Nokea
When planning care for a client with ulcerative colitis who is experiencing symptoms, which client care activities can the nurse appropriately delegate to a unlicensed assistant?
- A. Assessing the client's bowel sounds
- B. Providing skin care following bowel movements
- C. Evaluating the client's response to antidiarrheal medications
- D. administration of pain medication every 4 hours
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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Claire, a 33 y.o. is on your floor with a possible bowel obstruction. Which intervention is priority for her?
- A. Obtain daily weights.
- B. Measure abdominal girth.
- C. Keep strict intake and output.
- D. Encourage her to increase fluids.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Glenda has cholelithiasis (gallstones). You expect her to complain of:
- A. Pain in the right upper quadrant, radiating to the shoulder.
- B. Pain in the right lower quadrant, with rebound tenderness.
- C. Pain in the left upper quadrant, with shortness of breath.
- D. Pain in the left lower quadrant, with mild cramping.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Hepatic encephalopathy develops when the blood level of which substance increases?
- A. Ammonia
- B. Amylase
- C. Calcium
- D. Potassium
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Leigh Ann is receiving pancrelipase (Viokase) for chronic pancreatitis. Which observation best indicates the treatment is effective?
- A. There is no skin breakdown.
- B. Her appetite improves.
- C. She loses more than 10 lbs.
- D. Stools are less fatty and decreased in frequency.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
An intubated patient is receiving continuous enteral feedings through a Salem sump tube at a rate of 60ml/hr. Gastric residuals have been 30-40ml when monitored Q4H. You check the gastric residual and aspirate 220ml. What is your first response to this finding?
- A. Notify the doctor immediately.
- B. Stop the feeding, and clamp the NG tube.
- C. Discard the 220ml, and clamp the NG tube.
- D. Give a prescribed GI stimulant such as metoclopramide (Reglan).
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.