Critical thinkers...S.O.S....S.O.S....S.O.S...

  1. Hello gang,

    I was hoping to get some thoughts on the following question that appeared on my nursing exam last week:

    Which action is most important when teaching your client about the intake of bran to facilitate defication?

    a. wrong answer
    b. wrong answer
    c. start with three tablespoons of bran at morning
    d. drink at least eight (8) glasses of fluids a day.

    Thanks!!
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  2. 29 Comments

  3. by   Wheaties
    what is bran?

    is that a cereal?

    the answer is D 8 glasses per day, because fiber works best with increase fluid intake preventing constipation. if fiber alone is taken, then it wont be as effective. because fiber is like a sponge, with water it can absorb more compared to a sponge with no water.
  4. by   laughingfairy
    I'd say drink at least 8 glasses of water a day. Having worked in LTC, I have seen the results of too much fiber not enough fluids. And almost no one drinks enough fluid.
  5. by   Hellllllo Nurse
    I'd choose "D".
  6. by   Pab_Meister
    Good responses, but let me ask:

    Answer d. says "fluids" not "water". Fluids include things like Pepsi, tomato juice, milk, beer, etc. I dunno, am I grabbing at straws?
  7. by   twarlik
    Quote from Alexander
    Good responses, but let me ask:

    Answer d. says "fluids" not "water". Fluids include things like Pepsi, tomato juice, milk, beer, etc. I dunno, am I grabbing at straws?
    I think you may be reading too much into the answer. I'd go with D for the same reasons that everyone else has given.
  8. by   hobbes
    Quote from Alexander
    Good responses, but let me ask:

    Answer d. says "fluids" not "water". Fluids include things like Pepsi, tomato juice, milk, beer, etc. I dunno, am I grabbing at straws?
    I wouldn't think it should matter as all the above "fluids" have water as the primary constituent and once it is metabolized by the body you will still get your water - you'll just have some extra carbohydrates, etc that will be processed accordingly.
  9. by   Hellllllo Nurse
    I still say the answer is D. Many people are chronically constipated only because they are chronically dehydrated.

    The "three tablespoons of bran" answer does not make sense to me. Why three tablespoons, specifically? Why in the morning, specifically?
    There is no rationale for this answer within the context of the question.

    I would start with asking a pt about their fiber (not just bran) intake, as well as fluid intake, hx of laxative use, etc., before I started with the teaching. But, that answer is not an option.
    Maybe the pt has diverticulitis/losis or another condition in which intake of bran would be contraindicated. For all of these reasons (and more), the "three tablespoons of bran" answer seems all wrong to me.

    However, if exam questions in nursing school are still as goofy as they were when I was in school, I could be totally wrong, lol.


    Whatever the answer is, please let us know! Lots of people post exam question topics like this and then never return to let us know what the answer was. Drives me crazy!
  10. by   Tweety
    Three tablespoons of bran each morning is too much. I'd go with the fluids.
  11. by   RedSox33RN
    I say D also. Bran isn't going to do much good if you don't have the fluid to move things along.
  12. by   Pab_Meister
    Hello everyone,

    Yes, the answer is d.

    Thanks so much for your replies and rationales.

    Now here's the story:

    My instructor for the nutrition section of my Level One program dug herself into a bit of a pit. When she was lecturing on this topic, she held up a bottle of water and proclaimed, "...and not just any fluid guys - Water!"

    During the exam, those words came back to me as clearly as if she had just spoken them. So what did I do? I changed the answer from d. to c. What a dummy.

    Thanks again for all of your responses. I don't know what I'd do widouchas!
  13. by   timewood
    ahhh....
    nothing like an ambiguous question ....

    I agree with everyone else. Fiber will only constipate the pt if they are not getting enough fluids in the first place. (all together now:"phytobezoar". Now, why wasn't this great word ever on a test???)
  14. by   Carolanne
    Quote from 3rdShiftGuy
    Three tablespoons of bran each morning is too much. I'd go with the fluids.
    My rationale exactly.

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