Nokea
The nurse is developing a plan for bowel and bladder retraining for a client with paraplegia. The primary goal of a bowel and bladder retraining program is:
- A. Optimal restoration of the client's elimination pattern
- B. Restoration of the client's neurosensory function
- C. Prevention of complications from impaired elimination
- D. Promotion of a positive body image
Correct Answer: C
Rationale: The primary goal is to prevent complications like infections or skin breakdown by establishing effective bowel and bladder management.
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A client seen in the emergency department for influenza asks for an antibiotic prescription. Which of the following guidelines are important in helping the client decrease the risk of developing an antibiotic-resistant infection? Select all that apply.
- A. Stop taking antibiotics as soon as symptoms subside.
- B. Do not take antibiotics for viral infections, as they do no good.
- C. Do not take preventive antibiotics to avoid infection.
- D. Follow prescription directions when taking antibiotics.
- E. Take the same antibiotic for every infection.
Correct Answer: B,C,D
Rationale: Avoid antibiotics for viral infections (B), avoid prophylactic antibiotics (C), and follow prescription directions (D) reduce resistance. Stopping early (A) or reusing antibiotics (E) promotes resistance.
Two nurses are preparing to pull a client up in the bed. Which actions by the nurses are correct in regard to safe client handling? Select all that apply.
- A. place the bed in the lowest position possible
- B. ask the client to cross her arms over her chest if she is able
- C. use a patient lifting device, such as a Hoyer lift, if needed
- D. extend the elbows out away from the body while pulling client up
- E. place the head of the bed flat or slightly Trendelenburg if the client can tolerate it
Correct Answer: B, C, E
Rationale: Asking the client to cross arms, using a lifting device if needed, and flattening the bed or using slight Trendelenburg promote safe handling. The bed should be at working height, and elbows should stay close to the body.
Before administering a client's morning dose of Lanoxin (digoxin), the nurse checks the apical pulse rate and finds a rate of 54. The appropriate nursing intervention is to:
- A. Record the pulse rate and administer the medication
- B. Administer the medication and monitor the heart rate
- C. Withhold the medication and notify the doctor
- D. Withhold the medication until the heart rate increases
Correct Answer: C
Rationale: A pulse rate below 60 bpm is a contraindication for digoxin administration due to the risk of worsening bradycardia, so the nurse should withhold the dose and notify the physician.
The client is admitted for an open reduction internal fixation of a fractured hip. Immediately following surgery, the nurse should give priority to assessing the:
- A. Serum collection (Davol) drain
- B. Client's pain
- C. Nutritional status
- D. Immobilizer
Correct Answer: B
Rationale: Pain assessment is a priority post-surgery to manage discomfort and detect complications.
A client with myasthenia gravis is admitted in a cholinergic crisis. Signs of of cholinergic crisis include:
- A. Decreased blood pressure and constricted pupils
- B. Increased heart rate and increased respirations
- C. Increased respirations and increased blood pressure
- D. Anoxia and absence of the cough reflex
Correct Answer: A
Rationale: Cholinergic crisis, due to excessive acetylcholinesterase inhibitors, causes symptoms like constricted pupils and decreased blood pressure from parasympathetic overstimulation.