is crucial for nutrient absorption. 4. Hence, choosing a gastrostomy tube minimizes additional stress on already compromised mucosa. Summary of why other options are incorrect: - Option B: The sensory experience of eating is unrelated to the nutritional benefits of tube feeding. - Option C: Aspiration risk is not directly affected by the type of tube used but rather by proper feeding techniques and patient positioning. - Option D: All feeding tubes require periodic checking for placement to prevent complications, including gastrostomy tubes.

Correct Answer: B

Rationale: The correct answer is B: IV replacement of fluid and electrolytes. When a patient has been vomiting for several days, they are at risk of dehydration and electrolyte imbalance. Intravenous fluids are necessary to rehydrate the patient and restore electrolyte balance. Oral administration of broth and tea (choice A) may not be sufficient for severe dehydration. Administration of parenteral antiemetics (choice C) may help control vomiting but does not address the dehydration and electrolyte imbalance. Insertion of a nasogastric (NG) tube for suction (choice D) may be considered if the patient has severe gastric distention or ileus, but the priority is to address fluid and electrolyte imbalances first.

Correct Answer: C

Rationale: The correct answer is C because learning relaxation strategies to decrease stress can help manage peptic ulcer disease symptoms. Stress can exacerbate ulcer symptoms, so stress management is crucial. Choice A is incorrect as stopping medications abruptly can worsen the condition. Choice B is incorrect as treatment should be based on medical advice, not just pain presence. Choice D is incorrect as different antacids contain varying active ingredients and may not have the same effect.