A client with newly diagnosed Crohn’s disease asks the nurse about dietary restrictions. How should the nurse respond?

Instruct the client to avoid foods with gluten, such as wheat bread

Explain that the need to restrict fluids is the primary limitation

Advise the client to limit foods that are high in calcium and iron

Recommend a personalized diet plan with a dietitian

Answer and Explanation

The Correct Answer is D

Choice A reason: Avoiding gluten is specific to celiac disease, not Crohn’s, which involves inflammatory bowel disease without gluten sensitivity. Gluten restriction does not address Crohn’s mucosal inflammation, and this instruction misguides the client, as dietary triggers vary, requiring individualized management.

Choice B reason: Restricting fluids is incorrect, as Crohn’s patients need adequate hydration to manage diarrhea and prevent dehydration. Fluid restriction exacerbates electrolyte imbalances, worsening symptoms, making this an inappropriate recommendation for Crohn’s dietary management, which focuses on symptom-specific adjustments.

Choice C reason: Limiting calcium and iron is not standard for Crohn’s, as these nutrients support bone health and anemia prevention, common concerns in inflammatory bowel disease. This restriction could worsen deficiencies without addressing inflammation, making it an incorrect dietary focus for Crohn’s.

Choice D reason: Recommending a personalized diet plan with a dietitian is correct, as Crohn’s dietary triggers vary, requiring tailored plans to avoid exacerbating inflammation. Dietitians identify specific irritants, like high-fiber foods, ensuring nutritional balance while minimizing symptoms, making this the best approach for effective management.

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Correct Answer is A

Explanation

Choice A reason: Explaining the five positions for postural drainage is correct, as COPD clients benefit from varied postures to drain mucus from different lung segments. Positioning enhances gravity-assisted clearance, improving airway patency and gas exchange, ensuring the client understands the procedure for effective participation.

Choice B reason: Performing drainage after meals is incorrect, as it risks aspiration and discomfort due to gastric pressure in COPD clients with hyperinflated lungs. Timing drainage between meals ensures safety and efficacy, making this approach inappropriate for mucus clearance.

Choice C reason: Obtaining an ABG before drainage is unnecessary unless respiratory distress is evident. Postural drainage is routine in COPD to clear mucus, and ABGs monitor acid-base status, not procedure efficacy, making this choice irrelevant for standard drainage preparation.

Choice D reason: Instructing shallow, fast breathing is incorrect, as it reduces tidal volume, worsening mucus clearance in COPD. Deep, slow breathing enhances drainage by mobilizing secretions, making this approach counterproductive to the goal of improving airway clearance during the procedure.

A. Observe body language and movement B. Ask the client to describe the pain C. Identify effective pain relief measures D. Provide a numeric pain scale

Correct Answer is B

Explanation

Choice A reason: Observing body language and movement provides clues to pain but is subjective and incomplete. Clients may mask pain, and movements vary. Verbal description captures quality, like burning or stabbing, guiding specific interventions, making this approach less comprehensive for pain assessment.

Choice B reason: Asking the client to describe the pain is best, as it captures quality, location, and characteristics (e.g., sharp, dull), essential for diagnosing etiology and tailoring treatment. Subjective verbal input provides detailed data, aligning with pain management guidelines, making this the most effective approach.

Choice C reason: Identifying pain relief measures is part of management, not assessment. Understanding pain quality via description informs which measures are effective, and this step follows assessment, making it premature and less focused on capturing the pain’s nature.

Choice D reason: A numeric pain scale quantifies intensity but not quality, missing details like burning or throbbing, which guide diagnosis. Descriptive verbal input provides a fuller picture, making the scale useful but secondary to asking for a detailed pain description.

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A client with newly diagnosed Crohn’s disease asks the nurse about dietary restrictions. How should the nurse respond?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When performing postural drainage on a client with chronic obstructive pulmonary disease (COPD), which approach should the nurse use?

Correct Answer is A

Explanation

To assess the quality of an adult client’s pain, which approach should the nurse use?

Correct Answer is B

Explanation

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A client with newly diagnosed Crohn’s disease asks the nurse about dietary restrictions. How should the nurse respond?

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