Nokea
The client with a duodenal ulcer is ready for discharge. Which statement made by the client indicates a need for more teaching about his diet?
- A. It's a good thing I gave up drinking alcohol last year.'
- B. I will have to drink lots of milk and cream every day.'
- C. I will stay away from cola drinks after I am discharged.'
- D. Eating three nutritious meals and snacks every day is okay.'
Correct Answer: B
Rationale: Milk and cream cause rebound acidity and are not recommended for ulcer clients. Avoiding alcohol and cola, and eating regular meals and snacks, are appropriate.
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Which problem is most appropriate for the nurse to identify for the client with diarrhea?
- A. Alteration in skin integrity.
- B. Chronic pain perception.
- C. Fluid volume excess.
- D. Ineffective coping.
Correct Answer: A
Rationale: Diarrhea can cause perianal skin breakdown, making alteration in skin integrity the most appropriate problem. Pain is less common, fluid volume is deficient, and coping is secondary.
The male client had abdominal surgery and the nurse suspects the client has peritonitis. Which assessment data support the diagnosis of peritonitis?
- A. Absent bowel sounds and potassium level of 3.9 mEq/L.
- B. Abdominal cramping and hemoglobin of 14 g/dL.
- C. Profuse diarrhea and stool specimen shows Campylobacter.
- D. Hard, rigid abdomen and white blood cell count 22,000/mm3.
Correct Answer: D
Rationale: A hard, rigid abdomen and elevated WBC count (22,000/mm3) indicate peritonitis due to peritoneal inflammation and infection. Absent bowel sounds are nonspecific, cramping with normal hemoglobin is less indicative, and diarrhea with Campylobacter suggests gastroenteritis.
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 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.
Which assessment data indicate to the nurse the client recovering from an open cholecystectomy may require pain medication?
- A. The client's pulse is 65 beats per minute.
- B. The client has shallow respirations.
- C. The client's bowel sounds are 20 per minute.
- D. The client uses a pillow to splint when coughing.
Correct Answer: B
Rationale: Shallow respirations suggest pain, as patients avoid deep breathing to minimize discomfort. Normal pulse, bowel sounds, and splinting are less direct indicators of pain.