Nokea
A client who has been diagnosed with bladder cancer is scheduled for an ileal conduit. Preoperatively, the nurse reinforces the client's understanding of the surgical procedure by explaining that an ileal conduit:
- A. Is a temporary procedure that can be reversed later.
- B. Diverts urine into the sigmoid colon, where it is expelled through the rectum.
- C. Conveys urine from the ureters to a stoma opening on the abdomen.
- D. Creates an opening in the bladder that allows urine to drain into an external pouch.
Correct Answer: C
Rationale: An ileal conduit diverts urine from the ureters to an abdominal stoma, where it is collected in an external pouch, a permanent procedure for bladder cancer management.
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A client with diverticulosis asks about preventing flare-ups. Which recommendation should the nurse provide?
- A. Take a daily laxative to ensure regularity.
- B. Avoid nuts and seeds in the diet.
- C. Increase intake of red meat.
- D. Limit physical activity to reduce strain.
Correct Answer: B
Rationale: Avoiding nuts and seeds may reduce the risk of diverticulitis flare-ups by preventing irritation of diverticula, though evidence is mixed. Daily laxatives are not recommended, red meat is not restricted, and limiting activity is unnecessary. CN: Health promotion and maintenance; CL: Synthesize
The nurse is preparing a client with multiple sclerosis (MS) for discharge from the hospital to home. The nurse should tell the client:
- A. "You will need to accept the necessity for a quiet and inactive lifestyle."
- B. "Keep active, use stress reduction strategies, and avoid fatigue."
- C. "Follow good health habits to change the course of the disease."
- D. "Practice using the mechanical aids that you will need when future disabilities arise."
Correct Answer: B
Rationale: Encouraging activity, stress reduction, and fatigue management supports the client's quality of life and symptom control. Inactivity, changing disease course, or premature focus on aids are less appropriate.
During a home visit, a diabetic client begins to cry and says, 'I just cannot stand the thought of having to give myself a shot every day.' Which of the following would be the best response by the nurse?
- A. If you do not give yourself your insulin shots, you will die.'
- B. We can teach your daughter to give the shots so you will not have to do it.'
- C. I can arrange to have a home care nurse give you the shots every day.'
- D. What is it about giving yourself the insulin shots that bothers you?'
Correct Answer: D
Rationale: Exploring the client's concerns about insulin injections promotes understanding and helps address fears, supporting adherence to treatment.
A client weighs 300 lb (136 kg) and has a history of deep vein thrombosis and thrombophlebitis. When reviewing a teaching plan with this client, the nurse knows that the client has understood the nurse's instructions when he states he will:
- A. Avoid exercise
- B. Lose weight
- C. Perform leg lifts every 4 hours
- D. Wear support hose, using rubber bands to hold the stockings up
Correct Answer: B
Rationale: Weight loss reduces pressure on veins and improves circulation, critical for managing DVT and thrombophlebitis in an obese client. Avoiding exercise increases stasis, leg lifts are insufficient alone, and rubber bands can cause constriction, negating support hose benefits.
A sedentary, obese, middle-aged client is recovering from a right iliac blood clot. The nurse should develop a discharge plan with the client that will focus on participating in which of the following activities? Select all that apply.
- A. Aerobic activity
- B. Strength training
- C. Weight control
- D. Stress management
Correct Answer: A,C,D
Rationale: Rationales: A) Aerobic activity (e.g., walking) improves circulation and reduces clot recurrence. C) Weight control decreases venous pressure and clot risk. D) Stress management reduces sympathetic activation, aiding vascular health. B) Strength training is less critical for clot management and may be contraindicated initially.