The nurse is preparing a client with Crohn's disease for discharge. Which statement made by the client indicates to the nurse that further teaching is needed?

"I'll follow the instructions for sulfasalazine."

I'll call the healthcare provider for a fever."

I'll continue to enjoy split pea soup

I'll drink meal replacement shakes."

Answer and Explanation

The Correct Answer is C

A. This statement demonstrates correct understanding of the prescribed medication regimen. Sulfasalazine is an anti-inflammatory drug commonly used to manage Crohn’s disease by reducing inflammation in the intestinal lining and maintaining remission. Adherence to the medication schedule is essential for preventing flare-ups and managing chronic symptoms, so this statement indicates appropriate knowledge and readiness to manage the condition at home.

B. This is an appropriate response because a fever may signal infection or a complication related to Crohn’s disease, such as abscess formation or systemic inflammation. Recognizing early warning signs and contacting the healthcare provider promptly is an important self-management skill that reduces the risk of severe complications.

C. This statement indicates a need for further teaching. Split peas and other high-fiber legumes are difficult to digest and can exacerbate gastrointestinal symptoms such as bloating, cramping, and diarrhea during active Crohn’s disease flares. Clients with Crohn’s disease are typically advised to follow a low-residue or low-fiber diet during flare-ups to reduce mechanical irritation of the inflamed bowel. Teaching should focus on identifying foods that may worsen symptoms and planning a diet that supports gut healing while maintaining adequate nutrition.

D. This is an appropriate approach to nutrition management for a client with Crohn’s disease, especially during periods of poor appetite, weight loss, or malabsorption. Meal replacement shakes provide a controlled source of calories, protein, and vitamins, helping to maintain nutritional status and prevent deficiencies. This statement reflects the client’s understanding of how to supplement their diet safely.

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Correct Answer is C

Explanation

A. Explaining that no dietary restrictions are needed with warfarin is incorrect. While potassium-rich foods do not affect warfarin, the client still requires education about the influence of Vitamin K on anticoagulation. Warfarin works by inhibiting Vitamin K–dependent clotting factors, and sudden changes in Vitamin K intake can reduce the drug’s effectiveness or increase the risk of bleeding. Simply stating that no restrictions are needed does not address this critical safety concern.

B. Providing a written list of foods high in potassium is inappropriate because potassium intake does not interfere with warfarin therapy. Giving this information could reinforce the client’s misunderstanding and distract from the key teaching about maintaining a consistent intake of Vitamin K to ensure safe anticoagulation.

C. Reviewing teaching about the effects of foods rich in Vitamin K is correct. Clients on warfarin must maintain consistent Vitamin K intake to prevent fluctuations in anticoagulation levels. The nurse should explain that foods such as leafy greens, broccoli, and certain vegetable oils can influence warfarin’s effectiveness. The client does not need to avoid these foods completely but should eat them consistently while monitoring for signs of bleeding or bruising and keeping regular INR checks. This response directly addresses the client’s misconception and ensures safe, effective management of warfarin at home.

D. Discussing fluid restrictions and other food restrictions is irrelevant for a client on warfarin. Fluid management is not typically related to anticoagulation therapy, and introducing unnecessary restrictions could confuse the client and divert attention from the primary teaching about Vitamin K.

A. Review the client's current food and medication allergies. B. Encourage increasing the intake of high protein foods. C. Obtain the client's tympanic temperature measurement. D. Determine if the client has recently experienced a fall. E. Ask if the client is experiencing any pain with urination.

Correct Answer is ["C","D","E"]

Explanation

A. While knowing allergies is part of a general admission or intake process, it is not a priority diagnostic action for acute confusion. Allergies typically cause respiratory distress or skin reactions (anaphylaxis/urticaria), not sudden cognitive changes or hallucinations.

B. Encouraging increased intake of high-protein foods is not an immediate priority. While nutrition is important for long-term health, it does not address the urgent concern of acute confusion. Immediate assessment for potentially reversible causes takes precedence.

C. Obtaining a tympanic temperature measurement is crucial because infection can present atypically in older adults, sometimes only as confusion or behavioral changes rather than classic symptoms like fever. A urinary tract infection, pneumonia, or other systemic infection could be causing delirium, and detecting fever would guide timely intervention.

D. Determining whether the client has recently experienced a fall is important. Head trauma, even minor, can lead to acute cognitive changes, intracranial bleeding, or other complications. Older adults are particularly vulnerable, and history of falls must be assessed to rule out injury as a cause of confusion.

E. Asking if the client is experiencing pain with urination is important because urinary tract infections (UTIs) are a common cause of delirium in older adults, even when classic urinary symptoms like dysuria or frequency are absent. Early identification allows for rapid treatment and prevention of further complications.

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The nurse is preparing a client with Crohn's disease for discharge. Which statement made by the client indicates to the nurse that further teaching is needed?

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Naxlex Comprehensive Predictor Exams

Following a total knee arthroplasty, the client is discharged from the hospital with a prescription for warfarin. In reviewing discharge teaching, the client recounts to the nurse the need to avoid eating foods high in potassium, such as bananas and melon. How should the nurse respond?

Correct Answer is C

Explanation

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Correct Answer is ["C","D","E"]

Explanation

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