A nurse is doing a nursing assessment on a patient with chronic constipation. What data obtained during the interview may be a factor contributing to the constipation?

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.

Correct Answer: D

Rationale: The correct answer is D: Hepatitis E (HEV). The patient's symptoms of nausea, malaise, fatigue, and muscle aches are consistent with acute hepatitis, and HEV is commonly transmitted through contaminated water in developing countries like Somalia. Hepatitis B (HBV) and C (HCV) are more commonly transmitted through blood or body fluids. Hepatitis D (HDV) requires HBV for replication, making it less likely in this case. In summary, based on the patient's symptoms and travel history, Hepatitis E (HEV) is the most likely cause of the illness.

Correct Answer: C

Rationale: The correct answer is C: "It traps ammonia and eliminates it in the feces." In hepatic encephalopathy, excessive ammonia levels lead to neurological symptoms. Lactulose works by acidifying the colon, converting ammonia to ammonium, trapping it, and promoting its excretion in feces. This reduces ammonia absorption, alleviating encephalopathy. Explanation of other choices: A: Incorrect. Lactulose does not directly reduce portal venous pressure. B: Incorrect. Lactulose does not eliminate blood from the GI tract. D: Incorrect. Lactulose does not directly decrease bacteria to reduce ammonia formation. In summary, the nurse should explain to the patient's family that lactulose helps by trapping ammonia in the GI tract and facilitating its removal in the feces, thus reducing ammonia levels in the body and improving hepatic encephalopathy symptoms.

Correct Answer: D

Rationale: The correct answer is D. After a laparoscopic cholecystectomy, the patient typically has up to four small abdominal incisions that are covered with small dressings. This is because laparoscopic cholecystectomy is a minimally invasive procedure involving small incisions, which do not require extensive wound care. The incisions are small and usually heal well with minimal scarring. Explanation for why other choices are incorrect: A: Return to work in 2 to 3 weeks - This is not part of the immediate postoperative plan of care. Patients may need more time to recover before returning to work. B: Be hospitalized for 3 to 5 days postoperatively - Patients undergoing laparoscopic cholecystectomy typically have a shorter hospital stay, usually 1 to 2 days, not 3 to 5 days. C: Have a T-tube placed in the common bile duct to provide bile drainage - This is not typically done after a laparoscopic