Nokea
When working with a client who has chronic constipation, what should be included in client teaching to promote normal bowel function?
- A. Use glycerin suppositories on a regular basis
- B. Limit physical activity in order to promote bowel peristalsis
- C. Consume high-residue, high-fiber foods
- D. Resist the urge to defecate until the urge becomes intense
Correct Answer: C
Rationale: The correct answer is C: Consume high-residue, high-fiber foods. High-fiber foods promote regular bowel movements by adding bulk to the stool, making it easier to pass. Fiber also helps in maintaining bowel health and preventing constipation. Glycerin suppositories (A) should not be used regularly as they can lead to dependence. Limiting physical activity (B) is not recommended as exercise can aid in promoting bowel peristalsis. Resisting the urge to defecate (D) can worsen constipation and lead to complications. In summary, promoting high-fiber diet is the most effective way to help manage chronic constipation.
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A 45-year-old woman presents with fatigue, weight gain, and constipation. Laboratory tests reveal high TSH and low free T4 levels. What is the most likely diagnosis?
- A. Hypothyroidism
- B. Hyperthyroidism
- C. Thyroiditis
- D. Thyroid cancer
Correct Answer: A
Rationale: The most likely diagnosis is A: Hypothyroidism. High TSH and low free T4 levels indicate primary hypothyroidism. Elevated TSH is a compensatory response by the pituitary gland to stimulate the thyroid to produce more thyroid hormones, but the thyroid gland is unable to do so effectively, resulting in low free T4 levels. Fatigue, weight gain, and constipation are classic symptoms of hypothyroidism.
- B: Hyperthyroidism is characterized by low TSH and high free T4 levels, opposite of the lab results presented.
- C: Thyroiditis may initially present with high or low thyroid hormone levels, but the combination of high TSH and low free T4 levels is more indicative of hypothyroidism.
- D: Thyroid cancer typically does not cause abnormal thyroid hormone levels; it is more commonly associated with thyroid nodules or masses.
When creating a care plan for a 70-year-old obese client admitted to the postsurgical unit following a colon resection, the client's age and increased body mass index put them at increased risk for which complication in the postoperative period?
- A. Hyperglycemia
- B. Azotemia
- C. Falls
- D. Infection
Correct Answer: D
Rationale: The correct answer is D: Infection. Postoperative obese patients are at higher risk for surgical site infections due to impaired wound healing, decreased tissue oxygenation, and increased tissue pressure. Obesity also compromises the immune system, further increasing susceptibility to infections. Age is a risk factor for infection as well, as older adults may have weakened immune responses. Hyperglycemia (choice A) is a common issue in obese patients but not specifically related to postoperative complications. Azotemia (choice B) refers to elevated levels of nitrogen-containing compounds in the blood and is not directly related to obesity or age. Falls (choice C) are more related to mobility issues and environmental factors, not specifically to age and obesity in the postoperative period.
A client who is acutely ill has vigilant oral care included in their plan of care. What factor increases this client's risk for dental caries?
- A. Hormonal changes induced by the stress response leading to an acidic oral environment
- B. Systemic infections commonly affecting the teeth
- C. Intravenous hydration lacking fluoride
- D. Inadequate nutrition and reduced saliva production contributing to cavities
Correct Answer: D
Rationale: The correct answer is D because inadequate nutrition and reduced saliva production contribute to cavities. In acute illness, the client may not be able to consume a balanced diet, leading to nutrient deficiencies that weaken teeth. Reduced saliva flow decreases the mouth's ability to naturally clean and protect teeth. Choices A, B, and C are incorrect because hormonal changes from stress do not directly lead to acidic oral environment, systemic infections do not commonly affect teeth, and lack of fluoride from intravenous hydration is not a primary factor for dental caries.
After undergoing rigid fixation for a mandibular fracture from a fight, what area of care should the nurse prioritize for discharge education for this client?
- A. Resumption of activities of daily living
- B. Pain control
- C. Promotion of adequate nutrition
- D. Strategies for promoting adequate nutrition
Correct Answer: C
Rationale: The correct answer is C because promoting adequate nutrition is crucial for optimal healing of mandibular fractures. Malnutrition can delay recovery and impair bone healing. The nurse should prioritize educating the client on ways to maintain a balanced diet, such as consuming foods rich in protein, vitamins, and minerals.
A: Resumption of activities of daily living is important, but nutrition is more critical for healing.
B: Pain control is essential, but ensuring proper nutrition is a higher priority for optimal recovery.
D: Strategies for promoting adequate nutrition is redundant and less specific compared to the correct answer.
A 48-year-old man presents with fatigue, weight gain, and cold intolerance. Laboratory tests reveal high TSH and low free T4 levels. What is the most likely diagnosis?
- A. Hypothyroidism
- B. Hyperthyroidism
- C. Thyroiditis
- D. Thyroid cancer
Correct Answer: A
Rationale: The correct answer is A: Hypothyroidism. In this scenario, the patient has symptoms of hypothyroidism (fatigue, weight gain, cold intolerance) along with high TSH and low free T4 levels, indicating primary hypothyroidism. TSH is elevated as the body is trying to stimulate the thyroid to produce more thyroid hormones. Free T4 is low as the thyroid is not able to produce enough hormones. Hyperthyroidism (choice B) would present with low TSH and high free T4 levels. Thyroiditis (choice C) typically presents with symptoms of hyperthyroidism followed by hypothyroidism. Thyroid cancer (choice D) usually does not cause these specific symptoms and lab findings. Therefore, based on the symptoms and lab results, hypothyroidism is the most likely diagnosis.