Nokea
The nurse is caring for a geriatric client at a long-term care facility. When administering the client's medications, which age-related change(s) of the client is anticipated? Select all that apply.
- A. Increased saliva causing drooling
- B. Decreased motility in the esophagus
- C. A weak gag reflex
- D. Increased amount of gastric secretions
- E. Decreased elasticity of the rectal wall
Correct Answer: B,C,E
Rationale: Age-related considerations when administering medications to a geriatric client include administering medications slowly and allowing time between medications due to a decreased motility in the esophagus. Additionally, the client has a weakened gag reflex, which may cause the client to choke. The client has a decreased elasticity of the rectal wall potentially causing fecal incontinence. Geriatric clients have a decrease in saliva production requiring water with oral medication administration. There is also a decrease in the amount of gastric secretions, which could produce nausea.
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A client has undergone a barium swallow test. Which would be an appropriate action by the nurse to ensure that the client does not retain any barium after a barium swallow?
- A. Placing any stool passed in a specific preservative
- B. Monitoring the stool passage and its color
- C. Observing the color of urine
- D. Monitoring the volume of urine
Correct Answer: B
Rationale: Monitoring stool passage and its color will ensure that the client eliminates barium following a barium swallow test. The white or clay color of the stool would indicate barium retention. The stool should be placed in a special preservative if the client undergoes a stool analysis. Observing the color and volume of urine will not ensure that the client is barium free because barium is not eliminated through urine but through stool.
The nurse is accompanying the client to the diagnostic imaging unit for a magnetic resonance imaging (MRI). Which action by the nurse is most important prior to the test?
- A. Instruct the client that the scanner makes loud clanging.
- B. Calculate drop per minute for intravenous fluids and infuse by gravity.
- C. Support client, if nervous, by words of encouragement.
- D. Ensure that the client does not ingest fluids in the waiting area.
Correct Answer: B
Rationale: It is most important that the nurse calculate the drip rate of the intravenous fluids because the client will not be able to have an electrical or mechanical pump operating during the MRI. The MRI electrical charges during the test can affect the pump. It is also important to advise the client of the loud noises and offer support to the client. Water is typically not available in the waiting area prior to testing.
The nurse is preparing to measure the client's abdominal girth as part of the physical examination. At which location would the nurse most likely measure?
- A. In the right upper quadrant
- B. At the umbilicus
- C. At the lower border of the liver
- D. Just below the last rib
Correct Answer: B
Rationale: Measurement of abdominal girth is done at the widest point, which is usually the umbilicus. The right upper quadrant, lower border of the liver, or just below the last rib would be inappropriate sites for abdominal girth measurement.
The nurse is working with clients with digestive tract disorders. Which organ does the nurse realize has effects as an exocrine gland and an endocrine gland?
- A. Gallbladder
- B. Pancreas
- C. Stomach
- D. Liver
Correct Answer: B
Rationale: The pancreas is both an exocrine gland, one that releases secretions into a duct or channel, and an endocrine gland, one that releases substances directly into the bloodstream. The other organs have a variety of functions but do not have a combination function such as the pancreas.
When assisting with preparing a client scheduled for a barium swallow, which instruction would be appropriate to include?
- A. Avoid smoking for at least 12 to 24 hours before the procedure.
- B. Take vitamin K before the procedure.
- C. Take three cleansing enemas before the procedure.
- D. Avoid the intake of red meat before the procedure.
Correct Answer: A
Rationale: The nurse should instruct the client to avoid smoking for at least a day before the procedure of barium swallow because smoking stimulates gastric motility. The client is advised to take vitamin K before a liver biopsy and instructed to take three cleansing enemas before a barium enema. Instruction to avoid red meat would be appropriate for a client who is having a Hemoccult test.