Nokea
The client asks the nurse, 'Is it really possible to lead a normal life with an ileostomy?' Which action by the nurse would be the most effective to address this question?
- A. Have the client talk with a member of the clergy about these concerns.
- B. Tell the client to worry about those concerns after surgery.
- C. Arrange for a person with an ostomy to visit the client preoperatively.
- D. Notify the surgeon of the client's question.
Correct Answer: C
Rationale: Arranging for a person with an ostomy to visit provides a relatable, firsthand perspective, addressing the client's concerns about normalcy effectively. Clergy, postponing concerns, or notifying the surgeon are less direct or supportive. CN: Psychosocial adaptation; CL: Synthesize
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A client with a history of renal calculi formation is being discharged after surgery to remove the calculus. What instructions should the nurse include in the client's discharge teaching plan?
- A. Increase daily fluid intake to at least 2 to 3 L.
- B. Strain urine at home regularly.
- C. Eliminate dairy products from the diet.
- D. Follow measures to alkalinize the urine.
Correct Answer: A,B
Rationale: High fluid intake (2-3 L) prevents stone recurrence, and straining urine monitors for stone passage. Dairy restriction or urine alkalinization depends on stone type.
A client who has a history of Crohn's disease is admitted to the hospital with fever, diarrhea, cramping, abdominal pain, and weight loss. The nurse should monitor the client for:
- A. Hyperalbuminemia.
- B. Thrombocytopenia.
- C. Hypokalemia.
- D. Hypercalcemia.
Correct Answer: C
Rationale: Crohn's disease with diarrhea can lead to hypokalemia due to potassium loss in stool. Hyperalbuminemia and hypercalcemia are not typical, and thrombocytopenia is less directly related to these symptoms. CN: Physiological adaptation; CL: Analyze
A client with osteoporosis needs education about diet and ways to increase bone density. Which of the following should be included in the teaching plan? Select all that apply.
- A. Maintain a diet with adequate amounts of vitamin D, as found in fortified milk and cereals.
- B. Choose good calcium sources, such as figs, broccoli, and almonds.
- C. Use alcohol in moderation because a moderate intake has no known negative effects.
- D. None of the above
Correct Answer: A,B
Rationale: Vitamin D and calcium are essential for bone health. Excessive alcohol can reduce bone density, so moderation alone is insufficient.
A client with pneumonia is experiencing pleuritic chest pain. The nurse should assess the client for:
- A. A mild but constant aching in the chest.
- B. Severe midsternal pain.
- C. Moderate pain that worsens on inspiration.
- D. Muscle spasm pain that accompanies coughing.
Correct Answer: C
Rationale: Pleuritic chest pain is sharp or moderate and worsens with inspiration due to inflamed pleura. Constant aching, midsternal pain, or muscle spasm pain are not characteristic of pleurisy.
The client admitted with peripheral vascular disease (PVD) asks the nurse why her legs hurt when she walks. The nurse bases a response on the knowledge that the main characteristic of PVD is:
- A. Decreased blood flow
- B. Increased blood flow
- C. Slow blood flow
- D. Thrombus formation
Correct Answer: A
Rationale: The hallmark of PVD is decreased blood flow due to arterial narrowing from atherosclerosis or other occlusive processes. This reduced flow causes ischemia, leading to claudication (pain during walking) that is relieved by rest. Increased or slow blood flow and thrombus formation are not the primary characteristics.