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The nurse caring for a patient with Crohn disease will closely monitor the urinary output to ensure that the patient is excreting at least mL/day.
- A. 1500
Correct Answer: 1500
Rationale: The output of 1500 mL a day indicates good kidney perfusion. The disease allows such dramatic fluid loss that a constant watch on I&O is a major nursing intervention.
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The home health nurse is caring for a patient who has frequent bouts of diverticulitis accompanied by increased flatulence, diarrhea, and nausea. Which is the most appropriate suggestion to lessen these symptoms?
- A. Eat a diet high in fiber content.
- B. Increase dietary fat intake.
- C. Exercise to increase intraabdominal pressure.
- D. Take daily laxatives.
Correct Answer: A
Rationale: The symptoms of diverticulitis can be reduced or prevented by eating a high-fiber diet, reduction of meat and fats in the diet, and avoiding activities that increase intraabdominal pressure. Although laxatives might be prescribed sparingly, daily laxatives are not recommended.
Flexible sigmoidoscopy should be performed every years.
- A. 5
Correct Answer: 5
Rationale: Flexible sigmoidoscopy should be performed every 5 years. Endoscopy of the lower GI tract allows visualization and, if indicated, access to obtain biopsy specimens of tumors, polyps, or ulcerations of the anus, rectum, and sigmoid colon. The lower GI tract is difficult to visualize radiographically, but sigmoidoscopy allows direct visualization.
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.
What is the most lethal complication of a peptic ulcer?
- A. Bleeding
- B. Perforation
- C. Severe pain
- D. Gastric outlet obstruction
Correct Answer: B
Rationale: Perforation is considered the most lethal complication of peptic ulcer. Bleeding may occur when the ulcer erodes into a blood vessel; however, perforation occurs when the ulcer crater penetrates the entire thickness of the wall of the stomach or duodenum. Gastric outlet obstruction can occur at any time and can be relieved by NG aspiration of stomach contents.
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.