A patient at a long-term care facility makes the following statements regarding management of his constipation. Which statement would require follow-up teaching by the nurse?

I try to walk in the hallway each day with assistance.

I need to increase fiber in my diet and drink more water.

I take my laxative every morning and an enema every night.

The pain medication I take tends to make my constipation worse.

Answer and Explanation

The Correct Answer is C

Choice A reason: I try to walk in the hallway each day with assistance is a correct statement. Walking is a form of physical activity that can stimulate bowel movements and prevent constipation. Walking also has other benefits such as improving circulation, muscle strength, and mood. The patient should be encouraged to walk as much as possible with assistance to prevent falls and injuries.

Choice B reason: I need to increase fiber in my diet and drink more water is a correct statement. Fiber is a type of carbohydrate that is not digested by the body and helps to form soft and bulky stools. Fiber can be found in foods such as fruits, vegetables, whole grains, nuts, and seeds. Water is essential for hydration and helps to soften the stools and ease their passage. The patient should be advised to consume at least 25 grams of fiber and 8 glasses of water per day to prevent constipation.

Choice C reason: I take my laxative every morning and an enema every night is an incorrect statement that requires follow-up teaching by the nurse. Laxatives and enemas are medications that are used to treat constipation by stimulating or lubricating the bowel. However, they should not be used routinely or excessively, as they can cause side effects such as dehydration, electrolyte imbalance, abdominal cramps, diarrhea, or dependence. The patient should be instructed to use laxatives and enemas only as prescribed by the doctor and for a short period of time. The patient should also be informed of the potential risks and complications of overusing laxatives and enemas.

Choice D reason: The pain medication I take tends to make my constipation worse is a correct statement. Pain medications, especially opioids, can slow down the movement of the bowel and cause constipation. This is a common and expected side effect of pain medications. The patient should be educated on how to manage constipation caused by pain medications, such as increasing fiber and water intake, exercising regularly, and using stool softeners or laxatives as needed. The patient should also be reassured that constipation does not mean that the pain medication is not working or that they are addicted to it.

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Correct Answer is A

Explanation

Choice A reason: This is the correct answer because it shows that the RN understands delegation as a way of managing time effectively. Delegation is the process of assigning tasks to other members of the health care team who are competent and qualified to perform them. By working with the LPN and nursing assistant on dividing up patient care tasks, the RN can ensure that the tasks are done safely, efficiently, and according to the scope of practice of each team member.

Choice B reason: This is not the correct answer because it shows that the RN does not understand delegation as a way of managing time effectively. Working overtime until everything is finished is not a sustainable or productive strategy, as it can lead to fatigue, burnout, and errors. The RN should prioritize the tasks that are most important and urgent, and delegate the tasks that can be done by others.

Choice C reason: This is not the correct answer because it shows that the RN does not understand delegation as a way of managing time effectively. Checking to make sure that the tasks are done correctly is part of the supervision and evaluation of delegation, but it is not the main goal of delegation. The main goal of delegation is to optimize the use of resources and skills of the health care team, and to provide quality care to the patients. The RN should trust and respect the abilities of the LPN and nursing assistant, and only intervene if there is a problem or a concern.

Choice D reason: This is not the correct answer because it shows that the RN does not understand delegation as a way of managing time effectively. Completing every nursing intervention or report by the end of the shift is not always possible or realistic, especially in a busy and dynamic health care environment. The RN should focus on the outcomes and quality of care, rather than the quantity of tasks. The RN should also communicate and collaborate with the other members of the health care team, and hand over any unfinished tasks to the next shift.

A. Administering a vaccine to a well child. B. Obtaining a blood glucose level on a client with hypoglycemia (low blood sugar). C. Educating a patient on wound care. D. Administering a nebulizer treatment to a client with asthma.

Correct Answer is A

Explanation

Choice A reason: Administering a vaccine to a well child is an example of the RN working in a health promotion role through primary prevention. Primary prevention is the level of prevention that aims to prevent disease or injury before it occurs. It involves reducing exposure to risk factors and enhancing protective factors. Vaccination is a primary prevention strategy that protects the child from contracting or spreading infectious diseases, such as measles, polio, or tetanus.

Choice B reason: Obtaining a blood glucose level on a client with hypoglycemia (low blood sugar) is not an example of the RN working in a health promotion role through primary prevention. This is an example of the RN working in a disease management role through tertiary prevention. Tertiary prevention is the level of prevention that aims to reduce the complications and disability associated with chronic or irreversible diseases or injuries. It involves providing treatment, rehabilitation, and support services. Obtaining a blood glucose level on a client with hypoglycemia is a tertiary prevention strategy that monitors the client's condition and prevents further deterioration or complications, such as coma or seizures.

Choice C reason: Educating a patient on wound care is not an example of the RN working in a health promotion role through primary prevention. This is an example of the RN working in a disease management role through secondary prevention. Secondary prevention is the level of prevention that aims to detect and treat diseases or injuries early, before they become more serious or chronic. It involves screening, diagnosis, and intervention. Educating a patient on wound care is a secondary prevention strategy that helps the patient to prevent infection, promote healing, and avoid complications, such as scarring or gangrene.

Choice D reason: Administering a nebulizer treatment to a client with asthma is not an example of the RN working in a health promotion role through primary prevention. This is an example of the RN working in a disease management role through tertiary prevention. Tertiary prevention is the level of prevention that aims to reduce the complications and disability associated with chronic or irreversible diseases or injuries. It involves providing treatment, rehabilitation, and support services. Administering a nebulizer treatment to a client with asthma is a tertiary prevention strategy that helps the client to relieve symptoms, improve lung function, and prevent exacerbations, such as asthma attacks.

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A patient at a long-term care facility makes the following statements regarding management of his constipation. Which statement would require follow-up teaching by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which statement suggests that the RN understands delegation in the concept of time management?

Correct Answer is A

Explanation

Which intervention is an example of the RN working in a health promotion role through primary prevention?

Correct Answer is A

Explanation

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Twenty minutes after administering pain medication to the patient, the nurse asks if the patient's pain level has decreased. What phase of the nursing process does this demonstrate?