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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 male client tells the nurse he has been experiencing 'heartburn' at night that awakens him. Which assessment question should the nurse ask?
- A. How much weight have you gained recently?
- B. What have you done to alleviate the heartburn?
- C. Do you consume many milk and dairy products?
- D. Have you been around anyone with a stomach virus?
Correct Answer: B
Rationale: Asking what the client has done to alleviate the heartburn helps the nurse understand the severity, triggers, and any self-management strategies, which are critical for assessing GERD. Weight gain, dairy consumption, or exposure to a stomach virus are less directly related to the immediate assessment of heartburn symptoms.
The nurse is caring for an adult client diagnosed with GERD. Which condition is the most common comorbid disease associated with GERD?
- A. Adult-onset asthma.
- B. Pancreatitis.
- C. Peptic ulcer disease.
- D. Increased gastric emptying.
Correct Answer: A
Rationale: GERD is commonly associated with adult-onset asthma due to acid reflux irritating the airways, leading to bronchospasm. Pancreatitis and peptic ulcer disease are less directly linked, and increased gastric emptying is not a typical comorbidity.
Which type of precaution should the nurse implement to protect from being exposed to any of the hepatitis viruses?
- A. Airborne Precautions.
- B. Standard Precautions.
- C. Droplet Precautions.
- D. Exposure Precautions.
Correct Answer: B
Rationale: Standard Precautions protect against hepatitis viruses (A, B, C, D) by assuming all body fluids are infectious, covering fecal-oral and bloodborne transmission. Other precautions are inappropriate.
The nurse writes the problem 'imbalanced nutrition: less than body requirements' for the client diagnosed with hepatitis. Which intervention should the nurse include in the plan of care?
- A. Provide a high-calorie intake diet.
- B. Discuss total parenteral nutrition (TPN).
- C. Instruct the client to decrease salt intake.
- D. Encourage the client to increase water intake.
Correct Answer: A
Rationale: A high-calorie diet addresses malnutrition and weight loss common in hepatitis, supporting recovery. TPN is invasive, salt restriction is unrelated, and water intake is less critical.
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.