A patient is admitted to the hospital with a diagnosis of alcoholism.
The nurse should expect an order for:
Vitamin C 500mg orally daily.
Thiamine hydrochloride (vitamin B1) 50mg intramuscularly 3 times a day.
Magnesium 20 mEq in 100ml normal saline via IV one time only.
Albumin 25% 200ml via IV one time over 1 hour.
The Correct Answer is B
Choice A rationale
Vitamin C is an important antioxidant and plays a role in collagen synthesis and immune function. While individuals with alcoholism may have poor nutrition and potential vitamin deficiencies, thiamine (vitamin B1) deficiency is a more immediate and critical concern due to its role in glucose metabolism and the risk of Wernicke-Korsakoff syndrome.
Choice B rationale
Thiamine deficiency is common in individuals with chronic alcoholism due to poor dietary intake, impaired absorption, and increased utilization of thiamine in metabolizing alcohol. Intramuscular administration ensures adequate absorption, and the frequency addresses the ongoing need to prevent or treat Wernicke-Korsakoff syndrome, a serious neurological disorder.
Choice C rationale
Magnesium deficiency is also common in alcoholics due to poor intake, increased urinary excretion, and gastrointestinal losses. While a one-time intravenous dose of magnesium sulfate can help replete levels and prevent complications like seizures, it does not address the chronic nature of the deficiency and the need for ongoing management.
Choice D rationale
Albumin is a plasma protein that can be low in individuals with chronic liver disease, which can be associated with alcoholism. However, a one-time infusion of albumin primarily addresses low oncotic pressure and fluid shifts and is not a standard initial treatment for alcoholism itself. Addressing thiamine deficiency is a more immediate priority to prevent neurological complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["100"]
Explanation
Step 1 is: Calculate the total daily dose: 3 mg/kg/day × 100 kg = 300 mg/day.
Step 2 is: Calculate the amount per dose: 300 mg/day ÷ 3 doses/day = 100 mg/dose.
The amount for each dose should be 100 mg.
Correct Answer is C
Explanation
Choice A rationale
High blood urea nitrogen (BUN) levels primarily indicate impaired kidney function or dehydration, as urea is a waste product of protein metabolism filtered by the kidneys. While severe protein catabolism can elevate BUN, it is not the most direct or sensitive indicator of inadequate protein intake. Normal BUN ranges typically fall between 7 to 20 mg/dL.
Choice B rationale
Low specific gravity of urine suggests that the kidneys are excreting dilute urine, which can be caused by various factors such as excessive fluid intake, diabetes insipidus, or kidney dysfunction. It is not a reliable indicator of protein nutritional status. Normal urine specific gravity ranges from 1.005 to 1.030.
Choice C rationale
Serum albumin is a protein synthesized by the liver and is a key indicator of long-term protein status. Inadequate protein intake leads to decreased albumin synthesis, resulting in low serum albumin levels. Albumin has a relatively long half-life (around 20 days), making it a reflection of chronic protein deficiency. Normal serum albumin levels typically range from 3.5 to 5.0 g/dL.
Choice D rationale
Hemoglobin is the protein in red blood cells responsible for oxygen transport. While severe protein deficiency can eventually affect hemoglobin levels due to the protein component, it is not the most direct or immediate indicator of inadequate protein intake. Other factors like iron deficiency are more commonly associated with low hemoglobin. Normal hemoglobin ranges for adults are typically 13.5 to 17.5 g/dL for males and 12.0 to 15.5 g/dL for females.
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