Nokea
A client is scheduled for an intravenous pyelogram (IVP).
Nursing management prior to an intravenous pyelogram (IVP) would include which of the following?
- A. A fat-free meal the evening prior to the examination and radiopaque tablets at bedtime.
- B. Placement of a retention urinary catheter to facilitate dilation of the bladder sphincter.
- C. Cleansing enemas the evening before to provide for adequate visualization of the urinary tract.
- D. Explaining the importance of following directions regarding voiding during the Test .
Correct Answer: C
Rationale: Strategy: Answers are all implementations. Determine the outcome of each answer choice. Is it desired? (1) fat-free meal is associated with a gall bladder series (2) a retention Foley catheter may be in place, but not for the purpose of dilating the bladder sphincter (3) correct-because of the need to visualize the abdominal area, cleansing enemas the evening before an IVP are usually ordered (4) there are few directions the client needs to follow during the Test
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The nurse is caring for patients on the surgical floor and has just received report from the previous shift.
Which of the following patients should the nurse see FIRST?
- A. A 35-year-old admitted three hours ago with a gunshot wound; 1/5 cm area of dark drainage noted on the dressing.
- B. A 43-year-old who had a mastectomy two days ago; 23 cc of serosanguinous fluid noted in the Jackson-Pratt drain.
- C. A 59-year-old with a collapsed lung due to an accident; no drainage noted from chest tube in last eight hours.
- D. A 62-year-old who had an abdominal-perineal resection three days ago; patient complains of chills.
Correct Answer: D
Rationale: Strategy: Think ABCs. (1) does not indicate acute bleeding, small amount of blood (2) expected outcome (3) indicates resolution (4) correct-risk for peritonitis, should be assessed for further symptoms of infection
The nurse is caring for a schizophrenic client who has become increasingly withdrawn to the point of mutism. The MOST important nursing approach at this time would be to
- A. ignore the client until he is ready to respond.
- B. sit with the client for brief periods of time.
- C. read to the client in a quiet area of the unit.
- D. encourage the client to play dominos with the group.
Correct Answer: B
Rationale: nurse should maintain contact with client but not make demands to communicate or participate in activities
A teenager comes to the clinic complaining of fatigue, a sore throat, and flu-like symptoms for the previous two weeks. Physical exam reveals enlarged lymph nodes and temperature of 100.3°F (37.9°C). Which of the following statements by the nurse is BEST?
- A. Cover your mouth and nose when you sneeze or cough.
- B. Eat in a separate room away from your family.
- C. Don't share your drinking glass or silverware with anybody.
- D. Stay in your room until all of your symptoms are gone.
Correct Answer: C
Rationale: symptoms indicate mononucleosis, spread by direct contact; advise family to avoid contact with cups and silverware for about 3 months
The nurse is teaching a client with a new diagnosis of depression about citalopram (Celexa). Which of the following statements by the client indicates a need for further teaching?
- A. I should report suicidal thoughts to my doctor.
- B. I should take this medication in the morning.
- C. I should avoid drinking alcohol.
- D. I should stop this medication if I feel better.
Correct Answer: D
Rationale: Stopping citalopram when feeling better is incorrect, as depression requires prolonged treatment to prevent relapse. Options A, B, and C are correct: suicidal thoughts require immediate reporting, morning dosing minimizes insomnia, and alcohol increases sedation.
A client has an order for a low-sodium, low-cholesterol diet. The nurse knows that which of the following selections reflects the client's compliance?
- A. Canned vegetable soup, applesauce, and hot chocolate.
- B. Cheeseburger, french fries, and skim milk.
- C. Tomato and lettuce salad, roasted chicken, and lemonade.
- D. Tuna fish sandwich, cottage cheese, and a cola.
Correct Answer: C
Rationale: fresh fruits and vegetables are low sodium, roasted chicken is low cholesterol