Nokea
The patient with irritable bowel syndrome tells the home health nurse she is going to an acupuncturist for therapy for her condition. Which will be the best nursing response?
- A. Go for it. Alternative medicine does great things.'
- B. YIKES! An acupuncturist?'
- C. Some people have found relief from nausea and colon muscle spasms.'
- D. You should confirm that the acupuncturist and facility are state licensed.'
Correct Answer: C
Rationale: Some people find that acupuncture provides relief from nausea, vomiting and relaxation of muscle spasms in the colon. However, clinical trial data are inadequate to determine efficacy.
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A patient with a large inguinal hernia has abdominal distention and inguinal pain. The nurse recognizes these as indicators of which type of hernia?
- A. Strangulated
- B. Hiatal
- C. Ventral
- D. Umbilical
Correct Answer: A
Rationale: The hernia is strangulated when the blood supply and intestinal flow are occluded, which results in pain and distention.
The nurse anticipates that the patient who has had a subtotal gastrectomy will need which type of supplement?
- A. protein due to the loss of some of the digestive processes.
- B. vitamin B12 due to the loss of the intrinsic factor.
- C. bulk to prevent constipation.
- D. vitamin A due to the loss of the gastric lining.
Correct Answer: B
Rationale: It is recommended that all patients with a gastrectomy have a blood serum vitamin B12 level measured every 1 to 2 years. Decreased absorption of vitamin B12 may cause pernicious anemia.
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.
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.
The patient with a peptic ulcer has been placed on regular doses of bismuth salicylate to combat Helicobacter pylori. What color will this drug turn the stool?
- A. Gray-black
- B. Dark green
- C. Red-orange
- D. Yellow
Correct Answer: A
Rationale: Bismuth products turn the stool gray-black.