Nokea
The home health nurse caring for a patient who has dysarthria related to radiation therapy for an oral cancer would recommend that the family provide which device?
- A. a tablet and pencil as a communication aid.
- B. a TV for diversion.
- C. a bell to summon help.
- D. a walkie-talkie.
Correct Answer: A
Rationale: The provision of an alternative method of communicating will lessen the frustration of the patient who has trouble speaking understandably. The call bell would be helpful also, but without a way to communicate, the bell is not as essential as a method of communication.
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During the annual physical examination, the nurse will assess for which risk factor for the development of diverticulosis?
- A. Chronic diarrhea
- B. Excessive fiber intake
- C. Increased intake of refined carbohydrates
- D. Aging related increased elasticity of the colon
Correct Answer: C
Rationale: Refined carbohydrates, when eaten in large amounts, have been associated with the development of diverticulosis.
To assist a family with a bowel-training program to reduce fecal incontinence, the nurse would suggest the use of which item at an optimal time to stimulate defecation?
- A. warm bath
- B. a tap water enema
- C. glycerin suppository
- D. large glass of warm lemonade
Correct Answer: C
Rationale: The use of a glycerin suppository for fecal stimulation is a helpful aid in a bowel-training program. The suppository is administered at what the family and patient have determined is the optimal time for a bowel movement.
The nurse anticipates that the patient who has had a subtotal gastrectomy will need which type of supplement?
- A. protein due to the loss of some of the digestive processes.
- B. vitamin B12 due to the loss of the intrinsic factor.
- C. bulk to prevent constipation.
- D. vitamin A due to the loss of the gastric lining.
Correct Answer: B
Rationale: It is recommended that all patients with a gastrectomy have a blood serum vitamin B12 level measured every 1 to 2 years. Decreased absorption of vitamin B12 may cause pernicious anemia.
The nurse explains to the patient with Crohn disease that the tube feedings are placed for which reason?
- A. rapid absorption in the upper GI tract.
- B. decompression of the stomach.
- C. reduction of diarrheic episodes.
- D. a permanent nutritional support.
Correct Answer: A
Rationale: The tube feedings allow for rapid absorption of the nutrients in the upper GI tract. The tube feedings are not permanent and will be followed by oral intake of a low-residue, high-protein, high-calorie diet.
What should a nurse do when obtaining a stool specimen to be examined for ova and parasites?
- A. Use an oil retention enema to facilitate collection.
- B. Refrigerate the specimen immediately.
- C. Obtain three different stool specimens on subsequent days.
- D. Check the specimen for the presence of occult blood.
Correct Answer: C
Rationale: Diagnosing a parasitic infection requires three different stool specimens on subsequent days. Use only normal saline or tap water enemas to prevent alteration of results.