The nurse identifies a client problem of impaired skin integrity related to diarrhea for a client who has ulcerative colitis. The nurse recognizes that teaching about perianal care has been effective when the client:

cleans and dries the perianal area after each diarrheal stool.

uses alcohol compresses to provide relief from anal irritation.

asks for antidiarrheal medication after each stool.

takes an hour-long Sitz bath following each stool.

Answer and Explanation

The Correct Answer is A

A.   Cleans and dries the perianal area after each diarrheal stool: This is the correct option. Effective perianal care for a client with diarrhea, such as ulcerative colitis, involves gentle cleansing and thorough drying of the perianal area after each stool. Proper hygiene helps prevent skin breakdown and irritation caused by prolonged contact with stool.
B.   Alcohol can be irritating to the skin and may exacerbate perianal irritation and discomfort. Therefore, using alcohol compresses is not considered an appropriate perianal care practice.
C.   While antidiarrheal medications may be prescribed for clients with ulcerative colitis to help manage symptoms, asking for medication after each stool is not a typical or recommended approach. The frequency and timing of antidiarrheal medication administration should be based on healthcare provider recommendations and individual symptom management plans.
D.   While Sitz baths can provide relief from perianal discomfort and promote healing, taking an hour-long Sitz bath after each stool may be impractical and excessive. Sitz baths are typically recommended for shorter durations (e.g., 10-20 minutes) and may be used periodically rather than after every stool.

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Correct Answer is A

Explanation

A. Teach the client to support the surgical site while deep breathing and coughing: This action is appropriate as it helps prevent complications such as atelectasis and pneumonia by promoting lung expansion and clearing secretions. Supporting the surgical site while deep breathing and coughing helps reduce pain and discomfort during these activities.
B. This is an important teaching point for clients using PCA for pain control after surgery. Opioid medications used in PCA can lead to gastrointestinal motility issues, including constipation. However, pain management is central within the first 24 hours post operation.
C. Irrigating and repositioning the NGT frequently can increase the risk of complications such as displacement or irritation of the surgical site. NGT care should be performed as needed based on institutional protocols and the client's condition.

D. The client's diet will likely be advanced gradually, starting with clear fluids and progressing to full liquids and then solid foods as tolerated. Fruit juices may be introduced gradually as part of the liquid diet once the client's gastrointestinal function has recovered sufficiently.

A. take two pills each day for 5 days, and reserve the rest of the pills to take if the symptoms reappear. B. take the antibiotic for the full 7 days, even if symptoms improve in a few days C. increase the effectiveness of the drug by taking it with cranberry juice to acidify the urine D. return to the clinic in 3 days so that a urine culture can be done to evaluate the effectiveness of the drug.

Correct Answer is B

Explanation

B. It is essential to complete the full course of antibiotics as prescribed by the healthcare provider, even if symptoms improve before the course is finished. This ensures that all bacteria causing the infection are eradicated, reducing the risk of recurrence and development of antibiotic resistance.
A. Antibiotics should be taken exactly as prescribed and for the full duration of the treatment course. Incomplete or inconsistent use of antibiotics can lead to incomplete eradication of the infection, development of antibiotic resistance, and recurrence of the infection.
C. While cranberry juice is often recommended for urinary tract health due to its ability to prevent bacterial adherence to the bladder wall, it is not a substitute for antibiotics in treating urinary tract infections.
D. Typically, urine cultures are reserved for cases where the diagnosis is uncertain, or the infection is recurrent or complicated. In uncomplicated UTIs, empirical antibiotic treatment based on symptoms and clinical presentation is usually sufficient.

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The nurse identifies a client problem of impaired skin integrity related to diarrhea for a client who has ulcerative colitis. The nurse recognizes that teaching about perianal care has been effective when the client:

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Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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