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.”

Answer and Explanation

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.

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Correct Answer is D

Explanation

Choice A reason: Nebulizer and pulse oximeter monitor breathing but are less critical than preparing for respiratory failure, a Guillain-Barré complication. Intubation equipment is essential, making this incorrect, as it’s secondary to the nurse’s priority of addressing potential airway compromise in the client.

Choice B reason: Blood pressure cuff and flashlight are useful but don’t address the risk of respiratory paralysis in Guillain-Barré. Intubation tray is critical, making this incorrect, as it’s less urgent than the nurse’s need to prepare for life-threatening respiratory complications in the client.

Choice C reason: Nasal cannula and spirometer support breathing but are inadequate for acute respiratory failure in Guillain-Barré. Electrocardiographic and intubation equipment are vital, making this incorrect, as it doesn’t prioritize the nurse’s preparation for the client’s potential rapid respiratory deterioration.

Choice D reason: Electrocardiographic electrodes and intubation tray are essential for Guillain-Barré, as ascending paralysis risks respiratory failure and autonomic dysfunction. This aligns with neurological emergency protocols, making it the correct choice for the nurse to bring to manage life-threatening complications effectively.

A. A patient with a fractured femur who is receiving a dose of opioid pain medication and reports a pain level of 8/10. B. A patient who has just returned from a colonoscopy and is stable but complaining of minor bloating. C. A patient with newly diagnosed Type 1 diabetes who is receiving insulin for the first time and reports confusion. D. A patient with a history of heart failure who has a blood pressure of 90/60 mmHg and is lethargic.

Correct Answer is D

Explanation

Choice A reason: Pain of 8/10 is significant, but the patient is receiving opioids, and pain is less immediately life-threatening than hypotension and lethargy. This is incorrect, as it’s lower priority than the nurse’s need to address a patient with unstable vital signs.

Choice B reason: Minor bloating post-colonoscopy is expected and stable, not requiring immediate intervention. Hypotension in heart failure is critical, making this incorrect, as it’s less urgent than the nurse’s priority to manage a patient with potential decompensation.

Choice C reason: Confusion in new Type 1 diabetes may indicate hypoglycemia, but hypotension and lethargy in heart failure suggest acute decompensation, a higher priority. This is incorrect, as it’s less critical than the nurse’s focus on the heart failure patient’s instability.

Choice D reason: Hypotension (90/60 mmHg) and lethargy in a heart failure patient indicate possible cardiogenic shock, requiring immediate intervention. This aligns with prioritization in acute care, making it the correct patient for the charge nurse to prioritize for urgent assessment and action.

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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?

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

You are the charge nurse in a busy med-surg unit. There are several patients under your care, and you are managing a group of nurses. Which patient should be prioritized for immediate intervention?

Correct Answer is D

Explanation

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