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A nurse is caring for a 57 year old client and is teaching them about screening for colorectal cancer. Which of the following information should the nurse include?
- A. It is recommended that colon cancer screening with a colonoscopy should begin at age 45.
- B. It is recommended that colon cancer screening with a colonoscopy should begin at age 70.
- C. It is recommended that colon cancer screening with a colonoscopy should begin at age 40.
- D. It is recommended that colon cancer screening with a colonoscopy should begin at age 65.
Correct Answer: A
Rationale: Current guidelines recommend colonoscopy screening for colorectal cancer starting at age 45 (A) for average-risk individuals.
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The following scenario applies to the next 1 items.
The nurse is caring for a 44-year-old male with abdominal pain and persistent nausea/vomiting.
Item 1 of 1
History of Present Illness
Abdominal pain that started one day ago following heavy alcohol use. The pain is localized to the epigastric region. Persistent nausea and vomiting were reported. Physical exam showed ecchymosis around the umbilicus and tenderness upon palpation.
Vital Signs
• Oral temperature 99.0° F (37° C)
• Pulse 119
• Respirations 22
• BP 90/58
• Pulse oximetry 95% on room air
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, two priority actions the nurse should take to address that condition, and two priority parameters the nurse should monitor to assess the client's progress.
- A. Obtain a prescription of 0.9% saline bolus, Inquire about the clients alcohol drinking habits, Obtain a prescription for regular insulin, Establish peripheral intravenous (IV) access, Transport the client for an abdominal computed tomography (CT) scan.
- B. Acute Pancreatitis, Peptic Ulcer Disease, Diverticulitis, Peritonitis, Gastroenteritis.
- C. Level of Consciousness (LOC), Bowel Sounds, Vital Signs, Serum Glucose Level, Daily Weights.
Correct Answer: B: Acute Pancreatitis; A: Obtain a prescription of 0.9% saline bolus, Establish peripheral IV access; C: Vital Signs, Level of Consciousness
Rationale: Epigastric pain, nausea/vomiting, and periumbilical ecchymosis suggest acute pancreatitis (B). Saline bolus and IV access (A) address hypovolemia. Monitoring vital signs and LOC (C) tracks hemodynamic stability and complications.
The nurse is caring for a 26-year-old patient who cannot meet their nutritional needs by mouth. The interdisciplinary team decided inserting an NG tube for enteral feedings would be best. After inserting the tube, the nurse knows which of the following is the most accurate way to verify the placement of the tube?
- A. Aspiration of stomach contents
- B. pH verification of the aspirate
- C. Injecting air into the tube and then auscultating the left upper quadrant (LUQ)
- D. Visualization on an X-ray
Correct Answer: D
Rationale: X-ray visualization (D) is the most accurate method to confirm NG tube placement, ensuring it is in the stomach and not the lungs.
The nurse is caring for a client who is newly prescribed cimetidine. The nurse understands that this medication is prescribed to treat which condition?
- A. Cystic fibrosis
- B. Clostridium difficile
- C. H. pylori infection
- D. Crohn’s disease
Correct Answer: C
Rationale: Cimetidine, an H2 receptor blocker, is used in H. pylori infection to reduce gastric acid, aiding in ulcer healing alongside antibiotics. It is not indicated for cystic fibrosis, C. difficile, or Crohn’s disease.
The following scenario applies to the next 1 items
The emergency department (ED) nurse is caring for a client with liver cirrhosis
Item 1 of 1
Nurses' Note
57-year-old male reporting increasing dyspnea and abdominal pressure after missing his previously scheduled paracentesis. The client reports he feels 'uncomfortable.' He is alert and oriented x 4; sclera is yellow along with jaundice skin appearance. Respirations were labored, tachypnea, and clear breath sounds. Abdominal distention noted, hypoactive bowel sounds in all four quadrants. Ascites and dependent edema were noted. Peripheral pulses were intact.
Vital Signs
• Oral Temperature 101 o F (38.3o C)
• Heart rate 94/minute
• Respirations 24/minute
• Blood pressure 104/68 mm Hg
• Oxygen saturation 95% on room air
Medical History
• Hepatitis C
• Liver cirrhosis
• Substance use disorder
• Hyperlipidemia
Which assessment findings require follow-up? Select all that apply.
- A. Jaundice
- B. Labored breathing
- C. Hypoactive bowel sounds
- D. Respiratory rate
- E. Oral temperature
- F. Yellow sclera
Correct Answer: B,D,E
Rationale: Labored breathing (B), elevated respiratory rate (D), and fever (E) indicate potential complications like infection or respiratory compromise in liver cirrhosis, requiring urgent follow-up. Jaundice and yellow sclera (A, F) are expected, and hypoactive bowel sounds (C) are less urgent.
The nurse assesses a client receiving total parenteral nutrition (TPN) and fat emulsions. The nurse observes that the fat emulsion infusion is one hour behind schedule. The nurse should take which action?
- A. Adjust the infusion rate to make up the difference over the next hour, then revert the infusion rate back to the prescribed rate.
- B. Increase the infusion rate to ensure that the infusion finishes at the correct time.
- C. Ensure the fat emulsion infusion rate is infusing at the prescribed rate and maintain the rate at the prescribed rate.
- D. Stop the infusion and inform the primary health care provider (PHCP).
Correct Answer: C
Rationale: Fat emulsions must be infused at a steady, prescribed rate to prevent complications like fat overload syndrome. Adjusting or increasing the rate can be dangerous, and stopping the infusion is unnecessary unless there’s a specific issue.