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The nurse is working in an outpatient clinic. Which client is most likely to have a diagnosis of diverticulosis?
- A. A 60-year-old male with a sedentary lifestyle.
- B. A 72-year-old female with multiple childbirths.
- C. A 63-year-old female with hemorrhoids.
- D. A 40-year-old male with a family history of diverticulosis.
Correct Answer: A
Rationale: Diverticulosis is more common in older adults with sedentary lifestyles, which contribute to constipation and increased colonic pressure. Childbirth, hemorrhoids, and family history are less direct risk factors.
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Which data should the nurse expect to assess in the client diagnosed with acute gastroenteritis?
- A. Decreased gurgling sounds on auscultation of the abdominal wall.
- B. A hard, firm, edematous abdomen on palpation.
- C. Frequent, small melena-type liquid bowel movements.
- D. Bowel assessment reveals loud, rushing bowel sounds.
Correct Answer: D
Rationale: Loud, rushing bowel sounds are expected in gastroenteritis due to increased peristalsis from irritation. Decreased sounds, hard abdomen, or melena suggest other conditions.
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 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.
A child with appendicitis is scheduled for surgery this evening. The nurse enters the room and sees the child's mother starting to place hot, wet washcloths on her daughter's abdomen so that 'she will feel better.' The nurse explains that this action is contraindicated because heat:
- A. can cause the appendix to rupture and cause peritonitis.
- B. can mask symptoms of acute appendicitis.
- C. will increase peristalsis throughout the abdomen.
- D. will arrest progression of the disease.
Correct Answer: A
Rationale: Heat can increase inflammation and blood flow, risking appendix rupture and peritonitis in appendicitis.
The nurse is caring for the client diagnosed with cirrhosis. After completing discharge education, the nurse recognizes the need for further teaching when the client makes which statement?
- A. “My cirrhosis was caused from too much alcohol; I plan to stop drinking.”
- B. “I need to rest more; I plan on only going to work on a part-time basis.”
- C. “Propranolol has been ordered to decrease my blood pressure.”
- D. “Furosemide will help to reduce the amount of abdominal fluid.”
Correct Answer: C
Rationale: A. Alcohol intake is a major cause of cirrhosis and must be eliminated from the client’s diet. B. Rest may enable the liver to restore itself and should be encouraged. C. Although propranolol (Inderal) does decrease BP, it is not ordered for this purpose in treating cirrhosis. Prophylactic treatment with a nonselective beta blocker like propranolol has been shown to reduce the risk of bleeding from esophageal varices and to reduce bleeding-related deaths. D. Furosemide (Lasix) is used in combination with potassium-sparing diuretics to decrease ascites.