Nokea
The nurse is preparing a client diagnosed with GERD for discharge following an esophagogastroduodenoscopy (EGD). Which statement indicates the client understands the discharge instructions?
- A. I should not eat for at least one (1) day following this procedure.
- B. I can lie down whenever I want after a meal. It won't make a difference.
- C. The stomach contents won't bother my esophagus but will make me nauseous.
- D. I should avoid orange juice and eating tomatoes until my esophagus heals.
Correct Answer: D
Rationale: Avoiding acidic foods like orange juice and tomatoes reduces irritation to the esophagus, indicating understanding of dietary modifications for GERD. Not eating for a day is unnecessary, lying down after meals worsens reflux, and nausea is not the primary concern with GERD.
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Which sign/symptom should the nurse expect to find in a client diagnosed with ulcerative colitis?
- A. Twenty bloody stools a day.
- B. Oral temperature of 102°F.
- C. Hard, rigid abdomen.
- D. Urinary stress incontinence.
Correct Answer: A
Rationale: Ulcerative colitis commonly causes frequent bloody stools due to inflammation and ulceration of the colon mucosa. Fever may occur but is less specific, a hard abdomen suggests complications like perforation, and urinary incontinence is unrelated.
The nurse is reviewing the health history of the client receiving treatment for hemorrhoids. Which information, related to the development of hemorrhoids, should the nurse expect to find in the client’s medical history?
- A. Body mass index of 18
- B. Chronic constipation
- C. Nulliparous female
- D. Works as a salesperson
- E. Taking iron supplements
Correct Answer: B, E
Rationale: Clients who are thin (BMI = 18) would have a decreased risk of hemorrhoid development. Obesity is a risk factor for hemorrhoid development. B. Prolonged constipation is a risk factor for development of hemorrhoids. C. Since pregnancy is a common cause of constipation, nulliparous women would have a decreased risk of hemorrhoid development. D. Sedentary rather than active occupations have an increased risk of hemorrhoid development. E. Iron supplements can lead to constipation and straining, which can precipitate hemorrhoid development.
The nurse is caring for the client who has a temporary colostomy following surgery for colon cancer. The nurse assesses that the client’s colostomy bag is empty and that there has been no stool since surgery 24 hours ago. What should the nurse do?
- A. Call the surgeon immediately.
- B. Place the client left side-lying.
- C. Document these findings.
- D. Give a laxative medication.
Correct Answer: C
Rationale: The nurse should document the findings; the absence of stool is expected 24 hours postsurgery.
The client with a diagnosis of rule-out colon cancer is two (2) hours post-sigmoidoscopy procedure. Which assessment data warrant immediate intervention by the nurse?
- A. The client has hyperactive bowel sounds.
- B. The client is eating a hamburger the family brought.
- C. The client is sleepy and wants to sleep.
- D. The client's BP is 96/60 and apical pulse is 108.
Correct Answer: D
Rationale: Low BP (96/60) and tachycardia (pulse 108) suggest hypovolemia or bleeding post-sigmoidoscopy, requiring immediate intervention. Hyperactive bowel sounds, eating, and sleepiness are less urgent.
Which assessment data indicate to the nurse the client recovering from an open cholecystectomy may require pain medication?
- A. The client's pulse is 65 beats per minute.
- B. The client has shallow respirations.
- C. The client's bowel sounds are 20 per minute.
- D. The client uses a pillow to splint when coughing.
Correct Answer: B
Rationale: Shallow respirations suggest pain, as patients avoid deep breathing to minimize discomfort. Normal pulse, bowel sounds, and splinting are less direct indicators of pain.