Nokea
A client is scheduled for an Intravenous Pyelogram (IVP). In order to prepare the client for this test, the nurse would:
- A. Instruct the client to maintain a regular diet the day prior to the examination.
- B. Restrict the client's fluid intake 4 hours prior to the examination.
- C. Administer a laxative to the client the evening before the examination.
- D. Inform the client that only 1 x-ray of his abdomen is necessary.
Correct Answer: C
Rationale: The correct preparation for an Intravenous Pyelogram (IVP) involves administering a laxative to the client the evening before the examination. This is crucial to ensure adequate bowel preparation, which in turn allows for better visualization of the bladder and ureters during the procedure. An IVP is an x-ray exam that utilizes contrast material to evaluate the kidneys, ureters, and bladder, aiding in the diagnosis of conditions like blood in the urine or pain in the side or lower back. Administering a laxative helps in achieving optimal imaging quality, which is essential for accurate diagnosis and subsequent treatment planning.
Choice A is incorrect because maintaining a regular diet is not the standard preparation for an IVP. Choice B is incorrect as fluid intake is not typically restricted for this procedure. Choice D is incorrect as an IVP involves multiple x-rays to assess the urinary system, not just one of the abdomen.
You may also like to solve these questions
A 55-year-old patient admitted with an abrupt onset of jaundice and nausea has abnormal liver function studies, but serologic testing is negative for viral causes of hepatitis. Which question by the nurse is most appropriate?
- A. Is there any history of IV drug use?
- B. Do you use any over-the-counter drugs?
- C. Are you taking corticosteroids for any reason?
- D. Have you recently traveled to a foreign country?
Correct Answer: B
Rationale: The most appropriate question for the nurse to ask in this scenario is whether the patient uses any over-the-counter drugs. The patient's symptoms, negative serologic testing for viral hepatitis, and sudden onset of symptoms point towards toxic hepatitis, which can be triggered by commonly used over-the-counter medications like acetaminophen (Tylenol). Asking about IV drug use is relevant for viral hepatitis, not toxic hepatitis. Inquiring about recent travel to a foreign country is more pertinent to potential exposure to infectious agents causing viral hepatitis. Corticosteroid use is not typically associated with the symptoms described in the case.
Which action should the nurse take to evaluate treatment effectiveness for a patient who has hepatic encephalopathy?
- A. Ask the patient to extend both arms forward.
- B. Request that the patient walk with eyes closed.
- C. Ask the patient to perform the Valsalva maneuver.
- D. Observe the patient's breathing pattern.
Correct Answer: B
Rationale: To evaluate treatment effectiveness for a patient with hepatic encephalopathy, requesting the patient to walk with eyes closed is crucial. This test assesses the patient's balance, gait, and coordination, which can be impaired in hepatic encephalopathy due to altered mental status and brain function. Walking with eyes closed challenges the patient's sensory input and proprioception, providing valuable information on improvement or deterioration in neurological function. Asking the patient to extend both arms forward is used to check for asterixis, a sign often seen in hepatic encephalopathy, but it is not specific for evaluating treatment effectiveness. Performing the Valsalva maneuver is unrelated to assessing hepatic encephalopathy and is more commonly used in cardiac evaluations. Observing the patient's breathing pattern may be important in other conditions but is not directly relevant to evaluating treatment effectiveness for hepatic encephalopathy.
A 30-year-old man is being admitted to the hospital for elective knee surgery. Which assessment finding is most important to report to the healthcare provider?
- A. Tympany on percussion of the abdomen
- B. Liver edge 3 cm below the costal margin
- C. Bowel sounds of 20/minute in each quadrant
- D. Aortic pulsations visible in the epigastric area
Correct Answer: B
Rationale: The correct answer is 'Liver edge 3 cm below the costal margin.' Normally, the lower border of the liver is not palpable below the ribs, so this finding suggests hepatomegaly, which could indicate an underlying health issue. Tympany on percussion of the abdomen, bowel sounds of 20/minute in each quadrant, and aortic pulsations visible in the epigastric area are all within normal limits for a physical assessment and do not require immediate reporting to the healthcare provider.
The nurse is working in a support group for clients with HIV. Which point is most important for the nurse to stress?
- A. They must inform household members of their condition.
- B. They must take their medications exactly as prescribed.
- C. They must abstain from substance use.
- D. They must avoid large crowds.
Correct Answer: B
Rationale: The correct answer is that clients with HIV must take their medications exactly as prescribed. Antiretrovirals need to be taken as directed to prevent the development of drug-resistant strains and maintain treatment effectiveness. Missing doses can compromise the effectiveness of future treatments. Choice A, informing household members, is important for social support but not the most critical aspect of managing the condition. Choice C, abstaining from substance use, is important but not as crucial as medication adherence. Choice D, avoiding large crowds, is not directly related to HIV management as long as the individual's immune system is not significantly compromised.
A client with asthma has low-pitched wheezes present in the final half of exhalation. One hour later, the client has high-pitched wheezes extending throughout exhalation. This change in assessment indicates to the nurse that the client:
- A. Has increased airway obstruction.
- B. Has improved airway obstruction.
- C. Needs to be suctioned.
- D. Exhibits hyperventilation.
Correct Answer: B
Rationale: The change from low-pitched wheezes to high-pitched wheezes indicates a shift from larger to smaller airway obstruction, suggesting increased narrowing of the airways. This change signifies a progression or worsening of the airway obstruction. The absence of evidence of secretions does not support the need for suctioning. Hyperventilation is characterized by rapid and deep breathing, which is not indicated by the information provided in the question.