The physician orders pantoprazole 40mg PO daily for reflux.

The drug is supplied as 20mg tablets.

How many tablets will the nurse administer?

Choice A rationale

Memory loss is more commonly associated with neurological conditions, vitamin B12 deficiency, or aging, rather than a lack of dietary fiber. Fiber primarily affects the digestive system and blood sugar control, not cognitive function.

Choice B rationale

Bleeding gums are typically a sign of vitamin C deficiency (scurvy) or poor oral hygiene leading to gingivitis. While overall nutrition is important for oral health, a lack of fiber specifically does not directly cause bleeding gums.

Choice C rationale

Brittle hair can be a symptom of various nutritional deficiencies, including protein, biotin, and iron, but it is not a primary indicator of inadequate fiber intake. Fiber mainly impacts bowel function and glucose metabolism.

Choice D rationale

Constipation, characterized by infrequent or difficult bowel movements, is a well-established consequence of inadequate dietary fiber intake. Fiber adds bulk to the stool, absorbs water, and facilitates peristalsis, the muscular contractions that move stool through the intestines. A lack of fiber can lead to harder, drier stools that are more difficult to pass. .

Choice A rationale

NPO (nothing by mouth) might be a temporary measure immediately following a stroke if aspiration risk is very high. However, prolonged NPO can lead to malnutrition and dehydration, hindering recovery. Nutritional support is crucial for stroke patients, so alternative feeding methods should be explored.

Choice B rationale

Total parenteral nutrition (TPN) is a method of providing nutrients intravenously, bypassing the gastrointestinal tract. It is usually reserved for patients with severe gastrointestinal dysfunction or when enteral feeding is not feasible or tolerated. While it provides nutrition, it carries risks of infection and metabolic complications and is not the first-line treatment for dysphagia.

Choice C rationale

A mechanical soft diet consists of foods that are easy to chew and swallow, reducing the risk of choking and aspiration in patients with mild to moderate dysphagia. This diet provides necessary nutrients while minimizing the effort required for safe oral intake, promoting better nutrition and hydration compared to NPO.

Choice D rationale

Supplements via NG tube provide enteral nutrition directly into the stomach or small intestine, bypassing the oral cavity and pharynx. This is an appropriate nutritional therapy for patients with severe dysphagia who cannot safely swallow even modified textures, ensuring adequate caloric and nutrient intake to support recovery and prevent malnutrition.