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.

Describe the use of an elimination diet to find trigger foods.

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

Explain that the need to restrict fluids is the primary limitation.

Answer and Explanation

The Correct Answer is B

Choice A rationale:

While some individuals with Crohn's disease may find that avoiding gluten improves their symptoms, this is not a universal recommendation.

Gluten restriction is more often indicated for those with celiac disease or gluten sensitivity.

It's important to individualize dietary recommendations based on personal triggers and sensitivities.

Choice B rationale:

An elimination diet is a systematic approach to identifying foods that may trigger or worsen Crohn's disease symptoms.

It involves removing certain foods from the diet for a period of time, typically 2-4 weeks, and then gradually reintroducing them one at a time to observe any reactions.

This process can help individuals pinpoint specific foods that contribute to their symptoms and make informed dietary choices to manage their condition.

Choice C rationale:

There is no evidence to support a general restriction of calcium and iron in individuals with Crohn's disease.

In fact, these nutrients are essential for overall health and should be consumed in adequate amounts unless a specific deficiency or intolerance is identified.

Restriction of these nutrients could lead to nutritional deficiencies.

Choice D rationale:

Fluid restriction is not a primary dietary limitation for individuals with Crohn's disease.

Maintaining adequate hydration is crucial for overall health, especially during flares when fluid loss through diarrhea may be increased.

Restricting fluids could potentially lead to dehydration and electrolyte imbalances.

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Correct Answer is C

Explanation

Choice A rationale:

Diminished breath sounds in the right lung: This finding suggests that there is still some inflammation or fluid in the right lung, which is not consistent with fully effective treatment. Normal breath sounds should be clear and equal bilaterally.

PaCO2 55 mm Hg on a blood gas: This finding is slightly elevated, indicating that the patient may be having some difficulty clearing carbon dioxide from the lungs. A normal PaCO2 is 35-45 mm Hg.

Rhonchi in the right lung: Rhonchi are a type of abnormal breath sound that is caused by secretions in the airways. This finding suggests that there is still some inflammation or infection in the right lung.

Choice B rationale:

Oxygen saturation greater than 94%: This finding is within the normal range and indicates that the patient is getting enough oxygen.

Client ambulates without shortness of breath: This finding is a positive sign that the patient's respiratory status is improving. Symmetric chest expansion: This finding indicates that both lungs are expanding equally, which is a good sign.

Choice C rationale:

The assessment findings are mixed, with some findings suggesting improvement (oxygen saturation, ambulation without shortness of breath, symmetric chest expansion) and some findings suggesting that the infection is not fully resolved (diminished breath sounds, elevated PaCO2, rhonchi). This suggests that the treatment has been partially effective, but that the patient may need further treatment to fully resolve the pneumonia.

Choice D rationale:

It is important to evaluate the effectiveness of treatment over time, but the assessment findings in this case are clear enough to determine that the treatment has been partially effective.

A. Wild rice. B. Oatmeal. C. Corn chips. D. Potatoes.

Correct Answer is B

Explanation

Choice A rationale:

Wild rice is naturally gluten-free. It is not a grain, but rather a semi-aquatic grass seed. It is safe for individuals with celiac disease to consume.

Wild rice is a good source of nutrients. It is high in fiber, protein, and antioxidants, and it contains a variety of vitamins and minerals, including manganese, phosphorus, magnesium, and zinc. These nutrients can help to support overall health and well-being.

Wild rice can be a versatile ingredient in many dishes. It can be used in salads, soups, stews, pilafs, and even desserts.

Choice B rationale:

Oatmeal is not gluten-free. It is made from oats, which are a type of cereal grain that contains gluten. Individuals with celiac disease must avoid gluten, as it can trigger an autoimmune reaction that damages the small intestine.

Even small amounts of gluten can cause harm. Consuming even a small amount of oatmeal can cause symptoms such as abdominal pain, bloating, diarrhea, fatigue, and headache in individuals with celiac disease.

Long-term damage can occur. If individuals with celiac disease continue to consume gluten, it can lead to long-term health problems, such as malnutrition, osteoporosis, and infertility.

Choice C rationale:

Corn chips are typically gluten-free. However, it is important to check the label to be sure, as some brands may contain gluten- containing ingredients, such as wheat flour or barley malt.

Reading labels is essential. Individuals with celiac disease should always read food labels carefully to ensure that products are gluten-free.

Choice D rationale:

Potatoes are naturally gluten-free. They are a safe and healthy food choice for individuals with celiac disease.

Potatoes are a versatile and nutritious food. They are a good source of carbohydrates, fiber, potassium, vitamin C, and other nutrients.

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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

Correct Answer is C

Explanation

The nurse is discussing dietary choices with a client who is newly diagnosed with celiac disease. Which menu choice by the client indicates a need for further teaching?

Correct Answer is B

Explanation

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