A nurse is preparing a bowel training program for a patient. Which actions will the nurse take? (Select all that apply)

Choose a time based on the patient’s pattern to initiate defecation-control measures.

Lean backward on the hips while sitting on the toilet

Maintain normal exercise within the patient’s physical ability.

Record times when the patient is incontinent

Help the patient to the toilet at the designated time.

Apply pressure with hands over the abdomen and strain while pushing

Answer and Explanation

Correct Answer : A,B,D,E

Choice A reason: Choosing a time based on the patient’s defecation pattern leverages the gastrocolic reflex, promoting regular bowel movements. Scheduled toileting aligns with natural rhythms, enhancing bowel training success and reducing incontinence episodes.

Choice B reason: Leaning backward on the toilet is not recommended, as it misaligns the anorectal angle, hindering defecation. A forward-leaning or squatting position facilitates easier stool passage, making this action incorrect for bowel training.

Choice C reason: Normal exercise stimulates peristalsis through abdominal muscle movement and increased blood flow to the gut. Within the patient’s ability, it supports regular bowel function, making it an essential component of a bowel training program.

Choice D reason: Recording incontinence times identifies patterns and triggers, allowing tailored interventions. This data informs adjustments to the toileting schedule or dietary changes, improving the effectiveness of the bowel training program.

Choice E reason: Helping the patient to the toilet at designated times ensures adherence to the scheduled toileting plan, especially for those with mobility or cognitive issues. It promotes continence and reinforces the bowel training routine.

Choice F reason: Applying abdominal pressure and straining (Valsalva maneuver) risks pelvic floor strain, hemorrhoids, or cardiovascular stress. Gentle defecation with proper positioning is safer and more effective, making this action inappropriate for bowel training.

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Correct Answer is D

Explanation

Choice A reason: Endoscopy visualizes the gastrointestinal or urinary tract but is not the primary test for renal calculi. It may be used for ureteral stones but is invasive and less effective than imaging for initial diagnosis.

Choice B reason: Ultrasound can detect renal calculi, especially in pregnant patients or those avoiding radiation, but it is less sensitive than CT for small stones or precise location. It is not the preferred initial test in most cases.

Choice C reason: Chest radiography is irrelevant for renal calculi, as it images the thoracic cavity, not the kidneys or ureters. Flank pain from stones is unrelated to chest pathology, making this test inappropriate.

Choice D reason: Intravenous pyelogram (IVP) or CT scans are gold standards for diagnosing renal calculi. CT provides detailed images of stone size, location, and obstruction, while IVP assesses urinary tract function, making them the expected tests.

A. You should schedule a colonoscopy as soon as possible. B. This is probably a false negative. C. Are you under a lot of stress? D. Do you take iron supplements?

Correct Answer is D

Explanation

Choice A reason: A negative fecal occult blood test suggests no gastrointestinal bleeding, reducing the urgency for a colonoscopy. Black stool can result from benign causes like iron supplements, so immediate invasive procedures are not warranted without further history or symptoms.

Choice B reason: Assuming a false negative without evidence is premature. Fecal occult blood tests are reliable for detecting bleeding. Black stool may stem from non-bleeding causes like medications or diet, and suggesting a false result could unnecessarily alarm the patient.

Choice C reason: Stress does not directly cause black stool. While stress can exacerbate gastrointestinal issues, black stool is more likely due to dietary factors, medications, or rare conditions. This question is vague and less relevant to the symptom’s likely etiology.

Choice D reason: Iron supplements commonly cause black stool due to the oxidation of iron in the gastrointestinal tract, a benign side effect. Given the negative fecal occult blood test, asking about iron supplements is the most appropriate, targeted response to identify a likely cause.

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A nurse is preparing a bowel training program for a patient. Which actions will the nurse take? (Select all that apply)

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Naxlex Comprehensive Predictor Exams

A patient is being seen for complaints of severe flank pain lasting for 2 days. The emergency department physician suspects that the patient has renal calculi. Which of the following tests would the nurse expect the health care provider to order?

Correct Answer is D

Explanation

A patient expresses concerns over having black stool. The fecal occult blood test is negative. Which response by the nurse is most appropriate?

Correct Answer is D

Explanation

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