The nurse is caring for a 14-year-old client diagnosed with celiac disease. The nurse knows that the client understands the diet instructions when they request which of the following meals?
Low-fat yogurt with blueberries and granola
Cheese, banana slices, rice cakes, and whole milk
Eggs, bacon, rye toast, and lactose-free milk
Egg, cheese, and sausage wrapped in a flour tortilla
The Correct Answer is B
Rationale:
A. Granola often contains gluten, so this meal would not be suitable for someone with celiac disease.
B. Cheese, banana slices, rice cakes, and whole milk are gluten-free and appropriate for a child with celiac disease.
C. Rye toast contains gluten, which is contraindicated for someone with celiac disease.
D. Flour tortillas generally contain gluten, so this meal is not appropriate for someone with celiac disease.
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Correct Answer is A
Explanation
Rationale:
A. Hypertension (blood pressure of 136/92 mm Hg) in a child with acute pyelonephritis can indicate a severe condition that may lead to renal damage or worsening kidney function. Immediate intervention is necessary to manage high blood pressure and prevent complications.
B. A heart rate of 100 bpm is within normal limits for a 7-year-old and does not require immediate action.
C. Decreased urine output is concerning and needs monitoring, but hypertension is the more urgent issue.
D. Tea-colored urine suggests hematuria or concentrated urine, which is important but not as immediately life-threatening as high blood pressure.
Correct Answer is A
Explanation
Rationale:
A. Lethargy is an early sign of increased intracranial pressure (ICP) due to possible shunt malfunction and requires immediate medical attention.
B. Seizure activity can be a late sign of shunt malfunction and is also concerning but lethargy typically appears earlier.
C. Rapid weight gain is less directly related to shunt malfunction and more associated with conditions like hypothyroidism or edema.
D. Disinterest in school could suggest general malaise but is not a specific or early sign of shunt malfunction.