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A patient with Parkinsons disease is experiencing episodes of constipation that are becoming increasingly frequent and severe. The patient states that he has been achieving relief for the past few weeks by using OTC laxatives. How should the nurse respond?
- A. Its important to drink plenty of fluids while youre taking laxatives.
- B. Make sure that you supplement your laxatives with a nutritious diet.
- C. Lets explore other options, because laxatives can have side effects and create dependency.
- D. You should ideally be using herbal remedies rather than medications to promote bowel function.
Correct Answer: C
Rationale: The correct answer is C: Lets explore other options, because laxatives can have side effects and create dependency. The rationale for this is that while laxatives provide temporary relief for constipation, using them long-term can lead to dependency, electrolyte imbalances, and other side effects. The nurse should address the root cause of constipation and explore alternative strategies such as dietary changes, increased fluid intake, exercise, and bowel training. Choices A and B focus on supportive measures rather than addressing the issue of potential dependency on laxatives. Choice D suggests herbal remedies without considering the individual's specific condition and medical history.
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The patient is an 80-year-old male who is visiting the clinic today for a routine physical examination. The patient’s skin turgor is fair, but the patient reports fatigue and weakness. The skin is warm and dry, pulse rate is 116 beats/min, and urinary sodium level is slightly elevated. Which instruction should the nurse provide?
- A. Drink more water to prevent further dehydration.
- B. Drink more calorie-dense fluids to increase caloric intake.
- C. Drink more milk and dairy products to decrease the risk of osteoporosis.
- D. Drink more grapefruit juice to enhance vitamin C intake and medication absorption.
Correct Answer: A
Rationale: The correct answer is A: Drink more water to prevent further dehydration. Given the patient's fair skin turgor, fatigue, weakness, warm and dry skin, elevated pulse rate, and slightly elevated urinary sodium level, these are signs of dehydration. Increasing water intake would help improve the patient's hydration status. Other choices are incorrect because B (calorie-dense fluids) does not address the dehydration issue, C (milk and dairy products) does not directly address the symptoms presented, and D (grapefruit juice) is not essential for hydration in this case.
A nurse knows of several patients who have achieved adequate control of their allergy symptoms using over-the-counter antihistamines. Antihistamines would be contraindicated in the care of which patient?
- A. A patient who has previously been treated for tuberculosis
- B. A pregnant woman at 30 weeks gestation
- C. A patient who is on estrogen-replacement therapy
- D. A patient with a severe allergy to eggs
Correct Answer: B
Rationale: The correct answer is B. Antihistamines are generally considered safe during pregnancy, but it is recommended to avoid unnecessary medications, especially in the third trimester. Antihistamines should be used cautiously in pregnant women due to potential effects on the fetus. Choice A is incorrect because previous treatment for tuberculosis does not contraindicate the use of antihistamines. Choice C is incorrect as estrogen-replacement therapy does not interact significantly with antihistamines. Choice D is incorrect as a severe allergy to eggs does not directly contraindicate the use of antihistamines.
A nurse is assisting a patient in making dietarychoices that promote healthy bowel elimination. Which menu option should the nurse recommend?
- A. Broccoli and cheese soup with potato bread
- B. Turkey and mashed potatoes with brown gravy
- C. Grape and walnut chicken salad sandwich on whole wheat bread
- D. Dinner salad topped with hard-boiled eggs, cheese, and fat-free dressing
Correct Answer: C
Rationale: The correct answer is C because it includes fiber-rich whole wheat bread, grapes, and walnuts which promote healthy bowel elimination. Whole wheat bread and fruits provide dietary fiber that aids in digestion and prevents constipation. Walnuts are high in omega-3 fatty acids which can also help with bowel regularity.
Option A (Broccoli and cheese soup with potato bread) lacks fiber and may cause constipation due to the low fiber content. Option B (Turkey and mashed potatoes with brown gravy) may be low in fiber and high in fat, which can slow down digestion. Option D (Dinner salad topped with hard-boiled eggs, cheese, and fat-free dressing) is a healthier choice but may lack sufficient fiber for promoting healthy bowel elimination compared to option C.
The nurse is providing nutrition education to a Korean patient using the five food groups. In doing so, what should be the focus of the teaching?
- A. Discouraging the patient’s ethnic food choices
- B. Changing the patient’s diet to a more conventional American diet
- C. Including racial and ethnic practices with food preferences of the patient
- D. Comparing the patient’s ethnic preferences with American dietary choices
Correct Answer: C
Rationale: The correct answer is C because it emphasizes cultural competence and respect for the patient's background. By including racial and ethnic practices with food preferences of the patient, the nurse can provide tailored and relevant nutrition education. This approach promotes inclusivity and acknowledges the importance of cultural traditions in dietary habits. Choices A and B are incorrect as they disregard the patient's cultural background and may lead to cultural insensitivity. Choice D is also incorrect as it focuses on comparison rather than understanding and incorporating the patient's unique cultural context. Overall, choice C aligns with patient-centered care and facilitates effective communication and trust between the nurse and the patient.
A patient with a diagnosis of gastric cancer has been unable to tolerate oral food and fluid intake and her tumor location precludes the use of enteral feeding. What intervention should the nurse identify as best meeting this patients nutritional needs?
- A. Administration of parenteral feeds via a peripheral IV
- B. TPN administered via a peripherally inserted central catheter
- C. Insertion of an NG tube for administration of feeds
- D. Maintaining NPO status and IV hydration until treatment completion
Correct Answer: B
Rationale: The correct answer is B: TPN administered via a peripherally inserted central catheter. TPN provides comprehensive nutrition intravenously, bypassing the GI tract, which is important for patients unable to tolerate oral intake. A peripherally inserted central catheter allows for long-term TPN administration.
A: Administration of parenteral feeds via a peripheral IV is not ideal for long-term nutrition as it may not provide complete nutrition.
C: Insertion of an NG tube may not be feasible due to the tumor location and the patient's inability to tolerate oral intake.
D: Maintaining NPO status and IV hydration alone may lead to malnutrition over time as it does not provide adequate nutrition.