A 68-year-old patient is in the office for a physical. She notes that she no longer has regular bowel movements. Which suggestion by the nurse would be most helpful to the patient?

Correct Answer: D

Rationale: The correct answer is D because the gastrocolic reflex is a natural physiological response where eating triggers contractions in the colon, leading to increased peristalsis and bowel movements. By suggesting the patient to attempt defecation after breakfast, the nurse is utilizing this reflex to help stimulate bowel movements. This suggestion aligns with the patient's complaint of irregular bowel movements and aims to promote regularity. Choice A is incorrect as taking additional laxatives can lead to dependence and may not address the underlying cause of the irregular bowel movements. Choice B is incorrect as the acidity of foods does not directly impact peristalsis. Choice C is incorrect as reducing food intake may not necessarily address the issue of slowed peristalsis and could potentially lead to other nutritional deficiencies.

Correct Answer: C

Rationale: Rationale: Choice C is correct because vomiting involves the coordination of various structures and processes. The glottis closes to prevent aspiration, respiratory expiration aids in expelling contents, pylorus relaxes to allow stomach contents to move upward, and lower esophageal sphincter closes to prevent reflux. Summary of other choices: A: Incorrect - Metabolic alkalosis, not acidosis, is commonly associated with persistent vomiting due to loss of hydrochloric acid. B: Incorrect - Stimulation of the vomiting center by the CTZ is commonly triggered by chemicals/toxins, not stretch and distention of hollow organs. D: Incorrect - The parasympathetic nervous system stimulation occurs after the act of vomiting to aid in clearing the stomach.

Correct Answer: D

Rationale: The correct answer is D because NG intubation helps remove stimulation for hydrochloric acid and pepsin secretion by keeping the stomach empty. By reducing gastric acid production, it allows the ulcer to heal. Choice A is incorrect because it focuses on a different aspect of treatment. Choice B is incorrect because NG intubation is not primarily for removing excess fluids and undigested food. Choice C is incorrect as the primary purpose of NG intubation in this context is not to provide missing nutrients but to reduce acid secretion.

Correct Answer: B

Rationale: The correct answer is B: Notify the health care provider. In this scenario, the patient's increasing abdominal pain after surgery could indicate a complication or deterioration in their condition. Notifying the healthcare provider immediately allows for prompt assessment and intervention to prevent further harm. Taking vital signs (choice A) can provide important information but may not address the underlying issue. Positioning the patient with knees flexed (choice C) and determining IV intake (choice D) are important, but addressing the worsening abdominal pain takes precedence.

Correct Answer: D

Rationale: The correct answer is D because hanging the irrigation bag about 36 inches above the stoma ensures a slow, steady flow of irrigation solution. This allows for proper irrigation without causing discomfort or complications. If the bag is too high or too low, it can lead to issues such as cramping, leakage, or inadequate irrigation. Options A, B, and C are incorrect because they do not address the proper positioning of the irrigation bag, which is crucial for a successful colostomy irrigation procedure.