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Which intervention should the nurse include when discussing ways to help prevent potential episodes of gastroenteritis from Clostridium botulism?
- A. Make sure all hamburger meat is well cooked.
- B. Ensure all dairy products are refrigerated.
- C. Discuss why campers should drink only bottled water.
- D. Discard damaged canned goods.
Correct Answer: D
Rationale: Clostridium botulinum thrives in improperly canned foods, so discarding damaged cans prevents botulism. Cooking meat, refrigerating dairy, and bottled water are unrelated to botulism.
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The day after surgery in which a colostomy was performed, the client says, 'I know the doctor did not really do a colostomy.' The nurse understands that the client is in an early stage of adjustment to the diagnosis and surgery. What nursing action is indicated at this time?
- A. Agree with the client until the client is ready to accept the colostomy
- B. Say, 'It must be difficult to have this kind of surgery.'
- C. Force the client to look at his colostomy
- D. Ask the surgeon to explain the surgery to the client
Correct Answer: B
Rationale: Acknowledging the difficulty of the surgery supports the client emotionally during the denial stage without forcing confrontation.
The nurse has received the a.m. shift report. Which client should the nurse assess first?
- A. The 44-year-old client diagnosed with peptic ulcer disease who is complaining of acute epigastric pain.
- B. The 74-year-old client diagnosed with acute gastroenteritis who has had four (4) diarrhea stools during the night.
- C. The 65-year-old client diagnosed with IBD who has tented skin turgor and dry mucous membranes.
- D. The 15-year-old client diagnosed with food poisoning who has vomited several times during the night shift.
Correct Answer: C
Rationale: Tented skin turgor and dry mucous membranes in an elderly IBD patient indicate severe dehydration, a life-threatening condition requiring immediate assessment. Other clients have concerning but less urgent symptoms.
The nurse is preparing a client with Crohn's disease for discharge. Which of the following statements indicates that he needs further teaching?
- A. Stress can make it worse.'
- B. Since I have Crohn's disease, I don't have to worry about colon cancer.'
- C. I realize I shall always have to monitor my diet.'
- D. I understand there is a high incidence of familial occurrence with this disease.'
Correct Answer: B
Rationale: Crohn’s disease increases the risk of colon cancer, so the statement indicates a need for further teaching. The other statements are correct.
The client diagnosed with IBD is prescribed total parenteral nutrition (TPN). Which intervention should the nurse implement?
- A. Check the client's glucose level.
- B. Administer an oral hypoglycemic.
- C. Assess the peripheral intravenous site.
- D. Monitor the client's oral food intake.
Correct Answer: A
Rationale: TPN, high in dextrose, can cause hyperglycemia, so monitoring glucose levels is essential, especially in IBD patients with potential metabolic stress. Oral hypoglycemics are inappropriate, TPN uses central lines, and oral intake is typically minimal.
The nurse is caring for a client diagnosed with ulcerative colitis. Which symptom(s) support this diagnosis?
- A. Increased appetite and thirst.
- B. Elevated hemoglobin.
- C. Multiple bloody, liquid stools.
- D. Exacerbations unrelated to stress.
Correct Answer: C
Rationale: Multiple bloody, liquid stools are a hallmark of ulcerative colitis due to mucosal inflammation. Appetite/thirst increase, elevated hemoglobin, and stress-unrelated exacerbations are incorrect.