PREP-U Quiz Exam 5 Periop and Elimination
Which statement, if made by an adolescent preparing for abdominal surgery, would indicate to the nurse that the client requires additional instruction?
"I can have a hamburger and French fries as soon as I wake up." Chapter 29: Perioperative Nursing - Page 892-893
A postoperative client states "I don't understand why you are checking my skin on my back. My surgery was on my stomach." What is the nurse's best response?
"The operating table is a firm surface; we need to be sure your skin looks okay." Chapter 29: Perioperative Nursing - Page 867
The procedural physician has initiated performance of a time-out in the operating room before surgery. The student nurse asks the operating room nurse why this is important. What is the operating room nurse's best response?
"The time-out checks to be sure that we have the right client and procedure." Chapter 29: Perioperative Nursing - Page 872
A nurse is caring for a client with pelvic organ prolapse. As part of the client's workup, the nurse obtains a postvoid residual urine specimen via catheterization. Which specimen amount would lead the nurse to suspect that additional testing will be needed?
120 mL Chapter 7: Benign Disorders of the Female Reproductive Tract - Page 250
Which individuals are displaying identified risk factors for the development of lower urinary tract obstruction? Select all that apply.
68-year-old man who has been diagnosed with benign prostatic hyperplasia (BPH) 30-year-old woman who has been diagnosed with gonorrhea 74-year-old woman who has developed a lower bowel obstruction following several weeks of chronic constipation 20-year-old man who has spina bifida and consequent impaired mobility Chapter 27: Disorders of the Bladder and Lower Urinary Tract - Page 667
A warehouse worker is experiencing trouble with incontinence, especially when lifting heavy objects. What intervention is most appropriate for this client's needs?
Administration of alpha-adrenergic agonist drugs as ordered Chapter 27: Disorders of the Bladder and Lower Urinary Tract - Page 660
The nurse is employed in a urologist's office. Which classification of medication is anticipated for clients having difficulty with urinary incontinence?
Anticholinergic Chapter 55: Management of Patients With Urinary Disorders - Page 1626
The patient has been diagnosed with urge incontinence. What classification of medication does the nurse expect the patient will be placed on to help alleviate the symptoms?
Anticholinergic agents Chapter 55: Management of Patients With Urinary Disorders - Page 1626
Which of the following interventions are recommended guidelines for meeting patient postoperative elimination needs?
Assess for the return of peristalsis by auscultating bowel sounds every 4 hours when the patient is awake. Chapter 29: Perioperative Nursing - Page 880
A patient is admitted to the hospital after not having had a bowel movement in several days. The nurse observes the patient is having small liquid stools, a grossly distended abdomen, and abdominal cramping. What complication can this patient develop related to this problem?
Bowel perforation Chapter 47: Management of Patients With Intestinal and Rectal Disorders - Page 1313
A client is experiencing functional urinary incontinence. The nurse interprets this to mean which of the following?
Client does not reach the toilet before experiencing voiding. Chapter 10: Principles and Practices of Rehabilitation - Page 186
A nurse is caring for a female client with urinary incontinence. Which instructions should the nurse include in the client's teaching plan to reduce the incidence or severity of incontinence? Select all that apply.
Continue pelvic floor exercises. Increase fiber in the diet. Control blood glucose levels. Chapter 7: Benign Disorders of the Female Reproductive Tract - Page 254
When conducting an admission interview with a client with a history of urinary incontinence, the nurse will specifically ask whether the client is prescribed which classification of medications in order to determine a possible cause? Select all that apply.
Diuretics Hypnotics Sedatives Chapter 27: Disorders of the Bladder and Lower Urinary Tract - Page 666
An elderly client with a history of severe constipation tells the nurse that he has been experiencing watery stool and fecal incontinence the last 2 days. The nurse suspects this client may be experiencing which problem?
Fecal impaction Chapter 29: Disorders of Gastrointestinal Function - Page 714
The nurse is caring for a client with a suspected megacolon. The nurse anticipates that one of the findings of assessment will be
Fecal incontinence Chapter 47: Management of Patients With Intestinal and Rectal Disorders - Page 1313
Which nursing action is most appropriate for a client who has urge incontinence?
Have the client urinate on a timed schedule.
A patient has developed edema in her lower legs and feet, prompting her physician to prescribe furosemide (Lasix), a diuretic medication. After the patient has begun this new medication, what should the nurse anticipate?
Increased output of dilute urine Chapter 36: Urinary Elimination - Page 1269
After a client receives morphine sulfate for pain in the postanesthesia care unit (PACU), which assessment finding would the nurse obtain as a priority?
Measure respiratory rate. Chapter 29: Perioperative Nursing - Page 890
A cleansing enema is ordered for a patient who is scheduled to have colon surgery. What is the rationale for this procedure?
Peristalsis does not return for 24 to 48 hours after surgery. Chapter 29: Perioperative Nursing - Page 870
The nurse is caring for a client with type 2 diabetes mellitus who complains of waking up with damp sheets. The client is not "wetting the bed" but fears urine is leaking when sleeping. Which assessment is the nurse's priority?
Post-void residual urine assessment
In what phase of the surgical experience would advance directives be discussed with the patient?
Preoperative Chapter 29: Perioperative Nursing - Page 858
Which methods would the nurse anesthetist use when administering regional anesthesia to surgical clients? Select all that apply.
Spinal block Nerve block Epidural block Chapter 29: Perioperative Nursing - Page 857-858
A client who has a problem with incontinence loses a small amount of urine every time she coughs or sneezes. This type of incontinence is known as:
Stress Chapter 27: Disorders of the Bladder and Lower Urinary Tract - Page 664
A client is describing difficulty with urinating and informs the nurse that every time she coughs or laughs, she urinates and has begun to wear a thin pad. Which type of urinary incontinence is the client describing?
Stress incontinence Chapter 27: Disorders of the Bladder and Lower Urinary Tract - Page 664
Because they strengthen the pelvic floor muscles, Kegel exercises are most likely to help which urinary problem?
Stress incontinence Chapter 27: Disorders of the Bladder and Lower Urinary Tract - Page 665
The nurse is preparing to provide education to a client concerning prescribed medications to manage incontinence. The prescribed medication is oxybutynin. What information can be provided?
The medication will be used to reduce overactivity of muscles involved in voiding, thereby lessening incontinence.
A client has been experiencing occasional episodes of constipation and has been unable to achieve consistent relief by increasing physical activity and improving his diet. When introducing the client to the use of laxatives, what teaching should the nurse emphasize?
The risk of becoming laxative-dependent Chapter 47: Management of Patients With Intestinal and Rectal Disorders - Page 1313
Urinary obstruction in the lower urinary tract triggers changes to the urinary system to compensate for the obstruction. What is an early change the system makes in its effort to cope with an obstruction?
The stretch receptors in the bladder wall become hypersensitive. Chapter 27: Disorders of the Bladder and Lower Urinary Tract - Page 661
The nurse is caring for a client with concerns of urinary incontinence. A review of the client's data collection reveals the client has a history of spinal surgery and states, "I urinate all the time and cannot predict when I will urinate." This data collection would suggest to the nurse that this client is experiencing which type of urinary incontinence?
Total incontinence Chapter 36: Urinary Elimination - Page 1284
For which medication would the nurse caring for a patient experiencing urinary tract spasms, incontinence, and urinary frequency expect an order?
Trospium (Sanctura)
A client comes to the clinic for a follow-up visit. During the interview, the client states, "Sometimes when I have to urinate I can't control it, and do not reach the bathroom in time." The nurse suspects that the client is experiencing which type of incontinence?
Urge Chapter 55: Management of Patients With Urinary Disorders - Page 1624
A nurse's colleague has applied an incontinence pad to an older adult client who has experienced occasional episodes of functional incontinence. What principle should guide the nurse's management of urinary incontinence in older adults?
Urinary incontinence is not considered a normal consequence of aging. Chapter 55: Management of Patients With Urinary Disorders - Page 1624
To manage voiding issues, such as incontinence, male clients diagnosed with dementia would best be managed by what?
Use of disposable, adult diapers Chapter 24: Cognitive Disorders - Page 482
Which modification to bathing should be implemented for a client who is incontinent?
Use special perineal skin cleaners and moisture barriers. Chapter 30: Hygiene - Page 923-925
Which clinical manifestations would tell a nurse that a client is having progressive decompensation related to obstruction of urinary outflow?
When tested for residual urine volume, 1400 mL of urine is obtained when client is catheterized. Chapter 27: Disorders of the Bladder and Lower Urinary Tract - Page 661
The operating room nurse is aware that which client is at greatest risk related to a surgical procedure?
a woman 83 years of age Chapter 29: Perioperative Nursing - Page 860
A nurse is reinforcing wound edges and applying a blinder to the separated incisions of a client after a surgery. Which postoperative complication has the client developed?
dehiscence Chapter 29: Perioperative Nursing - Page 880
A client is undergoing surgery for an appendectomy. This would be considered what type of surgery?
emergency surgery Chapter 29: Perioperative Nursing - Page 856
A client scheduled for surgery has been taking aspirin since his heart attack in 1997. The client is at risk for:
hemorrhage. Chapter 29: Perioperative Nursing - Page 888
Which client will see the greatest permanent changes in lifestyle following surgery?
ileostomy
Which assessment data, collected by the nurse, indicates that a client may have the nursing diagnosis of urge urinary incontinence? Select all that apply.
loses urine when a toilet is not readily available urinates 20 times in 24 hours experiences accidental loss of urine when there is an urgent need to urinate Chapter 36: Urinary Elimination - Page 1284
An operating room nurse is bringing a client to the nurse in the postanesthesia care unit (PACU). Which information would the operating room nurse provide during a hand-off report? Select all that apply.
medications given in operating room length of surgery drains inserted in surgery Chapter 29: Perioperative Nursing - Page 874
In the postoperative phase of abdominal surgery, the client reports severe abdominal pain. In the second postoperative day, the client's bowel sounds are absent. What does the nurse suspect?
paralytic ileus Chapter 29: Perioperative Nursing - Page 880
A nurse is employed in an operative setting. Which of these roles is within the registered nurse (RN) scope of practice? Select all that apply.
positioning the client on the operating table counting sponges before and after surgery monitoring the client's vital signs Chapter 29: Perioperative Nursing - Page 873
The nurse is assessing a client who is bedridden. For which condition would the nurse consider this client to be at risk?
predisposition to renal calculi Chapter 32: Activity - Page 1053
The nurse is caring for a client who is preparing to have a hip replacement. How will the nurse document the type of education provided prior to surgery?
preoperative Chapter 29: Perioperative Nursing - Page 852-855
A nurse teaches deep breathing exercises to a client scheduled for surgery. In which perioperative phase would this action occur?
preoperative Chapter 29: Perioperative Nursing - Page 886
When educating a client in the postoperative period, it is important to educate the client to consume a diet high in:
protein. Chapter 29: Perioperative Nursing - Page 880
A client with spinal cord injury has no awareness of the need to void. This type of incontinence is termed
reflex (neurogenic) incontinence. Chapter 10: Principles and Practices of Rehabilitation - Page 186
The nurse is working with a client who has been diagnosed with urge incontinence related to detrusor muscle contractions. Part of the educational material suggesting lifestyle changes should include information that which situation increases muscular contractions?
smoking Chapter 7: Benign Disorders of the Female Reproductive Tract - Page 253
A client reports to the nurse that after delivering a baby, she loses small amounts of urine each time she sneezes or laughs hard. Which type of incontinence does the nurse anticipate?
stress Chapter 36: Urinary Elimination - Page 1284
A client comes to the genitourinary clinic reporting accidental leakage of urine. She says it happens whenever she coughs, laughs, or sneezes. It also happens sometimes when she exercises. Which condition should the nurse expect?
stress incontinence Chapter 7: Benign Disorders of the Female Reproductive Tract - Page 252
A client in the immediate postoperative period begins to report nausea and ultimately begins vomiting. The nausea and vomiting are most likely related to:
the effects of anesthetic agents. Chapter 29: Perioperative Nursing - Page 874
A nurse assists a client with leg exercises. What condition does this intervention help to prevent?
thrombophlebitis Chapter 29: Perioperative Nursing - Page 878
What is the rationale for having the client void before surgery?
to prevent bladder distention Chapter 29: Perioperative Nursing - Page 870
The nurse is caring for a client in the postpartum period. The client has difficulty in voiding and is catheterized. The nurse would monitor the client for which condition?
urinary tract infection Chapter 15: Postpartum Adaptations - Page 540
Which nursing intervention is most likely to prevent respiratory complications such as pneumonia and atelectasis in a postoperative client?
use of incentive spirometry Chapter 29: Perioperative Nursing - Page 879
What is the nurse's role in the informed consent process for a surgical procedure?
witnessing the signed informed consent document Chapter 29: Perioperative Nursing - Page 858
