Nokea
An important part of nutrition therapy for patients with cystic fibrosis is:
- A. A low-fat diet to prevent steatorrhea
- B. A low-sodium diet to normalize fluid status
- C. A high-fiber diet to normalize bowel function
- D. Pancreatic enzyme replacement therapy to help digestion
Correct Answer: D
Rationale: The correct answer is D: Pancreatic enzyme replacement therapy to help digestion. In cystic fibrosis, pancreatic insufficiency leads to the malabsorption of nutrients, making it essential for patients to take pancreatic enzymes to aid in digestion. Options A, B, and C are incorrect because a low-fat diet may not provide adequate nutrition for cystic fibrosis patients, a low-sodium diet is not the primary focus of nutrition therapy in cystic fibrosis, and a high-fiber diet may exacerbate gastrointestinal symptoms due to malabsorption.
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The client diagnosed with acute vein thrombosis is receiving a continuous heparin drip, an intravenous anticoagulant. The health care provider orders warfarin (Coumadin), an oral anticoagulant. Which action should the nurse take?
- A. Discontinue the heparin drip prior to initiating the Coumadin
- B. Check the client's INR prior to beginning Coumadin
- C. Clarify the order with the health care provider as soon as possible
- D. Administer the Coumadin along with the heparin drip as ordered
Correct Answer: D
Rationale: The correct action for the nurse to take is to administer the Coumadin along with the heparin drip as ordered. Heparin and warfarin are often given together initially because warfarin takes a few days to become effective. Discontinuing the heparin drip prior to initiating Coumadin could leave the patient without anticoagulation coverage during the period when warfarin's effects are not yet established. Checking the client's INR prior to beginning Coumadin is important but not the immediate action to take when both medications are ordered together. Clarifying the order with the health care provider is unnecessary in this scenario as it is common practice to give heparin and warfarin concurrently in the transition period.
Which nutrient deficiency is most likely to be seen in patients with chronic alcoholism?
- A. Vitamin C
- B. Vitamin D
- C. Vitamin B12
- D. Vitamin B1
Correct Answer: D
Rationale: In patients with chronic alcoholism, the most likely nutrient deficiency is Vitamin B1 (thiamine), not Vitamin B12. Chronic alcoholism often leads to Vitamin B1 deficiency, causing conditions like Wernicke's encephalopathy. While other vitamin deficiencies can also occur in chronic alcoholism, such as Vitamin C and Vitamin D, Vitamin B1 deficiency is more commonly associated with alcoholism.
Which nutrient deficiency is most likely to be seen in patients with chronic alcoholism?
- A. Vitamin C
- B. Vitamin D
- C. Vitamin B12
- D. Vitamin B1
Correct Answer: D
Rationale: Patients with chronic alcoholism are most likely to develop a deficiency in Vitamin B1 (thiamine) due to poor dietary intake and impaired absorption. This deficiency can lead to conditions like Wernicke's encephalopathy and Korsakoff's syndrome. While deficiencies in other vitamins can also occur in chronic alcoholism, Vitamin B1 deficiency is more commonly associated with this condition, making it the most likely nutrient deficiency in these patients. Therefore, the correct answer is Vitamin B1 (Choice D). Deficiencies in Vitamin C (Choice A), Vitamin D (Choice B), and Vitamin B12 (Choice C) can also be seen in patients with chronic alcoholism, but they are not as commonly linked to this condition compared to Vitamin B1 deficiency.
Which nursing instruction should the nurse discuss with the client who is receiving glucocorticoids for Addison's disease?
- A. Discuss the importance of tapering medications when discontinuing medication
- B. Explain that the dose will need to be decreased during times of stress or infection
- C. Instruct the client to take medication on an empty stomach with a glass of water
- D. Encourage the client to wear a MedicAlert bracelet and carry a card in the wallet
Correct Answer: A
Rationale: The correct answer is A because tapering glucocorticoids is crucial to prevent adrenal insufficiency, which can occur if the medication is stopped abruptly. Choice B is incorrect as it refers to dose adjustments during stress or infection, not discontinuation. Choice C is incorrect because it does not specifically address the issue of stopping the medication. Choice D is not directly related to the management of glucocorticoid therapy for Addison's disease.
A client who _____ diet requires _____ amounts of vitamin C.
- A. Follows a vegan diet
- B. Smokes cigarettes
- C. Follows a vegetarian diet
- D. Follows a ketogenic diet
Correct Answer: B
Rationale: Clients who smoke require more vitamin C due to increased oxidative stress and depletion of vitamin C. Smoking leads to the generation of free radicals in the body, causing oxidative stress and consuming higher levels of antioxidants like vitamin C. Choices A, C, and D are incorrect as they do not directly relate to the increased need for vitamin C as seen in smokers.