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 to discuss the importance of tapering medications when discontinuing medication. Tapering glucocorticoids is crucial to prevent adrenal insufficiency, which can occur if the medication is stopped abruptly. Choice B is incorrect because it focuses on adjustments during stress or infection, not discontinuation. Choice C is unrelated to the management of glucocorticoids. Choice D is important for emergency identification but is not directly related to medication management.
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Which type of diet is recommended for patients with diverticulitis during an acute flare-up?
- A. High-fiber
- B. Low-residue
- C. Low-fat
- D. High-protein
Correct Answer: B
Rationale: During an acute flare-up of diverticulitis, a low-residue diet is recommended. This diet helps reduce bowel movements and minimizes irritants in the colon, which can help alleviate symptoms and promote healing. High-fiber diets, like choice A, are typically recommended for diverticulosis prevention but may exacerbate symptoms during a flare-up due to increased bulk in the stool. Low-fat (choice C) and high-protein (choice D) diets are not specifically indicated for diverticulitis flare-ups.
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.
The nurse has given post-procedure instructions to a client who underwent a colonoscopy. Evaluation of learning would be evident if the client makes which statement(s)?
- A. All below
- B. "My abdominal muscles may be tender because of the procedure."
- C. "My diet should be light at first, and then I can progress to a regular diet."
- D. "It is normal to feel gassy or bloated for a short while after the procedure."
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
What intervention would be the most important for the nurse to implement for the client with a left nephrectomy?
- A. Assess the intravenous fluids for rate and volume
- B. Change the surgical dressing every day at the same time
- C. Monitor the client's medication levels daily
- D. Monitor the percentage of each meal eaten
Correct Answer: A
Rationale: The most important intervention for a client with a left nephrectomy is to assess the intravenous fluids for rate and volume. After nephrectomy, monitoring intravenous fluids is crucial to ensure proper hydration and kidney function. Changing the surgical dressing daily, monitoring medication levels, and tracking meal intake are also important aspects of care but not as critical as ensuring adequate intravenous fluid management post-surgery.
The nurse administers 2 units of salt-poor albumin to a client with portal hypertension and ascites. The nurse explains to the client that this is administered to:
- A. Provide nutrients
- B. Increase protein stores
- C. Elevate the circulating blood volume
- D. Divert blood flow away from the liver temporarily
Correct Answer: C
Rationale: The correct answer is C: Elevate the circulating blood volume. Salt-poor albumin is given to increase the circulating blood volume, which helps reduce ascites by improving fluid distribution within the body. Choices A, B, and D are incorrect because salt-poor albumin is not administered to provide nutrients, increase protein stores, or divert blood flow away from the liver.