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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.
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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.
The nurse caring for a patient with a peptic ulcer who has had a nasogastric tube inserted notes bright blood in the tube, the patient complains of pain and has become hypotensive. Which condition should the nurse recognize these as signs of?
- A. Hiatal hernia
- B. Gastritis
- C. Perforation
- D. Bowel obstruction
Correct Answer: C
Rationale: Perforation of the gastric wall causes pain, hypotension, and hematemesis. Immediate reporting to the charge nurse/physician is essential as peritonitis, potentially lethal, is the result of a perforation.
In reinforcing a teaching plan to present to a group of older adults regarding the prevention of esophageal cancer, the nurse would include which significant information?
- A. cessation of smoking.
- B. Frequent monitoring for Barrett's esophagus
- C. regular checkups if dysphagia is present.
- D. reducing excessive weight.
- E. limiting alcohol consumption.
- F. reduction of consumption of citrus fruits.
Correct Answer: A,B,C,E
Rationale: Preventive measures include cessation of smoking and alcohol consumption, monitoring for Barrett's esophagus, and medical evaluation of dysphagia. Weight and reduction of citrus fruits are noncontributory to prevention of esophageal cancer.
In caring for a patient with gastric bleeding who has a nasogastric (NG) tube in place, the nurse expects to see which intervention for the nasogastric tube included in the plan of care?
- A. clamp for 10 minutes every hour.
- B. keep the patent with irrigation.
- C. frequently reposition to the opposite nostril.
- D. change every 72 hours.
Correct Answer: B
Rationale: Irrigating the NG tube as needed will keep the tube patent and ensure effective decompression.
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.