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.

Answer and Explanation

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.

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Correct Answer is A

Explanation

Choice A rationale

A CPAP (Continuous Positive Airway Pressure) mask delivers a constant stream of pressurized air to keep the airway open during sleep, which is the primary treatment for sleep apnea. Sleep apnea is characterized by repeated pauses in breathing due to airway obstruction, and CPAP effectively prevents these episodes.

Choice B rationale

A nasal cannula delivers low-flow oxygen through two prongs inserted into the nostrils. While it can provide supplemental oxygen, it does not address the underlying airway obstruction that occurs in sleep apnea. Therefore, it is not the expected delivery device for this condition. Normal flow rate is 1 to 6 liters per minute, providing a fraction of inspired oxygen (FiO2) of 24% to 44%.

Choice C rationale

A non-rebreather mask delivers a high concentration of oxygen (60% to 90%) and is typically used for patients with acute respiratory distress. It is not the appropriate device for managing the chronic condition of sleep apnea, which primarily requires airway support rather than high oxygen levels.

Choice D rationale

A simple face mask delivers a moderate concentration of oxygen (40% to 60%) and requires a flow rate of 5 to 8 liters per minute. While it provides more oxygen than a nasal cannula, it does not address the airway obstruction inherent in sleep apnea and is therefore not the expected device for this condition.

A. respecting the client's desire to have the uncle make choices on her behalf. B. revisiting the decision when the uncle is not present at the bedside. C. holding a family meeting and encouraging the client to speak on her own behalf. D. educating the client about her right to autonomy.

Correct Answer is D

Explanation

Choice A rationale

While cultural sensitivity is important, respecting the client's desire to have her uncle make decisions would undermine her legal and ethical right to self-determination, which is a fundamental principle in healthcare. This right ensures individuals make their own healthcare decisions free from coercion.

Choice B rationale

Revisiting the decision without the uncle present might pressure the client and still not directly address her right to make her own informed choices. It doesn't empower the client to exercise her autonomy.

Choice C rationale

Holding a family meeting and encouraging the client to speak on her own behalf is a supportive approach, but it doesn't guarantee the client will feel empowered to make her own decision, especially if cultural norms strongly favor the uncle's authority.

Choice D rationale

Educating the client about her right to autonomy directly addresses the ethical principle of self-determination. By understanding her rights, the client is empowered to make her own informed decisions about her treatment, regardless of cultural influences or family dynamics.

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A patient is admitted to the hospital with a diagnosis of alcoholism.The nurse should expect an order for:

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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A patient is admitted to the hospital with a diagnosis of alcoholism.
The nurse should expect an order for: