Nokea
When assessing the client with celiac disease, the nurse can expect to find which of the following?
- A. Steatorrhea
- B. Jaundiced sclerae
- C. Clay-colored stools
- D. Widened pulse pressure
Correct Answer: A
Rationale: The correct answer is A: Steatorrhea. In celiac disease, the small intestine is unable to absorb nutrients properly due to gluten intolerance, leading to fat malabsorption. Steatorrhea is a common symptom characterized by foul-smelling, greasy, and bulky stools. Jaundiced sclerae (B) are associated with liver dysfunction, not celiac disease. Clay-colored stools (C) may indicate issues with the liver or bile ducts, not celiac disease. Widened pulse pressure (D) is not typically a direct symptom of celiac disease but may be seen in conditions like aortic regurgitation.
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A nurse teaches a preoperative client about the nasogastric tube that will be inserted in preparation for surgery. The nurse determines that the client understands when the tube will be removed in the postoperative period when the client states
- A. When my gastrointestinal system is healed enough.
- B. When I can tolerate food without vomiting.
- C. When my bowels begin to function again, and I begin to pass gas.
- D. When the doctor says so.
Correct Answer: C
Rationale: The correct answer is C. The rationale is as follows: The return of bowel function, evidenced by passing gas, is an important indicator of gastrointestinal motility and recovery postoperatively. It indicates that the gastrointestinal system is beginning to function normally, which is a key factor in determining when the nasogastric tube can be safely removed. Choices A and B are too general and do not provide a specific physiological indicator for tube removal. Choice D defers the decision solely to the doctor without considering the client's physiological progress. Therefore, the most appropriate and accurate indicator for tube removal is the return of bowel function and passage of gas, as stated in option C.
A home care nurse is visiting a client with a diagnosis of pernicious anemia that developed as a result of gastric surgery. The nurse instructs the client that because the stomach lining produces a decreased amount of intrinsic factor in this disorder, the client will need
- A. Vitamin B12 injections.
- B. Vitamin B6 injections.
- C. An antibiotic.
- D. An antacid.
Correct Answer: A
Rationale: The correct answer is A: Vitamin B12 injections. Pernicious anemia results from a lack of intrinsic factor, which is necessary for the absorption of vitamin B12 in the intestines. Therefore, the client with this disorder will need vitamin B12 injections to bypass the need for intrinsic factor.
Choice B (Vitamin B6 injections) is incorrect because pernicious anemia specifically involves a deficiency in vitamin B12, not B6. Choice C (An antibiotic) is incorrect as antibiotics are not indicated for pernicious anemia. Choice D (An antacid) is also incorrect as it does not address the underlying issue of vitamin B12 deficiency caused by the lack of intrinsic factor.
The nurse is caring for a client with an exacerbation of ulcerative colitis. Which of the following nursing measures should be included in the client's plan of care?
- A. Encourage regular use of antidiarrheal medications.
- B. Incorporate frequent rest periods into the client's schedule.
- C. Have the client maintain a high-fiber diet.
- D. Wear a gown when providing direct client care.
Correct Answer: B
Rationale: The correct answer is B: Incorporate frequent rest periods into the client's schedule. Rest periods are essential for managing ulcerative colitis exacerbations as they help reduce stress on the digestive system. Antidiarrheal medications (A) may worsen the condition by masking symptoms and delaying appropriate treatment. High-fiber diets (C) can aggravate symptoms in some individuals with ulcerative colitis. Wearing a gown (D) is unrelated to managing ulcerative colitis exacerbations.
A client has been diagnosed with gastroesophageal reflux disease. The nurse interprets that the client has dysfunction of which of the following parts of the digestive system?
- A. Chief cells of the stomach
- B. Parietal cells of the stomach
- C. Lower esophageal sphincter
- D. Upper esophageal sphincter
Correct Answer: C
Rationale: The correct answer is C: Lower esophageal sphincter. Gastroesophageal reflux disease (GERD) involves the dysfunction of the lower esophageal sphincter (LES), which fails to close properly, allowing stomach acid to reflux into the esophagus. This leads to symptoms such as heartburn and regurgitation. Choices A and B (Chief cells and Parietal cells of the stomach) are not directly related to GERD, as they are involved in gastric acid secretion. Choice D (Upper esophageal sphincter) is responsible for preventing air from entering the esophagus during breathing and is not typically implicated in GERD.
Cholestyramine resin (Questran Light) is prescribed for the client with an elevated serum cholesterol level. The nurse would instruct the client to take the medication
- A. After meals.
- B. Mixed with fruit juice.
- C. Via rectal suppository.
- D. At least 3 hours before meals.
Correct Answer: B
Rationale: The correct answer is B: Mixed with fruit juice. Cholestyramine resin should be taken mixed with a liquid, such as fruit juice, to prevent esophageal irritation and improve absorption. Taking it with a meal can interfere with nutrient absorption. Taking it via rectal suppository is incorrect as it is an oral medication. Taking it at least 3 hours before meals is not necessary and may lead to decreased effectiveness. Mixing it with fruit juice helps improve tolerability and effectiveness.