A client with ulcerative colitis, who experiences severe diarrhea, is prescribed a cleansing enema to relieve the symptoms. Which of the following interventions should the nurse consider at this stage?

Correct Answer: A

Rationale: The correct answer is A: Question the physician about the use of the cleansing enema. In this scenario, the nurse should question the physician because administering a cleansing enema to a client with ulcerative colitis and severe diarrhea can potentially exacerbate the condition. The nurse needs to verify if the enema is the appropriate intervention and if there are alternative treatments that may be safer and more effective. Summary: - Choice B: Educating the client about the procedure does not address the potential risks of administering the enema. - Choice C: Positioning the client comfortably is important but does not address the appropriateness of the enema. - Choice D: Instructing the client to visit the toilet before the enema does not address the potential risks associated with the procedure.

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.

Correct Answer: D

Rationale: The correct answer is D: Suppressing the urge to defecate while at work. This behavior can lead to chronic constipation as it disrupts the natural bowel movement process. By holding in the urge to defecate, the stool can become harder and more difficult to pass, leading to constipation. A: Taking methylcellulose daily is a form of fiber supplement that can actually help alleviate constipation by adding bulk to the stool and promoting regular bowel movements. B: History of hemorrhoids and hypertension may be relevant to the patient's health but are not direct contributors to constipation. C: High dietary fiber with high fluid intake is actually beneficial in preventing constipation by promoting healthy bowel movements.