A client with newly diagnosed Crohn’s disease asks the nurse about dietary restrictions. How should the nurse respond?

Instruct the client to avoid foods with gluten, such as wheat bread

Explain that the need to restrict fluids is the primary limitation

Advise the client to limit foods that are high in calcium and iron

Recommend a personalized diet plan with a dietitian

Answer and Explanation

The Correct Answer is D

Choice A reason: Avoiding gluten is specific to celiac disease, not Crohn’s, which involves inflammatory bowel disease without gluten sensitivity. Gluten restriction does not address Crohn’s mucosal inflammation, and this instruction misguides the client, as dietary triggers vary, requiring individualized management.

Choice B reason: Restricting fluids is incorrect, as Crohn’s patients need adequate hydration to manage diarrhea and prevent dehydration. Fluid restriction exacerbates electrolyte imbalances, worsening symptoms, making this an inappropriate recommendation for Crohn’s dietary management, which focuses on symptom-specific adjustments.

Choice C reason: Limiting calcium and iron is not standard for Crohn’s, as these nutrients support bone health and anemia prevention, common concerns in inflammatory bowel disease. This restriction could worsen deficiencies without addressing inflammation, making it an incorrect dietary focus for Crohn’s.

Choice D reason: Recommending a personalized diet plan with a dietitian is correct, as Crohn’s dietary triggers vary, requiring tailored plans to avoid exacerbating inflammation. Dietitians identify specific irritants, like high-fiber foods, ensuring nutritional balance while minimizing symptoms, making this the best approach for effective management.

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Correct Answer is B

Explanation

Choice A reason: Clay-colored stool indicates bile duct obstruction, not directly related to esophageal varices in cirrhosis. Varices are dilated veins prone to rupture, and while liver dysfunction affects bile, hematemesis is a more immediate, life-threatening complication, making this choice less critical.

Choice B reason: Hematemesis is critical to monitor, as esophageal varices in cirrhosis are fragile, dilated veins that can rupture, causing massive upper gastrointestinal bleeding. This leads to life-threatening hemorrhage, requiring urgent intervention, making it the priority due to its high mortality risk in portal hypertension.

Choice C reason: Anorexia is common in cirrhosis due to metabolic changes but is not specific to varices. While it affects nutrition, it is less urgent than hematemesis, which indicates variceal bleeding, a medical emergency, making this choice secondary to bleeding risk.

Choice D reason: Brown, foamy urine suggests renal issues, like proteinuria, not directly linked to esophageal varices. Variceal bleeding is a more immediate threat in cirrhosis, as urine changes are unrelated to portal hypertension’s acute complications, making this choice less critical.

A. Sleep flat in a supine position B. Administer a stool softener C. Turn, cough, and deep breathe every 2 hours D. Observe pupil response of the right eye

Correct Answer is B

Explanation

Choice A reason: Sleeping flat supine is incorrect, as elevating the head post-cataract surgery prevents intraocular pressure spikes, which can disrupt the lens implant. Supine positioning risks fluid accumulation, potentially causing complications like hemorrhage, making this instruction inappropriate for recovery.

Choice B reason: Administering a stool softener is correct, as straining during bowel movements increases intraocular pressure, risking surgical site complications post-cataract extraction. Soft stools reduce Valsalva maneuver effects, protecting the lens implant and promoting healing, making this a key discharge instruction.

Choice C reason: Turning, coughing, and deep breathing prevent pulmonary complications in major surgeries, not cataract extraction, a minor procedure. These actions may increase intraocular pressure, risking implant displacement, making this instruction irrelevant and potentially harmful for eye surgery recovery.

Choice D reason: Observing pupil response of the right eye is irrelevant, as the surgery affects the left eye. Pupil response monitoring is not a standard post-cataract instruction, and patients cannot self-assess this, making it impractical and unrelated to surgical recovery needs.

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A client with newly diagnosed Crohn’s disease asks the nurse about dietary restrictions. How should the nurse respond?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with chronic cirrhosis has esophageal varices. It is most important for the nurse to monitor the client for the onset of which problem?

Correct Answer is B

Explanation

Which information should the nurse include when giving discharge instructions to a client following a left eye cataract extraction with lens implant?

Correct Answer is B

Explanation

A client with open-angle glaucoma asks the nurse how long the prescribed eye drops will need to be used. Which response made by the nurse is accurate?

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The nurse is admitting a client with possible tuberculosis (TB). The client is placed in a private room with airborne precautions pending diagnostic test results. Which diagnostic test should the nurse review to confirm the diagnosis of TB?

A client with newly diagnosed Crohn’s disease asks the nurse about dietary restrictions. How should the nurse respond?

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