A nurse is reinforcing teaching with an older adult client about the aging process. The nurse should instruct the client that which of the following physiological changes are part of the aging process? (Select all that apply.)

Choice A Reason:

A client who has ulcerative colitis is correct. Ulcerative colitis, a type of inflammatory bowel disease (IBD), involves chronic inflammation and ulceration in the colon and rectum. This condition often results in bleeding from the inflamed mucosa, leading to the presence of blood in the stool that can be detected by a fecal occult blood test.

Choice B Reason:

A client who has stomatitis is incorrect. Stomatitis refers to inflammation in the mouth and does not typically cause bleeding in the gastrointestinal tract, which is what the fecal occult blood test detects. Stomatitis involves oral lesions or sores but does not directly impact stool blood content.

Choice C Reason:

A client who uses laxatives is incorrect. Laxative use does not necessarily cause bleeding in the gastrointestinal tract. While some laxatives can potentially irritate the intestinal lining, leading to minor bleeding in some cases, the presence of blood in the stool due to laxative use is less common compared to conditions like ulcerative colitis, where chronic inflammation and ulceration lead to significant bleeding.

Choice D Reason:

A client who has cholecystitis is incorrect. Cholecystitis is inflammation of the gallbladder and does not directly involve bleeding in the gastrointestinal tract. It typically presents with symptoms related to gallbladder inflammation such as abdominal pain, nausea, and vomiting, rather than causing bleeding that would be detected by a fecal occult blood test.

Choice A Reason:

To an employer for a pre-employment screening is correct. Generally, healthcare information disclosure to an employer for pre-employment screening requires the client's written consent. The Health Insurance Portability and Accountability Act (HIPAA) and other privacy regulations typically protect a client's health information from disclosure to employers without explicit authorization from the client.

Choice B Reason:

To a medical interpreter service on behalf of a client is incorrect. In situations where a medical interpreter service is required to facilitate communication between the healthcare provider and the client, limited disclosure of health information may be necessary to ensure proper care. However, the information shared should be relevant to the immediate healthcare needs and should not exceed what's necessary for effective communication.

Choice C Reason:

To a family member when the client is not available is incorrect. In certain circumstances, especially if the client is incapacitated or unavailable, disclosing limited health information to a family member might be necessary for the client's best interests, such as for care coordination or emergencies. However, the information shared should be limited to what's essential and relevant to the situation.

Choice D Reason:

To an insurance agency in regard to a life insurance policy is incorrect. Health information disclosure to an insurance agency might be permitted in the context of processing a life insurance policy, typically under the Health Insurance Portability and Accountability Act (HIPAA) and as allowed by state laws. However, this disclosure is usually limited to information necessary for underwriting the policy and may not require the client's explicit written consent.