A client was admitted to the emergency department with slurred speech and impaired motor coordination. The blood alcohol level is over 300 mg/dL. The physician orders thiamine for the client. The nurse understands that the physician ordered thiamine to:

Prevent Wernicke's encephalopathy.

Prevent alcoholic hepatitis.

Rehydrate the client.

Prevent pancreatitis.

Answer and Explanation

The Correct Answer is A

Choice A Reason
Thiamine, or vitamin B1, is essential for brain function and the metabolism of carbohydrates. In the context of high blood alcohol levels, thiamine is administered to prevent Wernicke's encephalopathy, a serious neurological disorder. This condition is often precipitated by a thiamine deficiency, which can be exacerbated by alcohol abuse. Alcohol consumption can impair thiamine absorption and utilization, leading to depleted stores. Wernicke's encephalopathy is characterized by symptoms such as confusion, ataxia, and ophthalmoplegia, and if left untreated, it can progress to Korsakoff syndrome, a chronic and debilitating condition.

Choice B Reason
While alcoholic hepatitis is a concern in individuals with excessive alcohol intake, thiamine is not specifically used to prevent this condition. Alcoholic hepatitis is inflammation of the liver due to alcohol abuse, and its prevention primarily involves abstinence from alcohol, nutritional support, and medical management of liver inflammation. Thiamine does not play a direct role in preventing liver inflammation but is crucial for overall nutritional replenishment in individuals with alcohol use disorder.

Choice C Reason
Rehydration is indeed important for clients with high blood alcohol levels; however, thiamine does not serve this purpose. Rehydration typically involves the administration of intravenous fluids to restore fluid balance and electrolytes. Thiamine is not a rehydrating agent but is given to prevent neurological complications associated with thiamine deficiency, which can be seen in individuals with chronic alcoholism.

Choice D Reason
Preventing pancreatitis is not the primary reason for administering thiamine in this scenario. Pancreatitis, an inflammation of the pancreas, can be associated with chronic alcohol abuse, but thiamine is not used as a preventative treatment for this condition. The management of pancreatitis involves addressing the underlying causes, supportive care, and sometimes hospitalization for more severe cases.

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Correct Answer is B

Explanation

Choice A reason:
A respiratory rate of 24/min is slightly elevated, which can be expected in a client with pneumonia due to the body's attempt to increase oxygen intake and carbon dioxide elimination. However, this rate does not directly indicate ineffective airway clearance.

Choice B reason:
A weak, nonproductive cough is a key indicator of ineffective airway clearance. In pneumonia, the presence of secretions in the airways is common, and an effective cough is necessary to clear these secretions. A weak cough that does not produce sputum suggests that the client is unable to clear their airways effectively, which can lead to impaired gas exchange and worsening of symptoms.

Choice C reason:
Pulse oximetry (SpO2) of 90% indicates that the client's oxygen saturation is below the normal range, which is typically between 95-100% for healthy individuals. While this finding is concerning and warrants intervention, it is a result of ineffective airway clearance rather than a direct indicator of it.

Choice D reason:
Shortness of breath with activity is common in clients with pneumonia and can result from various factors, including impaired gas exchange, decreased lung compliance, and increased work of breathing. While it may be associated with ineffective airway clearance, it is not as specific as a weak, nonproductive cough for indicating this particular problem.

A. Stop NSAIDs. B. Continue aspirin. C. Limit caffeine. D. Avoid alcohol. E. Eat large meals.

Correct Answer is ["A","C","D"]

Explanation

Choice A Reason:

Stopping NSAIDs is crucial for clients with PUD because NSAIDs can cause injury to the lining of the stomach or intestine, making it more vulnerable to damage from stomach acid. This can lead to the development or exacerbation of ulcers.

Choice B Reason:

Continuing aspirin may not be advisable for clients with PUD, as aspirin is an NSAID and can contribute to the development of peptic ulcers by inhibiting prostaglandin synthesis, reducing the protective mucosal layer, and increasing susceptibility to injury.

Choice C Reason:

Limiting caffeine is recommended for clients with PUD. Caffeine stimulates gastric acid secretion, which can exacerbate ulcer symptoms and impede the healing process.

Choice D Reason:

Avoiding alcohol is advised for clients with PUD. While there is mixed evidence on alcohol directly causing stomach ulcers, heavy alcohol consumption is considered a risk factor for developing stomach ulcers and can worsen the symptoms of existing ulcers.

Choice E Reason:

Eating large meals is not recommended for clients with PUD. It is better to eat smaller, more frequent meals to avoid overfilling the stomach and increasing gastric pressure, which can exacerbate symptoms.

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A client was admitted to the emergency department with slurred speech and impaired motor coordination. The blood alcohol level is over 300 mg/dL. The physician orders thiamine for the client. The nurse understands that the physician ordered thiamine to:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse formulates the problem of ineffective airway clearance for a client who has pneumonia. Which assessment data best supports this problem?

Correct Answer is B

Explanation

The nurse is providing discharge teaching for the client newly diagnosed with Peptic Ulcer Disease (PUD). The teaching should include instructions to: (Select all that apply)

Correct Answer is ["A","C","D"]

Explanation

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A client was admitted to the emergency department with slurred speech and impaired motor coordination. The blood alcohol level is over 300 mg/dL. The physician orders thiamine for the client. The nurse understands that the physician ordered thiamine to:

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