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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.
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The client diagnosed with ulcerative colitis is prescribed a low-residue diet. Which meal selection indicates the client understands the diet teaching?
- A. Grilled hamburger on a wheat bun and fried potatoes.
- B. A chicken salad sandwich and lettuce and tomato salad.
- C. Roast pork, white rice, and plain custard.
- D. Fried fish, whole grain pasta, and fruit salad.
Correct Answer: C
Rationale: A low-residue diet minimizes fiber to reduce bowel irritation, so roast pork, white rice, and plain custard (low-fiber foods) are appropriate. The other options include high-fiber foods like wheat, vegetables, and whole grains, which are contraindicated.
Which problem is most appropriate for the nurse to identify for the client with diarrhea?
- A. Alteration in skin integrity.
- B. Chronic pain perception.
- C. Fluid volume excess.
- D. Ineffective coping.
Correct Answer: A
Rationale: Diarrhea can cause perianal skin breakdown, making alteration in skin integrity the most appropriate problem. Pain is less common, fluid volume is deficient, and coping is secondary.
The client is diagnosed with salmonellosis secondary to eating some slightly cooked hamburger meat. Which clinical manifestations should the nurse expect the client to report?
- A. Abdominal cramping, nausea, and vomiting.
- B. Neuromuscular paralysis and dysphagia.
- C. Gross amounts of explosive bloody diarrhea.
- D. Frequent 'rice water stool' with no fecal odor.
Correct Answer: A
Rationale: Salmonellosis typically causes abdominal cramping, nausea, and vomiting due to bacterial irritation of the GI tract. Paralysis is botulism, bloody diarrhea is more typical of other pathogens, and rice water stool is cholera.
The nurse is preparing to administer the initial dose of an aminoglycoside antibiotic to the client diagnosed with acute diverticulitis. Which intervention should the nurse implement?
- A. Obtain a serum trough level.
- B. Ask about drug allergies.
- C. Monitor the peak level.
- D. Assess the vital signs.
Correct Answer: B
Rationale: Checking for drug allergies before administering an aminoglycoside prevents allergic reactions, a critical safety step. Trough and peak levels are monitored later, and vital signs are routine but not specific to the initial dose.
The clinic nurse is returning client calls. Which client should the nurse call first?
- A. The 39-year-old client complaining of headache pain with a 3 on the pain scale.
- B. The 45-year-old client who needs a prescription refill for warfarin.
- C. The 54-year-old client diagnosed with diabetes type 1 who has been vomiting.
- D. The 60-year-old client who cannot afford to buy food and needs assistance.
Correct Answer: C
Rationale: Vomiting in a type 1 diabetic risks diabetic ketoacidosis, a medical emergency, requiring immediate attention. Headache, warfarin refill, and food insecurity are less urgent.