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The nurse has administered an antibiotic, a proton pump inhibitor, and Pepto-Bismol for peptic ulcer disease secondary to H. pylori. Which data would indicate to the nurse the medications are effective?
- A. A decrease in alcohol intake.
- B. Maintaining a bland diet.
- C. A return to previous activities.
- D. A decrease in gastric distress.
Correct Answer: D
Rationale: A decrease in gastric distress (e.g., epigastric pain) indicates effective treatment of H. pylori and ulcer healing. Lifestyle changes like reduced alcohol or bland diets support treatment but are not direct indicators of medication efficacy.
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The client with a diagnosis of rule-out colon cancer is two (2) hours post-sigmoidoscopy procedure. Which assessment data warrant immediate intervention by the nurse?
- A. The client has hyperactive bowel sounds.
- B. The client is eating a hamburger the family brought.
- C. The client is sleepy and wants to sleep.
- D. The client's BP is 96/60 and apical pulse is 108.
Correct Answer: D
Rationale: Low BP (96/60) and tachycardia (pulse 108) suggest hypovolemia or bleeding post-sigmoidoscopy, requiring immediate intervention. Hyperactive bowel sounds, eating, and sleepiness are less urgent.
The nurse is working in an outpatient clinic. Which client is most likely to have a diagnosis of diverticulosis?
- A. A 60-year-old male with a sedentary lifestyle.
- B. A 72-year-old female with multiple childbirths.
- C. A 63-year-old female with hemorrhoids.
- D. A 40-year-old male with a family history of diverticulosis.
Correct Answer: A
Rationale: Diverticulosis is more common in older adults with sedentary lifestyles, which contribute to constipation and increased colonic pressure. Childbirth, hemorrhoids, and family history are less direct risk factors.
The nurse is preparing a client diagnosed with GERD for surgery. Which information warrants notifying the HCP?
- A. The client's Bernstein esophageal test was positive.
- B. The client's abdominal x-ray shows a hiatal hernia.
- C. The client's WBC count is 14,000/mm3.
- D. The client's hemoglobin is 13.8 g/dL.
Correct Answer: C
Rationale: An elevated WBC count (14,000/mm3) suggests infection or inflammation, which could complicate surgery and requires immediate attention. A positive Bernstein test and hiatal hernia are expected in GERD, and a hemoglobin of 13.8 g/dL is within normal limits.
The nurse is caring for the client one (1) day postoperative sigmoid colostomy. Which independent nursing intervention should the nurse implement?
- A. Change the infusion rate of the intravenous fluid.
- B. Encourage the client to ventilate feelings about body image.
- C. Administer opioid narcotic medications for pain management.
- D. Assist the client out of bed to sit in the chair twice daily.
Correct Answer: B
Rationale: Encouraging ventilation of feelings about body image is an independent nursing intervention addressing psychosocial needs post-colostomy. IV rate, opioids, and ambulation require orders or are less psychosocial.
The client in end-stage liver failure has vitamin K deficiency. Which interventions should the nurse implement?
- A. Avoid rectal temperatures.
- B. Use only a soft toothbrush.
- C. Monitor the platelet count.
- D. Use small-gauge needles.
- E. Assess for asterixis.
Correct Answer: A,B,D
Rationale: Vitamin K deficiency impairs clotting, increasing bleeding risk, so avoiding rectal temperatures, using a soft toothbrush, and small-gauge needles minimize trauma. Platelet counts and asterixis are unrelated to bleeding risk.