Nokea
A nurse at an outpatient surgery center is caring for a patient who had a hemorrhoidectomy. What discharge education topics should the nurse address with this patient?
- A. The appropriate use of antibiotics to prevent postoperative infection
- B. The correct procedure for taking a sitz bath
- C. The need to eat a low-residue, low-fat diet for the next 2 weeks
- D. The correct technique for keeping the perianal region clean without the use of water
Correct Answer: B
Rationale: Sitz baths are usually indicated after perianal surgery. A low-residue, low-fat diet is not necessary and water is used to keep the region clean. Postoperative antibiotics are not normally prescribed.
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A patient with a diagnosis of colon cancer is 2 days postoperative following bowel resection and anastomosis. The nurse has planned the patients care in the knowledge of potential complications. What assessment should the nurse prioritize?
- A. Close monitoring of temperature
- B. Frequent abdominal auscultation
- C. Assessment of hemoglobin, hematocrit, and red blood cell levels
- D. Palpation of peripheral pulses and leg girth
Correct Answer: B
Rationale: After bowel surgery, it is important to frequently assess the abdomen, including bowel sounds and abdominal girth, to detect bowel obstruction. The resumption of bowel motility is a priority over each of the other listed assessments, even though each should be performed by the nurse.
A nurse is presenting an educational event to a local community group. When speaking about colorectal cancer, what risk factor should the nurse cite?
- A. High levels of alcohol consumption
- B. History of bowel obstruction
- C. History of diverticulitis
- D. Longstanding psychosocial stress
Correct Answer: A
Rationale: Risk factors include high alcohol intake; cigarette smoking; and high-fat, high-protein, low-fiber diet. Diverticulitis, obstruction, and stress are not noted as risk factors for colorectal cancer.
A patient has been experiencing occasional episodes of constipation and has been unable to achieve consistent relief by increasing physical activity and improving his diet. What pharmacologic intervention should the nurse recommend to the patient for ongoing use?
- A. Mineral oil enemas
- B. Bisacodyl (Dulcolax)
- C. Senna (Senokot)
- D. Psyllium hydrophilic mucilloid (Metamucil)
Correct Answer: D
Rationale: Psyllium hydrophilic mucilloid (Metamucil) is a bulk-forming laxative that is safe for ongoing use. None of the other listed laxatives should be used on an ongoing basis because of the risk of dependence.
A patient admitted with inflammatory bowel disease asks the nurse for help with menu selections. What menu selection is most likely the best choice for this patient?
- A. Spinach
- B. Tofu
- C. Multigrain bagel
- D. Blueberries
Correct Answer: B
Rationale: Nutritional management of inflammatory bowel disease requires ingestion of a diet that is bland, low-residue, high-protein, and high-vitamin. Tofu meets each of these criteria. Spinach, multigrain bagels, and blueberries are not low-residue.
A nurse is caring for an older adult who has been experiencing severe Clostridium difficile-related diarrhea. When reviewing the patients most recent laboratory tests, the nurse should prioritize which of the following?
- A. White blood cell level
- B. Creatinine level
- C. Hemoglobin level
- D. Potassium level
Correct Answer: D
Rationale: In elderly patients, it is important to monitor the patients serum electrolyte levels closely. Diarrhea is less likely to cause an alteration in white blood cell, creatinine, and hemoglobin levels.