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The examiner is going to inspect and palpate for a hernia. During this exam, the man is instructed to:
- A. Hold his breath during palpation.
- B. Cough after the examiner has gently inserted the exam finger into the rectum.
- C. Bear down when the examiner’s finger is at the inguinal canal.
- D. Relax in a supine position while the exam finger is inserted into the canal.
Correct Answer: C
Rationale: The correct answer is C: Bear down when the examiner's finger is at the inguinal canal. This action increases intra-abdominal pressure, which helps to push out any potential hernia through the inguinal canal for easier detection. Holding his breath (A) would not facilitate hernia detection. Coughing after insertion (B) is used for rectal exams, not hernia assessment. Relaxing in a supine position (D) is not helpful for hernia examination as it does not aid in hernia protrusion.
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The nurse has implemented a bladder retraining
- A. Risk for deficient fluid volume related to urinary program for an older adult patient. The nurse places the diversion patient on a timed voiding schedule and performs an
- B. Risk for autonomic dysreflexia related to disruption of ultrasonic bladder scan after each voi
- C. The nurse notes the sacral plexus that the patient typically has approximately 50 mL of urine remaining in her bladder after voiding. What would
Correct Answer: A
Rationale: The correct answer is A because bladder retraining aims to improve urinary control and prevent incontinence in older adults. Implementing a timed voiding schedule helps the patient regain control over their bladder function and reduces the risk of urinary issues. Option B is incorrect as autonomic dysreflexia is not typically associated with bladder retraining. Option C is incorrect as it describes a normal bladder residual volume, which does not directly relate to bladder retraining. Option D is incomplete.
A 62-year-old man states that his physician told him that he has an “inguinal hernia.†He asks the nurse to explain what a hernia is. The nurse should:
- A. Tell him not to worry and that most men his age develop hernias.
- B. Explain that a hernia is often the result of prenatal growth abnormalities.
- C. Refer him to his physician for additional consultation because the physician made the initial diagnosis.
- D. Explain that a hernia is a loop of bowel protruding through a weak spot in the abdominal muscles.
Correct Answer: D
Rationale: Step 1: Define hernia as a condition where an organ or fatty tissue protrudes through a weak spot in the surrounding muscle or connective tissue.
Step 2: Emphasize the relevance to the patient's situation.
Step 3: Clarify that an inguinal hernia specifically involves the intestines protruding through the inguinal canal in the groin area.
Step 4: Explain that surgery may be needed to repair the hernia.
Step 5: Stress the importance of seeking medical attention for proper evaluation and treatment.
Summary:
A: Incorrect - Dismissing the patient's concerns is not appropriate.
B: Incorrect - Hernias are not typically related to prenatal growth abnormalities.
C: Incorrect - The nurse can provide basic information about hernias without needing the physician to explain further.
The mother of an 8-year-old girl has brought her child to the clinic because she is wetting the bed at night. What terminology should the nurse use when documenting this situation?
- A. Ascites
- B. Dysuria
- C. Enuresis
- D. Urgency
Correct Answer: C
Rationale: The correct terminology for bedwetting in an 8-year-old is enuresis. Enuresis specifically refers to the involuntary discharge of urine during sleep at an age where bladder control is expected. This term is appropriate for the child's situation as it accurately describes the bedwetting issue. Ascites (A) refers to abnormal accumulation of fluid in the abdomen, not related to bedwetting. Dysuria (B) is painful urination, which is not the issue described. Urgency (D) refers to a sudden compelling need to urinate, which is also not relevant to this scenario. Using the correct term, enuresis, will ensure accurate documentation and communication regarding the child's bedwetting issue.
When assessing the scrotum of a male patient, the nurse notices the presence of multiple firm, nontender, yellow 1-cm nodules. The nurse knows that these nodules are most likely:
- A. From urethritis.
- B. Sebaceous cysts.
- C. Subcutaneous plaques.
- D. COM
Correct Answer: B
Rationale: The correct answer is B: Sebaceous cysts. Sebaceous cysts are commonly seen as firm, nontender, yellow nodules in the scrotum. They are benign growths formed from blocked sebaceous glands. Urethritis (A) would present with symptoms such as pain or burning during urination, not as nodules on the scrotum. Subcutaneous plaques (C) are typically seen in conditions like Peyronie's disease, not as discrete nodules. COM (D) is not a recognized term in this context.
Desmopressin reduces urine volume in which of the following condition?
- A. Central (neurogenic) diabetes insipidus
- B. Renal (nephrogenic) diabetes insipidus
- C. Both (a) and (b)
- D. Neither (a) nor (b)
Correct Answer: A
Rationale: Desmopressin reduces urine volume by mimicking the effects of antidiuretic hormone (ADH). In central diabetes insipidus, there is a deficiency of ADH production, so desmopressin can help by supplementing ADH. In renal diabetes insipidus, the kidneys do not respond to ADH, so desmopressin would not be effective. Therefore, the correct answer is A. Choice B is incorrect because desmopressin does not address the underlying issue of kidney insensitivity to ADH. Choice C is incorrect because desmopressin is effective only in central diabetes insipidus. Choice D is incorrect because desmopressin is effective in central diabetes insipidus.