The nurse has completed initial instruction with a patient regarding a weight-loss program. Which patient comment indicates to the nurse that the teaching has been effective?

Correct Answer: D

Rationale: The correct answer is D because it demonstrates the patient's understanding of the importance of behavior modification for long-term weight loss success. By joining a behavior modification group, the patient shows a commitment to changing habits and lifestyle, which is crucial for sustained weight loss. Choice A focuses on tracking weight loss progress, which is important but does not necessarily indicate a deep understanding of behavior change. Choice B sets unrealistic weight loss goals that may not be safe or sustainable. Choice C shows a misconception about exercise and appetite, indicating a potential misunderstanding of weight loss principles. In summary, choice D is correct because it reflects a holistic approach to weight loss that includes addressing behavior patterns, while the other choices either focus on surface-level strategies or misunderstand key concepts related to weight loss.

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: C

Rationale: Rationale: 1. Choice C is correct because it acknowledges that all polyps are abnormal and should be removed, but the risk for cancer depends on the type and presence of malignant changes. 2. This response is accurate as not all polyps become cancerous, and the risk varies depending on the specific characteristics of the polyp. 3. It also emphasizes the importance of removing polyps and monitoring for any signs of malignancy, aligning with best practice guidelines for colon cancer prevention. 4. In contrast, choices A, B, and D provide misleading information by either downplaying or exaggerating the risk associated with polyps, which can lead to unnecessary anxiety or complacency in the patient.

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.