A client presents to the emergency room, reporting that he has been vomiting every 30 to 40 minutes for the past 8 hours. Frequent vomiting puts him at risk for which of the following?

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Metabolic alkalosis with hypokalemia. When a client vomits frequently, they lose hydrochloric acid from the stomach, leading to metabolic alkalosis. The loss of gastric contents also results in the loss of potassium, causing hypokalemia. Option A) Metabolic acidosis with hyperkalemia is incorrect because vomiting leads to the loss of acid, not an excess, and potassium is lost, not retained. Option B) Metabolic acidosis with hypokalemia is incorrect because vomiting causes metabolic alkalosis due to acid loss, not acidosis. Option C) Metabolic alkalosis with hyperkalemia is incorrect because vomiting results in hypokalemia due to potassium loss, not hyperkalemia. Educationally, understanding the electrolyte imbalances and acid-base disturbances that can result from vomiting is crucial in the care of patients with gastrointestinal issues. Recognizing these imbalances helps nurses provide appropriate interventions and prevent further complications. It also highlights the importance of monitoring electrolyte levels in patients with vomiting to prevent adverse outcomes.

Correct Answer: D

Rationale: In teaching an elderly client how to prevent constipation, including regular exercise (option D) is crucial for several reasons. Exercise helps stimulate intestinal motility, promoting more regular bowel movements. It also enhances overall health and well-being in older adults by improving circulation, muscle tone, and metabolism. Additionally, physical activity can help alleviate stress, which may contribute to constipation. Option A, drinking 6 glasses of fluid daily, is important for overall hydration but alone may not be sufficient to prevent constipation. Adequate fluid intake should be encouraged, but exercise plays a more direct role in preventing constipation in this scenario. Avoiding grain products and nuts (option B) is not necessary for preventing constipation unless the individual has specific dietary sensitivities or intolerances to these foods. In fact, whole grains and nuts can provide essential dietary fiber, which is beneficial for bowel regularity. Adding 4 grams of bran to cereal (option C) may seem like a good way to increase fiber intake, but it is not as effective or sustainable as incorporating a variety of fiber-rich foods into the diet. Furthermore, some individuals may find bran difficult to digest, leading to potential gastrointestinal discomfort. In an educational context, it is important to emphasize a holistic approach to preventing constipation in the elderly, which includes a balanced diet rich in fiber, adequate hydration, regular physical activity, and addressing any underlying health conditions or medications that may contribute to constipation. Encouraging lifestyle modifications like exercise can empower older adults to take an active role in their digestive health and overall well-being.

Correct Answer: C

Rationale: In a client with diarrhea, the outcome that indicates fluid resuscitation is successful is when the client exhibits firm skin turgor. Firm skin turgor is a reliable indicator of adequate hydration status. When a person is dehydrated, their skin loses elasticity and becomes less turgid, whereas improved skin turgor suggests proper fluid balance has been restored. Option A, the client passing formed stools at regular intervals, is incorrect as it primarily reflects bowel motility and consistency, not necessarily hydration status. Option B, the client reporting a decrease in stool frequency and liquidity, is also incorrect as it may indicate symptom improvement but does not directly reflect hydration status. Option D, the client no longer experiencing perianal burning, is related to symptom relief but does not provide a direct measure of hydration. In an educational context, understanding the signs of dehydration and effective fluid resuscitation is crucial in managing patients with diarrhea. By recognizing the importance of skin turgor assessment, nurses can accurately gauge hydration status and tailor interventions accordingly to promote optimal patient outcomes.

Correct Answer: A

Rationale: The correct answer to the question about preventing colon cancer in a community group is option A: Limit fat intake to 20% to 25% of your total daily calories. This instruction is crucial because high-fat diets have been linked to an increased risk of colon cancer. By reducing fat intake to the recommended percentage, individuals can lower their risk of developing this type of cancer. Option B, which suggests including 15 to 20 grams of fiber into the daily diet, is a good dietary recommendation for overall gastrointestinal health but is not specifically targeted at preventing colon cancer. Fiber can help with bowel regularity and overall digestive health but does not have a direct preventive effect on colon cancer. Option C, advising to get an annual rectal examination after age 35, is not a primary prevention measure for colon cancer. While regular screenings such as colonoscopies are essential for early detection, they are not preventive measures. Option D, recommending annual sigmoidoscopy after age 50, is also not the best preventive measure for colon cancer. While colonoscopies and sigmoidoscopies are important screening tools, they are typically not required annually and have specific guidelines for timing based on individual risk factors and findings. It is vital to educate the community on evidence-based preventive measures for colon cancer, such as maintaining a healthy diet low in fat, high in fiber, engaging in regular physical activity, avoiding tobacco and excessive alcohol use, and participating in recommended screening tests based on individual risk factors and guidelines. These interventions can significantly reduce the risk of developing colon cancer and promote overall gastrointestinal health.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Cereal grains (except rice and corn) that the client must eliminate from her diet permanently due to gluten-induced enteropathy, also known as celiac disease. Gluten is a protein found in wheat, barley, and rye, which are cereal grains. When individuals with celiac disease consume gluten, it triggers an immune response that damages the lining of the small intestine, leading to malabsorption of nutrients and various gastrointestinal symptoms. Option A) Milk and dairy products do not need to be eliminated unless the individual also has lactose intolerance or a separate dairy-related condition. Option B) Protein-containing foods are essential for overall health and should not be eliminated unless there is a specific allergy or intolerance. Option D) Carbohydrates are a broad category of nutrients and eliminating all carbohydrates is not necessary or healthy. From an educational perspective, this question highlights the importance of recognizing dietary restrictions in individuals with specific health conditions such as celiac disease. Understanding the role of gluten in triggering symptoms and the need for strict adherence to a gluten-free diet is crucial in managing this condition effectively and preventing complications. It also emphasizes the significance of nutritional therapy in the treatment of gastrointestinal disorders and the impact of diet on overall health outcomes.