Nokea
Postoperative nursing care for a client after an appendectomy should include which of the following?
- A. Administering sitz baths four times a day.
- B. Noting the first bowel movement after surgery.
- C. Limiting the client's activity to bathroom privileges.
- D. Measuring abdominal girth every 2 hours.
Correct Answer: B
Rationale: Noting the first bowel movement after an appendectomy is important to confirm the return of bowel function. Sitz baths, limited activity, or measuring girth are not standard post-appendectomy care. CN: Physiological adaptation; CL: Synthesize
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The nurse is providing discharge instructions to a client prescribed sulfamethoxazole-trimethoprim. Which of the following instructions should the nurse include?
- A. It is okay to stop taking this medication when you feel better.
- B. Restrict fluid intake to prevent hypertension.
- C. Increase your fluid intake while on this medication.
- D. Seek emergency care if your urine turns a dark brown.
Correct Answer: C
Rationale: Increasing fluid intake (Choice C) is important when taking sulfamethoxazole-trimethoprim to prevent crystalluria and kidney damage. Choice A is incorrect; the full course of antibiotics must be completed. Choice B is incorrect; fluid restriction is not recommended and does not prevent hypertension. Choice D is incorrect; dark brown urine is not a typical adverse effect requiring emergency care, though it should be reported.
A client is to have a cystoscopy to rule out cancer of the bladder. Which of the following indicate that the client has developed a complication after the cystoscopy?
- A. Dizziness.
- B. 2. skills.
- C. Pink-tinged urine.
- D. Bladder spasms.
Correct Answer: D
Rationale: Bladder spasms post-cystoscopy indicate a complication, often due to irritation or trauma to the bladder lining, requiring medical attention. Pink-tinged urine is expected, and dizziness may relate to other causes.
Which activity increases the risk of renal calculi?
- A. High fluid intake.
- B. Sedentary lifestyle.
- C. Low-sodium diet.
- D. Frequent urination.
Correct Answer: B
Rationale: A sedentary lifestyle promotes urinary stasis, increasing stone risk.
For a client with rib fractures and a pneumothorax, the physician prescribes morphine sulfate, 1 to 2 mg/hour, given I.V. as needed for pain. The nursing care goal is to provide adequate pain control so that the client can breathe effectively. Which of the following outcomes would indicate successful achievement of this goal?
- A. Pain rating of 0 on a scale of 0 to 10 by the client.
- B. Respiratory rate of 26 breaths/minute.
- C. PaO2 of 70 mm Hg.
- D. None of the above
Correct Answer: A
Rationale: A pain rating of 0 indicates adequate pain control, enabling effective breathing. A respiratory rate of 26 is elevated, and a PaO2 of 70 mm Hg suggests mild hypoxemia, neither confirming pain control.
The nurse is reviewing a client's preoperative checklist and notes the client has not voided in the last 6 hours. The nurse should:
- A. Insert a urinary catheter.
- B. Encourage the client to void before transport.
- C. Notify the anesthesiologist.
- D. Document the finding and proceed.
Correct Answer: B
Rationale: Encouraging the client to void prevents bladder distention during surgery and reduces the need for catheterization, which carries infection risks.