ATI LPN
Lewis's Medical Surgical Nursing in Canada, 5th Edition
Chapter 45 Questions
Question 1 of 5
The nurse is caring for a patient who is incontinent of watery diarrhea and has been diagnosed with Clostridium difficile. Which of the following actions should the nurse include in the plan of care?
Correct Answer: B
Rationale: Because C. difficile is highly contagious, the patient should be placed in a private room and contact precautions should be used. There is no need to restrict dairy products for this type of diarrhea. Metronidazole is frequently used to treat C. difficile. Improper food handling and storage do not cause C. difficile.
Question 2 of 5
A patient tells the nurse, 'I have problems with constipation now that I am older, so I use a suppository every morning.' Which of the following actions should the nurse take first?
Correct Answer: C
Rationale: The nurse's initial action should be further assessment of the patient for risk factors for constipation and for usual bowel pattern. The other actions may be appropriate but will be based on the assessment.
Question 3 of 5
The nurse is teaching a patient who has persistent constipation, about the use of psyllium. Which of the following information should the nurse include?
Correct Answer: D
Rationale: A high fluid intake is needed when patients are using bulk-forming laxatives to avoid worsening constipation. Although bulk-forming laxatives are generally safe, the nurse should emphasize the possibility of constipation or obstipation if inadequate fluid intake occurs. Although increased gas formation is likely to occur with increased dietary fibre, the patient should gradually increase dietary fibre and eventually may not need the psyllium. Fat-soluble vitamin absorption is blocked by stool softeners and lubricants, not by bulk-forming laxatives.
Question 4 of 5
The nurse is obtaining a history for a female patient who is being evaluated for acute lower abdominal pain and vomiting. Which of the following questions is most useful in determining the cause of the patient's symptoms?
Correct Answer: B
Rationale: A complete description of the pain provides clues about the cause of the problem. The usual diet and elimination patterns are less helpful in determining the reason for the patient's symptoms. Although the nurse should ask whether the patient is pregnant to determine whether the patient might have an ectopic pregnancy and before any radiology studies are done, this information is not the most useful in determining the cause of the pain.
Question 5 of 5
The nurse is caring for a patient who had an exploratory laparotomy with a resection of a short segment of small bowel two days previously. The patient has gas pains and abdominal distension. Which of the following nursing actions is best to take at this time?
Correct Answer: B
Rationale: Ambulation will improve peristalsis and help the patient eliminate flatus and reduce gas pain. Morphine will further reduce peristalsis. A return-flow enema may decrease the patient's symptoms, but ambulation is less invasive and should be tried first. Promethazine is used as an antiemetic rather than to decrease gas pains or distension.