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 B

Explanation

Choice A reason: Administering an antiemetic addresses vomiting but is not the first priority. Confusion and projectile vomiting in MS suggest increased intracranial pressure or brain injury post-fall, requiring neurological assessment to identify life-threatening conditions like hematoma, which takes precedence over symptom management.

Choice B reason: A head-to-toe neurological assessment is critical first, as confusion and projectile vomiting post-fall in MS indicate potential traumatic brain injury or exacerbation. Assessing pupil response, motor function, and consciousness level identifies neurological deterioration, guiding urgent interventions to prevent further brain damage.

Choice C reason: Determining the last corticosteroid dose is relevant for MS management but not urgent. Confusion and vomiting suggest acute neurological injury, requiring immediate assessment. Steroid history may guide long-term care but is secondary to evaluating current neurological status post-fall.

Choice D reason: Determining the neurological baseline is useful but not the first action. Acute confusion and vomiting require immediate assessment to detect changes like brain injury. Baseline data provide context but delay critical evaluation of current neurological status, making this choice less urgent.

A. Monitor daily urine output volume B. Use salt tablets after strenuous exercise C. Review food labels for sodium content D. Drink plenty of water whenever thirsty

Correct Answer is C

Explanation

Choice A reason: Monitoring urine output assesses fluid status but does not directly prevent hypernatremia, which results from excess sodium or water loss. Reducing dietary sodium intake is more proactive, as urine output is a secondary indicator, making this instruction less effective for management.

Choice B reason: Using salt tablets after exercise is dangerous, as they increase sodium intake, worsening hypernatremia. This condition requires sodium reduction and water replacement, making this instruction harmful, as it exacerbates elevated serum sodium levels, risking neurological complications.

Choice C reason: Reviewing food labels for sodium content is critical, as hypernatremia results from high sodium intake or water loss. Limiting dietary sodium prevents further elevation of serum sodium, protecting against cerebral edema or seizures, making this the most effective discharge instruction.

Choice D reason: Drinking water when thirsty helps hydration but is reactive and insufficient for hypernatremia, which requires proactive sodium reduction. Thirst may be impaired in some patients, and dietary sodium control is more direct, making this instruction less comprehensive than label review.

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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

A client with multiple sclerosis (MS) fell while walking to the bathroom. Upon transfer to the intensive care unit (ICU), the client is confused and has had projectile vomiting twice. Which intervention should the nurse implement first?

Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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