Nokea
After instructing a client with diverticulosis about appropriate self-care activities, which of the following client comments indicate effective teaching? Select all that apply.
- A. With careful attention to my diet, my diverticulosis can be cured.
- B. Using a cathartic laxative weekly is okay to control bowel movements.
- C. I should follow a diet that's high in fiber.
- D. It is important for me to drink at least 2,000 mL of fluid every day.
- E. I should exercise regularly.
Correct Answer: C,D,E
Rationale: Effective teaching is indicated by the client understanding the need for a high-fiber diet (C), adequate fluid intake (D), and regular exercise (E) to manage diverticulosis. Diverticulosis cannot be cured (A), and cathartic laxatives (B) are not recommended as they can irritate the bowel. CN: Health promotion and maintenance; CL: Evaluate
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A physician orders a lengthy X-ray examination for a client with osteoarthritis. Which of the following actions by the nurse would demonstrate client advocacy?
- A. Contact the X-ray department and ask the technician if the lengthy session can be divided into shorter sessions.
- B. Contact the physician to determine if an alternative examination could be scheduled.
- C. Provide a dose of acetaminophen (Tylenol).
- D. Cancel the examination because of the hard X-ray table.
Correct Answer: A
Rationale: Dividing the session into shorter ones reduces discomfort, advocating for the client's comfort while ensuring the test is completed.
The nurse is taking care of a client with a spinal cord injury. The extent of the client’s injury is shown below. Which of the following findings is expected when assessing this client?
- A. Inability to move his arms
- B. Loss of sensation in his hands and fingers.
- C. Dysfunction of bowel and bladder.
- D. Difficulty breathing.
Correct Answer: C
Rationale: This client has a spinal cord injury of the sacral region of the spinal cord and will have bladder and bowel dysfunction, as well as loss of sensation and muscle control below the injury. The other options are true of a client who has quadriplegia.
Nursing assessment of a 54-year-old client in the emergency department reveals severe back pain, Grey Turner's sign, nausea, blood pressure of 90/40, heart rate 128 beats per minute and respirations 28 per minute. The nurse should first:
- A. Assess the urine output
- B. Place a large bore I.V.
- C. Position onto the left side
- D. Insert a nasogastric tube
Correct Answer: B
Rationale: Severe back pain, Grey Turner's sign (flank bruising), and hemodynamic instability (hypotension, tachycardia, tachypnea) suggest a ruptured abdominal aortic aneurysm. Placing a large-bore I.V. first ensures access for fluids and blood transfusion to stabilize the client. Urine output, positioning, and nasogastric tube are secondary.
A client uses timolol maleate (Timoptic) eyedrops. The expected outcome of this beta-adrenergic blocker is to control glaucoma by:
- A. Constricting the pupils.
- B. Dilating the canals of Schlemm.
- C. Reducing aqueous humor formation.
- D. Improving the ability of the ciliary muscle to contract.
Correct Answer: C
Rationale: Timolol maleate, a beta-adrenergic blocker, reduces intraocular pressure by decreasing the production of aqueous humor in the eye.
An older, sedentary adult may not respond to emotional or physical stress as well as a younger individual because of:
- A. Left ventricular atrophy.
- B. Irregular heartbeats.
- C. Peripheral vascular occlusion.
- D. Pacemaker placement.
Correct Answer: A
Rationale: Aging leads to left ventricular atrophy, reducing cardiac reserve and impairing the heart's ability to respond to stress, unlike irregular heartbeats or pacemakers.