The nurse is discussing dietary choices with a client who is newly diagnosed with celiac disease. Which menu choice by the client indicates a need for further teaching?

Wild rice.

Oatmeal.

Corn chips.

Potatoes.

Answer and Explanation

The Correct Answer is B

Choice A rationale:

Wild rice is naturally gluten-free. It is not a grain, but rather a semi-aquatic grass seed. It is safe for individuals with celiac disease to consume.

Wild rice is a good source of nutrients. It is high in fiber, protein, and antioxidants, and it contains a variety of vitamins and minerals, including manganese, phosphorus, magnesium, and zinc. These nutrients can help to support overall health and well-being.

Wild rice can be a versatile ingredient in many dishes. It can be used in salads, soups, stews, pilafs, and even desserts.

Choice B rationale:

Oatmeal is not gluten-free. It is made from oats, which are a type of cereal grain that contains gluten. Individuals with celiac disease must avoid gluten, as it can trigger an autoimmune reaction that damages the small intestine.

Even small amounts of gluten can cause harm. Consuming even a small amount of oatmeal can cause symptoms such as abdominal pain, bloating, diarrhea, fatigue, and headache in individuals with celiac disease.

Long-term damage can occur. If individuals with celiac disease continue to consume gluten, it can lead to long-term health problems, such as malnutrition, osteoporosis, and infertility.

Choice C rationale:

Corn chips are typically gluten-free. However, it is important to check the label to be sure, as some brands may contain gluten- containing ingredients, such as wheat flour or barley malt.

Reading labels is essential. Individuals with celiac disease should always read food labels carefully to ensure that products are gluten-free.

Choice D rationale:

Potatoes are naturally gluten-free. They are a safe and healthy food choice for individuals with celiac disease.

Potatoes are a versatile and nutritious food. They are a good source of carbohydrates, fiber, potassium, vitamin C, and other nutrients.

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Correct Answer is B

Explanation

Step 1: Identify the desired dose and the available concentration. Desired dose: 500 mg of vancomycin

Available concentration: 500 mg per 100 ml

Step 2: Determine the volume needed to deliver the desired dose.

Since the available concentration is 500 mg per 100 ml, no further calculation is required. The volume needed to deliver 500 mg of vancomycin is already 100 ml.

Step 3: Calculate the infusion rate in mL/hr.

The medication needs to be administered over 1 hour.

Therefore, the infusion pump should be set to deliver the 100 ml of solution over 1 hour. Infusion rate = 100 ml / 1 hour = 100 mL/hr.

A. Leave the old ties in place until the new ones are secure. B. Secure tracheostomy ties by making knots close to the tube. C. Remove ties to secure a disposable, soft foam collar with self-adhesive fastening. D. Place knots of the ties laterally to prevent irritation and pressure.

Correct Answer is A

Explanation

Choice A rationale:

Maintains airway patency: Leaving the old ties in place until the new ones are secure ensures that the tracheostomy tube remains in the correct position and prevents accidental decannulation, which could obstruct the airway and lead to respiratory distress or arrest. This is the most important priority in tracheostomy care.

Prevents tube displacement: Accidental decannulation can occur during tie changes, especially in patients with copious secretions or who are restless or agitated. Keeping the old ties in place acts as a safety measure to keep the tube in position even if the new ties are not immediately secured.

Allows for adjustments: If the new ties are not tied correctly or are too tight, the old ties can be loosened or removed to make adjustments without compromising the airway.

Minimizes anxiety: Leaving the old ties in place can help to reduce anxiety in patients who are apprehensive about the tie- changing process, as it provides a sense of security and ensures that the tube will not be dislodged.

Choice B rationale:

Increases risk of skin irritation: Knots tied close to the tube can rub against the skin, causing irritation, discomfort, and potential skin breakdown, especially in patients with sensitive skin or who have copious secretions.

Impinges on blood flow: Tight knots can also constrict blood vessels, potentially impairing circulation to the skin around the tracheostomy site.

Difficult to remove in emergencies: Knots tied too close to the tube can be challenging to untie quickly in case of an emergency, such as accidental decannulation or the need to suction secretions.

Choice C rationale:

Not appropriate for all patients: Disposable, soft foam collars with self-adhesive fastening may not be suitable for patients with copious secretions, as the adhesive may not adhere well to moist skin.

May not provide adequate support: These collars may not provide the same level of support as traditional tracheostomy ties, especially in patients with active neck movement or who are at risk of accidental decannulation.

Potential for skin irritation: The adhesive on the collar can also irritate the skin around the tracheostomy site in some patients.

Choice D rationale:

May not prevent irritation: Placing knots laterally may not completely eliminate the risk of skin irritation, as the ties can still rub against the skin with neck movement or when the patient is lying down.

Could lead to accidental loosening: Knots tied laterally may be more prone to accidental loosening, especially if the patient is restless or agitated.

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The nurse is discussing dietary choices with a client who is newly diagnosed with celiac disease. Which menu choice by the client indicates a need for further teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client receives a prescription for vancomycin 500 mg IV every 8 hours. The medication is provided in "500 mg per 100 ml" of dextrose 5% in water. To administer the medication over an hour, the nurse should set the infusion pump to deliver how many mL/hr?

Correct Answer is B

Explanation

A client who has had a laryngectomy and tracheostomy frequently expectorates copious amounts of purulent secretions.When changing the ties of the tracheostomy tube, which action is most important for the nurse to take?

Correct Answer is A

Explanation

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