A nurse is reviewing the laboratory reports of four clients. Which of the following clients should the nurse expect to have a positive fecal occult blood test?
A client who has ulcerative colitis
A client who has stomatitis
A client who uses laxatives
A client who has cholecystitis
The Correct Answer is A
Choice A Reason:
A client who has ulcerative colitis is correct. Ulcerative colitis, a type of inflammatory bowel disease (IBD), involves chronic inflammation and ulceration in the colon and rectum. This condition often results in bleeding from the inflamed mucosa, leading to the presence of blood in the stool that can be detected by a fecal occult blood test.
Choice B Reason:
A client who has stomatitis is incorrect. Stomatitis refers to inflammation in the mouth and does not typically cause bleeding in the gastrointestinal tract, which is what the fecal occult blood test detects. Stomatitis involves oral lesions or sores but does not directly impact stool blood content.
Choice C Reason:
A client who uses laxatives is incorrect. Laxative use does not necessarily cause bleeding in the gastrointestinal tract. While some laxatives can potentially irritate the intestinal lining, leading to minor bleeding in some cases, the presence of blood in the stool due to laxative use is less common compared to conditions like ulcerative colitis, where chronic inflammation and ulceration lead to significant bleeding.
Choice D Reason:
A client who has cholecystitis is incorrect. Cholecystitis is inflammation of the gallbladder and does not directly involve bleeding in the gastrointestinal tract. It typically presents with symptoms related to gallbladder inflammation such as abdominal pain, nausea, and vomiting, rather than causing bleeding that would be detected by a fecal occult blood test.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason:
"Aren't you interested in learning how to perform this test?" is incorrect. This response might come across as accusatory or judgmental, potentially making the client feel uncomfortable or defensive, further hindering communication.
Choice B Reason:
"Let's talk about what you're thinking." Is correct. This response acknowledges the client's distraction and aims to understand and address their thoughts or concerns that might be hindering their focus. It invites the client to express any worries or questions they might have, allowing the nurse to provide reassurance or clarification.
Choice C Reason:
"I'll discuss this with your partner instead." Is incorrect. Redirecting the conversation to the client's partner without understanding the client's concerns directly could undermine the client's autonomy and miss the opportunity to address their needs.
Choice D Reason:
"Is this something you think you can do?" is incorrect. While this question aims to assess the client's confidence, it might not effectively address the underlying reason for the client's distraction or encourage open communication about their concerns.
Correct Answer is C
Explanation
Correct Answer: C
C. Flex hips and knees when assisting the client to a standing position.Flexing the hips and knees protects the nurse’s back by using proper body mechanics and distributes the force of lifting safely. This position provides stability and reduces the risk of injury to both the nurse and the client during the transfer.
Incorrect answers:
A: "Stand on the client's stronger side when moving the client into the chair."The nurse should stand on the weaker side, not the stronger side, to provide support and assistance where it is most needed. This ensures the client is stabilized and prevents falls or instability due to the weaker side giving way.
B: "Pivot on the foot farthest from the bed when assisting the client into the chair."The nurse should pivot on the foot closest to the chair or the bed to maintain balance and stability. Pivoting on the farthest foot could lead to poor body mechanics and an increased risk of injury to the nurse or client.
D: "Raise the bed to waist level before moving the client." For transferring a client to a chair, the bed should be lowered to a position where the client’s feet can touch the floor. This provides stability and facilitates a safe transfer.
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