Nokea
A client is to receive peritoneal dialysis. To prepare for the procedure, the nurse should?
- A. Assess the dialysis access for a bruit and thrill.
- B. Insert an indwelling urinary catheter and drain all urine from the bladder.
- C. Ask the client to turn toward the left side.
- D. Warm the solution in the warmer.
Correct Answer: D
Rationale: Warming the dialysis solution prevents discomfort and promotes effective dialysis by relaxing abdominal muscles.
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Which of the following nursing assessment findings indicates hypovolemic shock in a client who has had a 15% blood loss?
- A. Pulse rate less than 60 bpm.
- B. Respiratory rate of 4 breaths/minute.
- C. Pupils unequally dilated.
- D. Systolic blood pressure less than 90 mm Hg.
Correct Answer: D
Rationale: A 15% blood loss can cause hypovolemic shock, with early signs including hypotension (systolic BP <90 mm Hg) due to reduced circulating volume. Bradycardia, low respiratory rate, and unequal pupils are not typical findings.
The nurse is assessing the lower extremities of the client with peripheral vascular disease (PVD). During the assessment, the nurse should expect to find which of the following clinical manifestations of PVD?
- A. Hairy legs
- B. Mottled skin
- C. Pink, cool skin
- D. Warm, moist skin
Correct Answer: B
Rationale: Mottled skin (livedo reticularis) is a common manifestation of PVD due to poor perfusion, causing irregular skin discoloration. Hairy legs, pink cool skin, or warm moist skin are not typical; PVD often presents with hair loss, cool, pale, or cyanotic skin.
Post-cystectomy, a client asks about the purpose of the ileal conduit. The nurse explains it is to:
- A. Store urine in the bladder.
- B. Divert urine to an external pouch.
- C. Filter blood in the kidneys.
- D. Reabsorb water in the intestines.
Correct Answer: B
Rationale: An ileal conduit diverts urine from the ureters to a stoma, collected in an external pouch.
An advantage of using biologic burn grafts such as porcine (pigskin) grafts is that they appear to help:
- A. Encourage formation of tough skin.
- B. Promote the growth of epithelial tissue.
- C. Provide for permanent wound closure.
- D. Facilitate development of subcutaneous tissue.
Correct Answer: B
Rationale: Porcine grafts act as a temporary biological dressing, promoting epithelial tissue growth by providing a protective barrier and stimulating healing. They do not form tough skin, provide permanent closure, or directly affect subcutaneous tissue.
Which of the following nursing interventions is most important in preventing postoperative complications?
- A. Progressive diet planning.
- B. Pain management.
- C. Bowel and elimination monitoring.
- D. Early ambulation.
Correct Answer: D
Rationale: Early ambulation prevents multiple complications, including deep vein thrombosis, pneumonia, and atelectasis, by promoting circulation and lung expansion.