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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.
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A nurse assesses a client who is prescribed 5-fluorouracil (5-FU) chemotherapy intravenously for the treatment of colon cancer. Which assessment finding should alert the nurse to contact the health care provider?
- A. White blood cell (WBC) count of 1500/mm3
- B. Fatigue
- C. Nausea and diarrhea
- D. Mucositis and oral ulcers
Correct Answer: A
Rationale: A WBC count of 1500/mm3 is significantly below the normal range (5000-10,000/mm3), indicating a high risk for infection. The provider should be notified immediately, as chemotherapy may need to be delayed.
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.
A nurse cares for a client who states, 'My husband is repulsed by my colostomy and refuses to be intimate with me.' How should the nurse respond?
- A. Let's discuss ways to help you and your husband address these concerns together.
- B. You could try to wear longer lingerie that will better hide the ostomy appliance.
- C. You should empty the pouch first so it will be less noticeable for your husband.
- D. If you are not careful, you can hurt the ostomy if you engage in sexual activity.
Correct Answer: A
Rationale: The nurse should collaborate with the client and her husband, possibly involving an ostomy nurse, to address intimacy concerns. The other options either minimize the issue or provide inaccurate information.
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.
A nurse teaches a client who is recovering from a colon resection. Which statement should the nurse include in this client's plan of care?
- A. Avoid heavy lifting for at least 6 weeks.
- B. Monitor your incision site for signs of infection.
- C. Resume a normal diet as tolerated.
- D. All of the above.
Correct Answer: D
Rationale: All of these statements are appropriate postoperative instructions for a colon resection. The client should avoid heavy lifting, monitor for infection, and resume a normal diet as tolerated.