Nokea
A clinic patient has described recent dark-colored stools; the nurse recognizes the need for fecal occult blood testing (FOBT). What aspect of the patient's current health status would contraindicate FOBT?
- A. Gastroesophageal reflux disease (GERD)
- B. Peptic ulcers
- C. Hemorrhoids
- D. Recurrent nausea and vomiting
Correct Answer: C
Rationale: FOBT should not be performed when there is hemorrhoidal bleeding. GERD, peptic ulcers and nausea and vomiting do not contraindicate the use of FOBT as a diagnostic tool.
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A patient has been scheduled for a urea breath test in one month's time. What nursing diagnosis most likely prompted this diagnostic test?
- A. Impaired Dentition Related to Gingivitis
- B. Risk For Impaired Skin Integrity Related to Peptic Ulcers
- C. Imbalanced Nutrition: Less Than Body Requirements Related to Enzyme Deficiency
- D. Diarrhea Related to Clostridium Difficile Infection
Correct Answer: B
Rationale: Urea breath tests detect the presence of Helicobacter pylori, the bacteria that can live in the mucosal lining of the stomach and cause peptic ulcer disease. This test does not address fluid volume, nutritional status, or dentition.
A patient will be undergoing abdominal computed tomography (CT) with contrast. The nurse has administered IV sodium bicarbonate and oral acetylcysteine (Mucomyst) before the study as ordered. What would indicate that these medications have had the desired therapeutic effect?
- A. The patient's BUN and creatinine levels are within reference range following the CT.
- B. The CT yields high-quality images.
- C. The patient's electrolytes are stable in the 48 hours following the CT.
- D. The patient's intake and output are in balance on the day after the CT.
Correct Answer: A
Rationale: Both sodium bicarbonate and Mucomyst are free radical scavengers that sequester the contrast byproducts that are destructive to renal cells. Kidney damage would be evident by increased BUN and creatinine levels. These medications are unrelated to electrolyte or fluid balance and they play no role in the results of the CT.
A nurse is assessing the abdomen of a patient just admitted to the unit with a suspected GI disease. Inspection reveals several diverse lesions on the patient's abdomen. How should the nurse best interpret this assessment finding?
- A. Abdominal lesions are usually due to age-related skin changes.
- B. Integumentary diseases often cause GI disorders.
- C. GI diseases often produce skin changes.
- D. The patient needs to be assessed for self-harm.
Correct Answer: C
Rationale: Abdominal lesions are of particular importance, because GI diseases often produce skin changes. Skin problems do not normally cause GI disorders. Age-related skin changes do not have a pronounced effect on the skin of the abdomen when compared to other skin surfaces. Self-harm is a less likely explanation for skin lesions on the abdomen.
A nurse in a stroke rehabilitation facility recognizes that the brain regulates swallowing. Damage to what area of the brain will most affect the patient's ability to swallow?
- A. Temporal lobe
- B. Medulla oblongata
- C. Cerebellum
- D. Pons
Correct Answer: B
Rationale: Swallowing is a voluntary act that is regulated by a swallowing center in the medulla oblongata of the central nervous system. Swallowing is not regulated by the temporal lobe, cerebellum, or pons.
An inpatient has returned to the medical unit after a barium enema. When assessing the patient's subsequent bowel patterns and stools, what finding should the nurse report to the physician?
- A. Large, wide stools
- B. Milky white stools
- C. Three stools during an 8-hour period of time
- D. Streaks of blood present in the stool
Correct Answer: D
Rationale: Barium has a high osmolarity and may draw fluid into the bowel, thus increasing the intraluminal contents and resulting in greater output (large stools). The barium will give the stools a milky white appearance, and it is not uncommon for the patient to experience an increase in the number of bowel movements. Blood in fecal matter is not an expected finding and the nurse should notify the physician.