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The nurse is admitting the client for a colonoscopy. Which information, if found in the client’s medical record, should the nurse consider as the primary reason for this client’s colonoscopy?
- A. Chronic constipation
- B. Urostomy placed 3 years ago
- C. History of colon polyps
- D. Hemoglobin 10 g/dL
Correct Answer: C
Rationale: A. Although a colonoscopy may be performed to evaluate chronic constipation, this is less likely than evaluation of colon polyps. B. A urostomy is used for urinary diversion following bladder cancer; it does not affect the colon. C. Colonoscopy is used in screening and diagnosing colon cancer and for surveillance in persons with prior history of colon cancer or polyps. This is likely the primary reason for a colonoscopy with this client. D. An Hgb of 10 g/dL is slightly low. This could be a reason for a colonoscopy, especially if there is a pattern of low Hgb levels and the stool guaiac test is positive. However, this is less likely the primary reason than evaluation of colon polyps.
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The client has an eviscerated abdominal wound. Which intervention should the nurse implement?
- A. Apply sterile normal saline dressing.
- B. Use sterile gloves to replace protruding parts.
- C. Place the client in reverse Trendelenburg position.
- D. Administer intravenous antibiotic immediately (STAT).
Correct Answer: A
Rationale: Applying a sterile normal saline dressing keeps the eviscerated wound moist and protected until surgical repair. Replacing organs is contraindicated, reverse Trendelenburg is incorrect, and antibiotics are secondary.
The occupational health nurse is preparing a presentation to a group of factory workers about preventing colon cancer. Which information should be included in the presentation?
- A. Wear a high-filtration mask when around chemicals.
- B. Eat several servings of cruciferous vegetables daily.
- C. Take a multiple vitamin every day.
- D. Do not engage in high-risk sexual behaviors.
Correct Answer: B
Rationale: Cruciferous vegetables (e.g., broccoli, cauliflower) are high in fiber and antioxidants, which may reduce colon cancer risk. Masks, vitamins, and sexual behaviors are less directly linked to colon cancer prevention.
The client diagnosed with chronic pancreatitis is concerned about pain control. The nurse explains that the initial plan for chronic pancreatic pain control involves the administration of which of the following?
- A. Opioid analgesics, such as morphine sulfate
- B. Nonsteroidal anti-inflammatory drugs (NSAIDs)
- C. Pancreatic enzymes with H2 blocker medications
- D. Injection of medication directly into the nerves
Correct Answer: C
Rationale: A. Opioid analgesics may be prescribed if pancreatic enzymes do not relieve pain. B. NSAIDs, such as ibuprofen, may be used to treat chronic pancreatic pain, but they are not the initial treatment and are usually not sufficient to control the pain. C. The initial pain control measures include exogenous pancreatic enzymes because pancreatic stimulation by food is thought to cause pain. Pancreatic enzymes are coupled with H2 blockers, which block the action of histamine on parietal cells in the stomach. H2 blockers are used because gastric acid destroys the lipase needed to break down fats. D. A nerve block relieves pain in about 50 percent of people who undergo the procedure, but this is not the initial measure for pain control.
The nurse identifies the problem of 'fluid volume deficit' for a client diagnosed with gastritis. Which intervention should be included in the plan of care?
- A. Obtain permission for a blood transfusion.
- B. Prepare the client for total parenteral nutrition.
- C. Monitor the client's lung sounds every shift.
- D. Assess the client's intravenous site.
Correct Answer: D
Rationale: Assessing the IV site ensures proper fluid administration to correct fluid volume deficit in gastritis. Blood transfusion, TPN, and lung sounds are not directly related.
The client has end-stage liver failure secondary to alcoholic cirrhosis. Which complication indicates the client is at risk for developing hepatic encephalopathy?
- A. Gastrointestinal bleeding.
- B. Hypoalbuminemia.
- C. Splenomegaly.
- D. Hyperaldosteronism.
Correct Answer: A
Rationale: GI bleeding increases ammonia levels (from blood protein breakdown), a key trigger for hepatic encephalopathy. Other complications are less directly linked to this risk.