A nurse is reinforcing teaching with a client about how to collect stool specimens for a fecal occult blood test. Which of the following statements by the client indicates an understanding of the teaching?

“I should collect samples from three separate bowel movements."

“I can continue to take aspirin daily for pain."

“I should collect the samples even if my hemorrhoids are bleeding."

“I can continue to eat red meat because it will not affect the samples."

Answer and Explanation

The Correct Answer is A

A fecal occult blood test (FOBT) is used to detect hidden blood in the stool, which may indicate gastrointestinal bleeding from conditions such as ulcers, polyps, or colorectal cancer. Proper specimen collection is essential to ensure accuracy and reduce false-positive or false-negative results. Patient education focuses on correct sampling techniques, dietary and medication restrictions, and avoiding contamination from non-gastrointestinal sources of blood. Multiple samples are typically required to improve diagnostic reliability.

Rationale:
A. Collecting samples from three separate bowel movements demonstrates correct understanding because FOBT accuracy improves when multiple stool specimens are tested over different days. This helps account for intermittent bleeding and increases the likelihood of detecting occult blood associated with conditions such as Colorectal cancer. Consistent sampling reduces diagnostic error and improves screening sensitivity.

B. Continuing to take aspirin daily for pain is incorrect because aspirin can increase gastrointestinal bleeding and lead to false-positive test results. It inhibits platelet aggregation, which may cause occult bleeding unrelated to underlying pathology. Patients are typically instructed to avoid medications such as NSAIDs before testing.

C. Collecting samples when hemorrhoids are bleeding is incorrect because external bleeding from hemorrhoids can contaminate the stool sample and produce a false-positive result. The test is intended to detect hidden (occult) gastrointestinal bleeding, not visible rectal bleeding from external sources. Active hemorrhoidal bleeding should be reported before specimen collection.

D. Continuing to eat red meat is incorrect because red meat can cause false-positive results due to the presence of heme compounds. Dietary restrictions are often recommended prior to testing to improve accuracy. Patients are usually advised to avoid red meat and certain peroxidase-containing foods before sample collection.

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Correct Answer is B

Explanation

Urinary incontinence increases the risk of skin breakdown due to prolonged exposure of the skin to moisture, enzymes, and irritants found in urine. This can lead to incontinence-associated dermatitis, maceration, and secondary infection if not properly managed. Nursing care focuses on maintaining skin integrity through frequent cleansing, moisture control, and protective barriers. Preventive skin care is essential to reduce complications and promote comfort.

Rationale:
A. Keeping the client’s skin moist is incorrect because excess moisture increases skin maceration and breakdown. Prolonged exposure to urine weakens the skin barrier and increases susceptibility to irritation and infection. Skin should be kept clean and dry to maintain integrity.

B. Applying barrier cream to cleansed skin is correct because it forms a protective layer that shields the skin from moisture and irritants. In clients with conditions such as Urinary incontinence, barrier products help prevent dermatitis and preserve skin integrity. This is a key intervention in incontinence care.

C. Applying cornstarch is not recommended because it can cake on moist skin and potentially promote microbial growth. It does not provide an effective moisture barrier and may worsen skin irritation. Modern barrier creams are preferred for protection.

D. Rinsing the skin with hot water is inappropriate because hot water can damage the skin barrier and increase dryness and irritation. Warm water is recommended instead to gently cleanse without causing additional skin injury. Excessive heat may further compromise already vulnerable skin.

A. Instruct the client to massage the calf gently. B. Monitor the client's pulse oximetry. C. Apply a cold compress to the client's calf. D. Maintain the leg in a dependent position while in bed.

Correct Answer is B

Explanation

Postoperative calf pain in a client 2 days after surgery raises concern for possible venous thromboembolism, particularly deep vein thrombosis (DVT). Reduced mobility, surgical stress, and postoperative hypercoagulability increase the risk of clot formation in the lower extremities. If a clot dislodges, it may travel to the lungs and cause a life-threatening pulmonary embolism, which can first present with subtle respiratory changes. Monitoring oxygenation is essential for early detection of respiratory compromise associated with clot migration.

Rationale:
A. Instructing the client to massage the calf is contraindicated because it may dislodge a thrombus if a deep vein clot is present. This increases the risk of embolization to the lungs, leading to pulmonary embolism. Suspected DVT requires immobilization of the affected limb rather than manipulation or massage.

B. Monitoring pulse oximetry is appropriate because a decrease in oxygen saturation may indicate possible pulmonary embolism, a serious complication of suspected DVT. Early hypoxemia can occur even before obvious respiratory symptoms appear. Continuous assessment of oxygenation helps detect deterioration early in a client with suspected thromboembolic disease.

C. Applying a cold compress to the calf is not appropriate in suspected deep vein thrombosis. Cold therapy may provide comfort in musculoskeletal injuries but does not address clot-related pathology. The priority is to prevent clot dislodgement and monitor for systemic complications rather than local symptom relief.

D. Maintaining the leg in a dependent position is contraindicated because it can increase venous stasis and worsen thrombus formation. The affected limb should typically be kept immobile and elevated if appropriate, depending on provider guidance. Dependent positioning increases hydrostatic pressure and may exacerbate swelling and pain.

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A nurse is reinforcing teaching with a client about how to collect stool specimens for a fecal occult blood test. Which of the following statements by the client indicates an understanding of the teaching?

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