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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!!

It you look at the Question the question asked what to do to facilitate Defecation after teaching about bran. If you dont give enough fluids to push out the bran a client would get constipated. The definition of facilitate is the action of process. and defecation is the empting of the large intestinal tract. I hope this helps. Michele

Hi Michele,

Let me play devils advocate here:

Let's say that instead of fluid intake, answer d. was:

d. instruct the client to ambulate the length of the hall three times per day to promote bowel activity.

Would you still pick answer d.?

If you re-read the question, it does not state "...after teaching about bran", it says, "...when teaching about the intake of bran to facilitate defication." While both the increase of fluid intake and physical activity are important factors in bowel elimination, in regards to "bran intake", the only answer that makes any mention of bran intake is c.

In my opinion, the question is generally about bowel elimination, which includes exercise, fluids, fiber, etc. and is specifically about *intake of bran*.

I understand the other rationale too, that bran w/out water will not facilitate defication, but there are also a dozen other factors to consider when speaking generally about defication, and not specifically about bran intake.

This is fun....

that just what I would of done to answer that question. I didn't mean anything by my post.

Hey Michele,

I'm not the least bit offended by your reply. I'm sorry if I may have sounded that way. I really do love a good debate and welcome your comments. I'm still trying to figure out the rationale for 8 glasses of fluids.

On another point, we were taught in class that the correct amount of bran per day was 1 table spoon. I can't imagine that it takes 8 glasses of water to stimulate one tablespoon of bran. While I agree that 8 glasses of water are recommended for good health, a healthy colon, and ease of defication, I can't imagine that 8 glasses of water could possibly be absorbed by 1 tablespoon of bran.

Thanks Michele and everyone else who has kept the gray matter active.

Specializes in OB.

Alexnder,

This must be one of Mrs W's questions right? She always worded them screwy and there is not debating them with her, even when she is dead wrong.

My answer would be the fluid also, because it says after teaching your client about bran intake, so you have allready taught them how much bran per day to take and how to take it. If the answer choices also included ambulation then I would still pick fluid, because again, you can take all the bran, walk a mile and with not enough fluid you are still going to have hard stools that may be diffucult to pass.

It sounds like you are doing great though, you are really getting the rational behind the answers and that is great!

PS 4 more days and I am starting to FREAK OUT!!!! :uhoh21:

Hey Molly,

I guess you've seen enough of Mrs. W's questions to know 'em when you see 'em. Thanks for your input. I love reading into how others formulate their responses. Often, when I use the on-line resources for my text, I'll go through the sample questions a second time and pick all wrong answers just so I can read the rationale for all of the answers.

Hhhhmmmm.... I'm going to post some more as I come across some good ones....

Thanks again everyone!!!!

Best of luck Molly --- NCLEX on St. Patty's day!!!

I know you'll ACE it!!!

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