The nurse should urge a client with an ileoanal anastomosis to do perineal exercises four to six times a day for how many repetitions?

Correct Answer: C

Rationale: In the context of a client with an ileoanal anastomosis, perineal exercises are crucial for maintaining pelvic floor strength and function. The correct answer, option C (15 repetitions), is recommended for several reasons. Performing perineal exercises 15 times helps to adequately engage and strengthen the pelvic floor muscles, which are essential for bowel and bladder control post-surgery. This frequency strikes a balance between effectiveness and preventing muscle fatigue or strain. Option A (5 repetitions) is too few to provide significant benefit in strengthening the pelvic floor muscles. Option B (10 repetitions) may not offer enough stimulus for optimal muscle strengthening and rehabilitation. Option D (20 repetitions) may lead to muscle fatigue or overexertion, potentially causing discomfort or injury in the postoperative period. Educationally, understanding the correct frequency and number of repetitions for perineal exercises post ileoanal anastomosis is essential for nurses caring for these clients. Proper guidance ensures optimal recovery, prevention of complications like incontinence, and improved quality of life for the client. Nurses play a vital role in educating clients on postoperative care practices that promote healing and recovery, making this knowledge crucial in providing comprehensive and effective patient care.

Correct Answer: A

Rationale: The correct answer is option A) the patient has lost 20 lb (9 kg) toward a goal of 50 lb (23 kg) but is now discouraged that no weight has been lost in the last 2 weeks. Explanation: This answer is correct because it addresses the patient's situation directly and provides a reassuring and informative response. It acknowledges the progress made by the patient and explains that weight loss plateaus are normal during a weight-loss journey. By emphasizing the progress already achieved, it encourages the patient to stay motivated and continue with the program. Why the other options are wrong: B) Plateaus where no weight is lost normally occur during a weight-loss program. Although this statement is true, it lacks the personalized approach needed to address the patient's specific concerns and feelings of discouragement. It does not acknowledge the progress made by the patient. C) A weight considered by the body to be most efficient for functioning has been reached. This option does not address the patient's current situation or provide guidance on how to overcome the weight loss plateau. It may lead the patient to believe that further weight loss is not possible or necessary. D) A return to former eating habits is the most common cause of not continuing to lose weight. While this option highlights a common reason for weight loss plateaus, it does not offer constructive advice to the patient in their current situation. It does not acknowledge the patient's efforts or provide encouragement to continue with their healthy habits. Educational context: In a clinical setting, it is crucial for healthcare providers to address patients' concerns and provide tailored advice and support. Understanding the psychological aspects of weight loss and providing positive reinforcement are key in helping patients stay motivated and adhere to their treatment plans. By explaining the normalcy of weight loss plateaus and acknowledging the patient's progress, healthcare providers can empower patients to continue making healthy choices and achieve their goals.

Correct Answer: C

Rationale: In the context of teaching a patient with a hiatal hernia or GERD to control symptoms, the correct answer is C) Sleep with the head of the bed elevated on 4- to 6-inch blocks. Elevating the head of the bed helps prevent gastric reflux by using gravity to keep stomach acid from moving up into the esophagus while sleeping. This position can reduce symptoms such as heartburn and regurgitation. Option A) Drink 10 to 12 oz of water with each meal may exacerbate symptoms as consuming large amounts of liquid with meals can distend the stomach and increase pressure on the lower esophageal sphincter, leading to reflux. Option B) Spacing six small meals a day may be beneficial for some individuals with GERD to prevent overeating, but it may not directly address symptom control as effectively as elevating the head of the bed. Option D) Performing daily exercises of toe-touching, sit-ups, and weight lifting is not recommended for symptom control in patients with hiatal hernia or GERD. Vigorous exercises and certain movements like bending at the waist can worsen symptoms by increasing intra-abdominal pressure and promoting acid reflux. Educationally, it's important to teach patients evidence-based strategies backed by scientific rationale to effectively manage their condition. Understanding the physiological mechanisms behind each recommendation helps patients make informed decisions about their health and empowers them to take an active role in managing their gastrointestinal disorders.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Ground beef. The school nurse suspects food poisoning due to the symptoms of profuse diarrhea and bloody stools seen in the children. Ground beef is a common source of foodborne illnesses such as E. coli and Salmonella, which can cause these gastrointestinal symptoms. Ground beef is particularly susceptible to contamination during processing and cooking if not handled properly. Option A) Chicken is less likely to be the source of the food poisoning in this case, as the symptoms described are more commonly associated with beef-related pathogens. Option C) Commercially canned fish is also less likely to cause the symptoms described as it undergoes a sterilization process during canning which kills most pathogens. Option D) Salads with mayonnaise dressing are also less likely as the symptoms described are not typical of foodborne illnesses associated with salads, unless the mayonnaise was made with contaminated eggs. Educationally, this question highlights the importance of food safety and proper handling of ground beef to prevent foodborne illnesses. It also emphasizes the need for healthcare professionals to consider food sources when investigating outbreaks of gastrointestinal symptoms. Students can learn how different foods can be sources of pathogens and how to prevent foodborne illnesses through safe food handling practices.

Correct Answer: A

Rationale: The correct answer is A) Pallor and hair loss. This assessment data support the nursing diagnosis of imbalanced nutrition in a patient with inflammatory bowel disease because pallor indicates decreased hemoglobin levels due to nutritional deficiency, and hair loss can be a sign of malnutrition. These physical manifestations are directly related to inadequate nutritional intake and absorption in the gastrointestinal system. Option B) Frequent diarrhea stools may lead to dehydration and electrolyte imbalances, but it does not directly support the nursing diagnosis of imbalanced nutrition. Option C) Anorectal excoriation and pain are more indicative of complications related to diarrhea or inflammation in the anal area, rather than specifically pointing to imbalanced nutrition. Option D) Hypotension and low urine output suggest possible dehydration or renal issues, which are not directly linked to the nursing diagnosis of imbalanced nutrition. In an educational context, understanding how to assess and interpret data related to nutritional status in patients with gastrointestinal disorders is crucial for providing effective nursing care. Recognizing the signs and symptoms of malnutrition can help nurses develop appropriate interventions to address the patient's nutritional needs and improve their overall health outcomes.