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The client is diagnosed with an acute exacerbation of inflammatory bowel disease (IBD). Which food selection would be the best choice for a meal?
- A. Roast beef on wheat bread and a milk shake.
- B. Hamburger, french fries, and a cola.
- C. Pepper steak, brown rice, and iced tea.
- D. Roasted turkey, instant mashed potatoes, and water.
Correct Answer: D
Rationale: Roasted turkey, instant mashed potatoes, and water are low-residue, easy-to-digest foods suitable for acute IBD exacerbation. Other options are high-fiber or irritating.
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The client is admitted to a medical unit. The client’s medication list includes rifaximin, lactulose, and propranolol. Which assessment should be the nurse’s priority based on the client’s medication list?
- A. Assess the client for a history of PUD.
- B. Assess the client for abdominal pain.
- C. Place the client on airborne precautions.
- D. Assess neurological status and abdominal girth.
Correct Answer: D
Rationale: A. Antibiotics and acid-reducing medications are expected with the treatment of PUD, but propranolol (Inderal) would not be expected. Although these medications may cue the nurse to further explore a history of PUD, this is not the most likely conclusion. B. There is no indication that the client has abdominal pain, and there isn’t an analgesic on the medication list. C. There is no indication that the client has an infectious condition necessitating airborne precautions. D. All medications listed are used to treat liver cirrhosis and its complications of portal hypertension and hepatic encephalopathy. The antibiotic rifaximin (Xifaxan) and the laxative lactulose (Cephulac) are used for treating hepatic encephalopathy. Thus, assessing the client’s neurological status and measuring abdominal girth are most important.
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.
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.
A child with appendicitis is scheduled for surgery this evening. The nurse enters the room and sees the child's mother starting to place hot, wet washcloths on her daughter's abdomen so that 'she will feel better.' The nurse explains that this action is contraindicated because heat:
- A. can cause the appendix to rupture and cause peritonitis.
- B. can mask symptoms of acute appendicitis.
- C. will increase peristalsis throughout the abdomen.
- D. will arrest progression of the disease.
Correct Answer: A
Rationale: Heat can increase inflammation and blood flow, risking appendix rupture and peritonitis in appendicitis.
The nurse is caring for the client diagnosed with ascites secondary to hepatic cirrhosis. Which information should the nurse report to the health-care provider?
- A. A decrease in the client's daily weight of one (1) pound.
- B. An increase in urine output after administration of a diuretic.
- C. An increase in abdominal girth of two (2) inches.
- D. A decrease in the serum direct bilirubin to 0.6 mg/dL.
Correct Answer: C
Rationale: An increase in abdominal girth (2 inches) suggests worsening ascites, requiring HCP notification. Weight loss, increased urine output, and normal bilirubin are expected or less urgent.