Nokea
The nurse is caring for clients in an outpatient clinic. Which information should the nurse teach regarding the American Cancer Society's recommendations for the early detection of colon cancer?
- A. Beginning at age 60, a digital rectal examination should be done yearly.
- B. After reaching middle age, a yearly fecal occult blood test should be done.
- C. Have a colonoscopy at age 50 and then once every five (5) to 10 years.
- D. A flexible sigmoidoscopy should be done yearly after age 40.
Correct Answer: C
Rationale: The American Cancer Society recommends a colonoscopy starting at age 45–50, then every 5–10 years for average-risk individuals, as it effectively detects polyps and cancer. Other options are outdated or incorrect.
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The client is four (4) hours postoperative open cholecystectomy. Which data warrant immediate intervention by the nurse?
- A. Absent bowel sounds in all four (4) quadrants.
- B. The T-tube has 60 mL of green drainage.
- C. Urine output of 100 mL in the past three (3) hours.
- D. Refusal to turn, deep breathe, and cough.
Correct Answer: D
Rationale: Refusal to turn, deep breathe, and cough increases the risk of atelectasis and pneumonia post-surgery, requiring immediate intervention. Absent bowel sounds, T-tube drainage, and urine output are expected at this stage.
The client who has had an abdominal perineal resection is being discharged. Which discharge information should the nurse teach?
- A. The stoma should be a white, blue, or purple color.
- B. Limit ambulation to prevent the pouch from coming off.
- C. Take pain medication when the pain level is at an '8.'
- D. Empty the pouch when it is one-third to one-half full.
Correct Answer: D
Rationale: Emptying the pouch when one-third to one-half full prevents leaks and skin irritation. A healthy stoma is pink/moist, ambulation is encouraged, and pain medication should be taken before pain becomes severe.
The 36-year-old female client diagnosed with anorexia nervosa tells the nurse 'I am so fat. I won't be able to eat today.' Which response by the nurse is most appropriate?
- A. Can you tell me why you think you are fat?
- B. You are skinny. Many women wish they had your problem.
- C. If you don't eat, we will have to restrain you and feed you.
- D. Not eating might cause physical problems.
Correct Answer: A
Rationale: Asking why the client feels fat explores distorted body image, a therapeutic approach in anorexia. Dismissing feelings, threatening restraints, or stating consequences are nontherapeutic.
Which interventions should the nurse discuss regarding prevention of an acute exacerbation of diverticulosis? Select all that apply.
- A. Eat a low-fiber diet.
- B. Drink 2,500 mL of water daily.
- C. Avoid eating foods with seeds.
- D. Walk 30 minutes a day.
- E. Take an antacid every two (2) hours.
Correct Answer: B,C,D
Rationale: High fluid intake (2,500 mL), avoiding seeds, and exercise (walking) prevent constipation and reduce diverticulitis risk. Low-fiber diets worsen diverticulosis, and antacids are irrelevant.
Following a hemorrhoidectomy, the nurse is instructing the client in self-care. Which statement is especially important to include in these instructions?
- A. Wash the anal area with water after defecation and pat it dry.'
- B. Gently wipe the anal area after defecation from back to front.'
- C. Do not drink more than three glasses of fluid per day until after you have had the first bowel movement.'
- D. When you first feel the need to defecate, call me and I will give you the enema the doctor has ordered.'
Correct Answer: A
Rationale: Washing and patting dry promotes hygiene and healing post-hemorrhoidectomy, reducing irritation.