A nurse is reinforcing teaching with a client who reports constipation. Which of the following should the nurse discuss as causes of constipation? (Select all that apply.)
Ignoring the urge to defecate
Increased fiber in the diet
Excessive laxative use
Increased activity
Correct Answer : A,C
Choice A reason: Ignoring the urge to defecate is a cause of constipation, as it can lead to hardening and accumulation of stool in the colon. The nurse should advise the client to respond to the urge to defecate as soon as possible and to establish a regular bowel routine.
Choice B reason: Increased fiber in the diet is not a cause of constipation, but rather a prevention measure. Fiber helps to soften the stool and increase its bulk, which facilitates its passage through the colon. The nurse should encourage the client to consume adequate amounts of fiber from fruits, vegetables, whole grains, and legumes.
Choice C reason: Excessive laxative use is a cause of constipation, as it can interfere with the normal functioning of the colon and cause dependency. The nurse should instruct the client to avoid using laxatives unless prescribed by the provider and to use them only for a short period of time.
Choice D reason: Increased activity is not a cause of constipation, but rather a prevention measure. Activity helps to stimulate the peristalsis of the colon and promote bowel movements. The nurse should recommend the client to engage in moderate physical activity for at least 30 minutes a day
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Planning to administer insulin to the client is not a relevant action for the nurse to take, as it has no effect on respiratory alkalosis or hyperventilation. Insulin is used to lower blood glucose levels in patients with diabetes or hyperglycemia.
Choice B reason: Having the client breathe into a paper bag is a correct action for the nurse to take, as it helps to increase the carbon dioxide level in the blood and correct the alkalosis. Breathing into a paper bag creates a closed system that recycles the exhaled carbon dioxide and reduces the loss of carbon dioxide from the lungs.
Choice C reason: Planning to administer sodium bicarbonate to the client is not a correct action for the nurse to take, as it can worsen the alkalosis. Sodium bicarbonate is an alkali that can raise the pH of the blood and cause metabolic alkalosis. It is used to treat metabolic acidosis, not respiratory alkalosis.
Choice D reason: Having the client place their head between their knees is not a recommended action for the nurse to take, as it can impair the blood flow to the brain and cause fainting. It can also increase the respiratory rate and decrease the carbon dioxide level in the blood.
Correct Answer is C
Explanation
Choice A reason: Shaking the inhaler well before using it is a correct action for the client to take, as it helps to mix the medication and the propellant. However, it is not the best answer, as it is a general instruction that applies to most inhalers, not a specific one that indicates an understanding of the teaching.
Choice B reason: Holding the breath for 10 seconds after inhaling the medication is a correct action for the client to take, as it helps to keep the medication in the lungs and improve its absorption. However, it is not the best answer, as it is a general instruction that applies to most inhalers, not a specific one that indicates an understanding of the teaching.
Choice C reason: Rinsing the mouth with water after using the inhaler is the best answer, as it indicates an understanding of the teaching. Rinsing the mouth with water helps to prevent oral thrush, a fungal infection that can occur as a side effect of some inhalers, especially those that contain steroids.
Choice D reason: Waiting 30 seconds between each puff of the inhaler is not a correct action for the client to take, as it can reduce the effectiveness of the medication. The client should wait at least one minute between each puff of the inhaler, unless instructed otherwise by the provider.
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