Nokea
The nurse is preparing to administer liquid laxative to a patient in preparation for a colonoscopy. Which action should the nurse take?
- A. Offer a small snack.
- B. Take the patient's temperature.
- C. Mix the laxative with orange juice.
- D. Chill the laxative and pour it over ice.
Correct Answer: D
Rationale: The correct answer is D because chilling the laxative and pouring it over ice can help improve its taste and make it more palatable for the patient. This can encourage the patient to consume the laxative as needed for the colonoscopy preparation. Offering a small snack (choice A) may interfere with the effectiveness of the laxative. Taking the patient's temperature (choice B) is not relevant to administering a laxative. Mixing the laxative with orange juice (choice C) may alter its effectiveness and is not recommended.
You may also like to solve these questions
A 55-year-old female client comes to the clinic for a physical examination. Which of the following screening tests would the nurse recommend the client have beginning at the age of 50 and every 10 years after?
- A. Colonoscopy
- B. Ultrasound of the kidney
- C. Mammogram
- D. Pap smear
Correct Answer: A
Rationale: The correct answer is A: Colonoscopy. Beginning at age 50, it is recommended every 10 years to screen for colorectal cancer. This screening test is essential for early detection and prevention of colon cancer. Colonoscopy allows for direct visualization of the colon and removal of any precancerous polyps.
Choice B: Ultrasound of the kidney is not a recommended screening test for a 55-year-old female. Kidney ultrasound is typically used for evaluating specific kidney conditions, not as a routine screening test.
Choice C: Mammogram is typically recommended for breast cancer screening in women starting at age 40, not every 10 years after age 50.
Choice D: Pap smear is used for cervical cancer screening, typically starting at age 21 and continuing every 3-5 years, not every 10 years after age 50.
A 22-yr-old female patient with an exacerbation of ulcerative colitis is having 15 to 20 stools daily and has excoriated perianal skin. Which patient behavior indicates that teaching regarding maintenance of skin integrity has been effective?
- A. The patient uses incontinence briefs to contain loose stools.
- B. The patient uses witch hazel compresses to soothe irritation.
- C. The patient asks for antidiarrheal medication after each stool.
- D. The patient cleans the perianal area with soap after each stool.
Correct Answer: B
Rationale: The correct answer is B: The patient uses witch hazel compresses to soothe irritation. Witch hazel has astringent and anti-inflammatory properties, which can help reduce inflammation and soothe irritated skin. By using witch hazel compresses, the patient is actively taking steps to alleviate discomfort and promote skin healing.
A: The patient using incontinence briefs to contain loose stools does not address the issue of skin integrity maintenance and may lead to prolonged exposure of the skin to stool, exacerbating the problem.
C: Asking for antidiarrheal medication after each stool does not directly address the need for skin integrity maintenance. While it may help reduce stool frequency, it does not specifically target skin healing.
D: Cleaning the perianal area with soap after each stool can be harsh on the already excoriated skin and may further irritate it. Using soap can strip the skin of its natural oils and hinder the healing process.
If the submandibular salivary gland stops functioning:
- A. The volume of salivary secretion will be reduced by 20%
- B. There would be severe deficiency of
- C. amylase
- D. There would be no mucins in saliva
Correct Answer: B
Rationale: The correct answer is B because the submandibular salivary gland is responsible for producing around 70-75% of total saliva, including amylase. If it stops functioning, there would be a severe deficiency of amylase, leading to impaired digestion of starches. Choice A is incorrect because the reduction in salivary secretion would be more significant than 20%. Choice D is incorrect as mucins are produced by other salivary glands and not solely by the submandibular gland.
Which is most characteristic of carcinoma of the cecum or right colon (in contrast to carcinoma of the rectum)?
- A. anemia
- B. associated polyposis
- C. bowel obstruction
- D. diarrhea
Correct Answer: A
Rationale: The correct answer is A: anemia. Carcinoma of the cecum or right colon often presents with chronic blood loss, leading to iron deficiency anemia. This is due to the longer transit time in the right colon allowing for more time for blood to be lost and for the iron in the blood to be absorbed. Choices B, C, and D are less characteristic of carcinoma of the cecum or right colon. Polyposis is more commonly associated with familial adenomatous polyposis, bowel obstruction is more common in advanced stages regardless of location, and diarrhea is more commonly seen in rectal carcinomas due to irritation of the rectal mucosa.
Priority Decision: During the treatment of the patient with bleeding esophageal varices, what is the most important thing the nurse should do?
- A. Prepare the patient for immediate portal shunting surgery.
- B. Perform guaiac testing on all stools to detect occult blood.
- C. Maintain the patient's airway and prevent aspiration of blood.
- D. Monitor for the cardiac effects of IV vasopressin and nitroglycerin.
Correct Answer: C
Rationale: Rationale: The correct answer is C because maintaining the patient's airway and preventing aspiration of blood is the top priority in a patient with bleeding esophageal varices. This is crucial to prevent respiratory compromise and potential life-threatening complications. Immediate portal shunting surgery (A) is not the priority as stabilizing the patient comes first. Guaiac testing (B) is not the priority as it does not address the immediate risk of airway obstruction. Monitoring cardiac effects (D) is important but not as critical as ensuring the patient's airway is secure.