Nokea
The nurse is conducting a health screening at a local health fair. Which of the following should the nurse recognize as risk factors for developing colorectal cancer? Select all that apply.
- A. Ulcerative colitis
- B. Body Mass Index (BMI) of 21
- C. Human Immunodeficiency Virus (HIV) infection
- D. Low-fiber diet
- E. Excessive alcohol consumption
- F. African-American ethnicity
Correct Answer: A,D,E,F
Rationale: Ulcerative colitis (A), low-fiber diet (D), excessive alcohol (E), and African-American ethnicity (F) are risk factors for colorectal cancer. Normal BMI (B) and HIV (C) are not directly linked.
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The nurse is caring for a client with suspected bowel perforation. Which of the following would be contraindicated?
- A. Administering gastrografin for an upper GI x-ray.
- B. An exploratory laparotomy procedure.
- C. Administering milk of magnesia following an upper GI study.
- D. An abdominal CT scan.
Correct Answer: C
Rationale: Milk of magnesia (C) is contraindicated in suspected bowel perforation as it may worsen the condition by increasing intestinal motility or causing further leakage. Gastrografin (A), laparotomy (B), and CT scans (D) are appropriate diagnostic or therapeutic measures.
The nurse in the intensive care unit is caring for a client being treated for necrotizing pancreatitis. Which of the following findings would indicate the client is experiencing a complication?
- A. Periumbilical bruising
- B. Abdominal pain rated 5/10 on the numerical rating scale
- C. White blood cell count 13,500 mm3 [5,000-10,000 mm3]
- D. Decreased lung sounds in the left lower lung fields
Correct Answer: D
Rationale: Decreased lung sounds (D) may indicate a complication like pleural effusion or atelectasis in necrotizing pancreatitis, requiring further evaluation.
The nurse is taking care of a client that is scheduled to undergo a gastric analysis at 8:00 AM tomorrow. Which should be included in the client's plan of care?
- A. Instruct the client that she should not eat or drink anything after midnight.
- B. Teach the client that in case she feels hungry, she can chew some gum.
- C. Instruct the client that she needs to be on bed rest for 2 hours after the procedure.
- D. Tell the client that she is allowed to smoke 1 hour prior to surgery.
Correct Answer: A
Rationale: Fasting after midnight (A) ensures accurate gastric analysis results. Chewing gum (B), bed rest (C), and smoking (D) are not appropriate.
The emergency department (ED) nurse reviews the client's triage note. Select the findings in the triage note that require immediate follow-up.
- A. 56-year-old male reports persistent nausea and vomiting that has not improved with prescribed anti-emetic.
- B. He reports being diagnosed with viral gastroenteritis three days ago by his physician.
- C. He states that his n/v has gotten so bad that he cannot hold down food or fluids.
- D. On assessment, the client is lethargic and oriented. Unsteady gait.
- E. He reports that he can take his prescribed medications with sips of water.
- F. On assessment, the client is lethargic and oriented. Unsteady gait.
- G. Vital signs: T 99°F (37°C), P 108, RR 18, BP 132/77, pulse oximetry reading 97% on room air.
Correct Answer: A,C,D,F
Rationale: Persistent nausea/vomiting (A, C), lethargy, and unsteady gait (D, F) suggest dehydration or electrolyte imbalances requiring immediate follow-up.
The nurse is reviewing gastrointestinal assessment with a group of student nurses. It would be correct if the student identifies which of the following would cause hyperactive bowel sounds?
- A. Paralytic ileus
- B. Gastroenteritis
- C. Late bowel obstruction
- D. Peritonitis
Correct Answer: B
Rationale: Gastroenteritis (B) causes hyperactive bowel sounds due to increased intestinal motility from inflammation or infection. Paralytic ileus (A), late bowel obstruction (C), and peritonitis (D) typically cause hypoactive or absent bowel sounds.