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A nurse cares for a client with ulcerative colitis. The client states, 'I feel like I am tied to the toilet. This disease is controlling my life.' How should the nurse respond?
- A. Let's identify stress factors that worsen your symptoms to help you gain more control.
- B. If you take the prescribed medications, you will no longer have diarrhea.
- C. To decrease distress, do not eat anything before you go out.
- D. You must take control of your life. I will consult a therapist to help.
Correct Answer: A
Rationale: Identifying stress factors that exacerbate ulcerative colitis symptoms empowers the client to manage their condition. Medications reduce but do not eliminate diarrhea, fasting is not practical, and suggesting a therapist without discussion dismisses the client's concerns.
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A nurse cares for a client with a new ileostomy. The client states, 'I don't think my friends will accept me with this ostomy.' How should the nurse respond?
- A. Your friends will be happy you are alive.
- B. Tell me more about your concerns.
- C. A therapist can help you resolve your concerns.
- D. With time you will accept your new body.
Correct Answer: B
Rationale: Encouraging the client to express concerns addresses social anxiety and apprehension common with a new ostomy. Minimizing concerns, suggesting a therapist without discussion, or assuming acceptance over time are not therapeutic responses.
A nurse cares for a client who is prescribed 5 mg/kg of infliximab (Remicade) intravenously. The client weighs 110 lbs and the pharmacy supplies infliximab 100 mg/10 mL solution. How many milliliters should the nurse administer to this client? (Record your answer using a whole number)
- A. 20 mL
- B. 25 mL
- C. 30 mL
- D. 35 mL
Correct Answer: B
Rationale: The client weighs 110 lbs (50 kg). The dose is 5 mg/kg, so 5 mg/kg ? 50 kg = 250 mg. The pharmacy supplies 100 mg/10 mL, so 250 mg ÷ 100 mg/10 mL = 25 mL.
A nurse cares for an older adult client who has Salmonella food poisoning. The clients vital signs are heart rate: 102 beats/min, blood pressure: 98/56 mm Hg. Which statement by the client indicates a need for additional teaching?
- A. I should not prepare food for others while I am sick.
- B. I will take the ciprofloxacin until the diarrhea has resolved.
- C. I should wash my hands with antibacterial soap before each meal.
- D. I must place my dishes into the dishwasher after each meal.
Correct Answer: B
Rationale: Ciprofloxacin should be taken for 10 to 14 days to treat Salmonella infection and should not be stopped once diarrhea resolves. Clients must complete the full course of antibiotics to prevent recurrence and resistance. Not preparing food for others, washing hands with antibacterial soap, and cleaning dishes thoroughly are correct practices to prevent the spread of infection.
A nurse plans care for a client with Crohn's disease who has a heavily draining fistula. Which intervention should the nurse indicate as the priority action in this client's plan of care?
- A. Low-fiber diet
- B. Skin protection
- C. Antibiotic administration
- D. Blood glucose monitoring
Correct Answer: B
Rationale: A heavily draining fistula releases caustic intestinal fluids that can cause skin breakdown or infections. Skin protection is the priority to prevent complications. Nutrition, antibiotics, and glucose monitoring are important but secondary.
After teaching a client who is prescribed adalimumab (Humira) for severe ulcerative colitis, the nurse assesses the client's understanding. Which statement by the client indicates a need for additional teaching?
- A. I will avoid large crowds and people who are sick.
- B. I will take this medication with my breakfast each morning.
- C. Nausea and vomiting are common side effects of this drug.
- D. I must wash my hands after I play with my dog.
Correct Answer: B
Rationale: Adalimumab (Humira) is administered via subcutaneous injection, not orally with meals. Avoiding crowds and sick individuals, recognizing nausea and vomiting as side effects, and practicing good hand hygiene are correct actions, as adalimumab causes immune suppression.