Nokea
After surgery for an ileal conduit, the nurse should closely assess the client for the occurrence of which of the following complications related to pelvic surgery?
- A. Peritonitis.
- B. Thrombophlebitis.
- C. Ingestes.
- D. Inguinal hernia.
Correct Answer: A,B
Rationale: Peritonitis and thrombophlebitis are significant complications of pelvic surgery like an ileal conduit, due to potential infection or vascular issues. 'Ingestes' appears to be a typo and is not a recognized complication.
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A small airplane crashes in a neighborhood of 10 houses. One of the victims appears to have a cervical spine injury. What should first-aid for this victim should be selected that apply.
- A. Establish an airway with the jaw-thrust maneuver.
- B. Immobilize the spine.
- C. Logroll the victim to a side-lying position.
- D. Elevate the feet 6" (15.2 cm).
- E. Place a cervical collar around the neck.
Correct Answer: A,B,E
Rationale: For a suspected cervical spine injury, the airway should be opened with the jaw-thrust maneuver, the spine immobilized, and a cervical collar applied to prevent further injury. Logrolling or elevating feet could exacerbate the injury.
The nurse observes a constant gentle bubbling in the water-seal column of a water-seal chest drainage system. This observation should prompt the nurse to do which of the following?
- A. Continue monitoring as usual; this is expected.
- B. Check the connectors between the chest and drainage tubes and where the drainage tube enters the collection bottle.
- C. Decrease the suction to -15 cm H2O and continue observing the system for changes in bubbling during the next several hours.
- D. Drain half of the water from the water-seal chamber.
Correct Answer: B
Rationale: Constant gentle bubbling in the water-seal column suggests an air leak; checking connectors identifies the source. Expected bubbling is intermittent. Adjusting suction or draining water is inappropriate.
A client who has been diagnosed with gastroesophageal reflux disease (GERD) complains of heartburn. To decrease the heartburn, the nurse should instruct the client to eliminate which of the following items from the diet?
- A. Lean beef.
- B. Air-popped popcorn.
- C. Hot chocolate.
- D. Raw vegetables.
Correct Answer: C
Rationale: Hot chocolate contains caffeine and fat, both of which can relax the lower esophageal sphincter and worsen GERD-related heartburn. The other options are less likely to trigger symptoms.
The development of a culturally sensitive health education program for the socioeconomically disadvantaged requires the nurse to:
- A. Locate the program at an existing government facility.
- B. Integrate folk beliefs and traditions into the content.
- C. Prepare materials in the primary language of the program sponsor.
- D. Exclude community leaders from initial planning efforts.
Correct Answer: B
Rationale: Integrating folk beliefs and traditions ensures the program is culturally relevant and increases acceptance and effectiveness among socioeconomically disadvantaged populations.
A client with a history of hypertension and peripheral vascular disease underwent an aortobifemoral bypass graft. Preoperative medications included pentoxifylline (Trental); metoprolol (Toprol XL); and furosemide (Lasix). On postoperative day 1, the 12 noon vital signs are: Temperature 37.2°C; heart rate 132 beats per minute; respiratory rate 20; blood pressure 126/78. Urine output is 50 to 70 mL/hour. The hemoglobin and hematocrit are stable. Using the SBAR (Situation-Background-Assessment-Recommendation) technique for communication, the nurse recommends to the primary care provider:
- A. Continues the pentoxifylline
- B. Increases the I.V. fluids
- C. Restarts the metoprolol
- D. Resumes the furosemide
Correct Answer: C
Rationale: SBAR: Situation€”postop day 1, heart rate 132 bpm. Background€”aortobifemoral bypass, history of hypertension, on metoprolol preop. Assessment€”tachycardia suggests inadequate beta-blockade, other vitals stable. Recommendation€”restart metoprolol to control heart rate and blood pressure. Pentoxifylline is less urgent, fluids are adequate (urine output normal), and furosemide may cause dehydration.