The nurse is providing discharge teaching on nutritional therapy to a patient with stage 3 chronic kidney disease. Which statement by the patient suggests to the nurse that additional teaching is required?

"It's important for me to avoid foods that are high in sodium such as canned soups and processed meats."

"I should limit my intake of high-potassium foods like bananas and tomatoes."

"I will eat a high-protein diet with lots of dark green, leafy vegetables."

"I need to monitor my fluid intake to prevent fluid overload."

Answer and Explanation

The Correct Answer is C

Choice A reason: Avoiding foods that are high in sodium such as canned soups and processed meats is correct. High sodium intake can worsen fluid retention and hypertension, which are concerns in chronic kidney disease.

Choice B reason: Limiting intake of high-potassium foods like bananas and tomatoes is correct. High potassium levels can lead to dangerous cardiac arrhythmias in patients with chronic kidney disease.

Choice C reason: Eating a high-protein diet with lots of dark green, leafy vegetables is incorrect. While protein is important, excessive protein intake can increase the workload on the kidneys. Patients with chronic kidney disease often need to limit protein intake to prevent further kidney damage. Additionally, dark green, leafy vegetables are high in potassium, which should be limited.

Choice D reason: Monitoring fluid intake to prevent fluid overload is correct. Fluid overload can lead to hypertension, edema, and heart failure in patients with chronic kidney disease.

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

Explanation

Choice A reason: A hard, rigid abdomen and herniation of the umbilicus are not typical findings in ulcerative colitis. These symptoms may indicate other abdominal conditions such as hernia or peritonitis, but are not specific to ulcerative colitis.

Choice B reason: Pallor, anemia, and fatigue are consistent with ulcerative colitis due to chronic blood loss and inflammation. These symptoms indicate the body's response to ongoing disease activity and nutritional deficiencies.

Choice C reason: Abdominal cramping and passing of six or more liquid stools per day are hallmark symptoms of ulcerative colitis. These symptoms reflect active inflammation in the colon, leading to frequent and urgent bowel movements.

Choice D reason: Dehydration, vomiting, and weight loss are also consistent with ulcerative colitis, especially during severe flare-ups. These symptoms result from the body's inability to absorb nutrients and fluids properly due to inflammation.

Choice E reason: Free air in the peritoneum and bowel dilation on abdominal x-ray are more indicative of a perforation or obstruction, which are potential but severe complications of ulcerative colitis. These findings would require immediate medical attention.

A. Administer intravenous normal saline 300 mL/hour B. Administer regular insulin 20 units subcutaneously C. Start bicarbonate infusion intravenously D. Administer potassium chloride 40 mEq orally

Correct Answer is A

Explanation

Choice A reason: Administering intravenous normal saline at 300 mL/hour is the appropriate initial intervention for a patient presenting with a hyperglycemic emergency. Fluid replacement is crucial to correct dehydration and improve circulatory volume, which will help improve renal perfusion and facilitate the excretion of excess glucose and ketones.

Choice B reason: Administering regular insulin 20 units subcutaneously is not the immediate priority. Intravenous insulin is preferred in a hyperglycemic emergency to ensure rapid and effective lowering of blood glucose levels.

Choice C reason: Starting a bicarbonate infusion intravenously is not indicated unless there is severe acidosis (pH < 7.0) or the patient is in shock. The pH of 7.20, while low, can typically be corrected with fluid and insulin therapy.

Choice D reason: Administering potassium chloride 40 mEq orally is not necessary at this point. The potassium level of 3.6 mEq/L is within the normal range, and potassium should be monitored and replaced as needed during ongoing treatment, especially when insulin therapy is initiated.

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The nurse is providing discharge teaching on nutritional therapy to a patient with stage 3 chronic kidney disease. Which statement by the patient suggests to the nurse that additional teaching is required?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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