the nurse is caring for a client with Caron's disease who develops a fever and symptoms of a urinary tract infection (UTI) with tan, feral-smelling urine. which of the following information should the nurse teach the client?
a. about the effects of corticosteroid use on immune function
b. to em...
the nurse is caring for a client with Caron's disease who develops a fever and symptoms of a urinary
tract infection (UTI) with tan, feral-smelling urine. which of the following information should the nurse
teach the client?
a. about the effects of corticosteroid use on immune function
b. to empty the bladder before and after sexual intercourse
c. about fistula formation between the bowel and bladder
d. to clean the perineal area carefully after any stools - correct answer c. about fistula formation
between the bowel and bladder
rationale: fistulas between the bowel and bladder occur in chrons disease and can lead to UTI. there is
no information indicating that the client's risk for UTI is caused by poor cleaning or not voiding before
and after intercourse. steroid use may increase the risk for infection, but the characteristics of the
client's urine indicate that a fistula has occurred.
during the initial postoperative assessment of a clients stoma formed from a transverse colostomy. the
nurse finds it to be deep pink with moderate oedema and a small amount of bleeding. which of the
following actions should the nurse take based upon these findings?
a. place an ice pack on the stoma to reduce swelling
b. notify the surgeon about the stoma appearance
c. document the stoma assessment
d. monitor the stoma every 30 minutes - correct answer c. document the stoma assessment
rationale: the stoma appearance indicates good circulation to the stoma. there is no indication that
surgical intervention is needed or that frequent stoma monitoring is required. swelling of the stoma is
normal for 2-3 weeks after surgery and an ice pack is not needed.
,the home health nurse is providing teaching a clients and family about how to use glargine and regular
insulin safely. Which of the following nursing actions by the client indicated that the teaching has been
successful?
a. the client administers glargine 30-45 minutes before eating each meal
b. the client's family fills the syringes weekly and stores them in the refrigerator
c. the client draws up the regular insulin and then glargine in the same syringe
d. the client disposes of the open vial of glargine and regular insulin after 4 weeks - correct answer d.
the client disposes the open vials of glargine and regular insulin after 4 weeks
rationale: insulin can be stored at room temperature for 4 weeks. glargine should not be mixed with
other insulins or pre-filled and stored. short acting regular insulin is administered before meals, while
glargine is given once daily.
a client is suspected of having a pituitary tumour causing panhypopituitarism. during assessment of the
client, which of the following findings should the nurse anticipate?
a. high blood pressure
b. changes in secondary sex characteristics
c. elevated blood glucose - correct answer b. changes in secondary sex characteristics
which of the following information about a client who has just been admitted to the hospital with
nausea and vomiting requires the most rapid intervention by the nurse?
a. the client has taken only sips of water
b. the client has been vomiting for several times a day for the last 4 days
c. the client is lethargic and difficult to arouse
d. the clients chart indicates a recent reaction of the small intestine - correct answer c. the client is
lethargic and difficult to arouse
,rationale: a lethargic client is at risk for aspiration, and the nurse will need to position the client to
decrease aspiration risk. the other information also is important to collect, but it does not require as
quick action as the risk for aspiration.
the nurse is caring for a client with Crohn's disease who has megaloblastic anemia. which of the
following medications should the nurse anticipate teaching the client about taking on an ongoing basis?
a. regular blood transfusions
b. cobalamin (B12) nasal spray or injections
c. oral ferrous sulphate tablets
d. iron dextran (imferon) infusion - correct answer b. cobalamin (B12) nasal spray or injections
rationale: Crohn's disease frequently affects the ileum. where absorption of cobalamin occurs, and it
must be administered regularly by nasal spray or IM to correct the anemia. iron deficiency does not
cause megaloblastic anemia. the client may need occasional transfusion but not regularly scheduled
transfusions.
the health care provider prescribes antacids for treatment of a clients peptic ulcer. which of the
following information should the nurse include in the clients teaching plan?
a. sucralfate and antacids together 30 minutes before each meal
b. antacids after eating and sucralfate 30 minutes before eating
c. sucralfate at bedtime and antacids before meals
d. antacids 30 minutes before the sucralfate - correct answer b. antacids after eating and sucralfate 30
minutes before eating
rationale: sucralfate is most effective when the pH is low and should not be given with or soon after an
antacid. antacids are most effective when taken after eating. administration of sucralfate 30 minutes
before eating will ensure that both drugs can be the most effective. the other regimens will decrease the
effectiveness of the medications
the nurse is caring for a client who has an adrenocortical adenoma and hyperaldosteronism. which of
the following actions should the nurse implement?
, a. evaluate blood glucose level every 4 hours
b. monitor the blood pressure every 4 hours
c. maintain extremities in an elevated position
d. provide a potassium-restricted diet - correct answer b. monitor the blood pressure every 4 hours
hypertension caused by sodium retention is a common complication of hyperaldosteronism.
hyperaldosteronism does not cause an elevation in blood glucose. the client will be hypokalemic and
require potassium supplementation before surgery. edema does not usually occur hyperaldosteronism.
the nurse is caring for an older-adult client who is diagnosed with hypothyroidism and has a prescription
for levothyroxine. which of the following assessments is most important for the nurse to make during
initiation of thyroid replacement?
a. nutritional intake
b. apical pulse
c. orientation and alertness
d. intake and output - correct answer b. apical pulse rate
in older clients. initiation of levothyroxine therapy can increase myocardial oxygen demand and cause
angina or dysrhythmias. the medication is also expected to improve mental status and fluid balance and
will increase metabolic rate and nutritional needs, but these changes will not result in potentially life-
threatening complications.
which of the following actions should be included in the plan of care for a male client with bowel
irregularity and a new diagnosis of irritable bowel syndrome (IBS)?
a. encourage the client to express feelings and ask questions about IBS
b. teach the client to avoid using nonsteroidal anti-inflammatory drugs (NSAIDs)
c. suggest that the client increase the intake of milk and other dairy products
d. educate the client about the use of tegaserod to reduce symptoms - correct answer a. encourage the
client to express feelings and ask questions about IBS
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