The nurse is teaching a client who has pernicious anemia about necessary dietary changes. Which statement by the client indicates understanding about those changes?

“I'll limit my intake of citrus fruits."

“I'll avoid eating green leafy vegetables."

“I'll work on increasing my fats and carbohydrates.”

“I'll increase animal proteins like fish and meat.”

Answer and Explanation

The Correct Answer is D

Pernicious anemia is a megaloblastic anemia caused by an autoimmune-mediated deficiency of intrinsic factor. This glycoprotein is secreted by gastric parietal cells and is essential for the absorption of cobalamin in the terminal ileum. Without intrinsic factor, dietary vitamin B12 cannot be utilized, leading to impaired DNA synthesis in erythrocytes and progressive, irreversible neurological degeneration.

Rationale:

A. Limiting citrus fruits is an incorrect dietary strategy for any form of anemia. Vitamin C found in citrus actually enhances the absorption of non-heme iron. While pernicious anemia is specifically a B12 issue rather than an iron issue, restricting these fruits provides no therapeutic benefit and could potentially impair general nutritional health.

B. Avoiding green leafy vegetables is inappropriate because these foods are rich in folate. Folate is another essential B vitamin required for red blood cell maturation. While folate cannot correct the vitamin B12 deficiency of pernicious anemia, it is a vital component of a balanced diet for hematologic health and should not be restricted.

C. Increasing fats and carbohydrates does not address the underlying pathophysiology of pernicious anemia. This condition is not a calorie-deficiency disorder but a specific micronutrient absorption failure. Promoting a high-fat or high-carbohydrate diet could lead to metabolic issues without improving the megaloblastic red blood cell production or the patient's neurological symptoms.

D. Increasing animal proteins like fish and meat indicates an understanding that vitamin B12 is exclusively found in animal-derived foods. While patients with true pernicious anemia usually require lifelong parenteral injections because they cannot absorb oral B12, maximizing dietary intake is still taught as a supportive nutritional measure to ensure all available metabolic pathways are utilized.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is A

Explanation

Ascitesis the accumulation of fluid in the peritoneal cavity, driven by portal hypertension and low serum albumin levels. A major contributor to this process is the activation of the renin-angiotensin-aldosterone system, which causes the kidneys to retain sodium and water. Managing the total body sodium load is the primary non-pharmacological strategy used to reduce fluid accumulation and decrease the need for paracentesis.

Rationale:

A.Sodiumrestriction is the most important dietary intervention for managing ascites. Sodium promotes water retentionthrough osmotic pressure; as the body retains salt, it also retains water, worsening the peritoneal effusion. Typically, a limit of 2,000 milligrams per day or less is recommended to help mobilize fluid out of the abdomen and into the vascular space for excretion.

B.Potassium restriction is generally not required for ascites unless the patient also has significant renal failure. In fact, many patients with cirrhosis and ascites require potassium supplementation because the diuretics used to treat the fluid (like furosemide) cause potassium loss. Potassium is not the primary driver of the osmotic shifts that lead to ascites.

C.Magnesium levels are often low in patients with cirrhosis, especially those with a history of alcohol use. Restricting magnesium would be counterproductive and could lead to neurological or cardiac complications. There is no physiological benefit to restricting magnesium for the purpose of controlling fluid accumulation in the peritoneal cavity.

D.Calcium restriction is not indicated for the management of ascites. Many patients with liver disease are already at risk for bone loss due to malabsorption of fat-soluble vitamins, including Vitamin D. Restricting calcium would provide no benefit for fluid management and could potentially exacerbate underlying skeletal issues common in chronic liver disease.

A. “I should not take over-the-counter medications." B. "I should eat small, frequent, balanced meals.” C. "I need to avoid protein in my diet.” D. “I cannot drink any alcohol at all anymore."

Correct Answer is C

Explanation

Alcohol-induced cirrhosisis characterized by extensive hepatic fibrosis and regenerative nodules that disrupt liver architecture. The liver is responsible for protein synthesis, detoxification, and glucose storage. While severe hyperammonemiaonce led to universal protein restriction, modern evidence emphasizes maintaining adequate nutrition to prevent muscle wasting and support the metabolic demands of a compromised hepatic system.

Rationale:

A.The statement about avoiding over-the-counter medications does not require further teaching. Many common drugs, such as acetaminophen, are metabolized by the liver and can be highly hepatotoxic in cirrhotic patients. Avoiding these substances protects the remaining functional hepatocytes from chemical injury and prevents acute-on-chronic liver failure.

B.Eating small, frequent, balanced meals is an appropriate nutritional strategy for cirrhosis. Frequent meals help maintain stable blood glucose levels, as the liver's glycogen storage capacity is significantly reduced. This approach also manages the early satiety often caused by ascites and helps ensure the patient receives adequate caloric intake to prevent malnutrition.

C.The statement "I need to avoid protein in my diet" indicates a need for further teaching. Unless a patient is in an acute state of hepatic encephalopathywith severely elevated ammonia, protein is necessary to prevent cachexia and promote healing. Restricting protein can lead to malnutrition and further weaken the patient, so high-quality protein should generally be included.

D.Abstaining from alcohol is the most critical lifestyle modification for halting the progression of cirrhosis. Ethanol is a direct toxin to the liver and its continued use accelerates fibrogenesis and increases the risk of hepatocellular carcinoma. The client’s understanding that they can no longer drink indicates a successful grasp of the primary therapeutic goal.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

The nurse is teaching a client who has pernicious anemia about necessary dietary changes. Which statement by the client indicates understanding about those changes?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse collaborates with the registered dietitian nutritionist in providing teaching for a client who has ascites from cirrhosis. What daily dietary restriction would the nurse include in the health teaching?

Correct Answer is A

Explanation

After teaching a client who has alcohol-induced cirrhosis, a nurse assesses the client’s understanding. Which statement made by the client indicates a need for further teaching?

Correct Answer is C

Explanation

A client asks about the process of graft-versus-host disease. What explanation by the nurse is correct?

The nurse assesses a client who has chronic pancreatitis. What assessment findings would the nurse expect for this client? (Select all that apply) Select all that apply

A nurse assesses a client and identifies that the client has pale conjunctivae and complaints of fatigue. What laboratory test will the nurse request from the healthcare provider?

The nurse is caring for a client who reports stomach pain and heartburn. Which assessment finding is most significant suggesting the client’s ulcer is duodenal and not gastric?

The nurse is caring for a client who has cirrhosis of the liver. Which risk factor is the leading cause of cirrhosis?

The nurse is providing diet education to a client diagnosed with cholelithiasis. The goal is symptom management. Which menu selection indicates that the client understands the dietary teaching?

The nurse is preparing a client who has chronic pancreatitis about how to prevent exacerbations of the disease. Which health teaching will the nurse include? (Select all that apply) Select all that apply

The nurse plans care for a client with Crohn's disease who has a heavily draining fistula. Which intervention would be the nurse’s priority action?