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The nurse is taking a hospital admission history of the client. The nurse considers that the client may have IBS when the client makes which statement?
- A. “I am having a lot of bloody diarrhea.”
- B. “I have been vomiting for 2 days.”
- C. “I have lost 10 pounds in the last month.”
- D. “I have noticed mucus in my stools.”
Correct Answer: D
Rationale: A. Clients with IBS may have diarrhea, but it is not bloody. B. Vomiting is not a symptom of IBS. C. Clients with IBS do not have unintentional weight loss. D. Mucus in the stools is a sign of IBS.
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The client has been experiencing difficulty and straining when expelling feces. Which intervention should the nurse discuss with the client?
- A. Explain some blood in the stool will be normal for the client.
- B. Instruct the client in manual removal of feces.
- C. Encourage the client to use a cathartic laxative on a daily basis.
- D. Place the client on a high-fiber diet.
Correct Answer: D
Rationale: A high-fiber diet promotes regular, softer stools, reducing straining. Blood is not normal, manual removal is invasive, and daily laxatives cause dependency.
The client with a history of a duodenal ulcer is hospitalized with upper abdominal discomfort and projectile vomiting that has a foul odor. The nurse immediately notifies the HCP, concluding that the client may have developed which complication?
- A. Gastric perforation
- B. Gastrointestinal hemorrhage
- C. Gastric outlet obstruction
- D. Helicobacter pylori infection
Correct Answer: C
Rationale: A. Symptoms of perforation include severe abdominal pain; vomiting usually does not occur. B. The client with GI hemorrhage would have bright red or coffee-ground-colored emesis. C. Symptoms of gastric outlet obstruction include abdominal pain and projectile vomiting when the stomach fills enough to stimulate afferent nerve fibers relaying information to the vomiting center in the brain. The emesis may have a foul odor or contain food particles if the contents have been dormant in the stomach for a prolonged time period. D. Infection with H. pylori is not a complication of PUD; rather, it is a major cause of peptic ulcers.
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.
A client is to have a sigmoidoscopy in the morning. Which activity will be included in the care of this client?
- A. Give him an enema one hour before the examination.
- B. Keep him NPO for eight hours before the examination.
- C. Order a low-fat, low-residue diet for breakfast.
- D. Administer enemas until the returns are clear this evening.
Correct Answer: A
Rationale: An enema one hour before sigmoidoscopy clears the sigmoid colon for better visualization.
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.