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A client is scheduled for a colonoscopy. Which instruction should the nurse provide?
- A. Eat a light breakfast on the day of the procedure.
- B. You will need to drink a bowel preparation solution before the procedure.
- C. Avoid all liquids for 24 hours before the procedure.
- D. You can continue taking your blood thinners until the day of the procedure.
Correct Answer: B
Rationale: The correct answer is B because drinking a bowel preparation solution helps clear the colon for better visualization during the colonoscopy. This step is crucial to ensure accuracy of the procedure. Choice A is incorrect as the client should have a clear liquid diet the day before the procedure. Choice C is incorrect as hydration is important, but clear liquids are allowed. Choice D is incorrect because blood thinners may need to be adjusted prior to the procedure to reduce bleeding risk.
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The nurse is caring for a client with a spinal cord injury. Which intervention should the nurse implement to prevent autonomic dysreflexia?
- A. Restrict the client's fluid intake.
- B. Keep the client's room warm.
- C. Ensure the client's bladder is emptied regularly.
- D. Limit the client's intake of high-fiber foods.
Correct Answer: C
Rationale: The correct answer is C: Ensure the client's bladder is emptied regularly. Autonomic dysreflexia is a potentially life-threatening condition that occurs in clients with spinal cord injuries. It is triggered by a distended bladder or bowel. By regularly emptying the client's bladder, the nurse can prevent the stimulus that leads to autonomic dysreflexia. Option A is incorrect because restricting fluid intake can lead to dehydration, exacerbating the condition. Option B is incorrect as temperature regulation is not directly related to preventing autonomic dysreflexia. Option D is incorrect as high-fiber foods do not play a role in triggering this condition.
A client with a history of gout is experiencing an acute attack. Which medication should the nurse expect the healthcare provider to prescribe?
- A. Aspirin.
- B. Allopurinol (Zyloprim).
- C. Colchicine.
- D. Probenecid (Benemid).
Correct Answer: C
Rationale: The correct answer is C: Colchicine. Colchicine is used to treat acute gout attacks by reducing inflammation and pain. It works by decreasing the inflammatory response to urate crystals in the joints. Aspirin (choice A) is not recommended for gout treatment as it can worsen symptoms. Allopurinol (choice B) and Probenecid (choice D) are used for long-term management of gout by reducing uric acid levels and preventing future attacks, not for acute attacks. Colchicine is the appropriate choice for treating the client's acute gout symptoms.
A client with chronic kidney disease (CKD) is scheduled for a renal biopsy. Which pre-procedure instruction should the nurse provide?
- A. Maintain a low-protein diet for 24 hours before the biopsy.
- B. Avoid taking anticoagulant medications for one week before the biopsy.
- C. Drink plenty of fluids before the procedure.
- D. Take your routine medications with a full glass of water before the biopsy.
Correct Answer: B
Rationale: The correct answer is B: Avoid taking anticoagulant medications for one week before the biopsy. This is essential to prevent excessive bleeding during and after the procedure. Chronic kidney disease patients are at higher risk of bleeding due to impaired kidney function.
A: Maintaining a low-protein diet is not directly related to the biopsy procedure and is not necessary.
C: Drinking plenty of fluids may be beneficial for renal function but is not a specific pre-procedure instruction for a renal biopsy.
D: Taking routine medications with water is important, but specific instructions regarding anticoagulant medications are more critical in this case.
The healthcare professional is caring for a client with a chest tube following a thoracotomy. Which assessment finding requires immediate intervention?
- A. Continuous bubbling in the water seal chamber.
- B. Serosanguineous drainage in the collection chamber.
- C. Intermittent bubbling in the suction control chamber.
- D. Chest tube secured to the client's chest wall.
Correct Answer: A
Rationale: The correct answer is A: Continuous bubbling in the water seal chamber. Continuous bubbling in the water seal chamber indicates an air leak in the system, which can lead to pneumothorax or compromised lung function. Immediate intervention is required to prevent complications. Serosanguineous drainage in the collection chamber (B) is expected after thoracotomy. Intermittent bubbling in the suction control chamber (C) is normal and indicates proper suction function. Chest tube secured to the client's chest wall (D) is essential for stability and should not require immediate intervention.
A client with a history of hypertension is prescribed lisinopril (Prinivil). Which side effect should the nurse monitor for?
- A. Dry cough.
- B. Weight gain.
- C. Tachycardia.
- D. Hyperglycemia.
Correct Answer: A
Rationale: The correct answer is A: Dry cough. Lisinopril, an ACE inhibitor, commonly causes a dry cough due to the accumulation of bradykinin. This side effect can be bothersome and non-productive. Other choices are incorrect because weight gain is not a common side effect of lisinopril but rather a side effect of some other antihypertensive medications. Tachycardia is not associated with lisinopril; in fact, it can cause bradycardia in some cases. Hyperglycemia is not a common side effect of lisinopril and is more commonly associated with other classes of antihypertensive medications.