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The nurse working in a skilled nursing facility is collaborating with the dietitian concerning the meals of an immobile client. Which foods are most appropriate for this client?
- A. Oatmeal and wheat toast.
- B. Cream of wheat and biscuits.
- C. Cottage cheese and canned peaches.
- D. Tuna on a croissant and applesauce.
Correct Answer: C
Rationale: Cottage cheese and canned peaches are soft, low-fiber, and easy to digest, suitable for an immobile client at risk for constipation. High-fiber options (oatmeal, wheat) may be harder to tolerate.
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The nurse caring for a client diagnosed with GERD writes the client problem of 'behavior modification.' Which intervention should be included for this problem?
- A. Teach the client to sleep with a foam wedge under the head.
- B. Encourage the client to decrease the amount of smoking.
- C. Instruct the client to take over-the-counter medication for relief of pain.
- D. Discuss the need to attend Alcoholics Anonymous to quit drinking.
Correct Answer: A
Rationale: Sleeping with a foam wedge elevates the head, reducing reflux by preventing stomach acid from flowing into the esophagus during sleep, a key behavioral modification for GERD. Smoking cessation is beneficial but less specific to immediate symptom relief, and the other options are not directly related to behavior modification for GERD.
The nurse is admitting a client to a medical floor with a diagnosis of adenocarcinoma of the rectosigmoid colon. Which assessment data support this diagnosis?
- A. The client reports up to 20 bloody stools per day.
- B. The client has a feeling of fullness after a heavy meal.
- C. The client has diarrhea alternating with constipation.
- D. The client complains of right lower quadrant pain.
Correct Answer: C
Rationale: Alternating diarrhea and constipation are common in rectosigmoid colon cancer due to partial obstruction by the tumor. Frequent bloody stools are more typical of ulcerative colitis, fullness is nonspecific, and right lower quadrant pain is less likely with rectosigmoid involvement.
The weight loss clinic nurse identifies the concept of nutrition for a client diagnosed with obesity. Which interventions should the nurse implement? Select all that apply.
- A. Ask the client about previous diet attempts.
- B. Refer the client to the dietitian.
- C. Discuss maintaining a sedentary lifestyle.
- D. Weigh the client.
- E. Assist the client to set a realistic weight loss goal.
Correct Answer: A,B,D,E
Rationale: Asking about diets, dietitian referral, weighing, and setting goals support nutritional management for obesity. A sedentary lifestyle is contraindicated.
The client is two (2) hours post colonoscopy. Which assessment data warrant immediate intervention by the nurse?
- A. The client has a soft, nontender abdomen.
- B. The client has a loose, watery stool.
- C. The client has hyperactive bowel sounds.
- D. The client's pulse is 104 and BP is 98/60.
Correct Answer: D
Rationale: Tachycardia (pulse 104) and low BP (98/60) suggest possible bleeding or hypovolemia post-colonoscopy, requiring immediate intervention. A soft abdomen, watery stool, and hyperactive bowel sounds are expected.
The client is diagnosed with Crohn's disease, also known as regional enteritis. Which statement by the client supports this diagnosis?
- A. My pain goes away when I have a bowel movement.
- B. I have bright red blood in my stool all the time.
- C. I have episodes of diarrhea and constipation.
- D. My abdomen is hard and rigid and I have a fever.
Correct Answer: C
Rationale: Crohn's disease often causes alternating diarrhea and constipation due to inflammation and strictures throughout the GI tract. Pain relief after bowel movements is less specific, bright red blood is more typical of ulcerative colitis, and a rigid abdomen suggests complications.