A nurse is providing instructions about bowel cleansing with polyethylene glycol-electrolyte solution (PEG) for a client who is going to have a colonoscopy. Which of the following information should the nurse include?

"Drink 400 ml every hour until bowel movements are clear"

"Expect bowel movements to begin 3 hr following completion of solution. "

"To prevent dehydration, drink an additional liter of fluid during preparation time. "

"Abdominal bloating might occur"

Answer and Explanation

The Correct Answer is D

Answer: D

Rationale:

A. "Drink 400 ml every hour until bowel movements are clear": The standard recommendation for PEG is to drink a specific volume, usually 240 ml every 10 to 15 minutes, rather than 400 ml every hour. The goal is to ensure the bowel is adequately cleansed, and this rate is typically more effective in achieving that.

B. "Expect bowel movements to begin 3 hr following completion of solution": Bowel movements often start within an hour or two after starting the PEG solution rather than waiting for 3 hours after finishing it. The timing can vary, but the onset is generally sooner.

C. "To prevent dehydration, drink an additional liter of fluid during preparation time": While it is important to stay hydrated, the specific recommendation for additional fluid intake beyond the PEG solution can vary. Typically, the instructions focus on the volume of PEG solution to drink rather than specifying a set amount of additional fluid.

D. "Abdominal bloating might occur": Abdominal bloating is a common side effect of bowel cleansing preparations like PEG. It can occur due to the large volume of fluid ingested and the rapid movement of the bowel contents, making it a relevant point to include in the instructions.

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Correct Answer is A

Explanation

A. CD4 T cell count 180 cells/mm3: In a client with HIV, monitoring the CD4 T cell count is crucial for assessing immune function and determining the progression of the disease. A CD4 T cell count of less than 200 cells/mm3 indicates severe immunosuppression and an increased risk of opportunistic infections, making it the priority laboratory value to monitor in this client.
B. Platelets 150,000/mm3: While platelet count is important for assessing clotting function, it is not the priority laboratory value in a client with HIV. Thrombocytopenia can occur in HIV but is often secondary to other factors such as medication side effects or opportunistic infections. However, a platelet count within the normal range of 150,000/mm3 is reassuring and does not require immediate intervention.
C. WBC 5000 mm3: White blood cell (WBC) count is essential for assessing overall immune function, but it is not the priority laboratory value in a client with HIV. A WBC count of 5000 mm3 is within the normal range and does not require urgent attention.
D. Positive Western blot test: While a positive Western blot test confirms HIV infection, it does not provide information about the client's current immune status or the need for immediate intervention. Confirmatory tests such as Western blot are important for diagnosis, but they do not provide ongoing monitoring of disease progression or immune function.

A. Black-colored stools B. Staining of teeth C. Red colored urine D. Constipation

Correct Answer is C

Explanation

A. Black-colored stools: Black-colored stools are not an expected side effect of IV rifampin. Black stools can result from gastrointestinal bleeding or the consumption of certain foods or medications, but they are not directly related to rifampin administration.
B. Staining of teeth: Staining of teeth, often described as orange or red discoloration, is a well-known side effect of rifampin when taken orally. However, this side effect is typically associated with long-term oral use rather than IV administration. IV rifampin is not expected to cause staining of teeth.
C. Red-colored urine: Rifampin can cause red-orange discoloration of bodily fluids, including urine, sweat, saliva, and tears. This phenomenon is harmless and reversible but can be alarming to patients. It is important to educate clients about this potential side effect to alleviate concerns.
D. Constipation: Constipation is not a common side effect of rifampin. While gastrointestinal disturbances such as nausea, vomiting, and diarrhea can occur with rifampin therapy, constipation is not typically reported. If a client experiences persistent constipation while taking rifampin, other factors should be considered and evaluated.

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A nurse is providing instructions about bowel cleansing with polyethylene glycol-electrolyte solution (PEG) for a client who is going to have a colonoscopy. Which of the following information should the nurse include?

Nursing Test Bank

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