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A client had a colossoscopy and biopsy yesterday and calls the gastrointestinal clinic to report a spot of bright red blood on the toilet paper today. What response by the nurse is best?
- A. Come to the clinic immediately for evaluation.
- B. Monitor the bleeding and call back if it worsens.
- C. Take an over-the-counter stool softener.
- D. Avoid strenuous activity for a week.
Correct Answer: B
Rationale: A small amount of bright red blood on the toilet paper after a colonoscopy with biopsy is not uncommon due to minor irritation or trauma from the procedure. The nurse should advise the client to monitor the bleeding and call back if it worsens, as this could indicate a more serious issue. Immediate clinic evaluation is not necessary for a small spot of blood. Stool softeners or activity restrictions are not directly relevant unless specified by the provider.
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A nurse is examining a client reporting right upper quadrant (RUQ) abdominal pain. What technique should the nurse use to assess this clients abdomen?
- A. Auscultate after palpating.
- B. Avoid any palpation.
- C. Palpate the RUQ last.
Correct Answer: C
Rationale: If pain is present in a certain area of the abdomen, that area should be palpated last to keep the client from tensing up, which could affect the rest of the examination. Auscultation of the abdomen occurs prior to palpation to avoid altering bowel sounds.
A client scheduled for a percutaneous transhepatic cholangiography (PTC) denies allergies to medication. What action by the nurse is best?
- A. Ask the client about difficult allergies.
- B. Document this information on the chart.
- C. Insureat that the client has a ride home.
- D. Insureat that the client has a ride home.
Correct Answer: A
Rationale: PTC uses iodinated dye, so the client should be asked about seafood allergies, specifically to shellfish, as these may indicate a risk for iodine allergy. Documentation should occur, but this is not the priority. The client will need a ride home afterward if the procedure is done as an outpatient, but this is not the priority action.
The options for colon cancer screening for people over the age of 50 include which of the following? (Select all that apply.)
- A. Colonoscopy every 10 years
- B. CT colonography
- C. Double-contrast barium enema
- D. Flexible sigmoidoscopy every 5 years
- E. Fecal occult blood test annually
Correct Answer: A,C,D
Rationale: Colonoscopy every 10 years, CT colonography, double-contrast barium enema, and flexible sigmoidoscopy every 5 years are standard options for colon cancer screening in people over 50. Fecal occult blood test annually is also a screening option, but it was not listed in the original document and is included here for completeness.
A client presents to the family practice clinic reporting a week of watery, somewhat bloody diarrhea. The nurse assists the client to obtain a stool sample. What action by the nurse is most important?
- A. Ask the client about recent exposure to illness.
- B. Collect the stool sample for the client.
- C. Include the date and time on the specimen container.
- D. Don gloves prior to collecting the sample.
Correct Answer: D
Rationale: To avoid possible exposure to infectious agents, the nurse dons gloves prior to handling any bodily secretions. Recent exposure to illness is not related to collecting a stool sample. The nurse can visually inspect the stool for food particles, but it still needs analysis in the laboratory. The container should be dated and timed, but safety for the staff and other clients comes first.
The nurse working with older clients understands age-related changes in the gastrointestinal system. Which changes does this include? (Select all that apply.)
- A. Decreased hydrochloric acid production
- B. Diminished nerve function in the large intestine
- C. Decreased fat digestion
- D. Decreased peristalsis in the large intestine
- E. Increased peristalsis in the large intestine
Correct Answer: A,B,C,D
Rationale: Several age-related changes occur in the gastrointestinal system. These include decreased hydrochloric acid production, diminished nerve function that leads to decreased sensation of the need to pass stool, decreased fat digestion, decreased peristalsis in the large intestine, and calcification of pancreatic vessels. Increased peristalsis is not an age-related change.