BIOLOGY 102 Medical-Surgical Nursing Critical Thinking in Client Care, 4th Edition CHAPTER 26

Medical-Surgical Nursing Critical Thinking in Client Care, 4th Edition Priscilla LeMon

CHAPTER 26

Chapter 26

1. The client has a virus, and has been experiencing diarrhea. The client questions when it will be advisable to add foods back into the diet. What information should be provided to the client?

1. Withholding foods for the first 12 hours after acute diarrhea is recommended.

2. Add milk products to the diet first, as they can soothe the stomach.

3. It is safe to blend a home preparation of water, salt, sugar, and lemon extract for drinking to begin the process of rehydration.

4. Vegetable soup is helpful during the recovery process.

2. The physician has ordered kaolin to manage the client’s diarrhea. The nurse provides teaching to the client concerning use of the medication. What statement to the nurse concerning its use indicates the need for further teaching?

1. “I should continue to take this medication daily until my bowels are firm and dry.”

2. “If I start to have a fever, I need to contact my physician about continuing to take this medication.”

3. “I will need to take the medication after each loose stool.”

4. “If my diarrhea does not get better within two days, I will need to call my physician for further advice.”

3. A client reports to the ambulatory clinic with reports of frequent diarrhea. A food diary is reviewed. Which of the following items poses the greatest concern and warrants further discussion with the client?

a. Breakfast consisting of bran muffins and applesauce

b. Lunch consisting of cottage cheese, peaches, and a turkey sandwich

c. Dinner consisting of baked chicken, yeast rolls, and a small salad

d. Snack consisting of popcorn

4. A client is admitted to the clinical facility with acute abdominal pain. The physician determines that the client has appendicitis. An appendectomy is scheduled to take place in three hours. While waiting for the surgery, the client reports the pain has subsided. What initial action by the nurse is indicated?

1. Determine when the client can be medicated for pain again.

2. Contact the physician.

3. Contact the surgery department.

4. Notify the nursing supervisor.

5. Dietary management has been recommended for a client who has been experiencing pain, bloating, and diarrhea after eating. The client’s assessment reveals intestinal gas levels are not above normal. Which of the following dietary recommendations should be provided to the client?

1. Limit intake of decaffeinated coffee, tea, and soft drinks.

2. Increase intake of legumes, oats, and barley.

3. Chew gum after eating to reduce nausea and bloating.

4. Increase intake of cruciferous vegetables.

6. The client is admitted to the acute care facility through the Emergency Department after presenting with complaints of an elevated temperature, elevated white blood cell count, nausea, and pain and tenderness in the lower right lower quadrant of the abdomen. Analgesics were administered upon arrival to the Emergency Department, and are not due for administration for at least another two hours. What response by the nurse is most correct?

1. “I will need to review your assessment with the physician first.”

2. “Let’s try a heating pad or warm blanket.”

3. “I do not have any medications ordered for you at this time.”

4. “Why don’t you try to rest for a while longer until it is time?”

7. During the postoperative assessment of a client who had an appendectomy 36 hours ago, the nurse is unable to hear any bowel sounds. The client denies passing flatus. What action by the nurse is indicated?

1. Encourage the client to increase fluid intake to promote peristalsis.

2. Encourage the client to increase solid food intake to promote peristalsis.

3. Withhold food and fluid intake until intestinal motility has returned.

4. Encourage the client to slow the amount of oral intake.

8. The client diagnosed with peritonitis has reported pain unrelieved by the prescribed medications. The client asks if there are any other means to assist with managing this discomfort. Which of the following recommendations may be made to the client?

1. Place the client in low Fowler’s position.

2. Elevate the knees and the foot of bed.

3. Assist the client to side-lying position.

4. Assist the client to prone position.

9. A client presents with right-sided pain, cramping, nausea, and increased frequency of defecation. Acute diverticulitis is diagnosed. What course of treatment can the nurse anticipate will be recommended for the client?

1. Surgery to resect the diseased portion of bowel

2. A high-fiber diet to promote bulking of the stool

3. A diet high in insoluble fiber

4. The client will be made n.p.o.

10. The nurse is answering questions posed by a client who has a colostomy. The client is concerned about continued problems with stool odor. The nurse asks the client to recall foods eaten during the previous day. Which of the following meals should be discussed with the client with regard to the concerns voiced?

1. Breakfast consisting of cold cereal, milk, toast, and peaches

2. Lunch consisting of a cod fish sandwich, potato chips, and a pickle spear

3. Dinner consisting of baked chicken, a poppy seed roll, baked potato, and sliced tomatoes

4. Snack consisting of cheese and crackers