Nokea
The nurse is facilitating a support group for clients diagnosed with Crohn's disease. Which information is most important for the nurse to discuss with the clients?
- A. Discuss coping skills to assist with adaptation to lifestyle modifications.
- B. Teach about drug administration, dosages, and scheduled times.
- C. Teach dietary changes necessary to control symptoms.
- D. Explain the care of the ileostomy and necessary equipment.
Correct Answer: A
Rationale: Coping skills help clients adapt to the chronic, unpredictable nature of Crohn’s disease, addressing psychosocial needs in a support group. Medications, diet, and ileostomy care are secondary.
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A distal pancreatectomy and splenectomy is performed on a client with cancer of the pancreas. He is returned to his room postoperatively. The client is sleepy but can answer simple questions appropriately. His dressing is dry and intact. Vital signs are within normal limits. Which of the following nursing measures must be done before the nurse leaves the room?
- A. Inform his wife that he has returned to his room.
- B. Check to see if the indwelling urinary catheter bag is correctly attached to the bed frame.
- C. Assess to be sure he is not experiencing any discomfort.
- D. Put all four side rails in the high position.
Correct Answer: D
Rationale: Raising all four side rails ensures safety for a sleepy postoperative client, preventing falls.
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 emergency department nurse is working in a community hospital. During the past two (2) hours, 15 clients have been admitted with Salmonella food poisoning. Which information should the nurse discuss with the clients?
- A. Explain the incubation period is 48 to 72 hours.
- B. Explain the source of this poisoning is contaminated water.
- C. Explain the sources of contamination are eggs and chicken.
- D. Explain the bacterial contaminant came from canned foods.
Correct Answer: C
Rationale: Salmonella is commonly associated with undercooked eggs and poultry, making this the most accurate information. Incubation is 6–72 hours, water is less common, and canned foods are linked to botulism.
The client who has had a hemorrhoidectomy wants to know why she cannot take a sitz bath immediately upon return from the operating room. The nurse's response is based on which of the following concepts?
- A. Heat can stimulate bowel movement too quickly after surgery.
- B. Clients are generally not awake enough for several hours to safely take sitz baths.
- C. Heat applied immediately postoperatively increases the possibility of hemorrhage.
- D. Sitting in water before the sutures are removed may cause infection.
Correct Answer: C
Rationale: Heat increases blood flow, raising the risk of hemorrhage immediately post-hemorrhoidectomy.
Which instruction should be discussed with the client diagnosed with gastroesophageal reflux disease (GERD)?
- A. Eat a low-carbohydrate, low-sodium diet.
- B. Lie down for 30 minutes after eating.
- C. Do not eat spicy foods or acidic foods.
- D. Drink two (2) glasses of water before bedtime.
Correct Answer: C
Rationale: Avoiding spicy and acidic foods reduces esophageal irritation, a key instruction for managing GERD. Low-carb/sodium diets are not specific, lying down after eating worsens reflux, and water before bedtime is irrelevant.