The nurse has taught nutrition management for a client diagnosed with oxalate kidney stones.
Which of the following food choices by the client would indicate that the client requires more teaching?

Venison stew and ice cream.

Poached salmon and green beans.

Spinach salad and rhubarb pie.

Sautéed mushrooms and fried rice.

Answer and Explanation

The Correct Answer is C

Choice A rationale

Venison stew and ice cream are low in oxalate content. Oxalate kidney stones are formed due to high urinary oxalate levels, often from consuming oxalate-rich foods. Venison provides protein but does not contribute significantly to oxalate levels, while dairy products like ice cream have calcium which binds oxalate, reducing absorption in the gut.

Choice B rationale

Poached salmon and green beans are suitable choices as they have low oxalate content. Salmon provides omega-3 fatty acids, which can reduce kidney stone risk, and green beans are a low-oxalate vegetable, making this meal appropriate for oxalate management.

Choice C rationale

Spinach and rhubarb are high in oxalates. Spinach contains around 750 mg oxalates per 100 grams, and rhubarb contains 860 mg per 100 grams. Consuming these increases urinary oxalate excretion, elevating the risk of stone formation, indicating a need for further dietary education.

Choice D rationale

Sautéed mushrooms and fried rice are acceptable as both are low in oxalates. Mushrooms provide nutrients like selenium and vitamin D, while rice is a carbohydrate source free from oxalate, making this option suitable for oxalate kidney stone prevention.

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Correct Answer is A

Explanation

Choice A rationale

Corticosteroids are used in thrombocytopenia because they suppress the immune response, particularly in immune thrombocytopenic purpura (ITP). They reduce platelet destruction by inhibiting autoantibody formation and increasing platelet lifespan. Normal platelet count ranges from 150,000 to 400,000/µL. Thrombocytopenia occurs when platelets drop below 150,000/µL, increasing bleeding risk. Corticosteroids can also decrease capillary permeability, minimizing petechiae and ecchymoses.

Choice B rationale

Diphenhydramine, an antihistamine, is used for allergic reactions but has no role in treating thrombocytopenia. It does not address the underlying immune or hematologic causes of low platelet counts. Its primary actions include H1 receptor antagonism, reducing histamine-mediated symptoms like itching and swelling. However, it lacks immunosuppressive or hematologic-stimulating effects essential for managing thrombocytopenia.

Choice C rationale

Desmopressin (DDAVP) is a synthetic antidiuretic hormone analog used for certain bleeding disorders like von Willebrand disease or mild hemophilia A. It increases factor VIII and von Willebrand factor levels, improving clotting. However, it is not indicated for thrombocytopenia as it does not address platelet count deficiencies or immune-mediated platelet destruction.

Choice D rationale

Hydrochlorothiazide (HCTZ) is a thiazide diuretic used for hypertension and edema. Its mechanism of action involves inhibiting sodium reabsorption in the distal tubule, promoting diuresis. HCTZ has no effect on platelet counts or immune mechanisms and is not used in thrombocytopenia. Its side effects, like electrolyte imbalances, may complicate patient management.

A. How has your energy level been? B. How many pillows are you using to sleep? C. Have you been exercising regularly? D. Have you had any chest pain?.

Correct Answer is B

Explanation

Choice A rationale

Assessing energy levels provides indirect information about cardiac output but lacks specificity regarding fluid overload or pulmonary congestion, which are key indicators of heart failure exacerbation. It is a relevant question but not the best for evaluating treatment outcomes.

Choice B rationale

Asking about pillow use evaluates orthopnea, a common symptom of heart failure due to fluid buildup in the lungs when lying flat. It provides a direct assessment of fluid status and the effectiveness of heart failure management, making it the best question.

Choice C rationale

Exercising regularly is an important lifestyle aspect for heart failure patients but does not directly assess the status of symptoms such as fluid overload or cardiac function. Thus, it is not the most critical outcome measure.

Choice D rationale

Chest pain can indicate ischemia or worsening cardiac function but is not specific to fluid status or pulmonary congestion in heart failure. Therefore, it is a relevant but less optimal question for evaluating treatment goals.

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The nurse has taught nutrition management for a client diagnosed with oxalate kidney stones.Which of the following food choices by the client would indicate that the client requires more teaching?

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The nurse has taught nutrition management for a client diagnosed with oxalate kidney stones.
Which of the following food choices by the client would indicate that the client requires more teaching?