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The nurse is planning the care of a client diagnosed with lower esophageal sphincter dysfunction. Which dietary modifications should be included in the plan of care?
- A. Allow any of the client's favorite foods as long as the amount is limited.
- B. Have the client perform eructation exercises several times a day.
- C. Eat four (4) to six (6) small meals a day and limit fluids during mealtimes.
- D. Encourage the client to consume a glass of red wine with one (1) meal a day.
Correct Answer: C
Rationale: Eating small, frequent meals reduces stomach distension, which can trigger reflux, and limiting fluids during meals prevents excessive gastric volume. Favorite foods may include triggers, eructation exercises are not standard, and alcohol like red wine can worsen GERD.
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The occupational health nurse has had five (5) clients come to the clinic complaining of abdominal cramping, nausea, and vomiting. Which information should the nurse teach the employees to decrease the spread of this condition?
- A. Teach the employees to cough into the sleeve.
- B. Teach the housekeepers to use an antibacterial soap.
- C. Teach the coworkers to get a hepatitis vaccine.
- D. Teach the employees to wash their hands frequently.
Correct Answer: D
Rationale: Frequent handwashing prevents the spread of gastroenteritis, likely causing these symptoms. Coughing into sleeves, antibacterial soap, and hepatitis vaccines are less relevant.
The client diagnosed with acute diverticulitis is complaining of severe abdominal pain. On assessment, the nurse finds a hard, rigid abdomen and T 102°F. Which intervention should the nurse implement?
- A. Notify the health-care provider.
- B. Prepare to administer a Fleet's enema.
- C. Administer an antipyretic suppository.
- D. Continue to monitor the client closely.
Correct Answer: A
Rationale: A rigid abdomen and fever (102°F) suggest possible perforation or peritonitis, requiring immediate HCP notification for evaluation and possible surgical intervention. Enemas are contraindicated, and antipyretics or monitoring delay critical action.
The nurse is assessing a client complaining of abdominal pain. Which data support the diagnosis of a bowel obstruction?
- A. Steady, aching pain in one specific area.
- B. Sharp back pain radiating to the flank.
- C. Sharp pain increases with deep breaths.
- D. Intermittent colicky pain near the umbilicus.
Correct Answer: D
Rationale: Intermittent colicky pain near the umbilicus is characteristic of bowel obstruction due to peristalsis against the blockage. Steady pain, back pain, and pain with breathing suggest other conditions.
The client with type 2 diabetes is prescribed prednisone, a steroid, for an acute exacerbation of inflammatory bowel disease (IBD). Which intervention should the nurse discuss with the client?
- A. Take this medication on an empty stomach.
- B. Notify the HCP if experiencing a moon face.
- C. Take the steroid medication as prescribed.
- D. Notify the HCP if the blood glucose is over 160.
Correct Answer: D
Rationale: Prednisone can elevate blood glucose levels, particularly in diabetic patients, so monitoring and reporting elevated glucose (>160 mg/dL) is critical to prevent hyperglycemia complications. Moon face is a side effect but less urgent, and steroids should be taken with food to reduce gastric irritation.
The nurse is caring for an elderly client diagnosed with acute gastritis. Which client problem is priority for this client?
- A. Fluid volume deficit.
- B. Altered nutrition: less than body requirements.
- C. Impaired tissue perfusion.
- D. Alteration in comfort.
Correct Answer: A
Rationale: Fluid volume deficit is the priority in elderly clients with acute gastritis due to vomiting/diarrhea, risking dehydration. Nutrition, perfusion, and comfort are secondary.