Nokea
The nurse takes into consideration that long-term use of antibiotics can cause an antibiotic-associated pseudomembranous colitis from the organism
- A. Clostridium difficile
Correct Answer: Clostridium difficile
Rationale: C. difficile causes a type of colitis from long-term antibiotic use to which older adults are extremely susceptible.
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The home health nurse is caring for a patient who has frequent abdominal pain and diarrhea. The nurse uses the Rome Criteria to direct data collection for irritable bowel syndrome. What is included in the Rome Criteria?
- A. Discomfort at least 3 days a month
- B. Blood in stool
- C. Pain relieved by defecation
- D. Excessive flatulence
- E. Nausea and vomiting associated with onset
- F. Onset associated with change in stool consistency or frequency
Correct Answer: A,C,F
Rationale: The Rome Criteria include that the patient experience discomfort at least 3 days a month within the last 3 months, pain relieved by defecation, onset associated with change in stool frequency, and onset in association with a change in stool appearance. Although increased flatus is associated with diverticulitis, it is not part of the Rome Criteria.
Why are peptic ulcers a common problem of aging?
- A. Older adults develop esophageal diverticula
- B. Older adults have a higher incidence of hiatal hernia
- C. Older adults use nonsteroidal anti-inflammatory drugs to treat chronic joint conditions
- D. Older adults have decreased secretion of hydrochloric acid from the parietal cells of the stomach.
Correct Answer: C
Rationale: Medications such as aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) taken for arthritis or degenerative joint conditions may contribute to ulcer formation.
Which will the nurse reinforce in the patient teaching of a patient who had a gastrectomy to treat a severely bleeding peptic ulcer?
- A. Introducing irritating foods in minute amounts to desensitize the stomach
- B. Restricting fluid to 1000 mL per day
- C. Eating 6 small meals a day
- D. Drinking alcohol and caffeine in moderation
Correct Answer: C
Rationale: The patient who had a gastrectomy to treat a bleeding peptic ulcer should eat small meals daily. Restriction of fluid is not necessary and irritating foods, alcohol, and caffeine should be discouraged.
What should a nurse do when obtaining a stool specimen to be examined for ova and parasites?
- A. Use an oil retention enema to facilitate collection.
- B. Refrigerate the specimen immediately.
- C. Obtain three different stool specimens on subsequent days.
- D. Check the specimen for the presence of occult blood.
Correct Answer: C
Rationale: Diagnosing a parasitic infection requires three different stool specimens on subsequent days. Use only normal saline or tap water enemas to prevent alteration of results.
The home health nurse caring for a patient who has dysarthria related to radiation therapy for an oral cancer would recommend that the family provide which device?
- A. a tablet and pencil as a communication aid.
- B. a TV for diversion.
- C. a bell to summon help.
- D. a walkie-talkie.
Correct Answer: A
Rationale: The provision of an alternative method of communicating will lessen the frustration of the patient who has trouble speaking understandably. The call bell would be helpful also, but without a way to communicate, the bell is not as essential as a method of communication.