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A nurse cares for a client who has a family history of colon cancer. The client states, 'My father and my brother had colon cancer. What is the chance that I will get cancer?' How should the nurse respond?
- A. If you eat a low-fat and low-fiber diet, your chances decrease significantly.
- B. There's no way to predict your individual risk with certainty.
- C. Preemptive surgery and chemotherapy will remove cancer cells and prevent cancer.
- D. You should have a colonoscopy more frequently to identify abnormal polyps early.
Correct Answer: D
Rationale: A family history of colon cancer increases risk, so frequent colonoscopies are recommended to detect abnormal polyps early, improving outcomes through early intervention.
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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.
After teaching a client who has a femoral hernia, the nurse assesses the client's understanding. Which statement indicates the client needs additional teaching related to the proper use of a truss?
- A. I will put on the truss before I go to bed each night.
- B. I will place some padding under the truss to avoid skin irritation.
- C. The truss will help my hernia because I can't have surgery.
- D. If I have abdominal pain, I'll let my health care provider know right away.
Correct Answer: A
Rationale: The client should be instructed to apply the truss before arising, not before going to bed at night. The other statements show an accurate understanding of using a truss.
A nurse cares for a middle-aged male client who has irritable bowel syndrome (IBS). The client states, 'I have changed my diet and take bulk-forming laxatives, but my symptoms have not gotten better. I heard about a drug called Amitiza. Do you think it might help?' How should the nurse respond?
- A. This drug is still in the research phase and is not available for public use yet.
- B. Unfortunately, lubiprostone is approved only for use in women.
- C. Lubiprostone works well. I will recommend this prescription to your provider.
- D. This drug should not be used with bulk-forming laxatives.
Correct Answer: B
Rationale: Lubiprostone (Amitiza) is approved only for women with IBS with constipation. Trials with male participants are needed for FDA approval in men.
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.
A nurse assesses a client who is recovering from a hemorrhoidectomy that was done the day before. The nurse notes that the client has lower abdominal distention accompanied by dullness to percussion over the distended area. Which action should the nurse take?
- A. Assess the client's heart rate and blood pressure.
- B. Determine when the client last voided.
- C. Ask if the client is experiencing nausea.
- D. Auscultate all quadrants of the client's abdomen.
Correct Answer: B
Rationale: Assessment findings indicate that the client may have an over-full bladder. In the immediate postoperative period, the client may experience urinary retention. Determining when the client last voided helps confirm this.