A patient has a severe exacerbation of ulcerative colitis. Long-term medications will probably include:

Correct Answer: C

Rationale: In the context of a severe exacerbation of ulcerative colitis, the correct long-term medication choice is corticosteroids (Option C). Here's a detailed rationale: Corticosteroids are commonly used in ulcerative colitis to reduce inflammation and suppress the immune response in the colon. They help in inducing and maintaining remission in patients with severe disease activity. Antacids (Option A) are primarily used for conditions such as acid reflux and peptic ulcers, not for ulcerative colitis. Antibiotics (Option B) may be used in cases of infection but are not the mainstay of treatment for ulcerative colitis. Histamine2-receptor blockers (Option D) are used for conditions like GERD and peptic ulcers, not for inflammatory bowel diseases like ulcerative colitis. In an educational context, it's crucial for nursing students to understand the rationale behind medication choices in gastrointestinal disorders like ulcerative colitis. Knowing the appropriate pharmacological interventions based on the underlying pathophysiology and severity of the condition is essential for providing safe and effective patient care. This question highlights the importance of selecting the right medications tailored to the specific disease process.

Correct Answer: B

Rationale: The correct response, B) Stop the feeding, and clamp the NG tube, is based on the principle of patient safety and preventing complications. Aspirating 220ml of gastric residual suggests poor gastric emptying and potential risk for aspiration, which can lead to respiratory compromise. By stopping the feeding and clamping the NG tube, you are preventing the patient from receiving more feedings that could potentially exacerbate the situation. Option A) Notify the doctor immediately is not the first response because immediate action is needed to address the risk of aspiration. Waiting for a physician's response could delay necessary interventions. Option C) Discard the 220ml, and clamp the NG tube is incorrect because discarding the aspirate without taking action to prevent further feeding could still lead to complications. Option D) Give a prescribed GI stimulant such as metoclopramide (Reglan) is not appropriate in this situation as the priority is to address the immediate risk of aspiration rather than promoting gastric motility. In an educational context, understanding the significance of gastric residuals in enteral feedings is crucial for nurses caring for patients with NG tubes. Prompt recognition of abnormal findings and appropriate actions can prevent serious complications and promote patient safety in medical-surgical settings.

Correct Answer: D

Rationale: Delegating tasks such as providing skin care, maintaining intake and output records, and obtaining the client's weight are within the scope of practice for an unlicensed assistant. Assessing bowel sounds and evaluating the response to medications require nursing judgment and should not be delegated.

Correct Answer: B

Rationale: In the context of caring for a client with ulcerative colitis experiencing symptoms, the correct answer is B) Providing skin care following bowel movements. This task can be appropriately delegated to an unlicensed assistant as it involves maintaining the client's hygiene and preventing skin breakdown, which aligns with their scope of practice and does not require specialized nursing assessment or medical decision-making. Option A, assessing the client's bowel sounds, involves a higher level of assessment that requires nursing judgment and skill, so it should not be delegated to an unlicensed assistant. Option C, evaluating the client's response to antidiarrheal medications, involves monitoring for potential side effects and effectiveness of the medication, which requires nursing assessment and critical thinking. Option D, administration of pain medication every 4 hours, involves medication administration, which is a nursing responsibility due to the need for accurate dosage calculation, understanding of potential side effects, and monitoring the client's response. Educationally, understanding delegation in nursing is crucial for ensuring safe and effective patient care. Nurses must be able to differentiate tasks that can be delegated to unlicensed personnel from those that require nursing expertise to provide appropriate care and uphold patient safety. This rationale highlights the importance of delegation principles and the significance of knowing each team member's scope of practice to optimize patient outcomes.