A nurse in a provider's office is reviewing the health histories of four clients. For which of the following clients should the nurse anticipate scheduling a colonoscopy?

32-year-old who has a sister who died of colon cancer

56-year-old who had a colonoscopy 6 years ago

45-year-old who has Clostridium difficile

34-year-old who reports a new onset of constipation

Answer and Explanation

The Correct Answer is A

A. 32-year-old who has a sister who died of colon cancer: A first-degree relative with colon cancer increases risk; screening typically begins earlier (often at age 40 or 10 years younger than the relative’s age at diagnosis). This client should be evaluated/scheduled based on family history.

B. 56-year-old who had a colonoscopy 6 years ago: If the previous colonoscopy was normal, routine surveillance is often every 10 years, so they usually would not be scheduled at 6 years unless prior findings required earlier follow-up.

C. 45-year-old who has Clostridium difficile: C. difficile infection is not an indication for routine colonoscopy; it's typically managed medically unless there are complications.

D. 34-year-old who reports a new onset of constipation: New constipation alone in a 34-year-old without red-flag signs usually does not mandate immediate colonoscopy; conservative evaluation and treatment are typical first steps.

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Correct Answer is A

Explanation

A. Potassium 2.5 mEq/L: This is severe hypokalemia (normal ~3.5–5.0 mEq/L) and is life-threatening because it can cause cardiac arrhythmias and muscle weakness; it takes priority over the other findings.

B. Urine specific gravity 1.035: Abnormally high, indicating significant dehydration/concentrated urine, important but less immediately life-threatening than severe hypokalemia.

C. Blood glucose 150 mg/dL: Mildly elevated but not emergent in most adults; not the priority in gastroenteritis unless the patient is diabetic and symptomatic.

D. Weight loss of 3% of total body weight: This indicates fluid loss and is clinically important, but less immediately dangerous than a K⁺ of 2.5 mEq/L.

A. Measure abdominal girth daily. B. Provide bulk-forming agent. C. Elevate the head of the bed. D. Monitor intake and output every 8 hr.

Correct Answer is A

Explanation

A. Measure abdominal girth daily.Monitoring abdominal girth (often more than once daily if indicated) helps detect increasing distention that suggests worsening obstruction or bowel compromise.

B. Provide bulk-forming agent.Bulk-forming laxatives (fiber agents) are contraindicated in mechanical small bowel obstruction because they can worsen obstruction.

C. Elevate the head of the bed.Not a primary intervention specific to small bowel obstruction; head elevation may assist breathing but does not treat obstruction and can increase risk of aspiration if vomiting-positioning should be individualized.

D. Monitor intake and output every 8 hr.Inadequate frequency. I&O should be monitored more frequently (often hourly or every shift depending on severity) in small bowel obstruction to detect dehydration/electrolyte losses-every 8 hours is insufficient for most obstructed patients.

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A nurse in a provider's office is reviewing the health histories of four clients. For which of the following clients should the nurse anticipate scheduling a colonoscopy?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is A

Explanation

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