Nokea
The nurse is discussing the therapeutic diet for the client diagnosed with diverticulosis. Which meal indicates the client understands the discharge teaching?
- A. Fried fish, mashed potatoes, and iced tea.
- B. Ham sandwich, applesauce, and whole milk.
- C. Chicken salad on whole-wheat bread and water.
- D. Lettuce, tomato, and cucumber salad and coffee.
Correct Answer: C
Rationale: A high-fiber diet, like whole-wheat bread, prevents constipation and flare-ups in diverticulosis. Fried foods, low-fiber applesauce, and salads with seeds (e.g., tomatoes) are less appropriate.
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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.
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.
The client with Crohn’s disease has undergone a barium enema that showed strictures in the ileum. Based on this finding, the nurse should monitor the client closely for signs of which complication?
- A. Peritonitis
- B. Obstruction
- C. Malabsorption
- D. Fluid imbalance
Correct Answer: B
Rationale: A. Peritonitis would not be an expected consequence of a bowel stricture. B. The nurse should monitor for signs of a bowel obstruction. Bowel strictures are a common complication of Crohn’s disease and can result in an acute bowel obstruction. C. Malabsorption would not be an expected consequence of a bowel stricture. D. Fluid balance would be affected once total obstruction develops.
The HCP writes the following admission orders for the client with possible appendicitis. Which order should the nurse question?
- A. Place on NPO (nothing per mouth) status.
- B. No analgesics until diagnosis is confirmed.
- C. Apply heat to abdomen to decrease pain.
- D. Start IV lactated Ringer’s at 125 mL/hr.
Correct Answer: C
Rationale: A. Clients are kept NPO in case surgery is needed. B. Analgesic medications are usually withheld until a definitive diagnosis is established to avoid masking critical symptom changes. C. The nurse should question applying heat to the abdomen when appendicitis is suspected. Heat is contraindicated because it increases circulation, which, in turn, could cause the appendix to rupture. D. Isotonic IV fluids are initiated to replace lost body fluid and prevent dehydration.
The nurse identifies the problem of 'fluid volume deficit' for a client diagnosed with gastritis. Which intervention should be included in the plan of care?
- A. Obtain permission for a blood transfusion.
- B. Prepare the client for total parenteral nutrition.
- C. Monitor the client's lung sounds every shift.
- D. Assess the client's intravenous site.
Correct Answer: D
Rationale: Assessing the IV site ensures proper fluid administration to correct fluid volume deficit in gastritis. Blood transfusion, TPN, and lung sounds are not directly related.