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 A
Explanation
Choice A rationale
Creating a plan of care for a client recovering from a stroke requires comprehensive assessment, synthesis of complex data, and the establishment of nursing diagnoses and interventions. This falls within the scope of practice of a registered nurse who has the education and expertise in complex patient management.
Choice B rationale
Assessing a pressure injury involves observing and documenting wound characteristics. While an RN may perform this, an LVN, under the supervision of an RN, can also contribute to this task by collecting and reporting data about the wound.
Choice C rationale
Providing oral suctioning is a basic nursing skill that can be performed by both RNs and LVNs, following appropriate training and established protocols, to maintain airway patency for a client with pneumonia.
Choice D rationale
Administering internal feedings through a nasogastric tube is a task that can be delegated to an LVN who has received specific training and demonstrated competency, under the supervision of an RN, provided the client is stable and the feeding protocol is well-established.
Choice E rationale
Inserting a urinary catheter can be performed by both RNs and LVNs who have received the necessary education, training, and demonstrated competency in this invasive procedure, according to facility policies and state regulations.
Correct Answer is C
Explanation
Choice A rationale
Asking "How loud is his snoring?" is subjective and difficult for the spouse to quantify accurately. While loudness can be a factor, it doesn't directly address potential underlying medical conditions like obstructive sleep apnea.
Choice B rationale
Determining the frequency of awakenings due to snoring provides some information about the impact on the spouse's sleep but doesn't offer specific details about the nature of the snoring itself or potential pauses in breathing.
Choice C rationale
Asking "Is there silence after snoring which then is followed with a snort?" directly inquires about a pattern indicative of obstructive sleep apnea. Apneic episodes involve cessation of breathing (silence), followed by a gasp or snort as the airway reopens.
Choice D rationale
Knowing the duration of snoring each night provides a general overview but doesn't offer specific details about the characteristics of the snoring, such as pauses in breathing or gasping, which are crucial for identifying potential sleep disorders. .
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