The nurse is caring for an aging adult who reports constipation. Which intervention may provide relief for the patient? Select all that apply.

Restrict fluid intake at night

Ensure easy access to the toilet

Eat raw fruits and vegetables

Increase physical activity

Answer and Explanation

Correct Answer : B,C,D

A. Restrict fluid intake at night: Limiting fluids can lead to systemic dehydration and the formation of hard, dry stools that are difficult to evacuate. While it might reduce nocturia, it counteracts the goal of softening fecal matter for easier passage. Adequate hydration is essential for maintaining regular bowel motility in the elderly.

B. Ensure easy access to the toilet: Functional mobility issues often lead to the suppression of the urge to defecate, contributing to chronic constipation. Providing a clear path or bedside commode encourages the patient to respond promptly to physiological signals. This behavioral intervention supports the maintenance of a regular and healthy elimination schedule.

C. Eat raw fruits and vegetables: These food groups are high in insoluble fiber, which adds bulk to the stool and stimulates peristalsis. Fiber increases the speed of colonic transit and prevents the excessive absorption of water by the colon. Increasing dietary roughage is a primary non-pharmacological treatment for managing geriatric constipation.

D. Increase physical activity: Regular movement stimulates the smooth muscles of the gastrointestinal tract, promoting the forward movement of intestinal contents. Sedentary behavior is a major contributing factor to bowel stasis in the aging population. Walking or light exercise helps maintain the mechanical efficiency of the digestive system.

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Correct Answer is D

Explanation

A. Non-tender osteophytes of the finger joints: Osteophytes are bony spurs characteristic of degenerative joint disease, not the inflammatory erosion seen in RA. RA is characterized by synovial thickening and bone destruction rather than new bone growth. These spurs are hallmarks of osteoarthritis.

B. Deterioration of articular cartilage surfaces: While RA eventually destroys cartilage, this is the primary pathological mechanism of osteoarthritis (OA). In RA, the initial insult is an autoimmune attack on the synovium. The disease process is inflammatory and systemic rather than purely mechanical wear.

C. Joint pain that is worse later in the day: Pain that worsens with activity and later in the day is typical of osteoarthritis. RA patients characteristically experience significant morning stiffness that lasts longer than 60 minutes. RA pain typically improves with movement and throughout the day.

D. Bilateral swelling and tenderness of joints: Rheumatoid arthritis is a systemic autoimmune disease that typically presents with a symmetrical, bilateral pattern of joint involvement. Swelling, warmth, and tenderness result from chronic synovitis within the affected joints. This symmetry distinguishes it from the asymmetrical nature of OA.

A. Peptic ulcer B. Appendicitis C. Hemorrhoids D. Cholecystitis E. Tubal (ectopic) pregnancy

Correct Answer is ["B","E"]

Explanation

A. Peptic ulcer: Pain from a gastric or duodenal ulcer is typically localized in the epigastric region or the upper quadrants. It is often described as a burning or gnawing sensation related to food intake or fasting. It is anatomically distant from the right lower quadrant of the abdomen.

B. Appendicitis: The vermiform appendix is located in the cecum within the right lower quadrant of the abdominal cavity. Inflammation of this organ typically causes localized pain at McBurney's point along with rebound tenderness. It is the most common surgical emergency presenting with acute pain in this specific quadrant.

C. Hemorrhoids: These are swollen veins in the lower rectum and anus that cause localized discomfort, itching, or bleeding during defecation. They do not produce generalized or localized abdominal pain in the right lower quadrant. They are an anorectal vascular issue rather than an intra-abdominal inflammatory process.

D. Cholecystitis: Inflammation of the gallbladder typically manifests as severe pain in the right upper quadrant (RUQ). This pain may radiate to the right scapula or shoulder following the ingestion of fatty meals. It is not a standard finding in the lower regions of the abdominal cavity.

E. Tubal (ectopic) pregnancy: A fertilized ovum implanted in the right fallopian tube can cause sudden, severe pain in the right lower quadrant as the tube distends. This is a life-threatening emergency that must be ruled out in any female of childbearing age with lower abdominal pain. It requires immediate surgical or medical intervention.

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The nurse is caring for an aging adult who reports constipation. Which intervention may provide relief for the patient? Select all that apply.

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Naxlex Comprehensive Predictor Exams

The nurse is performing a health history and physical assessment on a patient with chronic rheumatoid arthritis (RA). Which symptom(s) should the nurse anticipate?

Correct Answer is D

Explanation

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Correct Answer is ["B","E"]

Explanation

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