A client has to undergo a barium enema for a suspected GI disorder. During the test, he experiences a strong urge to defecate and seeks the nurse's advice. Which of the following should the nurse do?

Correct Answer: B

Rationale: The correct answer is B: Assure him that most people can retain the urge. The rationale is as follows: 1. Retaining the urge during a barium enema is common due to the pressure from the barium solution. 2. Advising the client to clear his bowel immediately is incorrect because it may disrupt the test. 3. Giving analgesics to relieve the urge is incorrect as it does not address the issue. 4. Instructing to drink plenty of fluids is incorrect as it does not help in managing the urge. In summary, choice B is correct as it reassures the client and helps maintain the integrity of the test.

Correct Answer: A

Rationale: The correct answer is A because enteric-coated products are designed to bypass the stomach and dissolve in the small intestine, where absorption of medications occurs. Since an ileostomy bypasses the large intestine, the medication in enteric-coated products may not be fully absorbed, leading to reduced effectiveness. Choices B, C, and D are incorrect because they do not directly relate to the specific issue of absorption in the context of an ileostomy.

Correct Answer: C

Rationale: The correct answer is C because surgery on the gastrointestinal (GI) tract can impair the absorption of essential vitamins leading to deficiencies. This is due to the fact that many vitamins are absorbed in the GI tract, and any alteration or removal of parts of the tract can hinder this process. For example, surgeries like gastric bypass can reduce the absorption of certain vitamins such as B12. Choice A is incorrect because vegan diets can be deficient in various nutrients, not just vitamin B6 and folic acid. Choice B is incorrect because vitamin imbalances are not solely due to excessive fat intake but can also be caused by various factors. Choice D is incorrect because while skin disorders can be a symptom of vitamin deficiencies, they are not the most common clinical manifestation in adults.

Correct Answer: D

Rationale: The correct answer is D because it demonstrates the patient's understanding of the importance of behavior modification for long-term weight loss success. By joining a behavior modification group, the patient shows a commitment to changing habits and lifestyle, which is crucial for sustained weight loss. Choice A focuses on tracking weight loss progress, which is important but does not necessarily indicate a deep understanding of behavior change. Choice B sets unrealistic weight loss goals that may not be safe or sustainable. Choice C shows a misconception about exercise and appetite, indicating a potential misunderstanding of weight loss principles. In summary, choice D is correct because it reflects a holistic approach to weight loss that includes addressing behavior patterns, while the other choices either focus on surface-level strategies or misunderstand key concepts related to weight loss.

Correct Answer: D

Rationale: The correct answer is D because eosinophilic esophagitis is characterized by swelling of the esophagus due to an allergic response to food or environmental triggers. Eosinophils are a type of white blood cell typically involved in allergic reactions. Adenocarcinoma or squamous cell tumors (choice A) are types of esophageal cancer, not related to eosinophilic esophagitis. Dilated veins in the esophagus from portal hypertension (choice B) are seen in conditions such as cirrhosis, not eosinophilic esophagitis. Inflammation from irritants or gastric reflux (choice C) may cause esophagitis but not specifically eosinophilic esophagitis, which is immune-mediated.