The nurse is providing teaching to the parents of a school-aged child newly diagnosed with Crohn's disease about dietary measures to implement during an exacerbation. Which statement made by the parents indicates a need for further instruction?

"We will avoid giving our child any dairy products during an exacerbation."

"We will make sure our child eats plenty of fruits and vegetables during an exacerbation."

"We will increase our child's intake of high-fiber foods, such as whole grains and legumes."

"We will encourage our child to drink plenty of fluids, especially water."

Answer and Explanation

The Correct Answer is B

A. "We will avoid giving our child any dairy products during an exacerbation." Avoiding dairy products during a Crohn's disease exacerbation is often recommended because many individuals with Crohn's disease are lactose intolerant, and dairy can exacerbate symptoms such as diarrhea.

B. "We will make sure our child eats plenty of fruits and vegetables during an exacerbation." During an exacerbation of Crohn's disease, a high-fiber diet (including many fruits and vegetables) can be problematic, as it may irritate the intestines and worsen symptoms. This statement indicates a need for further teaching.

C. "We will increase our child's intake of high-fiber foods, such as whole grains and legumes." High-fiber foods should generally be avoided during a Crohn's disease flare-up because they can be difficult to digest and may worsen symptoms. However, this advice might be appropriate during periods of remission.

D. "We will encourage our child to drink plenty of fluids, especially water." Hydration is important, particularly during exacerbations, when the risk of dehydration increases due to diarrhea. This is a correct statement.

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Correct Answer is A

Explanation

A. This statement is incorrect because processed foods can contain gluten even if they don't have visible flour. Gluten can be found in many processed foods as an additive or stabilizer, such as in sauces, soups, and processed meats. It's important to always check food labels for gluten ingredients.

B. This is correct. Barley and rye are sources of gluten and must be avoided in a gluten-free diet for those with celiac disease.

C. This is correct. Foods like bread, pasta, and cereal commonly contain gluten and need to be avoided by individuals with celiac disease.

D. This is correct. Using separate serving utensils for gluten-free foods helps prevent cross-contamination, which is critical for managing celiac disease.

A. Hold the infant's chin to his chest and knees to his abdomen during the procedure. B. No sedation is needed, due to application of anesthetic cream. C. Apply an anesthetic mixture of lidocaine and prilocaine cream topically 15 min prior to the procedure. D. Keep the infant NPO for 6 hr prior the procedure.

Correct Answer is A

Explanation

A. Hold the infant's chin to his chest and knees to his abdomen during the procedure is correct. For a lumbar puncture in an infant, a proper position to facilitate the procedure is to curl the infant into a fetal position by holding the chin to the chest and the knees to the abdomen, which opens up the intervertebral spaces for better access.

B. No sedation is needed, due to application of anesthetic cream is incorrect. While an anesthetic cream is typically used to numb the skin, sedation or pain management may still be required depending on the infant's tolerance.

C. Apply an anesthetic mixture of lidocaine and prilocaine cream topically 15 min prior to the procedure is incorrect. Lidocaine and prilocaine are topical anesthetics, but the cream should be applied 30 minutes to 1 hour prior to the procedure to ensure effectiveness, not just 15 minutes.

D. Keep the infant NPO for 6 hr prior the procedure is incorrect. Most lumbar puncture procedures in infants do not require the infant to be NPO for 6 hours. The NPO guideline typically depends on whether anesthesia or sedation is being used, and for lumbar punctures, a shorter fasting period (if any) is often sufficient.

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The nurse is providing teaching to the parents of a school-aged child newly diagnosed with Crohn's disease about dietary measures to implement during an exacerbation. Which statement made by the parents indicates a need for further instruction?

Nursing Test Bank

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