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A client who is newly diagnosed with erosive esophagitis secondary to gastroesophageal reflux disease (GERD) reports to the nurse that they did not notice any reduction in symptoms after taking lansoprazole PO for one full week. Which action should the nurse take?

A.

Notify the healthcare provider that the client may need a change in dosage.

B.

Auscultate the client’s bowel sounds and measure the abdominal girth.

C.

Advise the client that healing typically takes several weeks to occur.

D.

Confirm that the client is taking the medication one hour after meals.

Answer and Explanation

The Correct Answer is C

Choice A rationale

 

Lansoprazole, a proton pump inhibitor (PPI), typically requires several weeks to achieve its full therapeutic effect. Notifying the healthcare provider for a dosage change after only one week is premature and not supported by clinical guidelines.

 

Choice B rationale

 

Auscultating bowel sounds and measuring abdominal girth are not directly related to the effectiveness of lansoprazole in treating GERD. These actions are more relevant for assessing gastrointestinal motility and potential complications like bowel obstruction.

 

Choice C rationale

 

Healing of erosive esophagitis with PPIs like lansoprazole usually takes several weeks. Advising the client that healing typically takes several weeks to occur is appropriate and aligns with the expected therapeutic timeline.

 

Choice D rationale

 

Lansoprazole should be taken before meals, not after, to maximize its effectiveness. Confirming that the client is taking the medication one hour after meals would not address the issue of symptom persistence.


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Correct Answer is A

Explanation

Choice A rationale

Asking the client to describe the pain is the best approach to assess the quality of pain. This allows the nurse to gather detailed information about the pain’s characteristics.

Choice B rationale

Identifying effective pain relief measures is important but does not directly assess the quality of pain.

Choice C rationale

Observing body language and movement can provide clues about pain but is not as effective as directly asking the client to describe the pain.

Choice D rationale

Providing a numeric pain scale helps quantify the pain but does not provide detailed information about the pain’s quality.

Correct Answer is C

Explanation

Choice A rationale

Restricting fluids is not a primary limitation for clients with Crohn’s disease. Adequate hydration is important for overall health and managing symptoms.

Choice B rationale

Limiting foods high in calcium and iron is not typically recommended for Crohn’s disease. These nutrients are important for maintaining bone health and preventing anemia, which can be concerns for individuals with Crohn’s disease.

Choice C rationale

An elimination diet can help identify trigger foods that may exacerbate symptoms of Crohn’s disease. This approach involves removing certain foods from the diet and gradually reintroducing them to determine which foods cause symptoms.

Choice D rationale

Avoiding gluten is not necessary for all individuals with Crohn’s disease. While some may benefit from a gluten-free diet, it is not a universal recommendation for managing the condition.

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