The student nurse is participating in colorectal cancer-screening program. Which patient has the fewest risk factors for colon cancer?

Correct Answer: C

Rationale: In the context of this question about colorectal cancer risk factors, the correct answer is option C) Herman, a 60-year-old who follows a low-fat, high-fiber diet. This option is the least likely to have risk factors for colon cancer because a diet high in fiber and low in fat is associated with a lower risk of developing colorectal cancer. High-fiber diets help maintain bowel regularity and reduce the time that potentially harmful substances are in contact with the colon lining, thus decreasing the risk of cancer development. Option A) Janice, with a 25-year history of ulcerative colitis, is at an increased risk for colorectal cancer as chronic inflammation of the colon is a known risk factor. Option B) George, whose father died of colon cancer, has a family history of the disease which increases his risk. Option D) Sissy, with a history of breast cancer, does not have a direct risk factor for colon cancer related to her breast cancer history. In an educational context, this question highlights the importance of understanding modifiable and non-modifiable risk factors for colorectal cancer. It reinforces the significance of lifestyle factors, such as diet, in cancer prevention. Educating student nurses about risk factors empowers them to assess patients holistically, provide targeted health promotion interventions, and advocate for appropriate screening measures to improve patient outcomes.

Correct Answer: C

Rationale: In the context of a patient with peritonitis who is NPO and complaining of thirst, the priority action is to provide frequent mouth care, as indicated by the correct answer C. Providing frequent mouth care helps to maintain oral hygiene, reduce dryness, and alleviate the sensation of thirst without compromising the patient's NPO status. It also promotes comfort and prevents complications such as oral mucosal breakdown and infection. Addressing the patient's thirst through mouth care is a non-invasive and safe approach that aligns with the patient's dietary restrictions. The other options are not the priority in this situation: - Option A (Increase the I.V. infusion rate) may not be necessary solely for thirst relief and could potentially lead to fluid overload or other complications. - Option B (Use diversion activities) is not the most appropriate intervention when the patient's primary concern is thirst related to NPO status and peritonitis. - Option D (Give ice chips every 15 minutes) is contraindicated for a patient who is NPO due to the risk of aspiration and potential worsening of the underlying condition. Understanding the rationale behind prioritizing mouth care in this scenario reinforces the importance of individualized patient care, critical thinking, and evidence-based practice in the field of medical-surgical nursing.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) His gastric bleeding occurred 2 hours earlier. This indicates that the coffee-ground emesis is a result of bleeding that happened some time ago. When blood stays in the stomach for a period of time, it undergoes partial digestion by gastric acid, leading to the coffee-ground appearance. Option A is incorrect because coffee-ground emesis typically indicates older bleeding rather than fresh, active bleeding. Option B is also incorrect because saline gastric lavage is not indicated in this situation and can be harmful. Option D is incorrect as the immediate need is not for a transfusion but rather for further assessment and management of the underlying cause of bleeding. From an educational perspective, understanding the significance of coffee-ground emesis in a patient with a history of peptic ulcer disease is crucial for nursing practice. It helps nurses recognize the timing of bleeding events and guides appropriate interventions. This knowledge empowers nurses to provide timely and effective care to patients experiencing gastrointestinal bleeding, ultimately improving outcomes and patient safety.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Red. After a partial gastrectomy for adenocarcinoma of the stomach, the gastric secretions are expected to be red due to blood in the stomach. This finding is significant as it indicates the presence of bleeding, which could be a complication postoperatively and requires immediate attention. Option A) Brown is incorrect because brown gastric secretions are not typically expected after this type of surgery. Brown color may indicate the presence of old blood or bile. Option B) Clear is incorrect as clear gastric secretions are not typical post-partial gastrectomy and would not be expected in this context. Option D) Yellow is also incorrect because yellow gastric secretions are more commonly associated with issues like bile reflux rather than immediate postoperative findings after a partial gastrectomy. Educationally, understanding the color and significance of gastric secretions post-gastrectomy is crucial for nurses caring for surgical patients. Recognizing abnormal findings like red gastric secretions can help prompt timely interventions and prevent complications, highlighting the importance of thorough assessment and clinical judgment in postoperative care.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Gastric pH. A gastric vagotomy involves cutting the vagus nerve to reduce acid secretion in the stomach. As a result, gastric pH increases because there is less stimulation for acid production. This surgical procedure is often done to manage peptic ulcers by decreasing the acidity in the stomach, which can help in ulcer healing and prevention of recurrence. Option A) Peristalsis is not affected by a vagotomy as it is primarily controlled by the autonomic nervous system and smooth muscle in the gastrointestinal tract. Option B) Gastric acidity decreases after a vagotomy due to reduced acid secretion as a direct result of cutting the vagus nerve. Option C) Gastric motility may be decreased after a vagotomy because the vagus nerve plays a role in regulating gastrointestinal motility, but it is not the factor that increases as a result of vagotomy. Understanding the effects of a gastric vagotomy on various physiological processes is crucial for nurses caring for patients who have undergone this procedure. It helps in providing appropriate postoperative care, monitoring for complications, and educating patients about dietary and lifestyle modifications to promote recovery.