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An adult is being treated for a peptic ulcer. The physician has prescribed cimetidine (Tagamet) for which reason?
- A. It blocks the secretion of gastric hydrochloric acid.
- B. It coats the gastric mucosa with a protective membrane.
- C. It increases the sensitivity of histamine (H2) receptors.
- D. It neutralizes acid in the stomach.
Correct Answer: A
Rationale: Cimetidine, an H2 receptor blocker, reduces gastric acid secretion, aiding peptic ulcer healing.
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The client is diagnosed with salmonellosis secondary to eating some slightly cooked hamburger meat. Which clinical manifestations should the nurse expect the client to report?
- A. Abdominal cramping, nausea, and vomiting.
- B. Neuromuscular paralysis and dysphagia.
- C. Gross amounts of explosive bloody diarrhea.
- D. Frequent 'rice water stool' with no fecal odor.
Correct Answer: A
Rationale: Salmonellosis typically causes abdominal cramping, nausea, and vomiting due to bacterial irritation of the GI tract. Paralysis is botulism, bloody diarrhea is more typical of other pathogens, and rice water stool is cholera.
The client of Chinese ethnicity has diarrhea and refuses to drink the prescribed oral hydration solution, insisting on having chicken broth instead. Which statement about clients of Chinese ethnicity should be the basis for the nurse’s intervention in this situation?
- A. They consider chicken a food with yang qualities.
- B. They believe extra protein is needed to treat diarrhea.
- C. They believe high-sodium foods are needed to treat diarrhea.
- D. They mistrust modern medicine and eat broth to treat disease.
Correct Answer: A
Rationale: A. Loose stools are a yin symptom, which should be treated with foods that have yang qualities, one of which is chicken. B. There is no belief in the Chinese culture related to consuming high-protein foods. C. There is no belief in the Chinese culture related to consuming high-sodium foods. D. The Chinese do not mistrust modern medicine but may combine Western medicine and Chinese herbal medicines to treat disease.
The 25-year-old client, hospitalized with an exacerbation of distal ulcerative colitis, is prescribed mesalamine rectally via enema. The client states that an enema is disgusting and wants to know why the medication cannot be given orally. Which is the best response by the nurse?
- A. “It can be given orally; I’ll contact the doctor and see if the change can be made.”
- B. “Rectal administration delivers the mesalamine directly to the affected area.”
- C. “Oral administration is not possible for treating your ulcerative colitis exacerbation.”
- D. “It can be given orally; I’ll make the change, and we’ll tell the doctor in the morning.”
Correct Answer: B
Rationale: A. If the client still desires a change in medication route after the rationale for rectal administration is explained, the HCP should be consulted. B. This is the nurse’s best response because it explains the purpose for administration via enema. This route delivers mesalamine (Asacol) directly to the affected area, thus maximizing effectiveness and minimizing side effects. C. Oral administration is possible, but rectal administration is preferred in distal colitis. D. Nurses cannot order medications or change medication routes without specific approval by the HCP, who is licensed to prescribe medications.
The client diagnosed with ulcerative colitis is prescribed a low-residue diet. Which meal selection indicates the client understands the diet teaching?
- A. Grilled hamburger on a wheat bun and fried potatoes.
- B. A chicken salad sandwich and lettuce and tomato salad.
- C. Roast pork, white rice, and plain custard.
- D. Fried fish, whole grain pasta, and fruit salad.
Correct Answer: C
Rationale: A low-residue diet minimizes fiber to reduce bowel irritation, so roast pork, white rice, and plain custard (low-fiber foods) are appropriate. The other options include high-fiber foods like wheat, vegetables, and whole grains, which are contraindicated.
The nurse is caring for the client one (1) day postoperative sigmoid colostomy. Which independent nursing intervention should the nurse implement?
- A. Change the infusion rate of the intravenous fluid.
- B. Encourage the client to ventilate feelings about body image.
- C. Administer opioid narcotic medications for pain management.
- D. Assist the client out of bed to sit in the chair twice daily.
Correct Answer: B
Rationale: Encouraging ventilation of feelings about body image is an independent nursing intervention addressing psychosocial needs post-colostomy. IV rate, opioids, and ambulation require orders or are less psychosocial.