Nokea
A client with suspected renal disease is to undergo a renal biopsy. The nurse plans to include which statement in the teaching session?
- A. You will be sitting for the examination procedure.
- B. Portions of the procedure will cause pain or discomfort.
- C. You will be asleep during the procedure.
- D. You will not be able to drink fluids for 24 hours following the study.
Correct Answer: B
Rationale: Renal biopsies may cause discomfort during needle insertion, and informing the client prepares them for the procedure.
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A client has recurrent episodes of constipation and fecal impaction. The nurse is assisting the client with a bowel-training regimen. Which of the following interventions should be included? Select all that apply.
- A. Scheduled toileting
- B. Stool softeners
- C. High-fiber diet
- D. Daily laxatives
- E. Periodic enemas
- F. Routine exercise
Correct Answer: A,B,C,F
Rationale: Bowel training includes scheduled toileting (A), stool softeners (B), high-fiber diet (C), and routine exercise (F) to promote regular bowel movements. Daily laxatives (D) and periodic enemas (E) are not preferred long-term.
The nurse is preparing to administer a dose of warfarin (Coumadin) to a client. The client’s international normalized ratio (INR) is 4.5. Which of the following actions should the nurse take?
- A. Administer the dose as ordered.
- B. Withhold the dose and notify the physician.
- C. Administer vitamin K as a reversal agent.
- D. Recheck the INR in 4 hours.
Correct Answer: B
Rationale: an INR of 4.5 is above the therapeutic range (2.0–3.0), indicating a risk of bleeding; the dose should be withheld and the physician notified
A client is admitted with symptoms of vertigo and syncope. Diagnostic tests indicate left subclavian artery obstruction. What additional findings would the nurse expect?
- A. Memory loss and disorientation
- B. Numbness in the face, mouth, and tongue
- C. Radial pulse differences over 10 bpm
- D. Frontal headache with associated nausea or emesis
Correct Answer: C
Rationale: Subclavian artery obstruction can cause reduced blood flow to the arm, leading to radial pulse differences between arms, a hallmark of conditions like subclavian steal syndrome.
A client is admitted with a possible bowel obstruction. Which question during the nursing history is least helpful in obtaining information regarding this diagnosis?
- A. Tell me about your pain.'
- B. What does your vomit look like?'
- C. Describe your usual diet.'
- D. Have you noticed an increase in abdominal size?'
Correct Answer: C
Rationale: Diet history is less directly related to diagnosing a bowel obstruction compared to pain, vomiting characteristics, or abdominal distension, which are hallmark symptoms.
A client with cystic fibrosis is taking pancreatic enzymes. The nurse should administer this medication:
- A. Once per day in the morning
- B. Three times per day with meals
- C. Once per day at bedtime
- D. Four times per day
Correct Answer: B
Rationale: Pancreatic enzymes are taken with meals to aid digestion, as cystic fibrosis impairs pancreatic enzyme production.