In planning a treatment and prevention program of chronic fecal incontinence for an elderly client, which intervention should you try first?

Correct Answer: C

Rationale: The correct answer is C: Assist the client to the bedpan or toilet 30 minutes after meals. This intervention is appropriate as it aligns with the natural physiological process of bowel movements after meals, increasing the likelihood of successful evacuation. This timing can help establish a routine and promote regular bowel movements, potentially reducing episodes of fecal incontinence. Choice A is incorrect because administering a glycerin suppository may not address the underlying cause of fecal incontinence and may not promote regular bowel movements. Choice B is incorrect as inserting a rectal tube is an invasive intervention that should only be considered after less invasive methods have been exhausted. Choice D is incorrect as using incontinence briefs or adult-sized diapers only manages the symptoms without addressing the root cause or promoting bowel regularity.

Correct Answer: D

Rationale: The correct answer is D: Teach the client how to apply ice. Applying ice helps reduce inflammation and pain associated with anal fissures. It constricts blood vessels, decreases blood flow, and numbs the area, promoting healing. A: Teaching strategies to relieve diarrhea is not directly related to managing anal fissures. B: Instructing the client to not eat any fiber is incorrect because fiber helps soften stools and prevent constipation, which can worsen anal fissures. C: Teaching the client how to insert a suppository may not be necessary for managing anal fissures unless prescribed by a healthcare provider for specific reasons.

Correct Answer: D

Rationale: The correct answer is D: Production of cholecystokinin by the duodenum. Cholecystokinin (CCK) is released by the duodenum in response to the presence of fatty acids and amino acids. It stimulates the gallbladder to contract, causing the release of bile into the small intestine to aid in digestion. This is directly related to the patient's symptoms of gallbladder pain after eating, as the contraction of the gallbladder is triggered by CCK. A: Production of bile by the liver is not the mechanism responsible for the gallbladder contraction. B: Production of secretin by the duodenum is involved in regulating the pH of the duodenum, not gallbladder contraction. C: Release of gastrin from the stomach antrum is related to stomach acid secretion, not gallbladder contraction. In summary, the correct answer, D, is directly related to the mechanism responsible for gallbladder pain after eating,

Correct Answer: D

Rationale: The correct answer is D. Mid-upper arm circumference and triceps skinfold are commonly used indicators to assess muscle and fat reserves in individuals with protein-calorie malnutrition. Mid-upper arm circumference reflects muscle mass, while triceps skinfold measures body fat. These indicators provide a comprehensive assessment of the patient's nutritional status, making them the best choice for evaluating the effectiveness of nutritional interventions. A: Height and weight do not provide a specific assessment of muscle and fat reserves and may not accurately reflect changes in nutritional status. B: Weight in relation to ideal body weight does not differentiate between muscle and fat mass, making it less specific for assessing protein-calorie malnutrition. C: BMI is a general indicator of weight status and does not specifically measure muscle and fat reserves, making it less suitable for evaluating nutritional interventions in patients with protein-calorie malnutrition.

Correct Answer: B

Rationale: The correct answer is B because the patient's blood pressure, HDL levels, and fasting blood glucose levels all indicate a higher likelihood of metabolic syndrome. High blood pressure, low HDL levels, and elevated blood glucose are key components of metabolic syndrome. Option A has normal blood pressure and slightly elevated triglycerides and blood glucose, but not as concerning as choice B. Option C has a normal blood pressure, slightly elevated triglycerides, and good HDL levels, which lowers the likelihood of metabolic syndrome. Option D has a normal blood pressure, very low HDL levels, and slightly elevated blood glucose, but the blood pressure is not in the hypertensive range as in choice B.