A nurse is reinforcing teaching with a client who will undergo a colonoscopy the following week.Which of the following instructions should the nurse include?
Do not eat or drink anything except water for 12 hr before the procedure.
Restrict the diet to clear liquids for 1 to 3 days before the procedure.
Administer enemas 2 days before the procedure.
Expect the provider to schedule another procedure to remove any polyps.
The Correct Answer is B
Choice A rationale
Drinking water is allowed before the procedure, but all other food and drinks should be avoided.
Choice B rationale
A clear liquid diet for 1 to 3 days before the procedure helps to clear the intestines and ensure visibility during the colonoscopy.
Choice C rationale
Administering enemas 2 days before the procedure is not recommended. The focus is on dietary restrictions and prescribed laxatives.
Choice D rationale
The removal of polyps can often be done during the same colonoscopy procedure, avoiding the need for a separate procedure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D,A,E,C,B
Explanation
Choice Drationale
Checking the medication administration record to verify the client's allergies ensures patient safety by preventing allergic reactions to enoxaparin. Allergies to medications can cause adverse reactions, which can be life-threatening. This step confirms that enoxaparin is safe for administration to the client.
Choice Arationale
Locating the injection site 5 cm (2 in) to the right or left of the umbilicus ensures that the injection is given in the appropriate subcutaneous tissue. This site has fewer blood vessels and nerves, reducing the risk of injury and ensuring proper absorption of the medication.
Choice Erationale
Ensuring an air bubble is present in the prefilled enoxaparin syringe helps to lock the medication into the subcutaneous tissue and prevents the medication from leaking out. The air bubble technique is specific to enoxaparin administration.
Choice Crationale
Pinching clean skin at the injection site and darting the needle into the skinfold at a 90° angle ensures that the medication is administered into the subcutaneous tissue. This technique minimizes pain and ensures that the medication is delivered correctly.
Choice Brationale
Slowly injecting the medication into the site without aspirating prevents tissue damage and ensures that the medication is delivered into the subcutaneous tissue. Aspirating is not required for subcutaneous injections and can cause unnecessary pain and discomfort.
Correct Answer is A
Explanation
Choice A rationale
Platelets 60,000/mm³ is significantly below the normal range of 150,000 to 400,000/mm³, which can indicate a risk of bleeding and is a concern for a procedure like a liver biopsy.
Choice B rationale
Ammonia levels of 55 mcg/dL are within the normal range of 10 to 80 mcg/dL, so this value does not need to be reported.
Choice C rationale
Bilirubin 1.0 mg/dL is at the upper limit of the normal range of 0.3 to 1.0 mg/dL, but it does not necessarily indicate a significant risk for a liver biopsy.
Choice D rationale
Aspartate aminotransferase 34 units/L is at the upper limit of the normal range of 0 to 34 units/L, but it does not indicate a contraindication for the biopsy.
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