Nokea
The client with chronic pancreatitis needs information on dietary modification to manage the health problem. The nurse teaches the client to limit which of the following items in the diet?
- A. Carbohydrate
- B. Protein
- C. Fat
- D. Water-soluble vitamins
Correct Answer: C
Rationale: The correct answer is C: Fat. In chronic pancreatitis, the pancreas struggles to produce digestive enzymes, leading to poor fat digestion. Limiting fat intake can help reduce symptoms like abdominal pain and diarrhea. Carbohydrates and proteins are essential for energy and tissue repair, so limiting them is not ideal. Water-soluble vitamins are generally well-absorbed and do not require restriction in chronic pancreatitis.
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The client is admitted to the hospital with viral hepatitis, complaining of 'no appetite' and 'losing my taste for food.' To provide adequate nutrition, the nurse would instruct the client to
- A. Eat a good supper when anorexia is not as severe.
- B. Eat less often, preferably only three large meals daily.
- C. Increase intake of fluids including juices.
- D. Select foods high in fat.
Correct Answer: C
Rationale: The correct answer is C: Increase intake of fluids including juices. This is because viral hepatitis can cause anorexia and a decreased taste for food, leading to poor nutrition. Increasing fluid intake, especially juices, can help provide essential nutrients and prevent dehydration.
A: Eating a good supper when anorexia is not as severe may not be effective in addressing the client's overall nutritional needs during the day.
B: Eating less often and only three large meals daily can worsen the client's nutritional status and may not address the decreased appetite and taste for food.
D: Selecting foods high in fat may not be appropriate for someone with viral hepatitis, as it can exacerbate liver inflammation and contribute to poor nutrition.
The nurse is performing an assessment on a client with acute pancreatitis who was admitted to the hospital. Which of the following assessment questions most specifically would elicit information regarding the pain that is associated with acute pancreatitis?
- A. Does the pain in your abdomen radiate to your groin.
- B. Does the pain in your stomach radiate to the back?
- C. Does the pain in your stomach radiate to your lower middle abdomen?
- D. Does the pain in your lower abdomen radiate to the hip?
Correct Answer: B
Rationale: The correct answer is B: "Does the pain in your stomach radiate to the back?" This question is specific to acute pancreatitis as the pain typically radiates from the epigastric area to the back. Pancreatitis pain often presents as severe, constant, and radiating to the back due to the inflammation of the pancreas affecting surrounding structures.
Choice A is incorrect as the pain in acute pancreatitis typically radiates to the back, not the groin. Choice C is incorrect as it specifies a different area in the abdomen, not the typical location for pancreatitis pain. Choice D is incorrect as pancreatitis pain does not typically radiate to the hip.
In summary, understanding the characteristic radiation of pain in acute pancreatitis is key to assessing and differentiating it from other abdominal conditions.
The nurse is caring for a client admitted to the hospital with a suspected diagnosis of acute appendicitis. Which of the following laboratory results would the nurse expect to note if the client indeed has appendicitis?
- A. Leukopenia with a shift to the right
- B. Leukocytosis with a shift to the right
- C. Leukocytosis with a shift to the left
- D. Leukopenia with a shift to the left
Correct Answer: C
Rationale: The correct answer is C: Leukocytosis with a shift to the left. In acute appendicitis, the body responds with an increase in white blood cells (leukocytosis) as a sign of infection. A shift to the left indicates an increase in immature neutrophils, which is a common response to acute bacterial infections like appendicitis. Leukopenia (choices A and D) would not be expected in appendicitis. Leukopenia is a decrease in white blood cells, which is not typical in an acute infection like appendicitis. Leukocytosis with a shift to the right (choice B) could be seen in chronic infections or conditions like leukemia, not in acute appendicitis where a shift to the left is more common due to the rapid response to infection.
Which of the following activities should the nurse encourage the client with a peptic ulcer to avoid?
- A. Chewing gum.
- B. Smoking cigarettes.
- C. Eating chocolate.
- D. Taking acetaminophen (Tylenol).
Correct Answer: B
Rationale: The correct answer is B: Smoking cigarettes. Smoking can increase stomach acid production and decrease blood flow to the stomach lining, which can worsen peptic ulcers. Chewing gum can actually help by increasing saliva production, which can neutralize stomach acid. Eating chocolate and taking acetaminophen are generally safe for peptic ulcer patients as long as they do not have specific allergies or sensitivities.
A client had an abdominal perineal resection with a colostomy 4 days ago and is ready for discharge. Which of the following would be an appropriate expected outcome at this point?
- A. The client maintains a high-fiber diet.
- B. The client discusses concerns about his sexual functioning.
- C. The client maintains bedrest.
- D. The client limits fluid intake to 1000 ml/day.
Correct Answer: B
Rationale: The correct answer is B because discussing concerns about sexual functioning is an appropriate expected outcome at this point. After an abdominal perineal resection with a colostomy, it is important for the client to address any concerns related to sexual functioning as it can impact their quality of life.
A: The client maintaining a high-fiber diet is not the most appropriate expected outcome at this point as it may be too soon after surgery to focus solely on dietary adjustments.
C: The client maintaining bedrest is not appropriate as early mobilization is usually encouraged after surgery to prevent complications.
D: Limiting fluid intake to 1000 ml/day is not recommended as adequate hydration is crucial for recovery post-surgery.