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A nurse prepares a client for a colonoscopy scheduled for tomorrow. The client states, 'My doctor told me that the fecal occult blood test was negative for colon cancer. I don't think I need the colonoscopy and would like to cancel it.' How should the nurse respond?
- A. Your doctor should not have given you that information prior to the colonoscopy.
- B. The colonoscopy is required due to the high percentage of false negatives with the blood test.
- C. A negative fecal occult blood test does not rule out the possibility of colon cancer.
- D. I will contact your doctor so that you can discuss your concerns about the procedure.
Correct Answer: C
Rationale: A negative result from a fecal occult blood test does not completely rule out the possibility of colon cancer. A colonoscopy is necessary to visualize the entire colon and take a tissue sample for biopsy.
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After teaching a client with irritable bowel syndrome (IBS), a nurse assesses the client's understanding. Which meal indicates the client correctly understands the dietary teaching?
- A. Ham sandwich on white bread, cup of applesauce, glass of diet cola
- B. Baked chicken with brown rice, steamed broccoli, glass of apple juice
- C. Grilled cheese sandwich, small banana, cup of tea with lemon
- D. Baked tilapia, fresh green beans, cup of coffee with low-fat milk
Correct Answer: B
Rationale: Clients with IBS are advised to eat a high-fiber diet (30 to 40 g/day), with 8 to 10 cups of liquid daily. Baked chicken with brown rice, broccoli, and apple juice has the highest fiber content. They should avoid alcohol, caffeine, and other gastric irritants.
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 cares for a client who is recovering from a hemorrhoidectomy. The client states, 'I need to have a bowel movement.' How should the nurse respond?
- A. I will administer a laxative to help you have a bowel movement.
- B. Let's get you to the bathroom to try and have a bowel movement.
- C. It's too soon after surgery; you should wait at least 24 hours.
- D. You should avoid straining; I'll consult with your provider about a stool softener.
Correct Answer: D
Rationale: After a hemorrhoidectomy, straining should be avoided to prevent complications. The nurse should consult with the provider about a stool softener to facilitate a bowel movement without straining.
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.
An emergency room nurse assesses a client after a motor vehicle crash and notes ecchymotic areas across the client's lower abdomen. Which action should the nurse take first?
- A. Measure the client's abdominal girth.
- B. Assess for abdominal guarding or rigidity.
- C. Check the client's hemoglobin and hematocrit.
- D. Obtain the client's complete health history.
Correct Answer: B
Rationale: Ecchymotic areas may indicate internal bleeding or organ injury. The nurse should first assess for abdominal guarding or rigidity, which could indicate a major organ injury, and then notify the provider.