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Why are peptic ulcers a common problem of aging?
- A. Older adults develop esophageal diverticula
- B. Older adults have a higher incidence of hiatal hernia
- C. Older adults use nonsteroidal anti-inflammatory drugs to treat chronic joint conditions
- D. Older adults have decreased secretion of hydrochloric acid from the parietal cells of the stomach.
Correct Answer: C
Rationale: Medications such as aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) taken for arthritis or degenerative joint conditions may contribute to ulcer formation.
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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.
Bowel sound assessment on a patient with an early bowel obstruction who has distention, nausea, and visible peristaltic waves will demonstrate which type of bowel sound?
- A. loud and clearly audible.
- B. high pitched.
- C. hyperactive.
- D. absent.
Correct Answer: B
Rationale: Because there are visible peristaltic waves, there will be bowel sounds that will be faint and high pitched.
Due to frequent bouts of constipation, the nurse examines the bedfast nursing home resident for ulceration of the anus, called anal
- A. fissure
Correct Answer: fissure
Rationale: Ulceration and laceration of the anal skin can occur because of overstretching with the passing of constipated stool.
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 nurse explains to the patient with Crohn disease that the tube feedings are placed for which reason?
- A. rapid absorption in the upper GI tract.
- B. decompression of the stomach.
- C. reduction of diarrheic episodes.
- D. a permanent nutritional support.
Correct Answer: A
Rationale: The tube feedings allow for rapid absorption of the nutrients in the upper GI tract. The tube feedings are not permanent and will be followed by oral intake of a low-residue, high-protein, high-calorie diet.