The nurse is providing discharge teaching for a client with newly diagnosed Crohn's disease about dietary measures to implement during exacerbation episodes. Which statement made by the client indicates a need for further instruction?
“I need to increase the fiber in my diet.”
“I will need to avoid caffeinated beverages.”
“I’m going to learn some stress-reduction techniques.”
“I can have exacerbations and remissions with Crohn’s disease.”
The Correct Answer is A
Choice A reason: Increasing fiber during Crohn’s exacerbation worsens diarrhea and inflammation, indicating a misunderstanding. A low-fiber diet is recommended, making this the correct statement needing further instruction, as it contradicts the nurse’s teaching on managing dietary needs during Crohn’s disease flare-ups.
Choice B reason: Avoiding caffeinated beverages is correct, as they stimulate the gut and worsen Crohn’s symptoms. This aligns with dietary teaching, making it incorrect, as it shows understanding, unlike the incorrect fiber statement requiring further instruction from the nurse.
Choice C reason: Learning stress-reduction techniques is appropriate, as stress can trigger Crohn’s exacerbations. This reflects understanding of self-management, making it incorrect, as it aligns with the nurse’s teaching, unlike the fiber statement indicating a need for further dietary instruction.
Choice D reason: Recognizing exacerbations and remissions is accurate for Crohn’s disease, showing disease knowledge. This aligns with the nurse’s education, making it incorrect, as it demonstrates understanding, unlike the fiber statement that requires further instruction to correct the client’s misconception.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","E"]
Explanation
Choice A reason: Coffee, caffeinated or decaf, relaxes the esophageal sphincter and irritates the mucosa, worsening GERD. This aligns with dietary restrictions, making it a correct substance the nurse would teach the client to avoid to prevent GERD symptom exacerbation.
Choice B reason: Chocolate contains methylxanthines and fat, relaxing the esophageal sphincter and triggering GERD symptoms. This aligns with GERD dietary guidelines, making it a correct item the nurse would include for the client to avoid to reduce reflux.
Choice C reason: Peppermint relaxes the lower esophageal sphincter, increasing acid reflux in GERD. This aligns with dietary teaching, making it a correct substance the nurse would advise the client to avoid to minimize GERD symptom flare-ups effectively.
Choice D reason: Nonfat milk is less likely to trigger GERD, as high-fat dairy worsens reflux. Coffee is a stronger trigger, making this incorrect, as it’s not a primary substance the nurse would include on the GERD avoidance list.
Choice E reason: Fried chicken, high in fat, delays gastric emptying and exacerbates GERD symptoms. This aligns with dietary restrictions, making it a correct item the nurse would teach the client to avoid to prevent GERD symptom exacerbation.
Choice F reason: Scrambled eggs are low-fat and unlikely to trigger GERD compared to chocolate or coffee. This is incorrect, as it’s not a primary substance the nurse would include on the list of items to avoid for GERD management.
Correct Answer is D
Explanation
Choice A reason: Checking urinary specific gravity monitors DI control but is less critical than detecting fluid retention from desmopressin, which can cause hyponatremia. Daily weighing identifies weight gain, making this incorrect, as it’s secondary to the nurse’s priority teaching on preventing serious drug-related complications.
Choice B reason: Monitoring blood pressure is relevant for cardiovascular health but not the primary concern with desmopressin, which risks fluid overload. Daily weighing detects this, making this incorrect, as it’s less specific than the nurse’s teaching to monitor for weight gain in DI treatment.
Choice C reason: Blood glucose monitoring is unrelated to desmopressin or DI, which affects water balance, not glucose. Weighing daily addresses fluid retention, making this incorrect, as it’s irrelevant compared to the nurse’s priority teaching on managing desmopressin’s fluid-related side effects in DI.
Choice D reason: Daily weighing and reporting weight gain is the priority teaching, as desmopressin can cause fluid retention, leading to hyponatremia. This aligns with DI therapy safety, making it the correct teaching to prevent complications, ensuring the client monitors for this critical adverse effect of desmopressin.
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