The physician orders psyllium for constipation.
Which client situation would require the nurse to his order?
A client with a hip fracture and is on bedrest for 4 weeks
A client who has severe pain and is prescribed morphine
A client who is post-operative and is on a clear liquid diet
A client with recent a stroke and has difficulty swallowing
The Correct Answer is D
Choice A rationale
A client with a hip fracture and is on bedrest for 4 weeks may indeed experience constipation due to decreased physical activity. However, this situation would not necessarily require the nurse to question the order for psyllium. Psyllium is a bulk-forming laxative that can help relieve constipation by increasing stool bulk and improving bowel regularity.
Choice B rationale
Morphine is an opioid medication that can cause constipation as a side effect. Therefore, a client who is experiencing severe pain and is prescribed morphine may benefit from a laxative like psyllium to help manage opioid-induced constipation. This situation would not necessarily require the nurse to question the order for psyllium.
Choice C rationale
A client who is post-operative and is on a clear liquid diet may experience constipation due to the low fiber content of the diet. However, this situation would not necessarily require the nurse to question the order for psyllium. Once the client progresses to a regular diet, psyllium can help add bulk to the stool and promote regular bowel movements.
Choice D rationale
This choice is correct. A client with a recent stroke who has difficulty swallowing may be at risk for aspiration, or the inhalation of food or liquid into the lungs, when taking psyllium. Psyllium is a bulk-forming laxative that absorbs water in the intestines to form a softer, bulkier stool. If a client with swallowing difficulties were to aspirate the psyllium, it could potentially expand in the lungs when it comes into contact with moisture, leading to serious complications. Therefore, the nurse should question the order for psyllium in this situation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Metformin is an oral antidiabetic medication that is typically withheld on the morning of surgery due to the risk of lactic acidosis, especially if the surgery involves the use of contrast dye.
Choice B rationale
Metoprolol is a beta-blocker used to treat hypertension and other heart conditions. It is typically continued up to and including the day of surgery to maintain heart rate and blood pressure control.
Choice C rationale
Prednisone is a corticosteroid medication. If a patient is on long-term corticosteroid therapy, it is typically continued on the day of surgery to prevent adrenal insufficiency.
Choice D rationale
Levothyroxine is a thyroid hormone replacement medication. It is typically continued on the day of surgery to maintain thyroid hormone levels.
Correct Answer is D
Explanation
Choice A rationale
While older age and the use of certain medications can increase the risk of developing drug- resistant tuberculosis, these factors alone do not pose the greatest risk.
Choice B rationale
The presence of a red-orange color in the urine after being treated with rifampin is a common side effect of the medication and does not indicate an increased risk of developing drug- resistant tuberculosis.
Choice C rationale
A patient who has been taking rifampin and isoniazid as prescribed for 24 months is not at the greatest risk of developing drug-resistant tuberculosis. Adherence to the prescribed treatment regimen is actually crucial in preventing the development of drug-resistant strains of the disease.
Choice D rationale
A patient who did not complete the full course of anti-tubercular therapy in the past is at the greatest risk of developing a drug-resistant form of the disease. Incomplete treatment can allow tuberculosis bacteria to develop resistance to the medications used, leading to the emergence of drug-resistant strains.
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