To confirm the presence of steatorrhea, which action should the nurse take?
Auscultate all quadrants of the client's abdomen.
Inspect the area around the client's umbilicus.
Lightly palpate areas of abdominal protuberance.
Observe the appearance of the client's stool.
The Correct Answer is D
A. Auscultation of the abdomen involves listening to bowel sounds and can provide information about the gastrointestinal system's activity, such as whether there is increased or decreased motility. While important for assessing general bowel function, auscultation is not specific for confirming steatorrhea. It does not provide direct information about the presence of fat in the stool.
B. Inspecting the area around the umbilicus may help in identifying other abdominal conditions, such as hernias or signs of ascites. However, it does not provide information about stool characteristics or fat content, so it is not the most appropriate action for confirming steatorrhea.
C. Light palpation of areas of abdominal protuberance can help assess for abdominal masses or tenderness. While palpation can provide useful information about the abdominal organs and possible fluid accumulation, it does not give information about stool fat content.
D. Observing the appearance of the client’s stool is the most direct method to confirm steatorrhea. Stool that is greasy, foul-smelling, and floats is characteristic of steatorrhea, indicating the presence of undigested fat. This observation directly assesses the presence of fat in the stool, making it the best action to confirm steatorrhea.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Performing light exercise may help in assessing how the client’s respiratory system responds to physical exertion and could reveal if the shortness of breath is related to activity. However, this action might not be appropriate if the client is currently asymptomatic or if the nurse needs more detailed information about the episodes of dyspnea.
B. Documenting "dyspnea on exertion" might be appropriate if the nurse has already confirmed that the shortness of breath occurs specifically with physical activity. However, based on the information provided, the nurse has not yet gathered sufficient details to confirm whether the dyspnea is related to exertion or another cause.
C. This option is the best initial action because it allows the nurse to gather detailed information about the nature, frequency, duration, and triggers of the client's shortness of breath. Understanding the context and specifics of the episodes will help in determining whether the dyspnea is related to underlying health issues, activity, or other factors.
D. While explaining the possible causes of dyspnea can be informative for the client, it may not address the immediate need for a detailed assessment of the client's symptoms. Providing education is valuable, but understanding the client's specific experience with dyspnea should take precedence to tailor the explanation and subsequent care effectively.
Correct Answer is D
Explanation
A. Auscultation of the abdomen involves listening to bowel sounds and can provide information about the gastrointestinal system's activity, such as whether there is increased or decreased motility. While important for assessing general bowel function, auscultation is not specific for confirming steatorrhea. It does not provide direct information about the presence of fat in the stool.
B. Inspecting the area around the umbilicus may help in identifying other abdominal conditions, such as hernias or signs of ascites. However, it does not provide information about stool characteristics or fat content, so it is not the most appropriate action for confirming steatorrhea.
C. Light palpation of areas of abdominal protuberance can help assess for abdominal masses or tenderness. While palpation can provide useful information about the abdominal organs and possible fluid accumulation, it does not give information about stool fat content.
D. Observing the appearance of the client’s stool is the most direct method to confirm steatorrhea. Stool that is greasy, foul-smelling, and floats is characteristic of steatorrhea, indicating the presence of undigested fat. This observation directly assesses the presence of fat in the stool, making it the best action to confirm steatorrhea.
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