Nokea
An inpatient has returned to the medical unit after a barium enema. When assessing the patient's subsequent bowel patterns and stools, what finding should the nurse report to the physician?
- A. Large, wide stools
- B. Milky white stools
- C. Three stools during an 8-hour period of time
- D. Streaks of blood present in the stool
Correct Answer: D
Rationale: Barium has a high osmolarity and may draw fluid into the bowel, thus increasing the intraluminal contents and resulting in greater output (large stools). The barium will give the stools a milky white appearance, and it is not uncommon for the patient to experience an increase in the number of bowel movements. Blood in fecal matter is not an expected finding and the nurse should notify the physician.
You may also like to solve these questions
Probably the most widely used in-office or at-home occult blood test is the Hemoccult II. The patient has come to the clinic because he thinks there is blood in his stool. When you reviewed his medications, you noted he is on antihypertensive drugs and NSAIDs for early arthritic pain. You are sending the patient home with the supplies necessary to perform 2 hemoccult tests on his stool and mail the samples back to the clinic. What instruction would you give this patient?
- A. Take all your medications as usual.
- B. Take all your medications except the antihypertensive medications.
- C. Don't eat highly acidic foods 72 hours before you start the test.
- D. Avoid vitamin C for 72 hours before you start the test.
Correct Answer: D
Rationale: Red meats, aspirin, nonsteroidal anti-inflammatory drugs, turnips, and horseradish should be avoided for 72 hours prior to the study, because they may cause a false-positive result. Also, ingestion of vitamin C from supplements or foods can cause a false-negative result. Acidic foods do not need to be avoided.
The nurse is caring for a patient with a duodenal ulcer and is relating the patient's symptoms to the physiologic functions of the small intestine. What do these functions include?
- A. Secretion of hydrochloric acid (HCl)
- B. Reabsorption of water
- C. Secretion of mucus
- D. Absorption of nutrients
- E. Movement of nutrients into the bloodstream
Correct Answer: C,D,E
Rationale: The small intestine folds back and forth on itself, providing approximately 7000 cm^2 (70 m^2) of surface area for secretion and absorption, the process by which nutrients enter the bloodstream through the intestinal walls. Water reabsorption primarily takes place in the large bowel. HCl is secreted by the stomach.
The nurse is preparing to perform a patient's abdominal assessment. What examination sequence should the nurse follow?
- A. Inspection, auscultation, percussion, and palpation
- B. Inspection, palpation, auscultation, and percussion
- C. Inspection, percussion, palpation, and auscultation
- D. Inspection, palpation, percussion, and auscultation
Correct Answer: A
Rationale: When performing a focused assessment of the patient's abdomen, auscultation should always precede percussion and palpation because they may alter bowel sounds. The traditional sequence for all other focused assessments is inspection, palpation, percussion, and auscultation.
A nurse is promoting increased protein intake to enhance a patient's wound healing. The nurse knows that enzymes are essential in the digestion of nutrients such as protein. What is the enzyme that initiates the digestion of protein?
- A. Pepsin
- B. Intrinsic factor
- C. Lipase
- D. Amylase
Correct Answer: A
Rationale: The enzyme that initiates the digestion of protein is pepsin. Intrinsic factor combines with vitamin B12 for absorption by the ileum. Lipase aids in the digestion of fats and amylase aids in the digestion of starch.
A nursing student has auscultated a patient's abdomen and noted one or two bowel sounds in a 2-minute period of time. How would you tell the student to document the patient's bowel sounds?
- A. Normal
- B. Hypoactive
- C. Hyperactive
- D. Paralytic ileus
Correct Answer: B
Rationale: Documenting bowel sounds is based on assessment findings. The terms normal (sounds heard about every 5 to 20 seconds), hypoactive (one or two sounds in 2 minutes), hyperactive (5 to 6 sounds heard in less than 30 seconds), or absent (no sounds in 3 to 5 minutes) are frequently used in documentation. Paralytic ileus is a medical diagnosis that may cause absent or hypoactive bowel sounds, but the nurse would not independently document this diagnosis.