Nokea
The nurse is caring for a client who uses cathartics frequently. Which statement made by the client indicates an understanding of the discharge teaching?
- A. In the future I will eat a banana every time I take the medication.
- B. I don't have to have a bowel movement every day.
- C. I should limit the fluids I drink with my meals.
- D. If I feel sluggish, I will eat a lot of cheese and dairy products.
Correct Answer: B
Rationale: Understanding that daily bowel movements are not necessary reflects proper teaching to reduce cathartic overuse. Bananas, fluid limits, and dairy are incorrect.
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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.
The client is diagnosed with irritable bowel syndrome (IBS). Which intervention should the nurse teach the client to reduce symptoms?
- A. Instruct the client to avoid drinking fluids with meals.
- B. Explain the need to decrease intake of flatus-forming foods.
- C. Teach the client how to perform gentle perianal care.
- D. Encourage the client to attend a support group meeting.
Correct Answer: B
Rationale: Decreasing flatus-forming foods (e.g., beans, broccoli) reduces bloating and discomfort in IBS. Avoiding fluids with meals is not standard, perianal care is secondary, and support groups are psychosocial.
The nurse is caring for clients on a surgical unit. Which client should the nurse assess first?
- A. The client who had an inguinal hernia repair and has not voided in four (4) hours.
- B. The client who was admitted with abdominal pain who suddenly has no pain.
- C. The client four (4) hours postoperative abdominal surgery with no bowel sounds.
- D. The client who is one (1) day postappendectomy and is being discharged.
Correct Answer: B
Rationale: Sudden resolution of abdominal pain may indicate perforation (e.g., appendicitis), a life-threatening emergency requiring immediate assessment. Urinary retention, absent bowel sounds, and discharge are less urgent.
The client developed a paralytic ileus after abdominal surgery. Which intervention should the nurse include in the plan of care?
- A. Administer a laxative of choice.
- B. Encourage the client to increase oral fluids.
- C. Encourage the client to take deep breaths.
- D. Maintain a patent nasogastric tube.
Correct Answer: D
Rationale: Maintaining a patent NG tube decompresses the bowel in paralytic ileus, preventing complications. Laxatives and oral fluids are contraindicated, and deep breathing is unrelated.
A nasogastric tube is ordered for an alert adult client. In addition to the tube and basin, what is essential for the nurse to have at the bedside during the procedure?
- A. A 5-cc syringe filled with water
- B. A glass filled with water and a straw
- C. A large clamp
- D. A container of sterile water
Correct Answer: B
Rationale: A glass of water with a straw helps the client swallow during nasogastric tube insertion, facilitating passage.