Nokea
Post-cystectomy, a client asks about the purpose of the ileal conduit. The nurse explains it is to:
- A. Store urine in the bladder.
- B. Divert urine to an external pouch.
- C. Filter blood in the kidneys.
- D. Reabsorb water in the intestines.
Correct Answer: B
Rationale: An ileal conduit diverts urine from the ureters to a stoma, collected in an external pouch.
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A client with a hip fracture has undergone surgery for insertion of a femoral head prosthesis. Which of the following activities should the nurse instruct the client to avoid?
- A. Crossing the legs while sitting down.
- B. Sitting on a raised commode seat.
- C. Using an abductor splint while lying on the side.
- D. Rising straight from a chair to a standing position.
Correct Answer: A
Rationale: Crossing the legs risks hip dislocation post-surgery.
A client post-extracorporeal shock wave lithotripsy should report:
- A. Mild hematuria.
- B. Severe flank pain.
- C. Clear urine.
- D. Bruising.
Correct Answer: B
Rationale: Severe flank pain may indicate a complication like hematoma or obstruction.
The nurse has reported to the hospital to work the evening shift on a respiratory unit. The nurse's assignment consists of four clients. Prioritize in order from highest to lowest priority how the nurse would assess the clients after receiving report.
- A. An 85-year-old client with bacterial pneumonia, temperature of 102.2°F (42°C), and shortness of breath.
- B. A 60-year-old client with chest tubes who is 2 days postoperative following a thoracotomy for lung cancer and is requesting something for pain.
- C. A 35-year-old client with suspected tuberculosis who is complaining of a cough.
- D. A 56-year-old client with emphysema who has a scheduled dose of a bronchodilator due to be administered, with no report of acute respiratory distress.
Correct Answer: A,B,C,D
Rationale: The client with pneumonia, fever, and shortness of breath is at highest risk for respiratory compromise (A). The postoperative client with pain (B) is next due to pain's impact on breathing. The client with suspected tuberculosis and cough (C) is lower priority but needs isolation precautions. The client with emphysema awaiting a scheduled bronchodilator (D) is stable.
Which of the following exercises should the nurse advise the client to avoid after a lumbar laminectomy?
- A. Knee-to-chest lifts.
- B. Hip tilts.
- C. Sit-ups.
- D. Pelvic tilts.
Correct Answer: C
Rationale: Sit-ups strain the surgical site and should be avoided to prevent injury post-laminectomy.
Which of the following clients is at greatest risk for Buerger's disease?
- A. A 29-year-old male with a 14-year history of cigarette smoking
- B. A 38-year-old female who is taking birth control pills
- C. A 54-year-old female with adult onset diabetes
- D. A 65-year-old male with atherosclerosis
Correct Answer: A
Rationale: Buerger's disease (thromboangiitis obliterans) is strongly associated with heavy tobacco use, particularly in young males. A 29-year-old male with a 14-year smoking history is at greatest risk. Birth control pills, diabetes, and atherosclerosis are not primary risk factors for Buerger's disease.