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A client has dumping syndrome. What menu selections indicate the client understands the correct diet to manage this condition? (Select all that apply.)
- A. Canned unsweetened apricots
- B. Canned cake
- C. Milk and water
- D. Potato soup
- E. Steamed broccoli
Correct Answer: A,D
Rationale: Canned apricots and potato soup are appropriate selections as they are part of a high-protein, high-fat, low- to moderate-carbohydrate diet. Cake and other sweets must be avoided. Milk products and sweet drinks such as shakes must be avoided. Gas-forming foods such as broccoli must also be avoided.
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A nurse is preparing to administer pantoprazole (Protonix) intravenously. What actions by the nurse are best? (Select all that apply.)
- A. Administer the drug through a separate IV line.
- B. Infuse pantoprazole using an IV pump.
- C. Keep the drug in its original brown bag.
- D. Take vital signs frequently during infusion.
- E. Use an in-line IV filter when infusing.
Correct Answer: A,B,E
Rationale: When infusing pantoprazole, use a separate IV line, a pump, and an in-line filter. A brown wrapper and frequent vital signs are not needed.
A client with peptic ulcer disease asks the nurse about taking slippery elm supplements. What response by the nurse is best?
- A. Ask your provider about it first.
- B. Slippery elm has no benefit for this problem.
- C. Slippery elm is often used for this disorder.
- D. There is no evidence that this will work.
Correct Answer: B
Rationale: Slippery elm is not recognized as an effective treatment for peptic ulcer disease. There is no evidence supporting its use for this condition, and it is not commonly recommended.
A client is being taught about drug therapy for Helicobacter pylori infection. What assessment by the nurse is appropriate?
- A. Alcohol intake of 1 to 2 drinks per week
- B. Family history of H. pylori infection
- C. Former smoker still using nicotine patches
- D. Willingness to adhere to drug therapy
Correct Answer: D
Rationale: Treatment for this infection involves either triple or quadruple drug therapy, which may make it difficult for clients to remain adherent. The nurse should assess the client's willingness and ability to follow the regimen. The other assessment findings are not as critical.
A client who had a partial gastrectomy has several expected nutritional problems. What actions by the nurse are best to provide better nutrition? (Select all that apply.)
- A. Administer vitamin B12 injections.
- B. Ask the provider about folic acid replacement.
- C. Request a digestive enzyme supplement.
- D. Obtain consent for total parenteral nutrition.
- E. Provide iron supplements for the client.
Correct Answer: A,B,E
Rationale: After gastrectomy, clients are at high risk for anemia due to vitamin B12 deficiency, folic acid deficiency, and iron deficiency. The nurse should administer vitamin B12 injections, ask about folic acid replacement, and provide iron supplements. The client does not need enteral feeding or total parenteral nutrition.
A client had an upper gastrointestinal hemorrhage and now has a nasogastric (NG) tube. What comfort measure may the nurse delegate to the unlicensed assistive personnel (UAP)?
- A. Irrigate the NG tube.
- B. Performing frequent oral care.
- C. Re-positioning the tube every 4 hours.
- D. Taking and recording vital signs.
Correct Answer: B
Rationale: Clients with NG tubes need frequent oral care both for comfort and to prevent infection. Irrigating the tube is done by the nurse. Re-positioning the tube, if needed, is also done by the nurse. The UAP can take vital signs, but this is not a comfort measure.