A 30-year-old woman is admitted to the hospital with complaints of severe abdominal cramping and diarrhea. The nurse evaluates the effectiveness of the patient's intravenous therapy. Which of the following laboratory tests BEST reflects hydration status?

Correct Answer: C

Rationale: The correct answer is C: Hematocrit. Hematocrit reflects the proportion of red blood cells in the blood and can indicate hydration status. When a person is dehydrated, their blood becomes more concentrated, leading to an increase in hematocrit levels. In this case, severe abdominal cramping and diarrhea can cause dehydration, making hematocrit the best indicator of hydration status. Explanation for other choices: A: Erythrocyte sedimentation rate is a nonspecific marker of inflammation and not directly related to hydration status. B: White blood cell count is an indicator of infection or inflammation, not hydration status. D: Serum glucose levels are related to blood sugar regulation, not hydration status.

Correct Answer: C

Rationale: The correct answer is C: Teaching the client to use a folded blanket or pillow to splint the incision. This measure helps support the incision site, reducing pain during coughing and deep breathing. Splinting the incision promotes effective coughing and deep breathing post-surgery, aiding in lung expansion and preventing complications like atelectasis. Explanation of why other choices are incorrect: A: Having the client take rapid, shallow breaths to decrease pain is incorrect as it can lead to inadequate lung expansion and retention of secretions. B: Having the client lay on the left side while coughing and deep breathing is incorrect as it does not directly support the incision site and may not be as effective in reducing pain. D: Withholding pain medication so the client can be alert enough to follow the nurse's instructions is incorrect as pain management is crucial post-surgery for comfort and optimal recovery.

Correct Answer: B

Rationale: The correct answer is B because discussing concerns about sexual functioning is an appropriate expected outcome at this point. After an abdominal perineal resection with a colostomy, it is important for the client to address any concerns related to sexual functioning as it can impact their quality of life. A: The client maintaining a high-fiber diet is not the most appropriate expected outcome at this point as it may be too soon after surgery to focus solely on dietary adjustments. C: The client maintaining bedrest is not appropriate as early mobilization is usually encouraged after surgery to prevent complications. D: Limiting fluid intake to 1000 ml/day is not recommended as adequate hydration is crucial for recovery post-surgery.

Correct Answer: D

Rationale: Rationale for Correct Answer (D): By assessing for gastric residual before administering another feeding through the nasogastric tube, the nurse can evaluate absorption of the last feeding. If there is a significant amount of residual, it may indicate poor absorption, which could lead to complications such as aspiration. This assessment helps in determining the appropriate timing and amount of the next feeding to prevent complications. Summary of Incorrect Choices: A: Confirming proper nasogastric tube placement is typically done using other methods like pH testing or X-ray. This assessment does not directly relate to evaluating absorption. B: Observing gastric contents may provide information about the patient's gastric secretions but does not specifically help in evaluating the absorption of the last feeding. C: Assessing fluid and electrolyte status is important but not the primary purpose of checking gastric residual before administering a feeding. This assessment is more focused on monitoring the patient's overall hydration and electrolyte balance.

Correct Answer: B

Rationale: The correct answer is B: The client verbalizes the importance of small, frequent feedings. This is appropriate for a client with ulcerative colitis because small, frequent feedings help reduce gastrointestinal distress and maintain proper nutrition. Clients with ulcerative colitis often have difficulty tolerating large meals, so small, frequent feedings can help prevent exacerbation of symptoms. A: Recording intake and output is important for certain conditions but not specifically for ulcerative colitis. C: Using a heating pad may provide temporary relief for abdominal cramping but does not address the underlying issue of ulcerative colitis. D: Accepting a colostomy is not an expected outcome for ulcerative colitis treatment unless all other options have failed.