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NurseDive Free Nursing Practice Question
A nurse is providing instructions for a 52-year-old client who is scheduled for a colonoscopy. The client reports that he has not had the procedure before and is very anxious about feeling pain during the procedure. Which of the following responses by the nurse is appropriate?
A. "I know you're anxious, but this procedure is recommended for people your age.”
Choice A reason: This is incorrect. This response is dismissive and does not address the client's concern about pain. The nurse should acknowledge the client's anxiety and provide factual information about the procedure and pain management. The nurse should also avoid using age as a reason for recommending the procedure, as this may imply that the client is old or at risk for colon cancer.
B. "Don't worry; most clients dislike the prep more than the procedure itself.”
Choice B reason: This is incorrect. This response is trivializing and does not address the client's concern about pain. The nurse should acknowledge the client's anxiety and provide factual information about the procedure and pain management. The nurse should also avoid comparing the client's experience with others, as this may imply that the client is overreacting or being unreasonable.
C. "After you have signed the consent form, we can talk more about this.”
Choice C reason: This is incorrect. This response is delaying and does not address the client's concern about pain. The nurse should acknowledge the client's anxiety and provide factual information about the procedure and pain management before asking the client to sign the consent form. The nurse should also ensure that the client understands the risks, benefits, and alternatives of the procedure and has an opportunity to ask questions.
D. "Before the examination, your provider will give you a sedative that will make you sleepy.”
Choice D reason: This is the correct answer. This response is informative and addresses the client's concern about pain. The nurse acknowledges the client's anxiety and provides factual information about the procedure and pain management. The nurse explains that the provider will give the client a sedative that will make him sleepy and reduce his awareness of pain during the examination. The nurse also implies that the procedure will be done under moderate sedation, which means that the client will be able to breathe on his own and respond to verbal commands.
This question is an excerpt from Nurse Dive's nursing test bank - NY BSN Proctored Exam. Take the full exam now
Similar Questions
A nurse is planning care for a client who is receiving enteral feedings through an NG tube. Which of the following actions should the nurse plan to take first?
A. Warm the feeding to room temperature.
Choice A reason: This is incorrect. Warming the feeding to room temperature is an important action to prevent abdominal cramps and discomfort, but it is not the first action to take. The nurse should warm the feeding to room temperature before administering it, but only after verifying that the client can tolerate the feeding.
B. Hang the feeding bag 30 cm (12 in) above the client.
Choice B reason: This is incorrect. Hanging the feeding bag 30 cm (12 in) above the client is an important action to ensure proper flow and prevent air embolism, but it is not the first action to take. The nurse should hang the feeding bag 30 cm (12 in) above the client before administering the feeding, but only after verifying that the client can tolerate the feeding.
C. Aspirate the client's stomach contents.
Choice C reason: This is the correct answer. Aspirating the client's stomach contents is the first action to take before administering an enteral feeding through an NG tube. The nurse should aspirate the client's stomach contents to check for gastric residual volume (GRV), which is the amount of fluid left in the stomach before feeding. The nurse should compare the GRV with the facility's protocol and determine if it is safe to proceed with the feeding or if it needs to be delayed or adjusted. The nurse should also assess the color, consistency, and pH of the aspirate to confirm tube placement and prevent aspiration.
D. Label the feeding bag with the date and time of the start of the feeding.
Choice D reason: This is incorrect. Labeling the feeding bag with the date and time of the start of the feeding is an important action to prevent bacterial contamination and ensure quality control, but it is not the first action to take. The nurse should label the feeding bag with the date and time of the start of the feeding before administering it, but only after verifying that the client can tolerate the feeding.
A nurse is completing dietary teaching on consuming a low fiber diet with a client who has ulcerative colitis. Which of the following foods should be eliminated in the client's diet?
A. Ice cream
Choice A reason: This is incorrect. Ice cream is not a high fiber food and does not need to be eliminated in the client's diet. Ice cream is a dairy product that contains fat, protein, and sugar. However, some clients with ulcerative colitis may have lactose intolerance and may experience abdominal cramps, bloating, or diarrhea after consuming ice cream. In that case, the nurse should advise the client to limit or avoid dairy products or use lactase supplements.
B. Ripe bananas
Choice B reason: This is incorrect. Ripe bananas are not a high fiber food and do not need to be eliminated in the client's diet. Ripe bananas are a fruit that contains carbohydrates, potassium, and vitamin C. However, some clients with ulcerative colitis may have difficulty digesting fructose, which is a type of sugar found in fruits. In that case, the nurse should advise the client to limit or avoid fruits or use fructose supplements.
C. Dried apricots
Choice C reason: This is the correct answer. Dried apricots are a high fiber food and should be eliminated in the client's diet. Dried apricots are a fruit that contains carbohydrates, iron, and vitamin A. However, they also contain insoluble fiber, which can increase bowel movements and irritate the inflamed colon. The nurse should advise the client to avoid dried fruits, nuts, seeds, and whole grains, which are high in insoluble fiber.
D. Cooked cabbage
Choice D reason: This is incorrect. Cooked cabbage is not a high fiber food and does not need to be eliminated in the client's diet. Cooked cabbage is a vegetable that contains carbohydrates, vitamin K, and vitamin C. However, some clients with ulcerative colitis may have gas or bloating after consuming cooked cabbage. In that case, the nurse should advise the client to limit or avoid cruciferous vegetables, such as broccoli, cauliflower, Brussels sprouts, and kale.
A nurse is providing teaching for a client who has experienced an acute episode of gastritis. Which of the following instructions should the nurse include in the teaching?
A. Take NSAIDs for pain.
Choice A reason: This is incorrect. Taking NSAIDs for pain is not a good instruction for a client who has experienced an acute episode of gastritis. NSAIDs are nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen, or naproxen, that are used to treat pain, inflammation, or fever. However, NSAIDs can also irritate and damage the gastric mucosa and worsen gastritis. The nurse should advise the client to avoid NSAIDs and use other pain relievers, such as acetaminophen, or consult with the provider for alternative options.
B. Avoid drinking alcohol.
Choice B reason: This is the correct answer. Avoiding drinking alcohol is a good instruction for a client who has experienced an acute episode of gastritis. Alcohol can irritate and damage the gastric mucosa and worsen gastritis. The nurse should advise the client to avoid alcohol and other substances that can trigger or aggravate gastritis, such as caffeine, tobacco, or spicy foods.
C. Limit strenuous exercise.
Choice C reason: This is incorrect. Limiting strenuous exercise is not a necessary instruction for a client who has experienced an acute episode of gastritis. Exercise can have many health benefits, such as improving blood circulation, reducing stress, and enhancing mood. However, exercise does not directly affect the gastric mucosa or gastritis. The nurse should encourage the client to maintain a regular exercise routine, unless otherwise contraindicated by the provider.
D. Limit drinking milk.
Choice D reason: This is incorrect. Limiting drinking milk is not a necessary instruction for a client who has experienced an acute episode of gastritis. Milk can have some nutritional benefits, such as providing calcium, protein, and vitamin D. However, milk does not directly affect the gastric mucosa or gastritis. The nurse should advise the client to drink milk as tolerated, unless the client has lactose intolerance or allergy to milk. The nurse should also caution the client that drinking too much milk can cause diarrhea or constipation in some people.