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The nurse is teaching the client diagnosed with colon cancer who is scheduled for a colostomy. Which behavior indicates the nurse is utilizing adult learning principles?
- A. The nurse repeats the information as indicated by the client's questions.
- B. The nurse teaches in one session all the information the client needs.
- C. The nurse uses a video so the client can hear the medical terms.
- D. The nurse waits until the client asks questions about the surgery.
Correct Answer: A
Rationale: Repeating information based on client questions respects adult learning principles by addressing the learner’s needs and reinforcing understanding. One-session teaching, videos, or waiting for questions are less interactive.
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The client diagnosed with IBD is prescribed total parenteral nutrition (TPN). Which intervention should the nurse implement?
- A. Check the client's glucose level.
- B. Administer an oral hypoglycemic.
- C. Assess the peripheral intravenous site.
- D. Monitor the client's oral food intake.
Correct Answer: A
Rationale: TPN, high in dextrose, can cause hyperglycemia, so monitoring glucose levels is essential, especially in IBD patients with potential metabolic stress. Oral hypoglycemics are inappropriate, TPN uses central lines, and oral intake is typically minimal.
Which oral medication should the nurse question before administering to the client with peptic ulcer disease?
- A. E-mycin, an antibiotic.
- B. Prilosec, a proton pump inhibitor.
- C. Flagyl, an antimicrobial agent.
- D. Tylenol, a nonnarcotic analgesic.
Correct Answer: A
Rationale: E-mycin (erythromycin) can irritate the gastric mucosa and exacerbate peptic ulcer disease, so it should be questioned. Prilosec and Flagyl treat ulcers (especially H. pylori-related), and Tylenol is safe for pain relief.
The nurse is caring for a client diagnosed with bulimia nervosa. Which nursing intervention should the nurse implement after the client's evening meal?
- A. Praise the client for eating all the food on the tray.
- B. Stay with the client for 45 minutes to an hour.
- C. Allow the client to work out on the treadmill.
- D. Place the client on bedrest until morning.
Correct Answer: B
Rationale: Staying with the client prevents purging, a key behavior in bulimia, post-meal. Praising eating, exercise, or bedrest does not address purging.
The home health nurse is performing a follow-up visit for the client diagnosed with chronic hepatitis B. The client is being treated with interferon alpha-2b. Which client comment requires further assessment by the nurse?
- A. “My clothes are tight; I gained 2 pounds this month.”
- B. “Whenever I just bump into anything, I get a bruise.”
- C. “I’ve been staying home and avoiding large crowds.”
- D. “I get tired easily, so I just take my time with things.”
Correct Answer: B
Rationale: A. Anorexia is commonly seen with hepatitis B. A weight gain of 2 lb in one month would typically not be a cause for concern. B. Bruising can indicate thrombocytopenia, which is an adverse effect of treatment. Thrombocytopenia can also occur from liver dysfunction. C. Avoiding large crowds is appropriate; the client will be at increased risk for infection while taking interferon alpha-2b. D. Fatigue is commonly associated with chronic hepatitis B.
The dietitian and the nurse in a long-term care facility are planning the menu for the day. Which foods should be recommended for the immobile clients for whom swallowing is not an issue?
- A. Cheeseburger and milk shake.
- B. Canned peaches and a sandwich on whole-wheat bread.
- C. Mashed potatoes and mechanically ground red meat.
- D. Biscuits and gravy with bacon.
Correct Answer: C
Rationale: Mashed potatoes and ground meat are soft, low-fiber, and digestible, suitable for immobile clients to prevent constipation. Burgers, whole-wheat, and fatty foods are harder to digest.