A community health nurse is presenting at a health fair and is addressing the high incidence of colorectal cancer that exists in Western nations. What measure should the nurse emphasize in order to reduce participants chances of dying of colorectal cancer

Increased physical activity

Regular use of cleansing enemas

Regular screening for colorectal cancers

A low protein, organic diet

Answer and Explanation

The Correct Answer is C

Colorectal cancer is a major cause of morbidity and mortality in Western populations, often developing silently from precancerous polyps over many years. Early detection significantly improves survival rates because treatment is most effective when cancer is identified at an early stage. Community health nursing emphasizes prevention strategies that include screening, lifestyle modification, and risk factor reduction. Among these, timely and routine screening remains the most effective measure to reduce mortality.

Rationale:
A. Increased physical activity can help reduce the risk of colorectal cancer by improving bowel motility and reducing obesity-related risk factors. However, while it is a beneficial preventive lifestyle measure, it does not directly reduce mortality as effectively as early detection through screening. Therefore, it is supportive but not the most critical intervention.

B. Regular use of cleansing enemas is not a recommended or evidence-based strategy for reducing colorectal cancer risk or mortality. Enemas do not prevent polyp formation or detect early malignant changes in the colon. Overuse may also disrupt normal bowel flora and electrolyte balance.

C. Regular screening for colorectal cancers, such as colonoscopy, is the most effective intervention to reduce mortality because it allows for early detection and removal of precancerous polyps. Early identification significantly improves treatment outcomes and survival rates. Screening directly targets disease progression before symptoms develop.

D. A low-protein, organic diet is not supported by evidence as a primary method for reducing colorectal cancer mortality. Dietary modifications such as increasing fiber intake and reducing red and processed meats are more relevant. However, diet alone is less effective than structured screening programs in preventing death from colorectal cancer.

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Correct Answer is D

Explanation

Total parenteral nutrition (TPN) is a highly concentrated intravenous solution containing glucose, amino acids, electrolytes, lipids, vitamins, and minerals. Because of its hyperosmolar nature, it requires reliable vascular access that can tolerate long-term infusion and reduce the risk of vein irritation or thrombophlebitis. Selection of appropriate vascular access is essential to ensure safe delivery and prevent complications such as infection, extravasation, or vascular damage. Long-term TPN therapy typically requires central venous access.

Rationale:
A. A peripherally inserted central catheter (PICC line) is appropriate for TPN administration because it provides central venous access with the catheter tip located in a large vein, allowing rapid dilution of hyperosmolar solutions. PICC lines are commonly used for intermediate to long-term TPN therapy due to lower infection risk compared to other central lines and ease of insertion at the bedside.

B. An implanted port is appropriate for long-term TPN administration because it provides stable central venous access with a subcutaneous reservoir. It is designed for prolonged therapy and reduces infection risk when not in use. Implanted ports are especially useful for patients requiring months of parenteral nutrition, such as those recovering from severe burns.

C. A central venous catheter is appropriate for TPN administration because it delivers hypertonic solutions directly into a high-flow central vein, minimizing vascular irritation. This type of access is standard for patients requiring prolonged or high-concentration nutritional support. It ensures safe infusion and reduces the risk of phlebitis associated with peripheral veins.

D. A peripheral IV is inappropriate for TPN administration because the solution is too hyperosmolar for peripheral veins. Infusing TPN through a peripheral line can lead to complications such as phlebitis, infiltration, and tissue damage. Peripheral veins cannot tolerate the concentration of nutrients required for long-term nutritional support, making central access necessary.

A. "I will allow him to be in the position where he is most comfortable during the feeding." B. "I will turn him on his left side during the feeding." C. "I will elevate the head of the bed 10 degrees during the feeding." D. "I will have him sit in his chair during the feeding."

Correct Answer is D

Explanation

Safe administration of enteral feedings requires proper positioning to reduce the risk of aspiration and promote optimal gastric emptying. Gravity plays an important role in preventing reflux of formula into the esophagus and airway. Clients receiving tube feedings should be positioned upright during feeding and for a period afterward. Understanding correct positioning is essential for safe home care management of enteral nutrition.

Rationale:
A. Allowing the client to remain in their most comfortable position is incorrect because comfort does not always align with safety during enteral feeding. Certain positions, especially supine or slouched, increase the risk of aspiration and reflux. Safety requires specific positioning regardless of client preference during feeding.

B. Turning the client onto the left side during feeding is not recommended because it may increase the risk of reflux depending on gastric anatomy and feeding route. The optimal position for reducing aspiration risk is upright or semi-upright. Left lateral positioning is not standard for safe enteral feeding administration.

C. Elevating the head of the bed only 10 degrees is insufficient to prevent aspiration during enteral feeding. The recommended elevation is typically at least 30 to 45 degrees to allow gravity-assisted gastric emptying and reduce reflux risk. A 10-degree elevation does not provide adequate protection.

D. Having the client sit in a chair during feeding indicates correct understanding because an upright position (at least 30–90 degrees) is ideal for safe enteral nutrition. Sitting upright promotes proper gastric emptying and significantly reduces the risk of aspiration. This position should be maintained during feeding and for at least 30–60 minutes afterward.

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A community health nurse is presenting at a health fair and is addressing the high incidence of colorectal cancer that exists in Western nations. What measure should the nurse emphasize in order to reduce participants chances of dying of colorectal cancer

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

A nurse is teaching a client's adult son about how to position the client when administering enteral feedings at home. Which of the following statements by the son indicates an understanding of the teaching?

Correct Answer is D

Explanation

A nurse is caring for a client who has ulcerative colitis and is teaching the client about the common link with Crohn's disease. Which of the following information should the nurse include?

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A nurse is caring for a client following an esophagogastroduodenoscopy (EGD) procedure. Which of the following assessments is the nurse's priority?

A nurse is providing teaching to a client who has long-term symptoms of GERD (gastroesophageal reflux disease). Which of the following statements should the nurse include in the educational materials?

A community health nurse is presenting at a health fair and is addressing the high incidence of colorectal cancer that exists in Western nations. What measure should the nurse emphasize in order to reduce participants chances of dying of colorectal cancer

A nurse is caring for a client who has peptic ulcer disease. The nurse should monitor the client for which of the following findings as an indication of gastrointestinal perforation?

A nurse is caring for a client who receives intermittent enteral feedings through an NG tube. Before administering a feeding the nurse should measure the gastric residual for which of the following purposes?

A nurse is assessing a client who is on long term omeprazole (Prilosec) therapy. Which of the following findings should indicate to the nurse the medication is effective?