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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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A client has had a liver biopsy. After the procedure, the nurse should position him on his right side with a pillow under his rib cage. What is the primary reason for this position?
- A. To immobilize the diaphragm
- B. To facilitate full chest expansion
- C. To minimize the danger of aspiration
- D. To reduce the likelihood of bleeding
Correct Answer: D
Rationale: Right-side positioning with a pillow applies pressure to the biopsy site, reducing the risk of bleeding.
The client recovering from acute pancreatitis who has been NPO asks the nurse, “When can I start eating again?” Which response by the nurse is most accurate?
- A. “As soon as you start to feel hungry you can begin eating.”
- B. “When I hear that your bowel sounds are active and you are passing flatus.”
- C. “When your pain is controlled and your serum lipase level has decreased.”
- D. “You will be NPO for at least more 2 weeks; oral intake stimulates the pancreas.”
Correct Answer: C
Rationale: A. Regaining appetite is a positive sign, but it must be accompanied by a decrease in pain before the client is allowed to take food orally. B. Intestinal peristalsis may be slowed due to inflammation associated with acute pancreatitis, but the return of bowel sounds and flatus is not used to determine when to begin oral intake. C. This response is correct. Once pain is controlled and the serum enzyme levels begin to decrease, the client can begin oral intake. These are signs that the pancreas is healing. D. There is no specific time limit for being NPO.
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 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 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.