Nokea
The home health nurse evaluates a patient being treated for a peptic ulcer with an antacid and famotidine (histamine receptor blocker). Which statement made by the patient indicates a need for further instruction?
- A. I know famotidine will not interfere with my Coumadin.'
- B. I take the antacid at least 2 hours after any of my other drugs.'
- C. Boy! That antacid keeps my stomach happy!'
- D. I take both those meds at the same time every morning.'
Correct Answer: D
Rationale: Antacids should not be taken with other drugs, because the absorption of the other drugs may be affected.
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The nurse points out which is an example of a nonmechanical bowel obstruction?
- A. A paralytic ileus
- B. Narrowed bowel lumen from an inflammatory process
- C. Tumor of the bowel
- D. Fecal impaction
Correct Answer: A
Rationale: A nonmechanical bowel obstruction can be caused by a paralytic ileus.
Which activities should the home health nurse suggest to an older adult patient to avoid constipation?
- A. Schedule toileting after meals
- B. Taking bulk-forming laxatives
- C. Increasing fiber intake
- D. Drinking at least 1000 mL fluid
- E. Taking a daily stool softener
- F. Using tap water enemas for persons with altered mobility
Correct Answer: A,B,C,D
Rationale: Inactivity and changes in diet and fluid intake can contribute to constipation. A nutritional diet high in fiber and bulk-forming foods can promote normal elimination. Increasing fluids to 8 to 10 glasses per day will be beneficial in preventing constipation. A daily bowel routine will also benefit elimination. Use of daily stool softeners is no longer recommended for the older adult. Tap water enemas for persons with altered mobility are not routine.
The nurse takes into consideration that a proton pump inhibitor drug, such as which drug, will completely eradicate gastric acid production?
- A. omeprazole
- B. misoprostol
- C. sucralfate
- D. olsalazine
Correct Answer: A
Rationale: Omeprazole is a proton pump inhibitor that interferes with the production of gastric acid.
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 home health nurse is caring for a patient who has frequent abdominal pain and diarrhea. The nurse uses the Rome Criteria to direct data collection for irritable bowel syndrome. What is included in the Rome Criteria?
- A. Discomfort at least 3 days a month
- B. Blood in stool
- C. Pain relieved by defecation
- D. Excessive flatulence
- E. Nausea and vomiting associated with onset
- F. Onset associated with change in stool consistency or frequency
Correct Answer: A,C,F
Rationale: The Rome Criteria include that the patient experience discomfort at least 3 days a month within the last 3 months, pain relieved by defecation, onset associated with change in stool frequency, and onset in association with a change in stool appearance. Although increased flatus is associated with diverticulitis, it is not part of the Rome Criteria.