Nokea
Which information should the nurse teach the client post-barium enema procedure?
- A. The client should not eat or drink anything for four (4) hours.
- B. The client should remain on bedrest until the sedative wears off.
- C. The client should take a mild laxative to help expel the barium.
- D. The client will have normal elimination color and pattern.
Correct Answer: C
Rationale: A mild laxative helps expel barium, preventing constipation or impaction post-barium enema. NPO, bedrest, and normal stool color are incorrect.
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The nurse is irrigating the client's colostomy when the client complains of cramping. What is the most appropriate initial action by the nurse?
- A. Increase the flow of solution
- B. Ask the client to turn to the other side
- C. Pinch the tubing to interrupt the flow of the solution
- D. Remove the tube from the colostomy
Correct Answer: C
Rationale: Pinching the tubing stops the flow, relieving cramping caused by rapid fluid instillation during colostomy irrigation.
Which assessment data indicate to the nurse the client recovering from an open cholecystectomy may require pain medication?
- A. The client's pulse is 65 beats per minute.
- B. The client has shallow respirations.
- C. The client's bowel sounds are 20 per minute.
- D. The client uses a pillow to splint when coughing.
Correct Answer: B
Rationale: Shallow respirations suggest pain, as patients avoid deep breathing to minimize discomfort. Normal pulse, bowel sounds, and splinting are less direct indicators of pain.
A nasogastric tube is ordered for an alert adult client. In addition to the tube and basin, what is essential for the nurse to have at the bedside during the procedure?
- A. A 5-cc syringe filled with water
- B. A glass filled with water and a straw
- C. A large clamp
- D. A container of sterile water
Correct Answer: B
Rationale: A glass of water with a straw helps the client swallow during nasogastric tube insertion, facilitating passage.
The client asks how he contracted hepatitis A. He reports all of the following. Which one is most likely related to hepatitis A?
- A. He ate home-canned corn.
- B. He ate oysters his roommate brought home from a fishing trip.
- C. He stepped on a nail two weeks ago.
- D. He donated blood two weeks before he got sick.
Correct Answer: B
Rationale: Hepatitis A is transmitted via the fecal-oral route, often through contaminated food like oysters. Oysters from unsafe waters are a common source.
The client who is obese presents to the clinic before beginning a weight loss program. Which interventions should the nurse teach? Select all that apply.
- A. Walk for 30 minutes three (3) times a day.
- B. Determine situations that initiate eating behavior.
- C. Weigh at the same time every day.
- D. Limit sodium in the diet.
- E. Refer to a weight support group.
Correct Answer: A,B,C,E
Rationale: Walking, identifying eating triggers, consistent weighing, and support groups promote sustainable weight loss. Sodium restriction is less critical unless hypertension is present.