Nokea
A home health patient with end-stage renal disease (ESRD) verbalizes feeling helplessness related to this life-altering disease. Which nursing intervention would be most helpful?
- A. Ensure restricted protein intake to prevent nitrogenous product accumulation.
- B. Include the patient in making the plan of care.
- C. Counsel patient about end-of-life provisions.
- D. Write out a detailed schedule of health care provider's appointments.
Correct Answer: B
Rationale: Listen to the patient and allow time for discussion about concerns and the plan of care to return some sense of control. End-of-life discussions are premature and will not benefit the patient who is experiencing helplessness.
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A 56-year-old patient with cancer of the bladder is recovering from a cystectomy with an ileal conduit. Which aspect is an important nursing intervention of the patient with an ileal conduit?
- A. Instructing the patient to report mucus from the stoma
- B. Maintaining skin integrity
- C. Limiting oral intake to 1000 mL/day
- D. Limiting acid-ash foods
Correct Answer: B
Rationale: Care of the patient with an ileal conduit is a nursing challenge because of the continual drainage of urine through the stoma. Complications of this procedure are wound infection, dehiscence, and urinary leakage. Maintaining skin integrity reduces the risk of infection. Mucus draining from the stoma is expected, due to secretions from the intestine. The patient is urged to drink adequate fluids to flush the conduit. Limiting acid-ash foods benefits some patients with kidney stones.
Which portion of the nephron is involved with filtration?
- A. Glomerulus of the Bowman capsule
- B. Henle loop
- C. Proximal convoluted tubule
- D. Distal convoluted tubule
Correct Answer: A
Rationale: Filtration of water and blood products occurs in the glomerulus of the Bowman capsule.
Exercises to increase muscle tone of the pelvic floor are known as ___ exercises.
- A. Kegel
Correct Answer: Kegel
Rationale: Women with weakened structures of the pelvic floor are prone to stress incontinence. For the female patient, Kegel exercises are helpful; 10 repetitions, 5 to 10 times a day, are suggested to improve muscle tone.
Which action can reduce the risk of skin impairment secondary to urinary incontinence?
- A. Decreasing fluid intake
- B. Catheterization of the older adult patient
- C. Limiting the use of medication (diuretics, etc.)
- D. Frequent toileting and meticulous skin care
Correct Answer: D
Rationale: Frequent toileting of the incontinent patient will prevent retained moisture in undergarments and bed linens and will preserve the integrity of the skin.
The nurse is reviewing the urinalysis report on an assigned patient. The nurse recognizes which finding to be normal?
- A. Turbidity clear
- B. pH 6.0
- C. Glucose negative
- D. Red blood cells, 15 to 20
- E. White blood cells
Correct Answer: A,C
Rationale: The normal findings are: turbidity clear, and glucose negative. The other findings are abnormal.