Correct Answer: C

Rationale: Elevating the head of the bed is a recommended practice for individuals with GERD, as it helps prevent stomach acid from flowing back into the esophagus during sleep. This shows the patient is taking proactive steps to manage their condition. Using antacids can provide symptomatic relief from heartburn and discomfort associated with GERD. Taking them between meals and at bedtime can help neutralize stomach acid, which is a common practice for managing GERD symptoms. Eating large meals, especially rich or fatty foods, and snacking before bedtime can exacerbate GERD symptoms by increasing stomach pressure and acid production. Patients with GERD are typically advised to eat smaller meals and avoid eating close to bedtime to reduce reflux episodes. Chewing gum can actually be beneficial for some GERD patients as it stimulates saliva production, which can help neutralize stomach acid.

Correct Answer: C

Rationale: A high specific gravity of urine typically indicates concentrated urine, which can occur in dehydration; however, moist mucous membranes suggest adequate hydration. This combination does not indicate severe dehydration. A low specific gravity of urine usually indicates dilute urine, which is not typical in dehydration; it suggests the kidneys are not concentrating urine due to good fluid intake or other factors. While pale skin can indicate poor perfusion, this option does not specifically indicate severe dehydration. A depressed fontanelle and a capillary refill time greater than 4 seconds are significant indicators of severe dehydration in infants. Depressed fontanelles suggest that the infant is not receiving enough fluids, and prolonged capillary refill time indicates poor perfusion and dehydration. Moist skin and mucous membranes indicate adequate hydration. Flushed skin may occur with certain conditions but does not suggest severe dehydration.

Correct Answer: C

Rationale: A vagotomy does not repair a perforation. It does not involve removing ulcerated tissue. It cuts the vagus nerve to decrease acid production, promoting ulcer healing. It is unrelated to preventing stomach sliding, which is addressed by fundoplication.

Correct Answer: D

Rationale: Dressing changes are not the highest priority immediately post-op. Bowel sounds are assessed later. NG tube repositioning addresses nausea but is not primary. Elevating the head reduces aspiration risk and improves breathing.

Correct Answer: D

Rationale: Spicy foods may cause irritation but are not linked to oral cancer. NSAIDs are not a direct risk factor. Cholecystitis is unrelated. HPV is a significant risk factor for oral cancers.