MEDSURG (GI) GASTROINTESTINAL EXAM 4 LATEST 2025 ACTUAL EXAM QUESTIONS AND ANSWERS, Exams of Nursing

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MEDSURG (GI) GASTROINTESTINAL

EXAM 4 LATEST 2024 - 2025 ACTUAL

EXAM QUESTIONS AND DETAILED

CORRECT ANSWERS | A+ GRADE

STUDYGUIDE

The client diagnosed with Crohn's disease is crying and tells the nurse, "I can't take it anymore. I never know when I will get sick and end up here in the hospital." Which statement is the nurse's best response?

1. "I understand how frustrating this must be for you."
2. "You must keep thinking about the good things in your life."
3. "I can see you are very upset. I'll sit down and we can talk."
4. "Are you thinking about doing anything like committing suicide?" Correct Answer 3 The client diagnosed with ulcerative colitis has an ileostomy. Which statement indicates the client needs more teaching concerning the ileostomy?
5. "My stoma should be pink and moist."
6. "I will irrigate my ileostomy every morning."
7. "If I get a red, bumpy, itchy rash I will call my HCP."
8. "I will change my pouch if it starts leaking." Correct Answer 2

The client diagnosed with IBD is prescribed sulfasalazine (Asulfidine), a sulfonamide antibiotic. Which statement best describes the rationale for administering this medication?

1. It is administered rectally to help decrease colon inflammation.
2. This medication slows gastrointestinal motility and reduces diarrhea.
3. This medication kills the bacteria causing the exacerbation.
4. It acts topically on the colon mucosa to decrease inflammation. Correct Answer 4 The client is diagnosed with Crohn's disease, also known as regional enteritis. Which statement by the client supports this diagnosis?
5. "My pain goes away when I have a bowel movement."
6. "I have bright red blood in my stool all the time."
7. "I have episodes of diarrhea and constipation."
8. "My abdomen is hard and rigid and I have a fever." Correct Answer 1 The client diagnosed with ulcerative colitis is prescribed a low-residue diet. Which meal selection indicates the client understands the diet teaching?
9. Grilled hamburger on a wheat bun and fried potatoes.
10. A chicken salad sandwich and lettuce and tomato salad.
11. Roast pork, white rice, and plain custard.

4. Fried fish, whole grain pasta, and fruit salad. Correct Answer 3 Which assessment data support to the nurse the client's diagnosis of gastric ulcer?
5. Presence of blood in the client's stool for the past month.
6. Reports of a burning sensation moving like a wave.
7. Sharp pain in the upper abdomen after eating a heavy meal.
8. Complaints of epigastric pain 30 to 60 minutes after ingesting food. Correct Answer 4 The nurse is caring for a client diagnosed with rule-out peptic ulcer disease. Which test confirms this diagnosis?
9. Esophagogastroduodenoscopy.
10. Magnetic resonance imaging.
11. Occult blood test.
12. Gastric acid stimulation. Correct Answer 1 Which specific data should the nurse obtain from the client who is suspected of having peptic ulcer disease?
13. History of side effects experienced from all medications.
14. Use of nonsteroidal anti-inflammatory drugs (NSAIDs).
15. Any known allergies to drugs and environmental factors.
16. Medical histories of at least three (3) generations. Correct Answer 2

Which physical examination should the nurse implement first when assessing the client diagnosed with peptic ulcer disease?

1. Auscultate the client's bowel sounds in all four quadrants.
2. Palpate the abdominal area for tenderness.
3. Percuss the abdominal borders to identify organs.
4. Assess the tender area progressing to nontender. Correct Answer 1 Which problems should the nurse include in the plan of care for the client diagnosed with peptic ulcer disease to observe for physiological complications?
5. Alteration in bowel elimination patterns.
6. Knowledge deficit in the causes of ulcers.
7. Inability to cope with changing family roles.
8. Potential for alteration in gastric emptying. Correct Answer 4 The nurse is caring for a client diagnosed with hemorrhaging duodenal ulcer. Which collaborative interventions should the nurse implement? Select all that apply.
9. Perform a complete pain assessment.
10. Assess the client's vital signs frequently.
11. Administer a proton pump inhibitor intravenously.
12. Obtain permission and administer blood products.
13. Monitor the intake of a soft, bland diet. Correct Answer 3, 4

Which expected outcome should the nurse include for a client diagnosed with peptic ulcer disease?

1. The client's pain is controlled with the use of NSAIDs.
2. The client maintains lifestyle modifications.
3. The client has no signs and symptoms of hemoptysis.
4. The client takes antacids with each meal. Correct Answer 2 The nurse has been assigned to care for a client diagnosed with peptic ulcer disease. Which assessment data require further intervention?
5. Bowel sounds auscultated fifteen (15) times in one (1) minute.
6. Belching after eating a heavy and fatty meal late at night.
7. A decrease in systolic BP of 20 mm Hg from lying to sitting.
8. A decreased frequency of distress located in the epigastric region. Correct Answer 3 Which oral medication should the nurse question before administering to the client with peptic ulcer disease?
9. E-mycin, an antibiotic.
10. Prilosec, a proton pump inhibitor.
11. Flagyl, an antimicrobial agent.
12. Tylenol, a nonnarcotic analgesic. Correct Answer 1 The nurse has administered an antibiotic, a proton pump inhibitor, and Pepto-Bismol

for peptic ulcer disease secondary to H. pylori. Which data would indicate to the nurse the medications are effective?

1. A decrease in alcohol intake.
2. Maintaining a bland diet.
3. A return to previous activities.
4. A decrease in gastric distress. Correct Answer 4 Which assessment data indicate to the nurse the client's gastric ulcer has perforated?
5. Complaints of sudden, sharp, substernal pain.
6. Rigid, boardlike abdomen with rebound tenderness.
7. Frequent, clay-colored, liquid stool.
8. Complaints of vague abdominal pain in the right upper quadrant. Correct Answer 2 The client with a history of peptic ulcer disease is admitted into the intensive care unit with frank gastric bleeding. Which priority intervention should the nurse implement?
9. Maintain a strict record of intake and output.
10. Insert a nasogastric tube and begin saline lavage.
11. Assist the client with keeping a detailed calorie count.
12. Provide a quiet environment to promote rest. Correct Answer 2 The client diagnosed with diverticulitis is complaining of severe pain in the left lower quadrant and has an oral temperature of 100.6˚F. Which intervention should the

nurse implement first?

1. Notify the health-care provider.
2. Document the findings in the chart.
3. Administer an oral antipyretic.
4. Assess the client's abdomen. Correct Answer 4 The nurse is teaching the client diagnosed with diverticulosis. Which instruction should the nurse include in the teaching session?
5. Discuss the importance of drinking 1,000 mL of water daily.
6. Instruct the client to exercise at least three (3) times a week.
7. Teach the client about a eating a low-residue diet.
8. Explain the need to have daily bowel movements. Correct Answer 4 The client is admitted to the medical unit with a diagnosis of acute diverticulitis. Which health-care provider's order should the nurse question?
9. Insert a nasogastric tube.
10. Start an IV with D5W at 125 mL/hr.
11. Put client on a clear liquid diet.
12. Place client on bedrest with bathroom privileges. Correct Answer 3 The nurse is discussing the therapeutic diet for the client diagnosed with diverticulosis. Which meal indicates the client understands the discharge teaching?

1. Fried fish, mashed potatoes, and iced tea.
2. Ham sandwich, applesauce, and whole milk.
3. Chicken salad on whole-wheat bread and water.
4. Lettuce, tomato, and cucumber salad and coffee. Correct Answer 3 The client is two (2) hours post-colonoscopy. Which assessment data warrant intermediate intervention by the nurse?
5. The client has a soft, nontender abdomen.
6. The client has a loose, watery stool.
7. The client has hyperactive bowel sounds.
8. The client's pulse is 104 and BP is 98/60. Correct Answer 4 The nurse is preparing to administer the initial dose of an aminoglycoside antibiotic to the client diagnosed with acute diverticulitis. Which intervention should the nurse implement?
9. Obtain a serum trough level.
10. Ask about drug allergies.
11. Monitor the peak level.
12. Assess the vital signs. Correct Answer 2 The client diagnosed with acute diverticulitis is complaining of severe abdominal pain. On assessment, the nurse finds a hard, rigid abdomen and T 102˚F. Which intervention should the nurse implement?
13. Notify the health-care provider.

2. Prepare to administer a Fleet's enema.
3. Administer an antipyretic suppository.
4. Continue to monitor the client closely. Correct Answer 1 The nurse is preparing to administer 250 mL of intravenous antibiotic to the client. The medication must infuse in one (1) hour. An intravenous pump is not available and the nurse must administer the medication via gravity with IV tubing at 10 gtts/min. At what rate should the nurse infuse the medication? _________ Correct Answer 42 gtts/min The client with acute diverticulitis has a nasogastric tube draining green liquid bile. Which intervention should the nurse implement?
5. Document the findings as normal.
6. Assess the client's bowel sounds.
7. Determine the client's last bowel movement.
8. Insert the N/G tube at least 2 more inches. Correct Answer 1 The nurse is teaching a class on diverticulosis. Which interventions should the nurse discuss when teaching ways to prevent an acute exacerbation of diverticulosis? Select all that apply.
9. Eat a high-fiber diet.
10. Increase fluid intake.
11. Elevate the HOB after eating.
12. Walk 30 minutes a day.

5. Take an antacid every two (2) hours. Correct Answer 1, 2, 4 The nurse is working in an outpatient clinic. Which client is most likely to have a diagnosis of diverticulosis?
6. A 60-year-old male with a sedentary lifestyle.
7. A 72-year-old female with multiple childbirths.
8. A 63-year-old female with hemorrhoids.
9. A 40-year-old male with a family history of diverticulosis. Correct Answer 3 The client is admitted to the medical floor with acute diverticulitis. Which collaborative intervention should the nurse anticipate the health-care provider ordering?
10. Administer total parenteral nutrition.
11. Maintain NPO and nasogastric tube.
12. Maintain on a high-fiber diet and increase fluids.
13. Obtain consent for abdominal surgery. Correct Answer 2 The male client tells the nurse he has been experiencing "heartburn" at night that awakens him. Which assessment question should the nurse ask?
14. "How much weight have you gained recently?"
15. "What have you done to alleviate the heartburn?"
16. "Do you consume many milk and dairy products?"

4. "Have you been around anyone with a stomach virus?" Correct Answer 2 The nurse caring for a client diagnosed with GERD writes the client problem of "behavior modification." Which intervention should be included for this problem?
5. Teach the client to sleep with a foam wedge under the head.
6. Encourage the client to decrease the amount of smoking.
7. Instruct the client to take over-the-counter medication for relief of pain.
8. Discuss the need to attend Alcoholics Anonymous to quit drinking. Correct Answer 1 The nurse is preparing a client diagnosed with GERD for discharge following an esophagogastroduodenoscopy. Which statement indicates the client understands the discharge instructions?
9. "I should not eat for at least one (1) day following this procedure."
10. "I can lie down whenever I want after a meal. It won't make a difference."
11. "The stomach contents won't bother my esophagus but will make me nauseous."
12. "I should avoid orange juice and eating tomatoes until my esophagus heals." Correct Answer 4

The nurse is planning the care of a client diagnosed with lower esophageal sphincter dysfunction. Which dietary modifications should be included in the plan of care?

1. Allow any of the client's favorite foods as long as the amount is limited.
2. Have the client perform eructation exercises several times a day.
3. Eat four (4) to six (6) small meals a day and limit fluids during mealtimes.
4. Encourage the client to consume a glass of red wine with one (1) meal a day. Correct Answer 3 The nurse is caring for a client diagnosed with GERD. Which nursing interventions should be implemented?
5. Place the client prone in bed and administer nonsteroidal anti-inflammatory medications.
6. Have the client remain upright at all times and walk for 30 minutes three (3) times a week.
7. Instruct the client to maintain a right lateral side-lying position and take antacids before meals.
8. Elevate the head of the bed 30 degrees and discuss lifestyle modifications with the client. Correct Answer 4 The nurse is caring for an adult client diagnosed with GERD. Which condition is the

most common comorbid disease associated with GERD?

1. Adult-onset asthma.
2. Pancreatitis.
3. Peptic ulcer disease.
4. Increased gastric emptying. Correct Answer 1 The nurse is administering morning medications at 0730. Which medication should have priority?
5. A proton pump inhibitor.
6. A nonnarcotic analgesic.
7. A histamine receptor antagonist.
8. A mucosal barrier agent. Correct Answer 4 The nurse is preparing a client diagnosed with GERD for surgery. Which information warrants notifying the HCP?
9. The client's Bernstein esophageal test was positive.
10. The client's abdominal x-ray shows a hiatal hernia.
11. The client's WBC count is 14,000/mm3.
12. The client's hemoglobin is 13.8 g/dL. Correct Answer 3 The charge nurse is making assignments. Staffing includes a registered nurse with five (5) years of medical- surgical experience, a newly graduated registered nurse, and two (2) unlicensed assistive personnel (UAPs). Which client should be assigned to the most experienced nurse?
13. The 39-year-old client diagnosed with lower esophageal dysfunction who is complaining of pyrosis.

2. The 54-year-old client diagnosed with Barrett's esophagus who is scheduled to have an endoscopy this morning.
3. The 46-year-old client diagnosed with gastroesophageal reflux disease who has wheezes in all five (5) lobes.
4. The 68-year-old client who is three (3) days postoperative for hiatal hernia and needs to be ambulated four (4) times today. Correct Answer 3 Which statement made by the client indicates to the nurse the client may be experiencing GERD?
5. "My chest hurts when I walk up the stairs in my home."
6. "I take antacid tablets with me wherever I go."
7. "My spouse tells me I snore very loudly at night."
8. "I drink six (6) to seven (7) soft drinks every day." Correct Answer 2 The nurse is performing an admission assessment on a client diagnosed with GERD. Which signs and symptoms would indicate GERD?
9. Pyrosis, water brash, and flatulence.
10. Weight loss, dysarthria, and diarrhea.
11. Decreased abdominal fat, proteinuria, and constipation.
12. Midepigastric pain, positive H. pylori test, and melena. Correct Answer 1 Which disease is the client diagnosed with GERD at greater risk for developing?

1. Hiatal hernia.
2. Gastroenteritis.
3. Esophageal cancer.
4. Gastric cancer. Correct Answer 3 Which sign/symptom should the nurse expect to find in a client diagnosed with ulcerative colitis?
5. Twenty bloody stools a day.
6. Oral temperature of 102˚F.
7. Hard, rigid abdomen.
8. Urinary stress incontinence. Correct Answer 1 The client with type 2 diabetes is prescribed prednisone, a steroid, for an acute exacerbation of inflammatory bowel disease. Which intervention should the nurse discuss with the client?
9. Take this medication on an empty stomach.
10. Notify the HCP if experiencing a moon face.
11. Take the steroid medication as prescribed.
12. Notify the HCP if the blood glucose is over 160. Correct Answer 3 The client diagnosed with inflammatory bowel disease has a serum potassium level of 3.4 mEq/L. Which action should the nurse implement first?
13. Notify the health-care provider.
14. Assess the client for muscle weakness.
15. Request telemetry for the client.
16. Prepare to administer potassium IV. Correct Answer 2

The client is diagnosed with an acute exacerbation of ulcerative colitis. Which intervention should the nurse implement?

1. Provide a low-residue diet.
2. Rest the client's bowel.
3. Assess vital signs daily.
4. Administer antacids orally. Correct Answer 2 The client diagnosed with IBD is prescribed total parental nutrition (TPN). Which intervention should the nurse implement?
5. Check the client's glucose level.
6. Administer an oral hypoglycemic.
7. Assess the peripheral intravenous site.
8. Monitor the client's oral food intake. Correct Answer 1 The client is diagnosed with an acute exacerbation of IBD. Which priority intervention should the nurse implement first?
9. Weigh the client daily and document in the client's chart.
10. Teach coping strategies such as dietary modifications.
11. Record the frequency, amount, and color of stools.
12. Monitor the client's oral fluid intake every shift. Correct Answer 3 The client is four (4) hours postoperative open cholecystectomy. Which data warrant immediate intervention by the nurse?
13. Absent bowel sounds in all four (4) quadrants.
14. The T-tube has 60 mL of green drainage.

3. Urine output of 100 mL in the past three (3) hours.
4. Refusal to turn, deep breathe, and cough. Correct Answer 4 The client two (2) hours postoperative laparoscopic cholecystectomy is complaining of severe pain in the right shoulder. Which nursing intervention should the nurse implement?
5. Apply a heating pad to the abdomen for 15 to 20 minutes.
6. Administer morphine sulfate intravenously after diluting with saline.
7. Contact the surgeon for an order to x-ray the right shoulder.
8. Apply a sling to the right arm, which was injured during surgery. Correct Answer 1 The nurse is teaching a client recovering from a laparoscopic cholecystectomy. Which statement indicates the discharge teaching is effective?
9. "I will take my lipid-lowering medicine at the same time each night."
10. "I may experience some discomfort when I eat a high- fat meal."
11. "I need someone to stay with me for about a week after surgery."
12. "I should not splint my incision when I deep breathe and cough." Correct Answer 2

Which signs and symptoms should the nurse report to the health-care provider for the client recovering from an open cholecystectomy? Select all that apply.

1. Clay-colored stools.
2. Yellow-tinted sclera.
3. Amber-colored urine.
4. Wound approximated.
5. Abdominal pain. Correct Answer 1, 2, 5 The nurse is caring for the immediate postoperative client who had a laparoscopic cholecystectomy. Which task could the nurse delegate to the unlicensed assistive personnel (UAP)?
6. Check the abdominal dressings for bleeding.
7. Increase the IV fluid if the blood pressure is low.
8. Ambulate the client to the bathroom.
9. Auscultate the breath sounds in all lobes. Correct Answer 3 Which data should the nurse expect to assess in the client who had an upper gastrointestinal (UGI) series?
10. Chalky white stools.
11. Increased heart rate.
12. A firm hard abdomen.
13. Hyperactive bowel sounds. Correct Answer 1 The client is one (1) hour post-endoscopic retrograde cholangiopancreatogram

(ERCP). Which intervention should the nurse include in the plan of care?

1. Instruct the client to cough forcefully.
2. Encourage early ambulation.
3. Assess for return of a gag reflex.
4. Administer held medications. Correct Answer 3 Which outcome should the nurse identify for the client scheduled to have a cholecystectomy?
5. Decreased pain management.
6. Ambulate first day postoperative.
7. No break in skin integrity.
8. Knowledge of postoperative care. Correct Answer 4 Which assessment data indicate to the nurse the client recovering from an open cholecystectomy may require pain medication?
9. The client's pulse is 65 beats per minute.
10. The client has shallow respirations.
11. The client's bowel sounds are 20 per minute.
12. The client uses a pillow to splint when coughing. Correct Answer 2 The charge nurse is monitoring client laboratory values. Which value is expected in the client with cholecystitis who has chronic inflammation?
13. An elevated white blood cell count.
14. A decreased lactate dehydrogenase.
15. An elevated alkaline phosphatase.
16. A decreased direct bilirubin level. Correct Answer 1

Which problem is highest priority for the nurse to identify in the client who had an open cholecystectomy surgery?

1. Alteration in nutrition.
2. Alteration in skin integrity.
3. Alteration in urinary pattern.
4. Alteration in comfort. Correct Answer 4 The nurse assesses a large amount of red drainage on the dressing of a client who is six (6) hours postoperative open cholecystectomy. Which intervention should the nurse implement?
5. Measure the abdominal girth.
6. Palpate the lower abdomen for a mass.
7. Turn client onto side to assess for further drainage.
8. Remove the dressing to determine the source. Correct Answer 3 The female client came to the clinic complaining of abdominal cramping and at least 10 episodes of diarrhea every day for the last two (2) days. The client just returned from a trip to Mexico. Which intervention should the nurse implement?
9. Instruct the client to take a cathartic laxative daily.
10. Encourage the client to drink lots of Gatorade.
11. Discuss the need to increase protein in the diet.
12. Explain the client should weigh herself daily. Correct Answer 2

Which intervention should the nurse include when discussing ways to help prevent potential episodes of gastroenteritis from Clostridium botulism?

1. Make sure all hamburger meat is well cooked.
2. Ensure all dairy products are refrigerated.
3. Discuss why campers should drink only bottled water.
4. Discard damaged canned goods. Correct Answer 4 The client is diagnosed with salmonellosis secondary to eating some slightly cooked hamburger meat. Which clinical manifestations should the nurse expect the client to report?
5. Abdominal cramping, nausea, and vomiting.
6. Neuromuscular paralysis and dysphagia.
7. Gross amounts of explosive bloody diarrhea.
8. Frequent "rice water stool" with no fecal odor. Correct Answer 1 The client is diagnosed with gastroenteritis. Which laboratory data warrant immediate intervention by the nurse?
9. A serum sodium level of 137 mEq/L.
10. Arterial blood gases of pH 7.37, PaO2 95, PaCO2 43, HCO3 24.
11. A serum potassium level of 3.3 mEq/L.
12. A stool sample positive for fecal leukocytes. Correct Answer 3

The client diagnosed with gastroenteritis is being discharged from the emergency department. Which intervention should the nurse include in the discharge teaching?

1. If diarrhea persists for more than 96 hours, contact the health-care provider.
2. Instruct the client to wash hands thoroughly before handling any type of food.
3. Explain the importance of decreasing steroids gradually as instructed.
4. Discuss how to collect all stool samples for the next 24 hours. Correct Answer 2 Which medication should the nurse expect the HCP to order to treat the client diagnosed with botulism secondary to eating contaminated canned goods?
5. An antidiarrheal medication.
6. An aminoglycoside antibiotic.
7. An antitoxin medication.
8. An ACE inhibitor medication. Correct Answer 3 Which nursing problem is priority for the 76-year-old client diagnosed with gastroenteritis from staphylococcal food poisoning?
9. Fluid volume deficit.
10. Nausea.
11. Risk for aspiration.
12. Impaired urinary elimination. Correct Answer 1

Which data should the nurse expect to assess in the client diagnosed with acute gastroenteritis?

1. Decreased gurgling sounds on auscultation of the abdominal wall.
2. A hard, firm, edematous abdomen on palpation.
3. Frequent, small melena-type liquid bowel movements.
4. Bowel assessment reveals loud, rushing bowel sounds. Correct Answer 4 The 79-year-old client diagnosed with acute gastroenteritis is admitted to the medical unit. Which task would be most appropriate for the nurse to delegate to the unlicensed assistive personnel (UAP)?
5. Evaluate the client's intake and output.
6. Take the client's vital signs.
7. Change the client's intravenous solution.
8. Assess the client's perianal area. Correct Answer 2 Which statement indicates to the emergency department nurse the client diagnosed with acute gastroenteritis understands the discharge teaching?
9. "I will probably have some leg cramps while I have gastroenteritis."
10. "I should decrease my fluid intake until the diarrhea subsides."
11. "I should reintroduce solid foods very slowly back into my diet."

4. "I should only drink bottled water until the abdominal cramping stops." Correct Answer 3 Which nursing interventions should be included in the care plan for the 84-yearold client diagnosed with acute gastroenteritis? Select all that apply.
5. Assess the skin turgor on the back of the client's hands.
6. Monitor the client for orthostatic hypotension.
7. Record the frequency and characteristics of sputum.
8. Use Standard Precautions when caring for the client.
9. Institute safety precautions when ambulating the client. Correct Answer 2, 4, 5 The nurse has received the a.m. shift report. Which client should the nurse assess first?
10. The 44-year-old client diagnosed with peptic ulcer disease who is complaining of acute epigastric pain.
11. The 74-year-old client diagnosed with acute gastroenteritis who has had four (4) diarrhea stools during the night.
12. The 65-year-old client diagnosed with IBD who has tented skin turgor and dry mucous membranes.
13. The 15-year-old client diagnosed with food poisoning who has vomited several times during the night shift. Correct Answer 3 The client being admitted from the emergency department is diagnosed with a fecal

impaction. Which nursing intervention should be implemented?

1. Administer an antidiarrheal medication every day and PRN.
2. Perform bowel training every two (2) hours.
3. Administer an oil retention enema.
4. Prepare for an upper gastrointestinal (UGI) series x-ray. Correct Answer 3 The nurse is caring for a client who uses cathartics frequently. Which statement made by the client indicates an understanding of the discharge teaching?
5. "In the future I will eat a banana every time I take the medication."
6. "I don't have to have a bowel movement every day."
7. "I should limit the fluids I drink with my meals."
8. "If I feel sluggish, I will eat a lot of cheese and dairy products." Correct Answer 2 The client has been experiencing difficulty and straining when expelling feces. Which intervention should the nurse discuss with the client?
9. Explain some blood in the stool will be normal for the client.
10. Instruct the client in manual removal of feces.
11. Encourage the client to use a cathartic laxative on a daily basis.
12. Place the client on a high-fiber diet. Correct Answer 4