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A nurse is preparing a hospitalized patient for a colonoscopy. Which nursing action is the recommended preparation for this test?
- A. Having the patient consume a low-fiber diet several days before the test
- B. Having the patient take bisacodyl and ingest a gallon oral polyethylene glycol solution (PEG)
- C. Preparing the patient for the use of general anesthesia during the test
- D. Explaining that barium contrast mixture will be given to drink before the test
Correct Answer: A
Rationale: A low-fiber diet several days before a colonoscopy (A) reduces residue in the colon. PEG is used, but bisacodyl (B) isn't standard for all preps. Conscious sedation, not general anesthesia (C), is typical, and barium (D) is for other GI tests.
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A nurse is performing digital removal of stool on a patient with a fecal impaction. During the procedure, the patient tells the nurse they are feeling dizzy and nauseated and then vomits. What should be the nurse's next action?
- A. Reassuring the patient that this is a normal reaction to the procedure
- B. Stopping the procedure, preparing to administer CPR, and notifying the primary care provider
- C. Stopping the procedure, assessing vital signs, and notifying the health care provider
- D. Pausing the procedure, waiting 5 minutes, and then resuming the procedure
Correct Answer: C
Rationale: Dizziness, nausea, and vomiting suggest vagal stimulation. Stopping the procedure, assessing vital signs, and notifying the provider (C) is appropriate. Reassuring (A) ignores the risk, CPR (B) is premature, and resuming after 5 minutes (D) is unsafe without assessment.
A nurse is caring for an older adult who reports persistent constipation and has a number of laxative prescriptions on the MAR. Which medication would the nurse avoid for this patient?
- A. Saline osmotic laxative
- B. Bulk-forming laxative
- C. Methylcellulose
- D. Stool softener
Correct Answer: A
Rationale: Saline osmotic laxatives (A) can cause fluid/electrolyte imbalances in older adults, especially with kidney or cardiac issues, and should be avoided. Bulk-forming (B, C) and stool softeners (D) are safer options.
A community health nurse is providing an adult education session about colon cancer. Which signs and symptoms of this cancer will the nurse include? Select all that apply.
- A. Blood in the stool
- B. Previous colonoscopy
- C. Passing two large bowel movements daily
- D. Unintentional weight loss
- E. Upper abdominal cramping
- F. Previous opioid use
Correct Answer: A,D
Rationale: Colon cancer symptoms include blood in the stool (A) and unintentional weight loss (D). Previous colonoscopy (B) and opioid use (F) are not symptoms, two large bowel movements (C) are normal, and upper abdominal cramping (E) is less specific.
A nurse caring for a patient who reports frequent constipation learns the patient uses phosphate and sodium citrate enemas several times weekly. What education would the nurse provide?
- A. Avoid consuming fiber or roughage in the diet.
- B. Sedentary activities will be helpful.
- C. These enemas should be avoided with kidney failure.
- D. Restrict your fluids to 1,000 mL daily.
Correct Answer: C
Rationale: Phosphate and sodium citrate enemas (C) are contraindicated in kidney failure due to risk of hyperphosphatemia. Fiber (A) promotes regularity, activity (B) aids peristalsis, and fluid restriction (D) worsens constipation.
For a patient with which health problem or issue would a nurse expect the health care provider to order colostomy irrigation?
- A. IBS
- B. Left-sided end colostomy in the sigmoid colon
- C. Postradiation damage to the bowel
- D. Crohn disease
Correct Answer: B
Rationale: Colostomy irrigation is indicated for left-sided end colostomies in the sigmoid colon (B) to promote regular evacuation. IBS (A), postradiation damage (C), and Crohn disease (D) are contraindications due to bowel instability.