Nokea
A client has an ileal conduit. Which of the following solutions will be useful to help control odor in the urine collecting bag after it has been cleaned?
- A. Salt water.
- B. Vinegar.
- C. Ammonia.
- D. Bleach.
Correct Answer: B
Rationale: Vinegar neutralizes odors in the urine collecting bag, is safe for use, and helps maintain appliance integrity.
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A client who has a history of Crohn's disease is admitted to the hospital with fever, diarrhea, cramping, abdominal pain, and weight loss. The nurse should monitor the client for:
- A. Hyperalbuminemia.
- B. Thrombocytopenia.
- C. Hypokalemia.
- D. Hypercalcemia.
Correct Answer: C
Rationale: Crohn's disease with diarrhea can lead to hypokalemia due to potassium loss in stool. Hyperalbuminemia and hypercalcemia are not typical, and thrombocytopenia is less directly related to these symptoms. CN: Physiological adaptation; CL: Analyze
Which action is contraindicated for a client with a risk of increased ICP?
- A. Elevate head of bed.
- B. Administer mannitol.
- C. Encourage coughing.
- D. Monitor neurological status.
Correct Answer: C
Rationale: Coughing is contraindicated as it increases intracranial pressure.
The nurse is caring for a client who is using a portable wound suction unit (see figure). Six hours following surgery, the drainage unit is full. The nurse should do which of the following?
- A. Remove the drain from the incision.
- B. Notify the surgeon.
- C. Empty drainage.
- D. Record the amount in the unit as output on the client's chart.
Correct Answer: C
Rationale: A full portable wound suction unit (e.g., Jackson-Pratt) should be emptied to maintain suction and prevent complications. The drainage is then measured and recorded.
A client's bone marrow report reveals normal stem cells and precursors of platelets (megakaryocytes) in the presence of decreased circulating platelets. The nurse recognizes a knowledge deficit when the client makes which of the following statements?
- A. I need to stop flossing and throw away my hard toothbrush.'
- B. I am glad that my report turned out normal.'
- C. Now I know why I have all these bruises.'
- D. I shouldn't jump off that last step anymore.'
Correct Answer: B
Rationale: Normal stem cells and megakaryocytes with decreased circulating platelets suggest a peripheral destruction issue, such as ITP, not a bone marrow production problem. The client's statement that the report is 'normal' indicates a misunderstanding, as the low platelet count is abnormal and requires management. The other statements reflect appropriate awareness of bleeding risks.
A client who was a victim of a gunshot wound was treated in the emergency department and died. What should the nurse direct the unlicensed assistive personnel (UAP) to do during postmortem care? Select all that apply.
- A. Remove all tubes and I.V. lines.
- B. Cover the body with a sheet.
- C. Notify the family.
- D. Transport the body to the morgue.
- E. Notify the chaplain.
Correct Answer: B,D
Rationale: UAP can cover the body and transport it to the morgue. Removing tubes may be restricted due to forensic needs, and notifying family or chaplain is typically a nurse's responsibility.