ELIMINATION

A nurse is caring for a client with an average heart rate of 56 beats/min. The client has no adverse symptoms associated with this heart rate and is receiving no treatment. Which activity modification should the nurse suggest to avoid further slowing of the heart rate? "Avoid stress or overexcitement." "Avoid bearing down while having a bowel movement." "Avoid strenuous aerobic exercise." "Limit your intake of caffeinated drinks."

"Avoid bearing down while having a bowel movement." Bearing down during a bowel movement stimulates the vagus nerve and results in a slowing of the heart rate

Because they strengthen the pelvic floor muscles, Kegel exercises are most likely to help which urinary problem? Overflow incontinence Urge incontinence Stress incontinence Mixed incontinence

Stress incontinence

A client with constipation takes psyllium granules as 1 rounded teaspoon mixed in fruit juice 3 times daily. Which of the following statements by the client indicates that further teaching is required? "I will mix this medication with at least 8 oz (240 mL) of water or juice immediately before taking it." "I will check for soft to semi-liquid stools being passed within 1 to 3 days of taking this medication." "I will drink 6 to 10 glasses of water or juice daily when taking this laxati

"I will need to take the medication for 4 weeks." Psyllium is a bulk-forming laxative used to treat constipation. It absorbs liquid in the intestines, swells, and forms a bulky, easy-to-pass stool. Psyllium comes in the following forms: powder, granules, capsule, liquid, and wafer to take by mouth. It is usually taken 1 to 3 times daily. It should not be taken for more than 1 week unless advised.

In a class teaching new parents basic information on how to care for their new infant, the nurse should suggest that the parents plan to use how many diapers on a daily basis? 10 8 6 12

10

A client has not voided for 8 hours after surgery. Which finding indicates the client has a distended bladder? A bulge between the symphysis pubis and the umbilicus A bulge over the costovertebral region of the flank A bulge in the left lower quadrant of the abdomen A bulge between ribs 11 and 12 and the umbilicus

A bulge between the symphysis pubis and the umbilicus

The hospital nurse is caring for a group of adult clients. For which client should the nurse most likely administer prophylactic anti-infectives? A client with colorectal cancer who is preoperative for a bowel resection A client with diabetic nephropathy who has recently begun dialysis A client who has hyperkalemia and who is receiving sodium polystyrene A client who is undergoing cardiac rehabilitation following a myocardial infarction

A client with colorectal cancer who is preoperative for a bowel resection Abdominal surgery is a common indication for antibiotic prophylaxis, since these surgeries present a significant risk for infection. For this reason, a preoperative client would be more likely to need prophylaxis than a client who has had an MI, a client with renal failure or a client with an electrolyte imbalance.

An adult has a serum sample taken to evaluate the BUN-creatinine ratio. Select the result that indicates a normal test. BUN 10 mg/dL (3.57 mmol/L) to creatinine 1 mg/dL (88.40 µmol/L) BUN 25 mg/dL (8.92 mmol/L) to creatinine 1 mg/dL (88.40 µmol/L) BUN 30 mg/dL (10.71 mmol/L) to creatinine 2.5 mg/dL (221.0 µmol/L) BUN 40 mg/dL (14.28 mmol/L) to creatinine 2 mg/dL (176.80 µmol/L)

BUN 10 mg/dL (3.57 mmol/L) to creatinine 1 mg/dL (88.40 µmol/L) The BUN-creatinine ratio is approximately 10:1. The other results, ratios greater than 15:1, represent prerenal conditions, such as congestive heart failure and upper gastrointestinal bleeding, that produce an elevation in BUN not creatinine.

Which occurrence is most likely to cause increased urination? Decrease in antidiuretic hormone Activation of angiotensin Decrease in glomerular filtration rate Increased secretion of aldosterone

Decrease in antidiuretic hormone

A female client is diagnosed with recurrent urinary tract infections (UTIs) and the nurse is providing education about preventative methods. What information is important for the nurse to give to the client to prevent another UTI? Select all that apply. Dry the perineal area after urination or defecation from the back to the front. Take baths instead of showers. Drink two 8-oz glasses (480 mL) of water before and after sexual intercourse and void immediately after intercourse. Wear underwear

Drink two 8-oz glasses (480 mL) of water before and after sexual intercourse and void immediately after intercourse. Wear underwear with a cotton crotch. Avoid clothing that is tight and restrictive on the lower half of the body.

The nurse is preparing to administer an antidiarrheal to a client. The nurse will question this order if which organism is documented on the stool sample report? Select all that apply. Staphylococcus Shigella Salmonella Streptococcus Escherichia coli

Escherichia coli Shigella Salmonella

A client in her 39th week of gestation arrives at the maternity clinic stating that earlier in her pregnancy, she experienced shortness of breath. However, for the past few days, she has been able to breathe easily, but she has also begun to experience increased urinary frequency. A nurse is assigned to perform the physical examination of the client. Which observation is most likely? Fundal height has dropped since the last recording. Fundal height is at its highest level at the xiphoid process

Fundal height has dropped since the last recording.

A client who is legally blind had orthopedic surgery 3 days ago and wants to urinate. She is using a walker for ambulation. It would be best for the nurse to Place a bedside commode next to the bed. Guide the client's hand to the armrest on the bedside commode prior to the client sitting on the commode. Obtain assistance of another staff member and not have the client use the walker. Assist the client in using a bedpan.

Guide the client's hand to the armrest on the bedside commode prior to the client sitting on the commode.

A nurse who provides care on a pediatric unit of a hospital is aware that the potential for harm as a result of drug errors is higher among infants and children than adults. This fact is primarily due to: the inability of infants and children and describe symptoms of adverse drug reactions. increased body surface area relative to body volume in infants and children. increased heart rate and subsequently rapid drug distribution among infants and children. immature liver and kidney function in in

Immature liver and kidney function in infants and children.

Penicillins and cephalosporins are used cautiously in neonates due to what factor? Immature liver function Immature immune function Immature kidney function Immature pancreatic function

Immature liver function

A male client reports awakening three to four times nightly to void, and often has a sudden need to void with little warning during the day. What is this client's most likely diagnosis and possible underlying pathophysiologic problem? Stress incontinence due to damage to central nervous system inhibitory pathways Overactive bladder that may result from both neurogenic and myogenic sources Overactive bladder due to intravesical pressure exceeding urethral pressure Overflow incontinence that c

Overactive bladder that may result from both neurogenic and myogenic sources The client's reports are typical of overactive bladder, a condition that can result from the interaction of both nervous control of bladder emptying and the muscles of the bladder itself.

One form of renal tubular acidosis (RTA) results from aldosterone deficiency or resistance to its action, which leads to impaired reabsorption of which electrolyte? Sodium Potassium Hydrogen Glucose

Sodium

Following percutaneous nephrolithotomy, the client is at greatest risk for which nursing diagnosis? Risk for altered urinary elimination Risk for deficient knowledge: self-catherization Risk for fluid volume excess Risk for infection

Risk for infection

A caregiver brings her 7-year-old son to the pediatrician's office, concerned about the child's bedwetting after being completely toilet trained even at night for over 2 years. The caregiver further reports that the child has wet the bed every night since returning home from a 1-week fishing trip. The child refuses to talk about the bedwetting. The nurse notes the child is shy, skittish, and will not make eye contact. Further evaluation needs to be done to rule out what possible explanation for

The child has been sexually abused, maybe on the fishing trip.

Which is a true statement regarding regional enteritis (Crohn's disease)? It has a progressive disease pattern. It is characterized by pain in the lower left abdominal quadrant. The clusters of ulcers take on a cobblestone appearance. The lesions are in continuous contact with one another.

The clusters of ulcers take on a cobblestone appearance.

A busy 45-year-old female executive has been diagnosed with diverticulitis. Her primary treatment is an increase in the fiber content of her diet. What effect will the fiber have on the diverticula? The fiber cleans out the diverticula, allowing for a remittance of inflammation. The fiber pulls water into the colon, increasing the intraluminal pressure, ensuring that fecal material will not become stagnant. The fiber increases bulk, promotes regular defecation, and increases colonic contents

The fiber increases bulk, promotes regular defecation, and increases colonic contents and colon diameter, thereby decreasing intraluminal pressure.

Which clinical finding should a nurse look for in a client with chronic renal failure? Hypotension Uremia Metabolic alkalosis Polycythemia

Uremia

The nurse is caring for several clients who are being treated with adrenergic antagonists. Which client is most likely to benefit from the administration of tamsulosin? a 76-year-old male client with urinary hesitation and nocturia an 81-year-old client admitted with pulmonary edema and exacerbation of heart failure a 66-year-old male client with a history of ischemic heart disease and worsening anginal pain a 58-year-old female client with narrow-angle glaucoma and recent loss of visual acuity

a 76-year-old male client with urinary hesitation and nocturia Tamsulosin is used to treat benign prostatic hyperplasia, not heart failure, glaucoma, or angina.

A nurse is teaching a new mother about intussusception. Which signs and symptoms should the nurse include? abdominal distension and vomiting hard black stools high fever and loss of appetite loss of bowel sounds

abdominal distension and vomiting Intussusception occurs when a portion of the bowel slides into the next, like the pieces of a telescope. When this occurs it can create a blockage in the bowel, with the walls of the intestines pressing against one another. This leads to abdominal swelling, inflammation, and decreased blood flow to the part of the intestines involved

An older adult client expresses concern about straining to pass stools that are small and hard. What term will the health care provider use to document this in this client's chart? Constipation Diverticulosis Irritable bowel syndrome Dehydration

constipation

A client with a history of renal insufficiency is experiencing a flare-up of his arthritis and he has increased his daily dose of ibuprofen (an NSAID). Knowing the effect that ibuprofen has on prostaglandin synthesis, the nurse should anticipate: excess blood and clots in the urine. decrease renal blood flow resulting in decrease in urine output. an angiotensin II effect resulting in higher blood pressure readings. large amounts of undiluted urine.

decrease renal blood flow resulting in decrease in urine output.

The nurse is caring for a client with polydipsia and large amounts of urine with a specific gravity of 1.003. Which disorder is anticipated? diabetes mellitus diabetes insipidus diabetic ketoacidosis SIADH secretion

diabetes insipidus Diabetes insipidus is characterized by a great thirst (polydipsia) and large amounts of dilute, watery urine with a specific gravity of 1.001 to 1.005

Which are anticholinergic side effects that may occur with the use of antipsychotic drugs? Select all that apply. dry mouth constipation urinary retention diarrhea runny nose

dry mouth constipation urinary retention

A client has been diagnosed with an uncomplicated urinary tract infection (UTI) for the second time in a year. Which teaching will the nurse include to prevent the most common cause of recurrent uncomplicated UTIs? proper handwashing to decrease amount of Pseudomonas growing on the hands hygiene practices to reduce exposing the urethral meatus to Escherichia coli wearing gloves when wiping perineum after defecation to prevent Staphylococcusaureus infection washing hands prior to inserting a tam

hygiene practices to reduce exposing the urethral meatus to Escherichia coli

A client's last bowel movement was 4 days ago and oral laxatives and dietary changes have failed to prompt a bowel movement. How should the nurse position the client in anticipation of administering a cleansing enema? left side-lying prone right side-lying supine

left side-lying When administering a cleansing enema, the client is most often positioned in a left side-lying (Sims') position

A client with influenza is prescribed a diet that is rich in fiber and carbohydrates. Which would the nurse incorporate into the education plan as a major reason for the high fiber diet? production of hemoglobin to carry oxygen to tissues regulation of osmotic pressure in the blood maintenance of normal bowel elimination promotion of energy storage in adipose tissue

maintenance of normal bowel elimination

A nurse is caring for a client on the second day postpartum. The client informs the nurse that she is voiding a large volume of urine frequently. Which factor should the nurse identify as a potential cause for urinary frequency? urinary overflow postpartum diuresis urinary tract infection trauma to pelvic muscles

postpartum diuresis

An 86-year-old client is being treated for dehydration and hyponatremia after curtailing fluid intake to prevent urinary incontinence. Given these findings, the nurse recognizes that this client is likely in what phase of acute kidney injury? prerenal postrenal intrinsic intrarenal

prerenal

The nurse working in a clinic is assessing a 33-year-old male client. Click to highlight the findings that will require follow-up. The client reports recent increase in lethargy, and shortness of breath with activity. The nurse performs a comprehensive assessment. Findings reveal pale, cool skin; weak pulses bilaterally; and delayed capillary refill time. Vital signs include: temperature, 97.7°F (36.5°C); heart rate, 95 beats/min; blood pressure, 110/65 mm Hg; respiratory rate, 16 breaths/min

recent increase in lethargy, and shortness of breath with activity. pale, cool skin; weak pulses bilaterally; and delayed capillary refill time. oxygen saturation, 93% on room air. reports dark, tarry stools for the past month.

A major complication of prolonged bed rest is an increased risk of kidney stones. The nurse knows that this is most likely related to: saturation of urine with calcium salts. a limited access to fluids while hospitalized. increased urine levels of citrate. frequency of urination.

saturation of urine with calcium salts.

A nurse is caring for a 55-year-old postoperative client. The client returns to the ICU after surgery intubated and mechanically ventilated with a Salem sump nasogastric tube, a Foley catheter, and a PICC line in place. Based on the nurse's knowledge of the most common hospital-acquired infections, which apparatus is most important to remove first? urinary catheter PICC line Salem sump nasogastric tube endotracheal tube

urinary catheter

A 4-year-old child with a urinary tract infection is scheduled to have a voiding cystourethrogram. When preparing the child for this procedure, the nurse would want to prepare the child to: have a local anesthetic injected prior to the procedure. drink three glasses of water during the procedure. void during the procedure. anticipate a headache afterward.

void during the procedure.

Which finding would alert the nurse to suspect that a client has a yeast infection? changes in skin color vulvar burning and itching lymphadenopathy acidic vaginal secretions

vulvar burning and itching The primary symptom of a yeast infection is burning and itching on the vulva or in the vagina.

For a normal adult, the client will sense fullness of the bladder when the bladder contains what amount of urine? 100 to 150 mL 200 to 250 mL 300 to 350 mL 400 to 500 mL

400 to 500 mL

A client reports not having a bowel movement for 7 days, followed by a day of small, loose stools. How does the nurse define the health problem? Constipation related to irregular evacuation patterns Readiness for Enhanced Nutrition related to constipation Bowel incontinence related to depressive state Diarrhea related to client report of small, loose stools

Constipation related to irregular evacuation patterns

The nursing instructor who is teaching about disorders of the lower urinary tract realizes a need for further instruction when one of the students makes which statement? "Alterations in bladder function can include urinary obstruction with retention or stasis of urine." "Alterations in bladder function can include urinary incontinence with involuntary loss of urine." "Alterations in bladder function can only occur when there is incontinence." "Alterations in bladder function occurs frequently i

Alterations in bladder function can only occur when there is incontinence."

The nurse is helping a client who experiences frequent constipation select meal choices for the day. Which food should the nurse encourage the client to order? Bananas Applesauce Bran cereal Pop-Tart

Bran cereal

An adult female client has been diagnosed with cystitis. Which symptoms reported by the client does the nurse recognize are significant for cystitis? Select all that apply. Burning and pain with urination Severe, upper-right flank pain Frequency of urination Lower abdominal and back discomfort Fever

Burning and pain with urination Severe, upper-right flank pain Lower abdominal and back discomfort

Which statements are true concerning sleepwalking? Select all that apply. Common in children between ages of 5 and 12 Individual is unaware of leaving the bed to walk May urinate in odd places like closets or waste baskets More likely to occur in Stage 1 of the sleep cycle Individual will return to bed when verbally encouraged to do so

Common in children between ages of 5 and 12 Individual is unaware of leaving the bed to walk May urinate in odd places like closets or waste baskets

A teenager is admitted for complications resulting from bulimia nervosa. The nurse's admission assessment should pay close attention to which manifestations relating to complications associated with this disorder? Select all that apply. Dry, cracked lips and poor skin turgor. Missing tooth enamel and increased number of dental caries. Painful swallowing and stomach cramping related to reflux and esophagitis. Fruity breath and labored, deep, gasping respirations. Painless enlargement of the pa

Dry, cracked lips and poor skin turgor. Missing tooth enamel and increased number of dental caries. Painful swallowing and stomach cramping related to reflux and esophagitis. Painless enlargement of the parotid gland due to vomiting.

The client with a diagnosis of heart failure reports frequently awakening during the night with the need to urinate. What explanation will the nurse offer to explain the urination? Edema is collected in dependent extremities during the day; at night when the client lays down, it is reabsorbed into the circulation and excreted by the kidneys. When the client is in the recumbent position, more pressure is put on the bladder, with the result of increased need to urinate. The blood pressure is lo

Edema is collected in dependent extremities during the day; at night when the client lays down, it is reabsorbed into the circulation and excreted by the kidneys.

A client with Crohn's disease is scheduled for a barium enema. What should the plan of care include today to prepare for the test tomorrow? Serve the client a regular diet. Order a high-fiber diet. Encourage plenty of fluids. Include low-fat dairy products in the evening meal.

Encourage plenty of fluids.

A nurse is caring for a client with Alzheimer disease who was admitted to the hospital from a nursing home. The hospital staff is having difficulty managing the client's urinary incontinence because the client wanders around the unit all day. What is the mostappropriate action by the nurse to assist with elimination? Incorporate a toileting schedule into the pattern of the client's wandering. Ask the health care provider to prescribe sedation to allow the client to rest. Teach the client Kege

Incorporate a toileting schedule into the pattern of the client's wandering.

A health care provider has prescribed a loop diuretic for a client with hypertension. The client also has diabetes mellitus. What condition should the nurse monitor for in this client after administering the prescribed drug? Sudden pain in the joints Increased blood glucose levels Occurrence of gout attacks Sudden increase in weight

Increased blood glucose levels The nurse should monitor for increased blood glucose levels in the diabetic client receiving a loop diuretic. The blood glucometer test results for these clients may be elevated, or urine may test positive for glucose.

A nurse is assessing a postpartum client. Which measure is appropriate? Place the client in a supine position with her arms overhead for the examination of her breasts and fundus. Instruct the client to empty her bladder before the examination. Wear sterile gloves when assessing the pad and perineum. Perform the examination as quickly as possible.

Instruct the client to empty her bladder before the examination.

While not being designated as endocrine glands, several organs within the body secrete hormones as part of their normal function. Which organ secretes hormones that are involved in increasing blood pressure and volume and maturation of red blood cells? Kidneys Cardiac atria Placenta Liver

Kidneys The kidneys release renin, a hormone that initiates the production of angiotensin and aldosterone to increase blood pressure and blood volume. The kidneys also secrete erythropoietin, a substance that promotes the maturation of red blood cells.

The nurse is caring for a patient in the oliguric phase of acute kidney injury (AKI). What does the nurse know would be the daily urine output? 1.5 L 1.0 L Less than 400 mL Less than 50 mL

Less than 400 mL

Which are functions of the digestive system? Select all that apply. Nutrients are absorbed. Wastes are collected. Wastes are eliminated. Vitamins are synthesized. Insulin is produced. Red blood cells are produced.

Nutrients are absorbed. Wastes are collected. Wastes are eliminated. Vitamins are synthesized.

The nurse has delegated obtaining a urine specimen for testing to the nursing assistant. What does the nurse emphasize the assistant should do to ensure accuracy of testing? Obtain a freshly voided specimen. Encourage the client to drink water prior to obtaining the specimen. Teach the client the purpose of the test. Record the volume of urine obtained in the medical record.

Obtain a freshly voided specimen.

As a nursing student is visiting a day care to observe growth and development in action. The nursing student completes assessments on infants and toddlers who are learning to walk, talk, and control elimination. According to Freud, in what developmental stage are they? Trust versus mistrust Relationships and events Oral; anal Phallic; genital

Oral; anal

A nurse is caring for a client in spinal shock. Which intervention is appropriate in relation to the client's urinary status? Perform intermittent catheterization Assess bowel sounds Perform a urine culture Palpate the lower abdomen

Perform intermittent catheterization After a spinal cord injury, the early effects on bladder function are quite different from those that follow recovery from the initial injury. During the period immediately after spinal cord injury, a state of spinal shock develops, during which all the reflexes, including the micturition reflex, are depressed. The bladder is atonic and cannot contract. Intermittent catheterization is necessary to prevent injury to urinary structures associated with overdistension of the bladder.

The health care provider orders a urinalysis on a 15-month-old toddler. The mother states that the child is not potty-trained. What is the best way for the nurse to collect the specimen? Observe the child for signs he needs to urinate and quickly pull the diaper down and catch the urine when he voids. Place a urine collection bag on the child after cleaning off the perineum. Clean off the penis with a commercial cleaning pad and catheterize the client. Aspirate urine out of the diaper with a sy

Place a urine collection bag on the child after cleaning off the perineum.

A client is scheduled for a colonoscopy. The nurse knows that the preferred drug for bowel cleansing before this procedure is: Polyethylene glycol-electrolyte solution (NuLYTELY) Polyethylene glycol solution (MiraLAX) Bisacodyl (Dulcolax) Psyllium (Metamucil)

Polyethylene glycol-electrolyte solution (NuLYTELY)

A client diagnosed with chronic kidney disease (CKD) with GFR < 5 mL/min/1.73 m2 should be monitored for which fluid and electrolyte imbalance? Select all that apply. Polyuria Hyperkalemia Metabolic alkalosis Hypocalcemia Hyponatremia

Polyuria Hyperkalemia Hypocalcemia Hyponatremia The failing kidneys lose ability to concentrate urine and to reabsorb sodium. Hyperkalemia develops late in CKD, as nephrons can no longer regulate potassium excretion and GFR < 5 mL/min/1.73 m2. Metabolic acidosis occurs when balance between sodium and bicarbonate is lost. Hypocalcemia develops as excretion of phosphate fails and blood levels of phosphate rise.

A 71-year-old client reports to the nurse that he often notices a pink tinge to his urine. Upon further questioning, he states that he experiences no pain when voiding and has not noticed any change in the frequency of his voiding. Which response by the nurse is best? Perform intermittent catheterization to obtain a sterile urine specimen. Instruct the client to avoid eating beets and berries to see if the issue resolves. Encourage the client to record a "voiding log" for the next several d

Promptly report this finding to the client's health care provider.

The nurse would be most concerned when the glomerular filtrate contains: Protein Sodium Potassium Water

Protein The glomerular filtrate has a chemical composition similar to plasma, but it contains almost no proteins because large molecules do not readily cross the glomerular wall. Potassium, sodium, and water would be filtered.

The client has been prescribed diphenoxylate with atropine (Lomotil) for diarrhea. The nurse recognizes that this drug is effective against diarrhea because of which action? Slows peristalsis by acting on the smooth muscles of the intestine Anti-inflammatory effects allowing absorption of fluids Antimicrobial effects Decreases GI secretions

Slows peristalsis by acting on the smooth muscles of the intestine

A client diagnosed with a cerebrovascular accident (CVA) 5 months prior is now experiencing episodes of urinary incontinence. The client asks, "Why is this happening?" Which statement best captures the facts that would underlie the answer to this question? Flaccid bladder dysfunction as a result of neurologic disease like a stroke Unable to sense bladder filling as a result of the stroke Lesions to the basal ganglia or extrapyramidal tract associated with stroke inhibit detrusor contraction Pat

Unable to sense bladder filling as a result of the stroke

A client is being treated with colchicine for pain in the big right toe. The client begins to complain of severe right flank pain and is diagnosed with kidney stones. Which type of kidney stone does the nurse recognize this client is most likely affected by? Magnesium ammonium phosphate Cystine Calcium Uric acid

Uric acid

The nurse is teaching the caregiver of an older adult client about urinary incontinence. What statement should the nurse make to the caregiver about urinary incontinence in the older adult? Urinary incontinence should be accepted as a relatively normal part of aging. Urinary incontinence has many causes and can often be improved with intervention. Among older adults, urinary incontinence is most often a sign of depression. Being incontinent can increase the client's risk for dehydration and conf

Urinary incontinence has many causes and can often be improved with intervention.

The nurse is caring for a client with an indwelling urinary catheter secondary to neurogenic bladder. The nurse completes a prescription to obtain a urine specimen from the catheter. After reviewing the image, what is the most accurate narrative note the nurse would document to demonstrate the steps to obtain the urine specimen were performed appropriately? Cleansed access port with warm soap and water, syringe attached and aspirated 10 mL of urine and placed in specimen container. Verified pr

Verified prescription, cleansed access port with antiseptic swab, aspirated urine from access port into sterile specimen container, client tolerated procedure well.

The nurse is explaining the pharmacokinetics of a drug being administered to a client. What is meant by the term "pharmacokinetics?" route of administration movement of drugs through the body treatment of overdoses dosages of drugs

movement of drugs through the body

The nurse walks into a room and finds the client forcefully expelling stomach contents into a wash basin. When documenting this occurrence, the nurse will use the term: Nauseous Retching Vomiting Expatriate

vomiting