Nokea
Which activities should the home health nurse suggest to an older adult patient to avoid constipation?
- A. Schedule toileting after meals
- B. Taking bulk-forming laxatives
- C. Increasing fiber intake
- D. Drinking at least 1000 mL fluid
- E. Taking a daily stool softener
- F. Using tap water enemas for persons with altered mobility
Correct Answer: A,B,C,D
Rationale: Inactivity and changes in diet and fluid intake can contribute to constipation. A nutritional diet high in fiber and bulk-forming foods can promote normal elimination. Increasing fluids to 8 to 10 glasses per day will be beneficial in preventing constipation. A daily bowel routine will also benefit elimination. Use of daily stool softeners is no longer recommended for the older adult. Tap water enemas for persons with altered mobility are not routine.
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What is the most lethal complication of a peptic ulcer?
- A. Bleeding
- B. Perforation
- C. Severe pain
- D. Gastric outlet obstruction
Correct Answer: B
Rationale: Perforation is considered the most lethal complication of peptic ulcer. Bleeding may occur when the ulcer erodes into a blood vessel; however, perforation occurs when the ulcer crater penetrates the entire thickness of the wall of the stomach or duodenum. Gastric outlet obstruction can occur at any time and can be relieved by NG aspiration of stomach contents.
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.
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.
Dumping syndrome after a Billroth II procedure occurs when high-carbohydrate foods are ingested over a period of less than 20 minutes. Which will the nurse suggest to reduce the risk of dumping syndrome?
- A. Eating a high-carbohydrate diet
- B. Drinking 10 oz of fluids with meals
- C. Remaining upright for 2 hours after meals
- D. Eating six small daily meals high in protein and fat
Correct Answer: D
Rationale: Treatment for dumping syndrome includes eating six small meals daily that are high in protein and fat, and low in carbohydrates. Fluids should be avoided during meals. If possible, the patient should lie down for 1 hour after meals.
During the annual physical examination, the nurse will assess for which risk factor for the development of diverticulosis?
- A. Chronic diarrhea
- B. Excessive fiber intake
- C. Increased intake of refined carbohydrates
- D. Aging related increased elasticity of the colon
Correct Answer: C
Rationale: Refined carbohydrates, when eaten in large amounts, have been associated with the development of diverticulosis.