Physician order reads: Furosemide 60 mg po bid. Available: 40 mg scored tablets. What do you administer to the patient?

Choice A reason: High intake of animal fats or red meat is a recognized risk factor for colorectal cancer. These foods, high in saturated fats, may promote inflammation and alter gut microbiota, increasing carcinogenesis risk in the colon, supported by epidemiological studies linking diet to cancer.

Choice B reason: Rectal bleeding is a warning sign of colorectal cancer. It results from tumor erosion or ulceration in the colon or rectum, causing blood in stool. This symptom prompts diagnostic evaluation, like colonoscopy, to detect malignancy early, improving treatment outcomes.

Choice C reason: Smoking is a risk factor for colorectal cancer. Tobacco’s carcinogenic compounds, like polycyclic aromatic hydrocarbons, damage colonic mucosa, increasing mutation risk. Smoking also promotes inflammation, contributing to tumor development, making it a significant modifiable risk factor in colorectal cancer prevention.

Choice D reason: Diarrhea is not a specific warning sign of colorectal cancer. While it may occur, it’s more commonly associated with infections or irritable bowel syndrome. Cancer typically presents with persistent bleeding, weight loss, or bowel habit changes, making diarrhea less diagnostic and misleading for teaching.

Choice A reason: Sufficient medication in the PCA syringe does not indicate effective pain management. It may reflect underuse due to inadequate pain control or patient misunderstanding of PCA use. Pain relief is assessed by patient-reported outcomes, not medication volume remaining.

Choice B reason: Sleeping and being difficult to arouse suggests oversedation, a potential adverse effect of PCA, particularly with opioids. This indicates excessive dosing rather than effective pain management, risking respiratory depression or other complications, requiring immediate dose adjustment or monitoring.

Choice C reason: A pain rating of 2 on a 0 to 10 scale indicates effective pain management. PCA allows patients to self-administer doses within safe limits, achieving low pain levels without excessive sedation, reflecting optimal balance of analgesia and patient safety post-trauma.

Choice D reason: Pressing the PCA button shows patient engagement but not pain control effectiveness. Frequent pressing may indicate inadequate relief, while infrequent use could reflect sufficient control or misunderstanding. Patient-reported pain levels are the primary indicator of PCA efficacy.