Nokea
The family members of a patient with hepatitis A ask if there is anything that will prevent them from developing the disease. What is the best response by the nurse?
- A. No immunization is available for hepatitis A, nor are you likely to get the disease.'
- B. All family members should receive the hepatitis A vaccine to prevent or modify the infection.'
- C. Those who have had household or close contact with the patient should receive immune globulin.'
- D. Only those individuals who have had sexual contact with the patient should receive immunization.'
Correct Answer: C
Rationale: The correct answer is C: Those who have had household or close contact with the patient should receive immune globulin. This is because immune globulin can provide passive immunity to those exposed to hepatitis A, reducing the risk of developing the disease. Hepatitis A vaccine is not effective post-exposure, so it would not prevent disease in this scenario (option B). Option A is incorrect as there is a vaccine available for hepatitis A. Option D is incorrect because hepatitis A is primarily transmitted through fecal-oral route, not sexual contact.
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After eating or drinking dairy products like cheese and milk, you have intestinal cramps, bloating and diarrhea. You most likely have
- A. lactose intolerance.
- B. diabetes mellitus, Type I.
- C. heartburn.
- D. peritonitis.
Correct Answer: A
Rationale: The correct answer is A: lactose intolerance. This is due to the inability to digest lactose, the sugar found in dairy products, leading to symptoms like intestinal cramps, bloating, and diarrhea. This is a common condition caused by a deficiency of lactase enzyme.
Choice B: Diabetes mellitus, Type I, is incorrect as it is an autoimmune condition affecting insulin production, not digestion of dairy products.
Choice C: Heartburn is incorrect as it is a symptom of acid reflux, not related to dairy product intolerance.
Choice D: Peritonitis is incorrect as it is an inflammation of the abdominal lining, usually caused by infection or injury, not related to dairy product intolerance.
Identify one nursing intervention indicated for each of the following desired outcomes of tube feeding.
- A. Prevention of aspiration
- B. Prevention of diarrhea
- C. Maintenance of tube patency
- D. Maintenance of tube placement
Correct Answer: A
Rationale: The correct answer is A: Prevention of aspiration. This is essential in tube feeding to avoid the risk of food or liquid entering the lungs, causing aspiration pneumonia. Nursing interventions for this include ensuring proper positioning during and after feeding, checking residual volumes before each feeding, and using the appropriate tube size and placement.
Incorrect Choices:
B: Prevention of diarrhea - Diarrhea is not directly related to tube feeding complications, but rather to factors such as infection, medication side effects, or underlying conditions.
C: Maintenance of tube patency - While important, this focuses on ensuring the tube remains clear and functional, not directly related to preventing aspiration.
D: Maintenance of tube placement - Ensuring proper tube placement is crucial for effective feeding but does not directly address the risk of aspiration.
Treatment of the patient with appendicitis includes:
- A. Transfusion to replace blood loss.
- B. Bowel prep for cleansing.
- C. Surgical removal of appendix.
- D. Medications to lower pH within the stomach.
Correct Answer: C
Rationale: The correct answer is C: Surgical removal of appendix. Appendicitis is inflammation of the appendix, which requires surgical intervention (appendectomy) to prevent rupture and potential life-threatening complications. Transfusion (A) is not a standard treatment for appendicitis unless severe bleeding occurs post-surgery. Bowel prep (B) is unnecessary for appendicitis treatment as it is not related to colon cleansing. Medications to lower stomach pH (D) are used to treat conditions like acid reflux, not appendicitis. In summary, surgical removal of the inflamed appendix is the definitive treatment for appendicitis to prevent complications.
A male client with a recent history of rectal bleeding is being prepared for a colonoscopy. How should the nurse position the client for this test initially?
- A. Lying on the right side with legs straight
- B. Lying on the left side with knees bent
- C. Prone with the torso elevated
- D. Bent over with hands touching the floor
Correct Answer: B
Rationale: The correct answer is B: Lying on the left side with knees bent. This position allows for better visualization and access to the colon during the colonoscopy procedure. By lying on the left side, the client's colon is in a more optimal position for the scope to navigate through the colon. Additionally, bending the knees helps to relax the abdominal muscles and make the procedure more comfortable for the client.
Incorrect choices:
A: Lying on the right side with legs straight - This position does not provide optimal access to the colon and may make the procedure more difficult.
C: Prone with the torso elevated - This position is not suitable for a colonoscopy as it does not allow for proper access to the colon.
D: Bent over with hands touching the floor - This position is not recommended for a colonoscopy as it is not conducive to the procedure and may cause discomfort for the client.
An endoscopic biopsy of gastric mucosa reveals small intestinal type epithelium. This finding is most likely due to:
- A. chronic gastritis
- B. congenital heterotopia
- C. precancerous dysplasia
- D. metastatic carcinoma
Correct Answer: B
Rationale: The correct answer is B: congenital heterotopia. This is because the presence of small intestinal type epithelium in the gastric mucosa indicates ectopic tissue that is not normally found in the stomach. This condition is known as congenital heterotopia, where tissues from one organ are found in another due to developmental abnormalities.
A: Chronic gastritis would not lead to the presence of small intestinal type epithelium in the gastric mucosa.
C: Precancerous dysplasia refers to abnormal cellular changes that can progress to cancer but does not explain the presence of small intestinal type epithelium.
D: Metastatic carcinoma would involve the spread of cancer cells from another primary site, not the presence of ectopic tissue.