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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.
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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 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 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.
The client who is obese presents to the clinic before beginning a weight loss program. Which interventions should the nurse teach? Select all that apply.
- A. Walk for 30 minutes three (3) times a day.
- B. Determine situations that initiate eating behavior.
- C. Weigh at the same time every day.
- D. Limit sodium in the diet.
- E. Refer to a weight support group.
Correct Answer: A,B,C,E
Rationale: Walking, identifying eating triggers, consistent weighing, and support groups promote sustainable weight loss. Sodium restriction is less critical unless hypertension is present.
The nurse is caring for the client who has a temporary colostomy following surgery for colon cancer. The nurse assesses that the client’s colostomy bag is empty and that there has been no stool since surgery 24 hours ago. What should the nurse do?
- A. Call the surgeon immediately.
- B. Place the client left side-lying.
- C. Document these findings.
- D. Give a laxative medication.
Correct Answer: C
Rationale: The nurse should document the findings; the absence of stool is expected 24 hours postsurgery.