The nurse is caring for a client with the nursing problem of Imbalanced Nutrition: Less than Body Requirements related to painful oral lesions. Which intervention would the nurse include in the plan of care?
Encourage rinsing mouth twice a day with a sodium bicarbonate solution
Encourage client to perform mouth care before and after every meal
Assess oral pain level once a shift
Offer 3 meals per day with a snack at bedtime
The Correct Answer is B
A. While mouth rinses can be helpful for some oral conditions, sodium bicarbonate solutions may not be appropriate for all types of oral lesions, and there are other more effective mouth care strategies for managing painful lesions.
B. This is a key intervention for managing painful oral lesions. Regular mouth care helps to maintain oral hygiene, reduce the risk of infection, and decrease discomfort while eating. It also promotes healing and prevents further complications.
C. While assessing pain is important, doing it just once a shift may not be sufficient. The nurse should assess pain more frequently, especially before and after meals, as pain from oral lesions can significantly impact a client’s ability to eat.
D. Offering small, frequent meals is typically more effective in improving nutrition for clients with painful oral lesions. The client may be more willing to eat smaller amounts rather than large meals, especially if pain is a significant issue.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["0.4"]
Explanation
Step 1: Desired dose = 2 mg
Step 2: Available concentration = 5 mg/mL
Step 3: Use the formula:
Volume to administer = Desired dose ÷ Concentration available
Step 4: Plug in the values:
Volume to administer = 2 mg ÷ 5 mg/mL = 0.4 mL
Correct Answer is B
Explanation
A. While age is a risk factor for colorectal cancer, the risk typically increases after age 50, not at 35. Most colorectal cancers are diagnosed in individuals over the age of 50, so age over 50 is a more significant risk factor.
B. Ulcerative colitis is a chronic inflammatory bowel disease that increases the risk of developing colorectal cancer, especially after long-term inflammation. The risk increases the longer someone has had ulcerative colitis, particularly if the disease affects a large portion of the colon.
C. A high fiber, low fat diet is actually protective against colorectal cancer. Diets rich in fiber and low in fat have been shown to reduce the risk of developing colorectal cancer by promoting bowel regularity and reducing inflammation in the colon.
D. While having a first-degree relative (parent, sibling, or child) with colorectal cancer is a significant risk factor, having a distant relative (e.g., cousin, aunt, uncle) with the disease does not carry the same increased risk. The genetic risk is more strongly associated with immediate family members.
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