Nursing Elites

1. A client with viral hepatitis has no appetite, and food makes the client nauseated. Which of the following interventions would be most appropriate?

• A. Explain that high-fat diets usually are tolerated better.
• B. Encourage intake of foods high in protein.
• C. Explain that the majority of calories need to be consumed in the evening hours.
• D. Monitor for fluid and electrolyte imbalance.

Correct answer: D

Rationale: If nausea occurs and persists, the client will need to be assessed for fluid and electrolyte imbalance. Explaining to the client that the majority of calories should be eaten in the morning hours is important because nausea occurs most often in the afternoon and evening. Clients should select a diet high in calories because energy is required for healing. Protein increases the workload on the liver. Changes in bilirubin interfere with fat absorption, so low-fat diets are tolerated better.

2. The client with chronic pancreatitis needs information on dietary modification to manage the health problem. The nurse teaches the client to limit which of the following items in the diet?

• A. Carbohydrate
• B. Protein
• C. Fat
• D. Water-soluble vitamins

Correct answer: C

Rationale: The client should limit fat in the diet. The client also should take in small meals, which also will reduce the amount of carbohydrates and protein that the client must digest at any one time. The client does not need to limit water-soluble vitamins in the diet.

3. Which of the following symptoms is associated with ulcerative colitis?

• A. Dumping syndrome
• B. Rectal bleeding
• C. Soft stools
• D. Fistulas

Correct answer: B

Rationale: Rectal bleeding is a common symptom of ulcerative colitis due to the inflammation and ulceration of the colon lining.

4. The client is admitted to the hospital with viral hepatitis, complaining of 'no appetite' and 'losing my taste for food.' To provide adequate nutrition, the nurse would instruct the client to

• A. Eat a good supper when anorexia is not as severe.
• B. Eat less often, preferably only three large meals daily.
• C. Increase intake of fluids including juices.
• D. Select foods high in fat.

Correct answer: C

Rationale: Although no special diet is required to treat viral hepatitis, it is generally recommended that clients consume a diet with low-fat content because fat may be tolerated poorly due to decreased bile production. Small, frequent meals are preferable and may prevent nausea. Appetite is often better in the morning, so it is easier to eat a good breakfast. An adequate fluid intake of 2500 to 3000 mL per day that includes nutritional juices is also important.

5. A client’s ulcerative colitis symptoms have been present for longer than 1 week. The nurse recognizes that the client should be assessed carefully for signs of which of the following complications?

• A. Heart failure
• B. DVT
• C. Hypokalemia
• D. Hypocalcemia

Correct answer: C

Rationale: The client should be assessed carefully for signs of hypokalemia, a common complication of prolonged ulcerative colitis symptoms.

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