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Choice A reason: Frequent surgery is not a common feature of ulcerative colitis or Crohn's disease. Surgery may be needed to remove damaged parts of the intestine or to repair complications, but it is not a cure and may not prevent recurrence of inflammation.

Choice C reason: Fistula formation is not a common feature of ulcerative colitis. A fistula is an abnormal connection between two organs or tissues that normally do not connect. Fistulas can occur in Crohn's disease due to severe inflammation that penetrates the deeper layers of the bowel wall and creates tunnels to other parts of the intestine or to the skin, bladder, or vagina. Fistulas can cause infections, abscesses, and leakage of stool or urine.

Choice D reason: Ulcerative colitis always begins in the rectum, which is the last part of the colon. It may spread to other parts of the colon, but it does not affect the small intestine. Crohn's disease can affect any part of the digestive tract, from the mouth to the anus, but it usually involves the small intestine and the colon. It can affect multiple segments or be continuous. It can also skip areas and leave normal tissue between inflamed areas.

Choice B reason: This is incorrect. Both plaster and synthetic casts can immobilize bone fractures effectively, depending on the type and location of the fracture. The choice of cast material depends on other factors, such as cost, availability, patient preference, and comfort.

Choice C reason: This is incorrect. Drying time is shorter with a synthetic cast than with a plaster cast. A synthetic cast can dry in 20 to 30 minutes, while a plaster cast can take several hours to dry completely.

Choice D reason: This is incorrect. A plaster cast does not require expensive equipment for application. A plaster cast is made of cotton or synthetic rolls that are soaked in water and wrapped around the affected limb. The plaster hardens as it dries, forming a rigid shell.

Choice A reason: This is incorrect. Measuring the circumference of the thigh can help detect swelling or compartment syndrome, but it does not assess the neurovascular status of the lower leg. The nurse should measure the circumference of both thighs and compare them for any significant difference.

Choice C reason: This is incorrect. Palpating the femoral pulse can assess the arterial blood supply to the lower leg, but it does not assess the venous return or the nerve function. The nurse should palpate both femoral pulses and compare them for any significant difference in strength or quality.

Choice D reason: This is incorrect. Monitoring the client's calf for edema can help detect venous congestion or deep vein thrombosis, but it does not assess the arterial blood supply or the nerve function. The nurse should inspect both calves and compare them for any significant difference in size, color, or temperature.

Choice A reason: This is incorrect. Foods high in starch and protein are not harmful for a client who has chronic cholecystitis, but they are not beneficial either. Starch and protein do not affect the production or secretion of bile, which is the main cause of biliary colic.

Choice C reason: This is incorrect. Foods high in sodium are not related to biliary colic or chronic cholecystitis. Sodium can affect blood pressure and fluid balance, but it does not affect bile production or secretion.

Choice D reason: This is incorrect. Foods high in fiber are beneficial for general health and digestion, but they do not prevent or treat biliary colic or chronic cholecystitis. Fiber can help prevent constipation and lower cholesterol levels, but it does not affect bile production or secretion.

Choice A reason: This is incorrect. Positioning the client's legs in an adducted position means bringing them together or crossing them. This can cause dislocation of the hip joint or damage to the nerves and blood vessels. The nurse should position the client's legs in an abducted position, which means keeping them apart with a pillow or wedge between them.

Choice B reason: This is incorrect. Bathing and dressing the client are not priority actions before physical therapy. The nurse should assist the client with hygiene and grooming as needed, but not at the expense of delaying or interfering with the therapy session. The nurse should also respect the client's preferences and level of independence.

Choice D reason: This is incorrect. Telling the client to bend forward at the waist when getting out of bed can cause dislocation of the hip joint or damage to the nerves and blood vessels. The nurse should instruct the client to keep the operative leg straight and use a trapeze bar or assistance to get out of bed. The nurse should also avoid flexing the hip more than 90 degrees or rotating it inward or outward.

Choice B reason: This is incorrect. Initiating the feeding after aspirating 50 mL of gastric residual is an acceptable practice, unless the facility has a different protocol. Gastric residual volume (GRV) is the amount of fluid left in the stomach before feeding. A GRV of less than 250 mL indicates that the stomach is emptying properly and that the client can tolerate the feeding.

Choice C reason: This is incorrect. Administering the feeding through a syringe barrel by gravity is an acceptable practice, unless the client has a history of aspiration or intolerance to bolus feedings. Gravity feedings are faster and easier than pump feedings, but they require careful monitoring of the flow rate and the client's response.

Choice D reason: This is the correct answer. Allowing the client to rest in a supine position during feeding is a dangerous practice that can cause aspiration, pneumonia, or death. The nurse should elevate the head of the bed at least 30 degrees during and for at least one hour after feeding. This can help prevent regurgitation and aspiration of the formula into the lungs.

Choice A reason: This is incorrect. Drinking green tea is not a risk factor for peptic ulcer. Green tea contains antioxidants and polyphenols that may have anti-inflammatory and protective effects on the gastric mucosa. However, green tea also contains caffeine, which can stimulate gastric acid secretion and aggravate ulcer symptoms. Therefore, the nurse should advise the client to limit or avoid caffeine intake.

Choice B reason: This is incorrect. History of bulimia is not a risk factor for peptic ulcer. Bulimia is an eating disorder characterized by binge eating and purging behaviors, such as vomiting, laxative use, or excessive exercise. Bulimia can cause damage to the esophagus, teeth, and mouth, but it does not directly affect the stomach or duodenum, where peptic ulcers occur.

Choice D reason: This is incorrect. Having a glass of wine with dinner each day is not a risk factor for peptic ulcer. Moderate alcohol consumption (one drink per day for women and two drinks per day for men) may have some health benefits, such as reducing the risk of cardiovascular disease or diabetes. However, excessive alcohol consumption (more than three drinks per day) can irritate and damage the gastric mucosa and increase the risk of peptic ulcer and bleeding. Therefore, the nurse should advise the client to limit or avoid alcohol intake.

Choice A reason: This is incorrect. Bearing down hard when defecating can cause straining, which can worsen constipation and increase the risk of hemorrhoids, anal fissures, or rectal prolapse. The nurse should advise the client to relax and avoid straining when defecating.

Choice B reason: This is incorrect. Limiting activity can reduce bowel motility and contribute to constipation. The nurse should encourage the client to increase physical activity, such as walking, swimming, or cycling, to stimulate bowel movements and improve overall health.

Choice D reason: This is incorrect. Drinking four to five glasses of water daily may not be enough to prevent or treat constipation. Water can help hydrate the stool and make it softer and easier to pass. However, the amount of water needed varies depending on the individual's age, weight, activity level, and health status. The nurse should advise the client to drink enough water to keep the urine clear or pale yellow and to avoid dehydration. The nurse should also caution the client to limit or avoid caffeinated or alcoholic beverages, which can have a diuretic effect and cause fluid loss.

Choice A reason: This is incorrect. Sliced ham with green salad is not a good menu selection for a client who has diverticulitis. Ham is high in fat and salt, which can irritate the digestive tract and worsen inflammation. Green salad contains raw vegetables, which are high in fiber and can increase bowel movements and pressure on the diverticula. Diverticula are small pouches that form in the wall of the colon and can become inflamed or infected.

Choice C reason: This is incorrect. Pork tenderloin with green peas is not a good menu selection for a client who has diverticulitis. Pork tenderloin is high in fat, which can irritate the digestive tract and worsen inflammation. Green peas are high in fiber and contain seeds, which can increase bowel movements and pressure on the diverticula and cause them to rupture or bleed.

Choice D reason: This is incorrect. Turkey sandwich with celery sticks is not a good menu selection for a client who has diverticulitis. Turkey sandwich may contain bread, cheese, or mayonnaise, which are high in fat and can irritate the digestive tract and worsen inflammation. Celery sticks are high in fiber and contain strings, which can increase bowel movements and pressure on the diverticula and cause them to rupture or bleed.

Choice A reason: This is incorrect. Offering the client ice cream postoperatively is not an appropriate nursing action. Ice cream is high in fat and can trigger biliary colic or nausea and vomiting in a client who had a laparoscopic cholecystectomy. A laparoscopic cholecystectomy is a minimally invasive surgery to remove the gallbladder, which stores and releases bile to help digest fats.

Choice B reason: This is incorrect. Instructing the client not to lift over 4.5 kg (10 lb) is not an appropriate nursing action. The client can resume normal activities, including lifting, within a few days after a laparoscopic cholecystectomy, unless otherwise advised by the surgeon. Lifting restrictions are usually applied to clients who had an open cholecystectomy, which involves a larger incision and longer recovery time.

Choice D reason: This is incorrect. Placing the client in a supine position postoperatively is not an appropriate nursing action. The client should be placed in a semi-Fowler's position (30 to 45 degrees elevation of the head of the bed) or Fowler's position (45 to 60 degrees elevation of the head of the bed) postoperatively. These positions can help reduce abdominal pressure and pain, facilitate breathing, and prevent aspiration in a client who had a laparoscopic cholecystectomy.