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A nurse assesses a client who is prescribed alosetron (Lotronex). Which assessment question should the nurse ask this client?
- A. Have you been experiencing any constipation?
- B. Are you eating a diet high in fiber and fluids?
- C. Do you have a history of high blood pressure?
- D. Have you noticed any changes in your vision?
Correct Answer: A
Rationale: Constipation is a life-threatening complication of alosetron. The nurse should assess the client for constipation. The other questions do not identify complications related to alosetron.
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A nurse cares for a client with colon cancer who has a new colostomy. The client states, 'I think it would be helpful to talk with someone who has had a similar experience.' How should the nurse respond?
- A. I have a good friend with a colostomy who would be willing to talk with you.
- B. I will make a referral to the United Ostomy Associations of America.
- C. I will arrange for a visit from an enterostomal therapist.
- D. I can talk with people who have colostomies, but many don't want to share their experiences.
Correct Answer: B
Rationale: The nurse should refer the client to a community-based resource like the United Ostomy Associations of America, where they can connect with others who have similar experiences.
A nurse assesses clients for the risk of colorectal cancer. Which client has the highest risk for colorectal cancer?
- A. A 37-year-old who drinks eight cups of coffee daily
- B. A 60-year-old lawyer who works long hours
- C. A 45-year-old with irritable bowel syndrome
- D. A 70-year-old who eats a high-fat diet
Correct Answer: D
Rationale: Colorectal cancer is rare before the age of 40, but its incidence increases rapidly with advancing age. A high-fat diet also increases the risk for colorectal cancer. Coffee intake, IBS, and a heavy workload do not increase the risk.
A nurse prepares a client for a colonoscopy scheduled for tomorrow. The client states, 'My doctor told me that the fecal occult blood test was negative for colon cancer. I don't think I need the colonoscopy and would like to cancel it.' How should the nurse respond?
- A. Your doctor should not have given you that information prior to the colonoscopy.
- B. The colonoscopy is required due to the high percentage of false negatives with the blood test.
- C. A negative fecal occult blood test does not rule out the possibility of colon cancer.
- D. I will contact your doctor so that you can discuss your concerns about the procedure.
Correct Answer: C
Rationale: A negative result from a fecal occult blood test does not completely rule out the possibility of colon cancer. A colonoscopy is necessary to visualize the entire colon and take a tissue sample for biopsy.
A nurse assesses a client with irritable bowel syndrome (IBS). Which questions should the nurse include in this client's assessment? (Select all that apply.)
- A. Which food types cause an exacerbation of symptoms?
- B. Which food types cause an amelioration of symptoms?
- C. Have you lost a significant amount of weight lately?
- D. Are your stools soft, watery, and black in color?
- E. Do you experience nausea associated with defecation?
Correct Answer: A,B,E
Rationale: The nurse should assess factors that exacerbate or ameliorate IBS symptoms, such as food, stress, and nausea related to defecation. Weight loss and black stools are not typical of IBS.
A nurse assessing a client with colorectal cancer auscultates high-pitched bowel sounds and notes visible peristaltic waves. Which action should the nurse take next?
- A. Ask if the client is experiencing pain in the right shoulder.
- B. Perform a rectal examination and assess for polyps.
- C. Contact the provider and recommend computed tomography.
- D. Administer a laxative to increase bowel movement activity.
Correct Answer: C
Rationale: The presence of visible peristaltic waves, accompanied by high-pitched or tingling bowel sounds, is indicative of a partial obstruction caused by the tumor. The nurse should contact the provider and recommend a computed tomography scan for further diagnostic testing.