A nurse is administering a tap water enema to a client who is constipated. During the administration of the enema, the client states he is having abdominal cramps. Which of the following actions should the nurse take to relieve the client's discomfort?

Correct Answer: A

Rationale: The correct answer is A: Lower the height of the solution container. Lowering the height of the solution container will decrease the flow rate of the enema solution, which can help reduce the client's abdominal cramps by slowing down the infusion. This allows the client's colon to more gradually distend and adjust to the increased volume of fluid. Encouraging the client to bear down (choice B) can increase discomfort and lead to straining. Allowing the client to expel some fluid before continuing (choice C) may not address the root cause of the discomfort. Stopping the enema and documenting intolerance (choice D) should be considered only if the discomfort persists despite adjusting the flow rate.

Correct Answer: A

Rationale: The correct answer is A: Auscultate to determine changes in bowel sounds. This is the priority because changes in bowel sounds can indicate various conditions like obstruction or peritonitis. It helps in assessing the function of the gastrointestinal tract. Observing the contour of the abdomen (B) and palpating for a mass (C) are important but come after auscultation. Percussing the abdomen (D) is not the priority in this scenario as it does not provide immediate information on the cause of abdominal pain.

Correct Answer: B

Rationale: The correct answer is B: stratified squamous. The epithelium of the mouth, oropharynx, esophagus, and anal canal is stratified squamous because these areas are subject to mechanical stress and friction. Stratified squamous epithelium provides protection against abrasion and wear. Simple squamous (A) is found in areas involved in filtration like the kidneys. Simple columnar (C) is found in the intestines for absorption. Pseudostratified columnar (D) is typically found in the respiratory tract to help with mucus production and movement.

Correct Answer: C

Rationale: The correct answer is C: stratified squamous epithelium. The oral cavity and oropharynx are exposed to mechanical stress and potential abrasion from food particles and pathogens, requiring a protective lining. Stratified squamous epithelium is ideal for providing protection due to its multiple layers of cells, with the outermost layer being flat and scale-like. This structure helps to resist damage and maintain integrity in areas of high wear and tear. Simple squamous (A) is too thin and delicate for this function. Simple columnar (B) is typically found in areas involved in absorption and secretion, not in protective roles. Stratified cuboidal (D) is rare in the body and not suited for the mechanical stress experienced in the oral cavity and oropharynx.

Correct Answer: C

Rationale: The correct answer is C: mucus. The esophagus secretes mucus to facilitate the passage of food from the mouth to the stomach, providing lubrication and protection to the esophageal lining. Bile (A) is produced by the liver and stored in the gallbladder, amylase (B) is an enzyme produced by the pancreas to break down carbohydrates in the small intestine, and hydrochloric acid (D) is produced by the stomach to aid in digestion. None of these substances are major secretions of the esophagus.