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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.
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The nurse is caring for clients on a surgical unit. Which client should the nurse assess first?
- A. The client who had an inguinal hernia repair and has not voided in four (4) hours.
- B. The client who was admitted with abdominal pain who suddenly has no pain.
- C. The client four (4) hours postoperative abdominal surgery with no bowel sounds.
- D. The client who is one (1) day postappendectomy and is being discharged.
Correct Answer: B
Rationale: Sudden resolution of abdominal pain may indicate perforation (e.g., appendicitis), a life-threatening emergency requiring immediate assessment. Urinary retention, absent bowel sounds, and discharge are less urgent.
The 85-year-old male client diagnosed with cancer of the colon asks the nurse, 'Why did I get this cancer?' Which statement is the nurse's best response?
- A. Research shows a lack of fiber in the diet can cause colon cancer.
- B. It is not common to get colon cancer at your age; it is usually in young people.
- C. No one knows why anyone gets cancer, it just happens to certain people.
- D. Women usually get colon cancer more often than men but not always.
Correct Answer: A
Rationale: Low dietary fiber is a known risk factor for colon cancer, as it slows bowel transit and increases exposure to carcinogens. Colon cancer is common in older adults, not younger ones, and gender differences are minimal.
The client with liver problems asks the nurse, 'Why are my stools clay-colored?' On which scientific rationale should the nurse base the response?
- A. There is an increase in serum ammonia level.
- B. The liver is unable to excrete bilirubin.
- C. The liver is unable to metabolize fatty foods.
- D. A damaged liver cannot detoxify vitamins.
Correct Answer: B
Rationale: Clay-colored stools result from the liver’s inability to excrete bilirubin, which gives stool its brown color. Ammonia, fat metabolism, and vitamin detoxification are unrelated.
The client is diagnosed with irritable bowel syndrome (IBS). Which intervention should the nurse teach the client to reduce symptoms?
- A. Instruct the client to avoid drinking fluids with meals.
- B. Explain the need to decrease intake of flatus-forming foods.
- C. Teach the client how to perform gentle perianal care.
- D. Encourage the client to attend a support group meeting.
Correct Answer: B
Rationale: Decreasing flatus-forming foods (e.g., beans, broccoli) reduces bloating and discomfort in IBS. Avoiding fluids with meals is not standard, perianal care is secondary, and support groups are psychosocial.
The client has had a liver biopsy. Which postprocedure intervention should the nurse implement?
- A. Instruct the client to void immediately.
- B. Keep the client NPO for eight (8) hours.
- C. Place the client on the right side.
- D. Monitor blood urea nitrogen (BUN) and creatinine level.
Correct Answer: C
Rationale: Placing the client on the right side applies pressure to the biopsy site, reducing bleeding risk. Voiding, NPO status, and BUN/creatinine are not specific to liver biopsy care.