A client who developed viral gastroenteritis with vomiting and diarrhea is scheduled to be seen in the clinic the following day. What intervention would the nurse recommend for the client to do?

"Consume extra fluids to replace fluid losses."

"Take an over-the-counter antidiarrheal medication."

"Avoid all solid foods to allow complete bowel rest."

"Contact your primary health care provider for an antibiotic medication."

Answer and Explanation

The Correct Answer is A

Viral gastroenteritis is an acute infection of the GI tract, characterized by the inflammation of the stomach and small intestine. The virus invades the enterocytes, causing a secretory response that leads to vomiting and watery diarrhea. The primary clinical risk is dehydration and electrolyte imbalance. Management is primarily supportive, focusing on maintaining fluid volume until the self-limiting viral process resolves.

Rationale:

A. Consuming extra fluids is the most important recommendation to prevent dehydration. The nurse should suggest oral rehydration solutions that contain electrolytes, as plain water may not be sufficient to replace the salts lost through vomiting and diarrhea. Maintaining adequate hydration is the cornerstone of managing gastroenteritis and preventing hospital admission for intravenous therapy.

B. Over-the-counter antidiarrheal medications like loperamide are often discouraged during the acute phase of an infection. These drugs slow down intestinal motility, which can trap the pathogen and its toxins inside the bowel, potentially prolonging the illness. The body’s natural response of diarrhea helps clear the virus from the gastrointestinal system.

C. Complete bowel rest and avoiding all solid foods for an extended period is no longer the standard recommendation. While a brief period of clear liquids may be necessary during active vomiting, early reintroduction of easily digestible solids is encouraged to provide nutrients for mucosal healing. Prolonged fasting can actually delay the recovery of the intestinal lining.

D. Antibiotics are ineffective against viral gastroenteritis because they target bacteria, not viruses. Recommending antibiotics would be medically inappropriate and contributes to the global problem of antibiotic resistance. The nurse must educate the client that the illness is viral and will not respond to antimicrobial therapy, focusing instead on supportive fluid management.

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Correct Answer is A

Explanation

Pale conjunctivaeand systemic fatigue are hallmark physical indicators of reduced red blood cell mass. These signs occur because the body redistributes blood flow away from non-vital areas like the skin and mucous membranes to preserve oxygen delivery to the brain and heart. Accurate diagnosis requires a complete blood countto quantify the concentration of oxygen-carrying proteins and the volume of erythrocytes.

Rationale:

A.The nurse will request hemoglobin and hematocrittests because these are the definitive labs to diagnose anemia. Hemoglobin measures the oxygen-binding protein in the blood, while hematocrit measures the percentage of total blood volume made up of red cells. These values directly correlate with the patient's symptoms of tissue hypoxiaand pale mucous membranes.

B.A basic metabolic panel (BMP) measures electrolytes, glucose, and renal function. While abnormalities in potassium or sodium can cause fatigue, they do not cause pale conjunctivae. Pale mucous membranes are specifically a vascular sign of low red blood cell density, which is not evaluated by a standard chemistry panel or electrolyte assessment.

C.Liver enzymes like ALT and AST are used to detect hepatocellular injury. While chronic liver disease can eventually lead to anemia, these enzymes do not measure the blood's oxygen-carrying capacity. Requesting liver enzymes would be an indirect and inefficient way to investigate the immediate clinical signs of pallor and fatigue presented by the patient.

D.Partial thromboplastin time (PTT) evaluates the intrinsic pathway of the coagulation cascade. It is used to monitor heparin therapy or screen for bleeding disorders. It does not provide any information regarding the quantity of red blood cells or hemoglobin. Therefore, it is irrelevant for diagnosing the suspected anemia indicated by the patient's pale conjunctivae.

A. Being exposed to blood or blood products B. Having unprotected sex C. Sharing needles for illicit drugs D. Eating contaminated food or water

Correct Answer is D

Explanation

Hepatitis Ais an acute, self-limiting viral infection of the liver caused by the HAV virus. It is primarily transmitted through the fecal-oral route, often involving the ingestion of substances contaminated by an infected person. Proper hand hygieneand sanitation are the most effective ways to prevent the spread of this highly contagious enteric pathogen.

Rationale:

A.Exposure to blood or blood products is the primary transmission route for Hepatitis B and C, but not Hepatitis A. The HAV virus is not typically found in high concentrations in the blood for long periods. Therefore, percutaneous exposure is an extremely rare and unlikely cause of this specific type of viral hepatitis infection.

B.Having unprotected sex is a risk factor for sexually transmitted infections and blood-borne viruses like Hepatitis B and HIV. While some forms of sexual contact involving fecal exposure can transmit Hepatitis A, it is not categorized primarily as a sexually transmitted disease. The most common source in general populations remains contaminated food or water supplies.

C.Sharing needles is a high-risk behavior for transmitting parenteral viruses such as Hepatitis C and B. Hepatitis A is not commonly associated with intravenous drug use unless there is concurrent poor sanitation or fecal contamination. The transmission mechanism of HAV is almost exclusively through the digestive tract rather than through direct bloodstream injection.

D.Eating contaminated food or water is the most likely cause of Hepatitis A. This occurs when food is handled by an infected individual with poor hand hygiene or when water supplies are tainted with sewage. Outbreaks are frequently traced back to raw shellfish or contaminated produce, making enteric precautionsthe standard for preventing the spread of HAV.

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A client who developed viral gastroenteritis with vomiting and diarrhea is scheduled to be seen in the clinic the following day. What intervention would the nurse recommend for the client to do?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse assesses a client and identifies that the client has pale conjunctivae and complaints of fatigue. What laboratory test will the nurse request from the healthcare provider?

Correct Answer is A

Explanation

The nurse is caring for a client with Hepatitis A. The client asks how someone gets this disease. What is the most likely cause of the client’s Hepatitis A?

Correct Answer is D

Explanation

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