Priority Decision: When medications are used in the treatment of obesity

Correct Answer: B

Rationale: In the context of NCLEX questions on gastrointestinal disorders, the priority decision regarding the use of medications for obesity is crucial for safe and effective patient care. Option B, stating that over-the-counter (OTC) diet aids are safer than other agents and can be useful in controlling appetite, is the correct answer. This is because OTC diet aids are generally considered safer due to their lower potency and fewer side effects compared to prescription weight loss medications. Option C is incorrect because while it is true that drugs should be used as adjuncts to diet and exercise for obesity treatment, it does not specifically address the safety or efficacy of OTC diet aids. Option D is incorrect as it generalizes all weight control drugs as capable of altering CNS function, which is not universally true for all medications used in obesity treatment. In an educational context, it is important for nurses to understand the differences between various weight loss medications, including OTC options, prescription drugs, and their mechanisms of action, side effects, and appropriate patient education. Nurses should also be able to prioritize patient safety and provide evidence-based information to guide patients in making informed decisions about weight loss interventions.

Correct Answer: C

Rationale: The correct answer is C) Wear gloves and wash hands with soap and water. When caring for a patient with Clostridium difficile (C. diff), the most crucial aspect is to prevent the spread of the infection. C. diff is highly contagious and can be transmitted through spores that are resistant to many disinfectants. Wearing gloves and practicing proper hand hygiene with soap and water are essential to prevent the spread of the infection to other patients, healthcare workers, and the environment. Option A is incorrect because cleaning the entire room with ammonia is not the priority when caring for a patient with C. diff. While environmental cleaning is important, the immediate focus should be on preventing transmission through proper hand hygiene. Option B is incorrect because while probiotics may be beneficial in some cases to restore gut flora balance, it is not the priority when dealing with a C. diff infection. Option D is incorrect because alcohol-based hand sanitizers are not effective against C. diff spores. Washing hands with soap and water is necessary to mechanically remove the spores from the hands. In an educational context, it is crucial for nurses to understand the principles of infection control when caring for patients with infectious diseases like C. diff. Emphasizing the importance of proper hand hygiene, wearing appropriate personal protective equipment, and following standard precautions can help prevent the spread of infections in healthcare settings.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Upper small intestine. Intermittent crampy abdominal pain, nausea, projectile vomiting, and dehydration are classic signs of a gastrointestinal (GI) obstruction. The upper small intestine (duodenum and jejunum) is the most common site for mechanical obstructions due to its narrower luminal diameter and more fixed position in the abdomen. The incorrect options are: A) Large intestine: Symptoms of a large intestine obstruction typically include changes in bowel habits, such as constipation or diarrhea, and abdominal distention. B) Esophageal sphincter: An issue with the esophageal sphincter would present with dysphagia, heartburn, regurgitation, and chest pain. D) Lower small intestine: Obstructions in the lower small intestine (ileum) would manifest with symptoms like abdominal distention, cramping, and constipation. Educational context: Understanding the location-specific manifestations of GI disorders is crucial for nurses in assessing and managing patients with potential obstructions. Knowing the typical signs and symptoms associated with different areas of the bowel helps guide clinical decision-making, including appropriate diagnostic tests and treatment interventions. This knowledge is essential for nurses preparing for the NCLEX exam and for providing safe and effective patient care in clinical practice.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Obstructive jaundice with elevated unconjugated and conjugated bilirubin. When a patient has a biliary obstruction from gallstones, it leads to obstructive jaundice. The obstruction prevents the flow of bile into the intestine, causing a buildup of both unconjugated and conjugated bilirubin in the bloodstream. Option A) Hemolytic jaundice with normal conjugated bilirubin is incorrect because hemolytic jaundice results from increased breakdown of red blood cells and would typically have elevated unconjugated bilirubin levels. Option B) Posthepatic icteris with decreased unconjugated bilirubin is incorrect as posthepatic icterus, also known as obstructive jaundice, presents with elevated levels of both conjugated and unconjugated bilirubin due to impaired bile flow. Option D) Hepatocellular jaundice with altered conjugated bilirubin in severe disease is incorrect because hepatocellular jaundice is a result of liver cell damage, which would primarily affect conjugated bilirubin levels, not both forms as seen in obstructive jaundice. Understanding the different types of jaundice and their associated bilirubin patterns is crucial in the diagnosis and management of various gastrointestinal disorders. This knowledge is essential for nurses and healthcare providers to effectively care for patients with these conditions and to interpret laboratory results accurately.

Correct Answer: A

Rationale: In patients with cirrhosis, malnutrition is a common issue due to various factors like decreased appetite, altered metabolism, and nutrient malabsorption. The correct nursing intervention to improve nutrient intake in these patients is option A) Oral hygiene before meals and snacks. Rationale for Option A: Oral hygiene before meals and snacks is crucial in patients with cirrhosis because these individuals often suffer from complications like oral health problems, which can affect their ability to eat and digest food. By ensuring proper oral hygiene, such as brushing teeth and cleaning the mouth before meals, nurses can help improve the patient's appetite, taste perception, and overall willingness to eat. This intervention can enhance the patient's ability to consume essential nutrients, ultimately addressing the issue of malnutrition. Rationale for why the other options are incorrect: B) Providing all foods the patient likes to eat may not always be nutritionally adequate or appropriate for a patient with cirrhosis. While it is essential to consider the patient's food preferences, the focus should be on offering a well-balanced diet that meets their nutritional needs. C) Improving oral intake by feeding the patient is not a sustainable or empowering approach. Patients with cirrhosis should be encouraged to eat independently to maintain their dignity and autonomy. Nursing interventions should focus on supporting and facilitating the patient's ability to eat rather than feeding them. D) Limiting snack offers to when the patient is hungry does not address the underlying issues contributing to malnutrition in patients with cirrhosis. It is essential to provide regular, nutritious meals and snacks to ensure an adequate nutrient intake and prevent malnutrition. Educational context: Understanding and implementing appropriate nursing interventions for patients with cirrhosis is crucial for promoting optimal health outcomes. By prioritizing interventions like oral hygiene before meals and snacks, nurses can play a significant role in addressing malnutrition and supporting the nutritional needs of patients with gastrointestinal disorders. This rationale highlights the importance of evidence-based practice and individualized care in improving patient outcomes.