Nokea
Diphenoxylate hydrochloride and atropine sulfate (Lomotil) is prescribed for the client with ulcerative colitis. The nurse realizes that the medication is having a therapeutic effect when the following is noted:
- A. There is an absence of peristalsis.
- B. The number of diarrhea stools decreases.
- C. Cramping in the abdomen has increased.
- D. Abdominal girth size increases.
Correct Answer: B
Rationale: Lomotil is an antidiarrheal that slows intestinal motility, reducing the frequency of diarrhea stools, indicating its therapeutic effect.
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After a cardiac catheterization procedure, the nurse should ask the client to remain in which position?
- A. on the left side, with both knees bent slightly
- B. semi-Fowler's position
- C. supine with a small pillow under the head
- D. high-Fowler's position
Correct Answer: C
Rationale: The supine position with a small pillow under the head promotes comfort and prevents bleeding from the catheter insertion site (usually femoral) after cardiac catheterization.
The nurse is obtaining a history on a 74-year-old client. Which statement made by the client would alert the nurse to a possible fluid and electrolyte imbalance?
- A. My skin is always so dry.'
- B. I often use a laxative for constipation.'
- C. I have always liked to drink a lot of water.'
- D. I sometimes have a problem with dribbling urine.'
Correct Answer: B
Rationale: Frequent laxative use can cause fluid and electrolyte losses (e.g., potassium, sodium), leading to imbalances, unlike the other statements.
The physician has prescribed NPH insulin for a client with diabetes mellitus. Which statement indicates that the client knows when the peak action of the insulin occurs?
- A. I will make sure I eat breakfast within 2 hours of taking my insulin.
- B. I will need to carry candy or some form of sugar with me all the time.
- C. I will eat a snack around three o'clock each afternoon.
- D. I can save my dessert from supper for a bedtime snack.
Correct Answer: C
Rationale: NPH insulin peaks 4-12 hours after administration, so a snack around 3 PM helps prevent hypoglycemia during peak action.
The physician has ordered a paracentesis for a client with severe abdominal ascites. Before the procedure, the nurse should:
- A. Provide the client with a urinal
- B. Prep the area by shaving the abdomen
- C. Encourage the client to drink extra fluids
- D. Request an ultrasound of the abdomen
Correct Answer: A
Rationale: Providing a urinal allows the client to empty their bladder, reducing the risk of bladder puncture during paracentesis.
A client has been on prolonged bedrest following surgery. The nurse notes that the patient has pain in the right calf on palpation with dorsiflexion of the ankle. Which of the following causes does the nurse suspect?
- A. Arthritis
- B. Muscle strain
- C. Compartment syndrome
- D. Deep vein thrombosis
Correct Answer: D
Rationale: Calf pain with dorsiflexion (Homan's sign) suggests deep vein thrombosis (D), common after prolonged bedrest. Arthritis (A), muscle strain (B), and compartment syndrome (C) present differently.