A nurse is assessing a client who has a stage III pressure ulcer that is healing poorly. The nurse should identify that which of the following vitamin deficiencies increases the client's risk for delayed wound healing?

Correct Answer: A

Rationale: In the context of wound healing, the correct answer is option A) Vitamin C. Vitamin C plays a crucial role in the synthesis of collagen, a key component of connective tissue and skin. Collagen is essential for wound repair and the formation of new tissue. A deficiency in Vitamin C can impair collagen production, leading to delayed wound healing. Option B) Vitamin D is important for bone health and immune function but does not have a direct role in collagen synthesis or wound healing. Option C) Vitamin E is an antioxidant that helps protect cells from damage but does not directly impact collagen production or wound healing. Option D) Vitamin B6 is involved in protein metabolism but does not have a direct role in collagen synthesis or wound healing. Educationally, understanding the role of vitamins in wound healing is essential for nurses caring for patients with pressure ulcers or other wounds. Nurses need to assess for potential deficiencies, provide appropriate nutrition interventions, and collaborate with healthcare providers to optimize healing outcomes. This knowledge helps in developing comprehensive care plans tailored to individual patient needs.

Correct Answer: D

Rationale: In the context of a client receiving parenteral nutrition, the most indicative finding of therapy effectiveness is the client's blood glucose level being within the expected reference range (Option D). This is because parenteral nutrition is directly infused into the bloodstream, and monitoring blood glucose levels is crucial in assessing the body's ability to metabolize this nutrition source efficiently. Options A, B, and C are incorrect as they do not directly correlate with the effectiveness of parenteral nutrition therapy. Soft, formed bowel movements (Option A) are more related to enteral nutrition, while pink mucous membranes (Option B) and the ability to complete activities of daily living (Option C) are general indicators of overall health and well-being, but they do not specifically reflect the effectiveness of parenteral nutrition therapy. In an educational context, understanding the rationale behind monitoring blood glucose levels in clients receiving parenteral nutrition is vital for nurses and healthcare providers to ensure the therapy is meeting the patient's nutritional needs adequately and to prevent complications such as hyperglycemia or hypoglycemia. This knowledge helps in providing safe and effective care to patients requiring parenteral nutrition support.

Correct Answer: B

Rationale: In this scenario, the correct action for the nurse to perform first is to determine the client's daily caloric intake (Option B). This is crucial because understanding the client's current caloric intake provides a baseline for creating an effective weight loss plan. By assessing the client's current intake, the nurse can identify areas for modification and tailor dietary recommendations to the individual's needs. Option A, educating the client about daily caloric requirements, may be important later in the teaching process, but without knowing the client's current intake, it is challenging to provide personalized guidance. Option C, providing meal planning information, would be premature without first understanding the client's baseline intake. Option D, showing the client how to identify the fat content of packaged foods, is relevant but not as critical as determining the starting point of the client's caloric intake. In an educational context, it is essential for nurses to prioritize assessment and individualization when teaching clients about dietary changes. This ensures that interventions are tailored to the client's specific needs and increases the likelihood of successful outcomes in weight management. By starting with a thorough assessment of the client's caloric intake, the nurse can develop a more targeted and effective plan for supporting the client's weight loss goals.

Correct Answer: B

Rationale: In the context of medical-surgical education, understanding the physiological effects of stress on metabolism is crucial for nurses to provide comprehensive care to their patients. The correct answer, option B, states that acute stress causes an increase in metabolism. This is important to note because during times of stress, the body releases hormones like cortisol and adrenaline, which can lead to an increase in metabolic rate to provide the body with the energy needed to respond to the stressor. Option A, stating that protein requirements decrease in times of stress, is incorrect. In reality, protein requirements may actually increase during stress as the body may need additional amino acids for tissue repair and to support the immune system. Option C, suggesting that stress causes a positive nitrogen balance in the body, is also incorrect. Stress typically leads to a negative nitrogen balance due to increased catabolism of protein stores in the body. Option D, claiming that glucose is broken down more slowly during times of stress, is incorrect as well. In fact, glucose is broken down more rapidly during stress to provide immediate energy for the body's fight-or-flight response. By understanding these physiological responses to stress, nurses can better assess and support patients experiencing stress-related health issues, thereby improving patient outcomes and overall quality of care.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Prednisone. Prednisone is a corticosteroid that can impair wound healing by suppressing the immune response and reducing collagen synthesis. This places the client at risk for wound dehiscence, which is the separation of the surgical incision before it has fully healed. Option A) Omeprazole is a proton pump inhibitor used to reduce stomach acid production and does not directly impact wound healing or increase the risk of dehiscence in this context. Option B) Zolmitriptan is a medication used to treat migraines and does not have a direct effect on wound healing or dehiscence risk postoperatively. Option D) Verapamil is a calcium channel blocker used to treat hypertension and cardiac conditions. It does not interfere with wound healing or increase the risk of wound dehiscence. In an educational context, understanding the effects of different medications on wound healing is crucial for nurses caring for postoperative patients. Knowledge of which medications can impair wound healing helps nurses identify and prevent complications such as wound dehiscence, ultimately improving patient outcomes. It highlights the importance of medication review and assessment in postoperative care to ensure optimal recovery for surgical patients.