Nokea
A patient has been experiencing disconcerting GI symptoms that have been worsening in severity. Following medical assessment, the patient has been diagnosed with lactose intolerance. The nurse should recognize an increased need for what form of health promotion?
- A. Annual screening colonoscopies
- B. Adherence to recommended immunization schedules
- C. Regular blood pressure monitoring
- D. Frequent screening for osteoporosis
Correct Answer: D
Rationale: Persons with lactose intolerance often experience hypocalcemia and a consequent risk of osteoporosis related to malabsorption of calcium. Lactose intolerance does not create an increased need for screening for colorectal cancer, immunizations, or blood pressure monitoring.
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The nurse is caring for a patient who is undergoing diagnostic testing for suspected malabsorption. When taking this patients health history and performing the physical assessment, the nurse should recognize what finding as most consistent with this diagnosis?
- A. Recurrent constipation coupled with weight loss
- B. Foul-smelling diarrhea that contains fat
- C. Fever accompanied by a rigid, tender abdomen
- D. Bloody bowel movements accompanied by fecal incontinence
Correct Answer: B
Rationale: The hallmarks of malabsorption syndrome from any cause are diarrhea or frequent, loose, bulky, foul-smelling stools that have increased fat content and are often grayish (steatorrhea). Constipation and bloody bowel movements are not suggestive of malabsorption syndromes. Fever and a tender, rigid abdomen are associated with peritonitis.
A patient has been diagnosed with a small bowel obstruction and has been admitted to the medical unit. The nurses care should prioritize which of the following outcomes?
- A. Preventing infection
- B. Maintaining skin and tissue integrity
- C. Preventing nausea and vomiting
- D. Maintaining fluid and electrolyte balance
Correct Answer: D
Rationale: All of the listed focuses of care are important for the patient with a small bowel obstruction. However, the patients risk of fluid and electrolyte imbalances is an immediate threat to safety, and is a priority in nursing assessment and interventions.
A nurse is providing care for a patient who has a diagnosis of irritable bowel syndrome (IBS). When planning this patients care, the nurse should collaborate with the patient and prioritize what goal?
- A. Patient will accurately identify foods that trigger symptoms.
- B. Patient will demonstrate appropriate care of his ileostomy.
- C. Patient will demonstrate appropriate use of standard infection control precautions.
- D. Patient will adhere to recommended guidelines for mobility and activity.
Correct Answer: A
Rationale: A major focus of nursing care for the patient with IBS is to identify factors that exacerbate symptoms. Surgery is not used to treat this health problem and infection control is not a concern that is specific to this diagnosis. Establishing causation likely is more important to the patient than managing physical activity.
A patients colorectal cancer has necessitated a hemicolectomy with the creation of a colostomy. In the 4 days since the surgery, the patient has been unwilling to look at the ostomy or participate in any aspects of ostomy care. What is the nurses most appropriate response to this observation?
- A. Ensure that the patient knows that he or she will be responsible for care after discharge.
- B. Reassure the patient that many people are fearful after the creation of an ostomy.
- C. Acknowledge the patients reluctance and initiate discussion of the factors underlying it.
- D. Arrange for the patient to be seen by a social worker or spiritual advisor.
Correct Answer: C
Rationale: If the patient is reluctant to participate in ostomy care, the nurse should attempt to dialogue about this with the patient and explore the factors that underlie it. It is presumptive to assume that the patients behavior is motivated by fear. Assessment must precede referrals and emphasizing the patients responsibilities may or may not motivate the patient.
A patient admitted with inflammatory bowel disease asks the nurse for help with menu selections. What menu selection is most likely the best choice for this patient?
- A. Spinach
- B. Tofu
- C. Multigrain bagel
- D. Blueberries
Correct Answer: B
Rationale: Nutritional management of inflammatory bowel disease requires ingestion of a diet that is bland, low-residue, high-protein, and high-vitamin. Tofu meets each of these criteria. Spinach, multigrain bagels, and blueberries are not low-residue.