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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.
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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.
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 cares for a client who has been diagnosed with a small bowel obstruction. Which assessment findings should the nurse correlate with this diagnosis? (Select all that apply.)
- A. Serum potassium of 2.5 mEq/L
- B. Loss of 15 pounds without eating
- C. Abdominal pain in upper quadrants
- D. Low-pitched bowel sounds
- E. Serum sodium of 121 mEq/L
Correct Answer: A,C,E
Rationale: Small bowel obstructions can cause fluid and electrolyte imbalances, such as low potassium and sodium, and upper quadrant pain due to obstruction. Weight loss and low-pitched bowel sounds are less specific.
A nurse assesses clients for the risk of colorectal cancer. Which client has the highest risk for colorectal cancer?
- A. A 37-year-old who drinks eight cups of coffee daily
- B. A 60-year-old lawyer who works long hours
- C. A 45-year-old with irritable bowel syndrome
- D. A 70-year-old who eats a high-fat diet
Correct Answer: D
Rationale: Colorectal cancer is rare before the age of 40, but its incidence increases rapidly with advancing age. A high-fat diet also increases the risk for colorectal cancer. Coffee intake, IBS, and a heavy workload do not increase the risk.
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.