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Which recommendation is most appropriate for a patient who has had an esophageal dilation related to achalasia?
- A. Consume only liquid.
- B. Avoid fruit juices.
- C. Drink 10 oz of fluid with each meal.
- D. Lie down for 30 minutes after each meal.
Correct Answer: C
Rationale: The patient should drink fluid with each meal to increase lower esophageal pressure to push food into the stomach.
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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.
Because bowel contents from an ileostomy are virtually liquid, which does the nurse expect to see in the plan of care?
- A. Evaluation and assessment of dietary intake of fiber
- B. Evaluation and assessment of patient cleanliness
- C. Evaluation and assessment of peristomal skin integrity
- D. Evaluation and assessment of the adequacy of the collection device
Correct Answer: C
Rationale: The nurse should assess the peristomal skin for impairment of integrity. The fecal material is liquid and has a potential for severe skin excoriation from the digestive enzymes.
The home health nurse is caring for a patient who has frequent bouts of diverticulitis accompanied by increased flatulence, diarrhea, and nausea. Which is the most appropriate suggestion to lessen these symptoms?
- A. Eat a diet high in fiber content.
- B. Increase dietary fat intake.
- C. Exercise to increase intraabdominal pressure.
- D. Take daily laxatives.
Correct Answer: A
Rationale: The symptoms of diverticulitis can be reduced or prevented by eating a high-fiber diet, reduction of meat and fats in the diet, and avoiding activities that increase intraabdominal pressure. Although laxatives might be prescribed sparingly, daily laxatives are not recommended.
Flexible sigmoidoscopy should be performed every years.
- A. 5
Correct Answer: 5
Rationale: Flexible sigmoidoscopy should be performed every 5 years. Endoscopy of the lower GI tract allows visualization and, if indicated, access to obtain biopsy specimens of tumors, polyps, or ulcerations of the anus, rectum, and sigmoid colon. The lower GI tract is difficult to visualize radiographically, but sigmoidoscopy allows direct visualization.
The home health nurse evaluates a patient being treated for a peptic ulcer with an antacid and famotidine (histamine receptor blocker). Which statement made by the patient indicates a need for further instruction?
- A. I know famotidine will not interfere with my Coumadin.'
- B. I take the antacid at least 2 hours after any of my other drugs.'
- C. Boy! That antacid keeps my stomach happy!'
- D. I take both those meds at the same time every morning.'
Correct Answer: D
Rationale: Antacids should not be taken with other drugs, because the absorption of the other drugs may be affected.