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A client with ulcerative colitis expresses serious concerns about her career as an attorney because of the effects of stress on ulcerative colitis. Which of the following stress interventions will be most helpful to the client?
- A. Review her current coping mechanisms and develop alternatives, if needed.
- B. Suggest a less stressful career in which she would still use her education and experience.
- C. Suggest that she ask her colleagues to help decrease her stress by giving her the easier cases.
- D. Prepare family members for the fact that she will have to work part-time.
Correct Answer: A
Rationale: Reviewing and developing coping mechanisms helps the client manage stress nbr without assuming drastic changes like altering her career or relying on others to adjust her workload. Preparing family for part-time work is premature and not directly stress-focused. CN: Psychosocial adaptation; CL: Synthesize
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A client with cirrhosis is receiving Lactulose (Cephulac). During the assessment the nurse notes increased confusion and asterixis. The nurse should:
- A. Assess for GI bleeding.
- B. Hold the Lactulose (Cephulac).
- C. Increase protein in the diet.
- D. Monitor serum bilirubin levels.
Correct Answer: A
Rationale: Confusion and asterixis indicate hepatic encephalopathy, often precipitated by GI bleeding (A), which increases ammonia levels. Holding lactulose (B) is incorrect as it reduces ammonia. Increasing protein (C) worsens encephalopathy. Bilirubin (D) is unrelated to acute symptoms.
A client with cancer has diarrhea and a nursing diagnosis of Impaired skin integrity related to the frequent diarrhea. Which of the following nursing interventions is appropriate for this diagnosis?
- A. Discourage sitz baths because they promote bacterial growth.
- B. Apply zinc oxide ointment to the rectal area after each bowel movement to protect the skin.
- C. Apply a skin-barrier dressing daily to the rectal area to form a protective barrier.
- D. Clean the rectal area with unscented soap and water after each bowel movement, rinse well, and pat dry.
Correct Answer: D
Rationale: Cleaning with unscented soap and water, rinsing, and patting dry after each bowel movement prevents skin breakdown and maintains integrity in clients with diarrhea.
A client has an ileal conduit. Which of the following solutions will be useful to help control odor in the urine collecting bag after it has been cleaned?
- A. Salt water.
- B. Vinegar.
- C. Ammonia.
- D. Bleach.
Correct Answer: B
Rationale: Vinegar neutralizes odors in the urine collecting bag, is safe for use, and helps maintain appliance integrity.
What is the nurse's best action for a client with a migraine headache?
- A. Administer oxygen.
- B. Provide a quiet, dark environment.
- C. Encourage fluid restriction.
- D. Apply a warm compress.
Correct Answer: B
Rationale: A quiet, dark environment reduces stimuli that exacerbate migraine symptoms.
A client has mitral stenosis and is a prospective valve recipient. The nurse is instructing the client about health maintenance prior to surgery. Inability to follow which of the following regimens would pose the greatest health hazard to this client at this time?
- A. Medication therapy.
- B. Diet modification.
- C. Activity restrictions.
- D. Dental care.
Correct Answer: A
Rationale: Medication therapy (e.g., anticoagulants, diuretics) is critical to manage symptoms and prevent complications like thromboembolism in mitral stenosis.