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A client is admitted with a diagnosis of ulcerative colitis. Which of the following symptoms should the nurse expect the client to report when responding to questions about his bowel elimination pattern?
- A. Constipation.
- B. Bloody, diarrheal stools.
- C. Steatorrhea.
- D. Alternating periods of constipation and diarrhea.
Correct Answer: B
Rationale: The correct answer is B: Bloody, diarrheal stools. In ulcerative colitis, inflammation of the colon leads to symptoms such as bloody diarrhea. This occurs due to ulceration and inflammation of the colon lining. The presence of blood in the stool is a hallmark symptom of ulcerative colitis. The other choices are incorrect because:
A: Constipation is not typically associated with ulcerative colitis. It is more common in conditions like irritable bowel syndrome.
C: Steatorrhea, which is fatty, greasy stools, is not a common symptom of ulcerative colitis.
D: Alternating periods of constipation and diarrhea are more indicative of conditions like irritable bowel syndrome or functional gastrointestinal disorders, not specifically ulcerative colitis.
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A nurse is giving dietary instructions to a client who has a new colostomy. The nurse encourages the client to eat foods representing which of the following diets for the first 4 to 6 weeks postoperatively?
- A. High-protein
- B. High-carbohydrate
- C. Low-calorie
- D. Low-residue
Correct Answer: D
Rationale: The correct answer is D: Low-residue. After colostomy surgery, the bowel needs time to heal. A low-residue diet helps reduce the amount of undigested food passing through the colon, easing digestion and minimizing strain on the stoma. This diet typically includes easily digestible foods like white bread, rice, pasta, and well-cooked vegetables. High-protein (choice A) and high-carbohydrate (choice B) diets can be harder to digest and may cause discomfort. A low-calorie diet (choice C) is not necessary during the initial postoperative period when the focus should be on promoting healing and comfort.
The nurse assesses the client's understanding of the relationship between body position and gastroesophageal reflux. Which response would indicate that the client understands measures to avoid problems with reflux while sleeping?
- A. I can elevate the foot of the bed 4 to 6 inches.
- B. I can sleep on my stomach with my head turned to the left.
- C. I can sleep on my back without a pillow under my head.
- D. I can elevate the head of the bed 4 to 6 inches.
Correct Answer: D
Rationale: The correct answer is D: "I can elevate the head of the bed 4 to 6 inches." Elevating the head of the bed helps to prevent gastroesophageal reflux by promoting gravity to keep stomach acid from moving back into the esophagus. This position helps to keep the stomach contents in place and reduces the likelihood of reflux during sleep.
Choice A is incorrect because elevating the foot of the bed would not be effective in preventing reflux; it may even exacerbate the issue. Choice B is incorrect as sleeping on the stomach can increase pressure on the stomach and worsen reflux. Choice C is also incorrect as sleeping on the back without a pillow under the head may not provide the necessary elevation to prevent reflux effectively.
Lactulose (Chronulac) is prescribed for a client with a diagnosis of hepatic encephalopathy. The nurse would determine that this medication has had a therapeutic effect if which of the following is noted?
- A. Increased red blood cell count
- B. Decreased serum ammonia level
- C. Increased protein level
- D. Decreased white blood cell level
Correct Answer: B
Rationale: The correct answer is B: Decreased serum ammonia level. Lactulose is used to treat hepatic encephalopathy by reducing serum ammonia levels through its laxative effect, promoting the excretion of ammonia in the feces. Decreased ammonia levels indicate that the medication is effectively managing the condition. Increased red blood cell count (A), increased protein level (C), and decreased white blood cell level (D) are not directly related to the therapeutic effect of lactulose in hepatic encephalopathy.
A client with viral hepatitis is discussing with the nurse the need to avoid alcohol and states, 'I'm not sure I can avoid alcohol.' The most appropriate response is
- A. Everything will be alright.
- B. I think you should talk more with the doctor about this.
- C. I don't believe that.
- D. I'm not sure that I don't understand. Would you please explain?
Correct Answer: D
Rationale: The correct answer is D because it shows active listening and empathy towards the client's concerns. By asking the client to explain, the nurse can gain a better understanding of the client's perspective and provide tailored support and information. Choice A is incorrect as it dismisses the client's concerns. Choice B is incorrect as it deflects responsibility from the nurse. Choice C is incorrect as it shows disbelief and lacks empathy.
A nurse is performing an assessment on a client with a suspected diagnosis of acute pancreatitis. The nurse assesses the client, knowing that which of the following is a hallmark sign of this disorder?
- A. Severe abdominal pain relieved by vomiting
- B. Severe abdominal pain that is unrelieved by vomiting
- C. Hypothermia
- D. Epigastric pain radiating to the neck area
Correct Answer: B
Rationale: The correct answer is B: Severe abdominal pain that is unrelieved by vomiting. In acute pancreatitis, the pancreatic enzymes cause inflammation and damage to the pancreas, leading to severe abdominal pain that is typically constant and not relieved by vomiting. Vomiting may even worsen the pain. Other choices are incorrect because severe abdominal pain in acute pancreatitis is not relieved by vomiting (A), hypothermia is not a hallmark sign of acute pancreatitis (C), and epigastric pain radiating to the neck area is not a specific hallmark sign (D).