Practice Question
A nurse is caring for a client in a clinic.
Answer Choices:
Rationale:
Avoid eating foods that are cold — Not Indicated
🔷 Food temperature has no consistent evidence of altering UC inflammation or symptom burden.
🔷 UC flares are driven by mucosal immune activation, not whether food is cold or warm.
🔷 Some individuals have personal triggers (e.g., ice‑cold drinks causing cramps), but this is not universal guidance.
🔷 Education should emphasize evidence‑based dietary strategies rather than blanket rules on temperature.
Practice stress‑reducing activities — Indicated
🔷 Psychological stress can exacerbate UC symptoms via gut–brain axis pathways and higher cortisol/sympathetic tone.
🔷 Techniques such as paced breathing, CBT skills, mindfulness, and sleep hygiene can reduce cramping/diarrhea frequency.
🔷 Stress control improves medication adherence and overall quality of life in IBD.
🔷 Incorporate daily, structured stress‑management (10–15 min) alongside medical therapy.
Expect medication to take effect within 3 days — Not Indicated
🔷 Oral mesalamine (5‑ASA) typically requires 2–6 weeks for meaningful symptom response, not 3 days.
🔷 Setting realistic expectations improves adherence and prevents premature discontinuation.
🔷 Teach to continue therapy as prescribed and to report worsening bleeding, severe pain, or dehydration.
🔷 Reinforce kidney function monitoring (rare nephrotoxicity) and do not crush certain formulations.
Avoid consuming nuts and corn — Indicated
🔷 During flares, a low‑residue diet helps by reducing mechanical irritation and stool volume.
🔷 Nuts, seeds, popcorn, and corn are hard to digest and can aggravate abdominal cramping/diarrhea.
🔷 Once in remission, some patients re‑challenge cautiously to expand diet based on tolerance.
🔷 Pair with small, frequent meals and adequate hydration.
Replace water with carbonated beverages — Not Indicated
🔷 Carbonation and high fructose can increase bloating, gas, and motility, worsening discomfort.
🔷 Water (and oral rehydration solutions if diarrhea is frequent) best supports fluid/electrolyte balance.
🔷 Many sodas add caffeine or artificial sweeteners that may stimulate bowel activity.
🔷 Encourage plain water as the primary fluid.
Abstain from foods containing dairy if symptoms increase — Indicated (conditional)
🔷 Secondary lactose intolerance is common in UC, especially during active inflammation.
🔷 Dairy can worsen bloating, gas, and diarrhea in sensitive individuals; a trial elimination is reasonable.
🔷 Recommend lactose‑free alternatives and ensure calcium/vitamin D intake to protect bone health.
🔷 Reassess tolerance in remission and personalize the plan.
Avoid smoking — Indicated
🔷 Regardless of mixed epidemiology in UC, smoking is not recommended due to cardiovascular, pulmonary, and cancer risks.
🔷 Nicotine is not a first‑line therapy; safer, evidence‑based options (5‑ASA, rectal formulations, biologics) exist.
🔷 Smoking impairs wound healing and increases infection risk, relevant in chronic disease care.
🔷 Provide cessation support (NRT, counseling) as part of comprehensive management.
Increase intake of caffeinated beverages — Not Indicated
🔷 Caffeine increases colonic motility and can worsen diarrhea and urgency.
🔷 It may aggravate sleep disturbance and anxiety, amplifying gut–brain axis effects.
🔷 Recommend limiting or avoiding caffeine during flares; re‑introduce cautiously if asymptomatic.
🔷 Favor non‑caffeinated fluids for hydration.
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This question is from RN CONCEPT-BASED ASSESSMENT LEVEL 3 WITH NGN which contains 140 questions.
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RN CONCEPT-BASED ASSESSMENT LEVEL 3 WITH NGN
140 Questions
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- Category: RN Nursing Exam(s)
- Subcategory: ATI Exam(s)
- Domain: RN Concept-Based Assessment Level Exam(s)
- Answer Choices: 0