Elimination

A client who is undergoing treatment for osteomyelitis reports bloody, watery diarrhea. The client also has hives and mouth sores. Which medication will the nurse check for in the client's medication administration record? 1 Cefazolin 2 Neomycin 3 Tobramycin 4 Ciprofloxacin

1 Cephalosporin antibiotics, such as cefazolin, are used to treat osteomyelitis. Cefazolin can alter gastrointestinal function, resulting in adverse effects such as watery diarrhea, bloody stools, and mouth or throat sores. Cefazolin can also alter skin integrity and cause hives. Aminoglycoside antibiotics such as neomycin and tobramycin do not generally alter the gastrointestinal system; instead, they can cause ototoxicity and nephrotoxicity. Fluoroquinolones such as ciprofloxacin generally do not alter the gastrointestinal system and therefore do not cause watery, bloody stools. However, tendon rupture, especially of the Achilles tendon, can occur with the use of fluoroquinolones.

What should a nurse include in the plan of care for a 9-year-old child with nephrotic syndrome? 1 Providing meticulous skin care 2 Restricting fluids to 4 oz (120 mL) each shift 3 Offering a diet low in carbohydrates and protein 4 Sending blood to the laboratory for typing and crossmatching

1 Massive edema, typical of nephrotic syndrome, predisposes the child to skin breakdown. The child requires more fluid than 4 oz (120 mL) each shift to maintain hydration. Carbohydrates and proteins are not restricted. Children with nephrotic syndrome usually do not receive blood transfusions.

A nurse is reviewing the admission laboratory report of an infant with severe gastroenteritis. The serum potassium is 3 mEq/L. Potassium chloride 20 mEq/L is prescribed to be added to the infant's intravenous (IV) line. What should the nurse do next? 1 Find out when the infant last had a wet diaper. 2 Question the prescription and withhold the medication. 3 Ask the mother whether the infant is allergic to potassium. 4 Administer the potassium and then monitor the infant's response.

1 Potassium chloride is excreted by functioning kidneys; if there is anuria, which is a sign of kidney failure, the potassium should be withheld and the practitioner notified. There is no reason to question the prescription because the laboratory value is below the expected level for an infant, which is 4.1 to 5.3 mEq/L. Potassium is a component of body fluid and will not cause an allergic response. Administering the potassium without confirming adequate kidney function is unsafe because potassium can accumulate and cause lethal cardiac dysrhythmias.STUDY TIP: You have a great resource in your classmates. We all have different learning styles, strengths, and perspectives on the material. Participating in a study group can be a valuable addition to your nursing school experience.

A health care provider prescribes sodium biphosphate for a client before a colonoscopy. How does the drug accomplish its therapeutic effect? 1 Irritates the intestinal mucosa 2 Provides water-absorbing bulk 3 Softens stool by exerting a detergent effect 4 Increases osmotic pressure in the intestines

4 Sodium biphosphate is a saline (hypertonic) cathartic that increases osmotic pressure within the intestine so that body fluids are drawn into the bowel, stimulating bowel stretching, peristalsis, and defecation. Intestinal stimulants increase peristalsis by irritating the mucosa. Bulk-forming laxatives are cellulose derivatives that remain in the intestinal tract and absorb water; they stimulate peristalsis by increasing bulk. Emollients have a detergent action, softening stool by facilitating its absorption of water.Test-Taking Tip: Do not read too much into the question or worry that it is a "trick." If you have nursing experience, ask yourself how a classmate who is inexperienced would answer this question from only the information provided in the textbooks or given in the lectures.

What should the plan of care for a newborn with hypospadias include? 1 Preparing the infant for insertion of a cystostomy tube 2 Explaining to the parents the genetic basis for the defect 3 Keeping the infant's penis wrapped with petrolatum gauze 4 Giving the parents reasons why circumcision should not be performed

4 The parents need to know why circumcision should not be performed. The foreskin may be needed for repair and reconstruction of the penis. A cystostomy tube is not inserted, because there is no interference with voiding. Hypospadias is not a genetic disorder, although there appears to be some evidence that it is familial. The penis is generally wrapped in petrolatum gauze after, not before, surgical correction of hypospadias.

After tolerating an oral rehydration solution (Pedialyte) being given because of dehydration resulting from diarrhea, a 20-month-old toddler's condition improves and a regular diet is started. What foods should the nurse suggest that the parents offer their child? Select all that apply. 1 Poached eggs 2 Creamed soup 3 Strained carrots 4 Vanilla pudding 5 Animal crackers

1,3,5 Poached eggs are nutritious and are easily digested. Carrots help replace the sodium lost in diarrhea. Animal crackers are not irritating to the gastrointestinal tract. Creamed foods and puddings contain milk, which may irritate the gastrointestinal tract in some children.

The nurse is caring for an older adult client. Which genitourinary factor that contributes to urinary incontinence in older adults should the nurse consider when planning care? 1 Sensory deprivation 2 Urinary tract infection 3 Frequent use of diuretics 4 Inaccessibility of a bathroom

2 Urinary incontinence in older adults can be a sign of urinary tract infection. Urinary tract infections affect the genitourinary tract and interfere with voluntary control of micturition. Sensory deprivation is a neurologic, not a genitourinary, factor. Frequent use of diuretics is an iatrogenic, not genitourinary, factor. Inaccessibility of a bathroom is an environmental, not genitourinary, factor.

A client who has had a continent urostomy created reports postoperative pain. What should the nurse do first? 1 Tell the client to take deep breaths. 2 Measure the client's current vital signs. 3 Interview the client to gather more information. 4 Administer the prescribed analgesic to the client.

3 Assessment should occur before nursing intervention; pain is subjective. Measuring the client's current vital signs is done after assessing the characteristics of the pain. Taking just the vital signs is an incomplete assessment. The nurse should determine the location, intensity, and other characteristics of the pain before other assessments or initiating an intervention.

Which findings in the older client are associated with a urinary tract infection (UTI)? Select all that apply. 1 Fever 2 Urgency 3 Confusion 4 Incontinence 5 Slight rise in temperature

3,4,5 An older client with a urinary tract infection (UTI) is likely to appear confused. An older client may experience incontinence while a younger client may experience urgency. The older client may develop a slight rise in temperature. The classic symptoms of a UTI in a younger client are fever, dysuria, and urgency.Test-Taking Tip: The nurse must remember that classic symptoms of disease may not be seen in the older client with age-related physiological changes.

A client with chronic kidney disease is admitted to the hospital with severe infection and anemia. The client is depressed and irritable. The client's spouse asks the nurse about the anticipated plan of care. Which is an appropriate nursing response? 1 "The staff will provide total care, because the infection causes severe fatigue." 2 "Mood elevators will be prescribed to improve depression and irritability." 3 "Vitamin B₁₂ will be prescribed for the anemia, and the stools will be dark." 4 "The intake of meat, eggs, and cheese will be restricted so the kidneys can clear the body of waste products."

4 One of the kidney's functions is to excrete nitrogenous waste from protein metabolism; restriction of protein intake decreases the workload of the damaged kidneys. The client is encouraged to be as active and independent as possible. Medications are avoided because they may mask symptoms. Iron and folic acid supplements are used for anemia in chronic kidney disease; Vitamin B 12 is used for pernicious anemia and does not make the stools dark; iron makes the stools dark.

The nurse is assessing a toddler with a diagnosis of pinworms. What complication of pinworm infestation, although rare, should the nurse be aware of? 1 Hepatitis 2 Stomatitis 3 Pneumonitis 4 Appendicitis

4 Pinworms, which attach themselves to the bowel wall in the cecum and appendix, can damage the mucosa, causing appendicitis. Pinworms do not migrate to the liver. Although pinworms (and their ova) are ingested by mouth, they do not attach themselves there; inflammation of the mouth is not a complication of pinworm infestation. Pinworms do not migrate to the respiratory system.