exam 4 review

The nurse understands that an antimicrobial drug is most likely to be prescribed for which condition?

Acute otitis media

Which drug is used to decrease the risk of myocardial infarction in patients with unstable angina or previous myocardial infarction?

Aspirin

Which drug is the most effective treatment for trichomoniasis?

Metronidazole

A client presents with pain, severe constipation, abdominal distention, dehydration, and vomiting. The nurse would prepare the client for which diagnostic test?

Plain film radiography of the abdomen

The nurse planning to insert an indwelling urinary catheter into a client should utilize which technique?

Surgical asepsis

It is important for home health care nurses to remember which point?

The nurse is the guest in the client's home.

A client is admitted with lower urinary tract obstruction and stasis. Which action is the primary intervention?

Urinary catheterization

The nurse recognizes that test results that most likely indicate a urinary tract infection include:

WBC 50

A longitudinal tear or ulceration in the lining of the anal canal is termed a(n):

anal fissure.

A hospitalized client requests a magnesium citrate "bisacodyl pill" every night to "stay regular." The nurse should initially be most concerned about what potential health risk for this client?

laxative abuse

A nurse assesses a client and notes an area that is reddened and warm. The nurse understands that these findings are related to:

vasodilation

A client has been taking a urinary tract anti-infective for two days for treatment of a severe urinary tract infection. Today, the client calls the clinic reporting continued burning on urination. What is the nurse's best response?

"Burning on urination is a common side effect of these drugs. This may continue the entire time that you are on the medication."

A nurse is teaching a female client with a history of multiple urinary tract infections (UTIs). Which statement indicates the client understands the teaching about preventing UTIs?

"I should take at least 1,000 mg of vitamin C each day."

The nurse is providing care to a client who has had a kidney biopsy. The nurse would need to be alert for signs and symptoms of which of the following?

Bleeding

The nurse is asking admission interview questions and the client has explained the reason for seeking care. What is the most appropriate way to document the response?

Client states, "I feel winded all of the time and yesterday I started spitting up a lot of phlegm."

The nurse is encouraging the client with recurrent urinary tract infections to increase fluid intake to 8 large glasses of fluids daily. Which beverage would the nurse discourage for this client?

Coffee in the morning

A nurse is carrying out a prescription to remove an indwelling catheter. Which explanation should the nurse use with the client prior to removing an indwelling catheter?

"I am going to remove the catheter after withdrawing the fluid from the balloon."

A nurse is talking with a client who recently attempted suicide. The client asks the nurse not to tell anyone about their conversation. How should the nurse respond?

"If information is important to your care, I'll need to share it with the rest of your health care team."

Mr. Ashum is prescribed an albuterol inhaler as part of his treatment regimen for asthma. What is the mechanism of action for this medication?

Albuterol causes relaxation of the bronchial smooth muscles.

The nurse is discussing the ears and hearing in a child with a group of peers. Which statement is most accurate related to this topic?

The eustachian tube in the infant is straighter and wider than in the adult.

The nurse is giving discharge instructions to a woman who will be taking amoxicillin for treatment of acute otitis media. The nurse teaches the client that which symptom indicates the development of a superinfection and should be reported to the physician?

Vaginal itching and discharge

A client has just been admitted to the unit with a history of recent streptococcal infection, hematuria, and proteinuria. Based on these findings, the nurse suspects which condition?

acute glomerulonephritis

A client is diagnosed with pericarditis. What symptom will be the nurse's priority for treatment?

acute pain

A client who suffers from spastic bladder has been catheterized to promote bladder emptying. Which medication should the nurse plan on the physician ordering to also treat this problem?

Anticholinergic medication

A client is frustrated and embarrassed by urinary incontinence. Which measure should the nurse include in a bladder retraining program?

Assessing present voiding patterns

The family asks the nurse what the usual treatment of focal segmental glomerulosclerosis entails. What is the nurse's best response?

Corticosteroids

A 3-year-old has a history of recurrent urinary tract infections (UTI). Which practice implemented by the parents for the child indicates an understanding of preventive measures regarding these infections?

No use of bubble bath liquids or salts

The nurse is preparing to catheterize a client who is incontinent of urine following bladder surgery. What fact should the nurse keep in mind when performing catheterization?

The bladder normally is a sterile cavity.

The nurse is assessing a client for constipation. Which review should the nurse conduct first to identify the cause of constipation?

Usual pattern of elimination

The nurse is assessing a client with the autoimmune disease ankylosing spondylitis for complications related to the eye. For which eye disorder should the nurse assess?

Uveitis

The nurse is caring for a 10-year-old girl with acute periorbital cellulitis. Which nursing intervention (therapy) is primary for this disorder?

administering antibiotics IV as ordered

A woman comes to the clinic reporting intense pruritus and a thick curd-like vaginal discharge. On examination, white plaques are observed on the vaginal wall. The nurse suspects which condition?

vulvovaginal candidiasis

A nurse has just admitted a client with symptoms of vulva inflammation, pain, odor, and pruritus. Based on these findings, the nurse could conclude that this client will be diagnosed with which condition?

vulvovaginitis

A client has been prescribed INH for the treatment of tuberculosis. The nurse teaches the client about dietary restrictions while taking this medication. What is the most important instruction?

"Do not drink beer or red wine while taking this medication because a serious adverse reaction can occur."

A client is being discharged following an allergic reaction after ingesting aspirin. When providing client education about the allergy, the nurse would provide the client with what information?

"Do not take any NSAIDs."

The nurse has just finished client education with a client who is being discharged home on bulk-forming laxatives. The nurse knows the client understands discharge instructions regarding these medications when which statement is made?

"I will mix the medication with 4 to 8 ounces of liquid and follow it by an additional 4 to 8 ounces."

The nurse is teaching a group of novice nurses how to assess bowel sounds. Which statement will the nurse include in the education?

"You should auscultate all four quadrants for a full minute each."

A client with a history of heroin addiction is admitted to the hospital intensive care unit with a diagnosis of opioid drug overdose. While talking with a nurse, the client's parent reports a plan to have his child declared legally incompetent. Which response by the nurse is most therapeutic?

"Your child is ill and can't make decisions about health care and safety right now, but this situation is temporary."

What should a nurse recognize as a property of ibuprofen/Motrin? (Select all that apply.)

- Anti-inflammatory - Analgesic - Antipyretic

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.

The nurse at a community clinic is assessing an 8-month-old child who has a history of frequent episodes of acute otitis media. Which assessment findings should prompt the nurse to refer the child to the emergency department? Select all that apply.

- Resistance with neck flexion -Decreased response to sounds -Swelling behind the ear

The nursing students have learned in class that causes of urinary obstruction and urinary incontinence include which of the following? Select all that apply.

- Structural changes in the bladder - Structural changes in the urethra - Impairment of neurologic control of bladder function

When a nurse is administering medications to a client with rheumatoid arthritis (RA), which medication interferes with tumor necrosis factor (TNF)-alpha?

Adalimumab

Which is a correct rationale for encouraging a client with otitis externa to eat soft foods?

Chewing may cause discomfort.

A client with a history of osteoarthritis is admitted to the rehabilitation unit after hospitalization for a hip fracture. Which plan by the multidisciplinary team best optimizes client outcomes?

Including the client in developing a care plan that works toward meeting discharge goals

In pharmacology class the students are learning about the mechanism of action of different laxatives. What would the students learn about the mechanism of action of psyllium hydrophilic mucilloid?

Increasing mass and water content of stool

A client complains of vertigo. The nurse anticipates that the client may have a problem with which portion of the ear?

Inner ear

A client is diagnosed with methamphetamine abuse, an intellectual development disorder, and has been repeatedly admitted to inpatient facilities for treatment. Which treatment option will the nurse advocate for the client?

Integrated care

Which of the following is the most effective treatment for trichomoniasis?

Metronidazole (Flagyl)

Which of the following assessments should the nurse perform to determine the development of peptic ulcers when caring for a patient with Cushing's syndrome?

Observe the color of stool.

Otitis media (OM), which can occur is any age group, is the most common diagnosis made by health care providers who care for children. Which bacterial pathogen causes the largest proportion of cases that result in sensorineural hearing loss?

Streptococcus pneumoniae

What form of laxative would likely be prescribed to manage long-term constipation?

bulk-forming laxative plus increased water intake

The nurse is preparing a presentation for a local community group about sexually transmitted infections (STIs). Which most common bacterial STI in the United States would the nurse expect to include?

chlamydia

A client who has suffered a myocardial infarction is prescribed a laxative to help prevent straining during defecation. Which medication would the nurse expect to administer?

docusate

A nurse taking a health history of a newborn notes that there is a maternal history of polyhydramnios. What GI condition might this history precipitate?

esophageal atresia (EA)

Which action is the best precaution against transmission of infection?

eye prophylaxis with antibiotics for a neonate whose mother has gonorrhea infection

The nurse suspects a client has developed pericarditis after a week of cold-like symptoms. Which of the client's signs and symptoms indicate pericarditis?

fever, chest discomfort, and elevated erythrocyte sedimentation rate (ESR)

Diet therapy for clients diagnosed with irritable bowel syndrome (IBS) includes:

high-fiber diet.

The selection of a nursing care delivery system (NCDS) is critical to the success of client care in a nursing area. Which factor is essential to the evaluation of an NCDS?

identifying who will be responsible for making client care decisions

The nurse is evaluating the urinalysis results of a client presenting with polyuria and lower abdominal pain due to a suspected urinary tract infection. Which finding should the nurse expect?

increased nitrites

A nurse is taking stock of the equipment in the room of an older adult client with pneumonia who has been on parenteral nutrition for a long time. Which equipment can transmit infection to older adult clients?

indwelling catheter

A resident at a long-term care facility lost the ability to swallow following a stroke 4 years ago. The client receives nutrition via a PEG tube, has adapted well to the tube feedings, and remains physically and socially active. Occasionally, the client develops constipation that requires administration of a laxative to restore regular bowel function. What is the most likely cause of this client's constipation?

lack of free water intake

A modern approach to the development of clinical decisions and clinical judgments is the use of human client simulators in simulation laboratories on campus. Human client simulators are best described as:

life-sized mannequins with a sophisticated computer interface.

The nurse is assessing the breast of a woman who is 1 month postpartum. The woman reports a painful area on one breast with a red area. The nurse notes a local area on one breast to be red and warm to touch. What should the nurse consider as the potential diagnosis?

mastitis

If a client were to develop rheumatic carditis, which cardiac structure would most likely be affected?

mitral valve

The first method of choice for obtaining a urine specimen from a 3-year-old child with a possible urinary tract infection is:

obtaining a clean catch voided urine.

A client with chronic bowel inflammation reports abdominal cramping and diarrhea for the past 4 days. The nurse would anticipate which test based on the client's concerns?

occult blood and organisms

A client at a health care facility is being treated for cancer of the bladder. The health care provider uses a urinary diversion to help the client with urinary elimination. What describes a urinary diversion?

one or both of the ureters are surgically implanted elsewhere

The nurse is caring for a client newly diagnosed with acute glomerulonephritis? When receiving the pediatric client's history, which is anticipated?

onset of a streptococcus infection last week

A nurse has collected the blood, urine, and stool specimens of a client with meningococcal meningitis. Which precaution should the nurse take when transporting the specimens?

place the specimens into plastic biohazard bags

A nurse is reviewing a postpartum woman's history and labor and birth record. The nurse determines the need to closely monitor this client for infection based on which factor?

placenta removed via manual extraction

Which intervention listed in the care plan for a client with an ectopic pregnancy requires revision?

providing for dietary needs and nursing in a dark quiet room

A client tells the nurse that the stool was colored yellow. The nurse assesses the client for

recent foods ingested.

An older adult woman tells the nurse that she has trouble controlling her urine. She states, "The urine starts dripping even before I feel like I have to go." The nurse interprets this as:

reflex incontinence.

A client with a urinary tract infection (UTI) has a new prescription for nitrofurantoin. The nurse would question this order if the client has a history of:

renal dysfunction.

The nurse is caring for a client receiving opioid medication for the treatment of postoperative pain. What are common side effects that the nurse should observe for?

respiratory depression, constipation, and pruritis

A client is admitted to the emergency department with abdominal pain. The client's caregiver states the pain began about 12 hours ago. The nurse notes the client has a temperature of 100.8° F (38.2° C) and nausea. The client vomited once. Which abdominal area would be most appropriate for the nurse to assess?

right lower abdominal quadrant

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.

The client is taking an antibiotic for a urinary tract infection. The client asks how the antibiotic interferes with the growth of bacteria. The nurse explains that the antibiotic has the ability to suppress or kill an infecting microbe without injury to the host. This is referred to as:

selective toxicity.

Dexamethasone is often prescribed for the child who has sustained a severe head injury. Dexamethasone is a(n):

steroid.

Which catheter would the nurse use to drain a client's bladder for short periods (5 to 10 minutes)?

straight catheter

A client reports to the nurse that after delivering an infant, she loses small amounts of urine each time she sneezes or laughs hard. Which type of incontinence does the nurse anticipate?

stress

A client with a history of type 1 diabetes is admitted to the hospital with community-acquired pneumonia. The client's blood glucose level in the emergency care unit was 576 mg/dl (31.97 mmol/L). The physician orders an I.V. containing normal saline solution, an insulin infusion, and I.V. levofloxacin. The nurse piggybacks the insulin infusion into the normal saline solution. The nurse questions whether piggybacking the levofloxacin into the same I.V. line is appropriate. Which health team member should the nurse collaborate with to check the compatibility of these solutions?

the pharmacist covering the floor

A nurse is performing an assessment on a new client. The woman estimates that she is approximately 16 weeks pregnant. While assessing her, the nurse asks her about apparent scratch marks on her hands, and she tells the nurse that she has three cats at home. What screening would be prescribed for this woman?

toxoplasmosis

A client with urinary retention needs to undergo a procedure to insert an indwelling catheter. What should the nurse discuss with the health care provider before catheterization?

type and size of the catheter to be used

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

A client with an indwelling urinary catheter is suspected of having a urinary tract infection. The nurse should collect a urine specimen for culture and sensitivity by

wiping the self-sealing aspiration port with antiseptic solution and aspirating urine with a sterile needle.

A 7-year-old child has tonsillitis and is prescribed penicillin V, which is to be administered at home. The nurse will instruct the parents to administer the drug

with a glass of water 1 hour before or 2 hours after a meal.

A client has been given the diagnosis of diffuse glomerulonephritis. The client asks the nurse what diffuse means. The nurse responds:

"All glomeruli and all parts of the glomeruli are involved."

A client in the emergency department is being treated for a wrist fracture. The client asks why a splint is being applied instead of a cast. What is the best response by the nurse?

"A splint is applied when more swelling is expected at the site of injury."

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 only occur when there is incontinence."

A young adult client is currently in a rehabilitation facility following a spinal cord injury at level T2. The nurse and client are discussing long-term options for continence management. Which statement demonstrates the client has a clear understanding of the issue?

"An indwelling catheter certainly would work well, but it comes with a number of risks and possible complications."

A parent has informed the nurse that she has been applying an OTC antifungal to her infant's buttocks and perineal region. What question related to safety should the nurse ask the parent?

"Are there any open wounds on the areas where you're putting the ointment?"

Upon assessment, the nurse suspects that a client with COPD may have bronchospasm. What manifestations validate the nurse's concern? Select all that apply.

- Wheezes - Decreased airflow - Compromised gas exchange

A nurse is caring for an older adult client who is incontinent. Which effects of aging might contribute to urinary alterations? Select all that apply.

-Diminished ability of kidneys to concentrate urine may result in nocturia. -Decreased bladder muscle tone may reduce the capacity of the bladder to hold urine. -Decreased bladder contractility may lead to urine retention and stasis. -Neuromuscular problems may interfere with voluntary control of urination - Altered thought processes may cause urinary frequency.

A nurse is assessing a client with diarrheal disease and determines that the condition has most likely resulted from a parasitic infection. Which of the following would be a potential cause? Select all that apply.

-Giardia -Cryptosporidium

The nurse is teaching a class on diseases of the ear. What would the nurse teach the class is the most characteristic symptom of otosclerosis?

A progressive, bilateral loss of hearing

A patient with end-stage kidney disease (ESKD) has developed anemia. What laboratory finding does the nurse understand to be significant in this stage of anemia?

Creatinine level of 6 mg/100 mL

Following a voiding cystogram, the client has a nursing diagnosis of risk for infection related to the introduction of bacterial following manipulation of the urinary tract. An appropriate nursing intervention for the client is to:

Encourage high fluid intake.

Which is an appropriate nursing intervention in the care of the client with osteoarthritis?

Encourage weight loss and an increase in aerobic activity

Which nursing intervention can prevent a client from experiencing autonomic dysreflexia?

Monitoring the patency of an indwelling urinary catheter

Although both eukaryotes and prokaryotes are capable of causing infectious diseases in humans, eukaryotes are unique because they have a/an:

Organized nucleus

Which nursing diagnosis would be the priority for the client experiencing acute delirium?

Risk for injury related to confusion and cognitive deficits

With repeated reactions of contact dermatitis, which of the following can occur?

Secondary bacterial infection

A nurse has pharyngitis and will be providing self care at home. It is most important for the nurse to

Seek medical help if he experiences inability to swallow

Which would be most important to include when teaching a patient about using psyllium?

Taking the agent with a large amount of water

The nurse is caring for a child admitted with acute glomerulonephritis. Which clinical manifestation would likely have been noted in the child with this diagnosis?

Tea-colored urine

Which statement is true in regards to the oral administration of tetracyclines?

Tetracyclines should be administered with a full glass of water.

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 bedwetting?

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

Which is a cultural norm of the health care system?

There is the use of a systematic approach and problem-solving methodology.

A nurse-manager in the office of a group of surgeons has received complaints from discharged clients about inadequate instructions for performing home care. Knowing the importance of good, timely client education, the nurse-manager should take which steps?

Work with the surgeons' staff and the nursing staff in the hospital and outpatient surgical center to evaluate current client education practices and make revisions as needed.

A 70-year-old client is seen in the family practice clinic. Which vaccine should be administered to prevent herpes zoster?

Zoster vaccine

A nurse is managing the care of a client with osteoarthritis. Appropriate treatment strategies for osteoarthritis include

administration of nonsteroidal anti-inflammatory drugs (NSAIDs) and initiation of an exercise program.

A recent immigrant is diagnosed with pulmonary tuberculosis (TB). Which intervention is the most important for the nurse to implement with this client?

developing a list of people with whom the client has had contact

Which factor contributes to the development of polycystic kidney disease?

hereditary mutations in polycystin I and II

When NSAIDs are combined with lithium, there is a potential for:

lithium toxicity.

A young mother asks, "Why can my 3-year-old daughter have a bowel movement on the toilet but she wets her pants?" What is the nurse's best response?

"Bowel control occurs earlier than bladder control."

A young child has been brought to the clinic with signs and symptoms that are consistent with otitis externa. What assessment question should the nurse ask to address the etiology of this health problem?

"Has your child been swimming a lot lately?"

A client with an intravenous line in place states having pain at the insertion site. Assessment of the site reveals a vein that is red, warm, and hard. Which actions would the nurse take? Select all that apply.

- Discontinue the infusion at the affected site. - Apply warm soaks to the intravenous site. - Document the assessment, nursing actions taken, and the client's response.

What recommendations should be included in client teaching as a means of avoiding constipation? (Select all that apply.)

- Drink plenty of fluids. - Be active and exercise daily. - Eat foods high in bulk or roughage.

When planning care for a client with a Foley catheter, which actions should the nurse include? Select all that apply.

- Encourage fluid intake, unless contraindicated. - Record volume and character of the urine. - Maintain a closed urinary catheter system.

Several of the clients on a geriatric subacute medicine unit are experiencing urinary incontinence from differing causes. Which statement suggests that the client requires further education?

"I make sure to limit how much I drink so that I don't have accidents."

A nurse is teaching an older adult client about good bowel habits. Which statement by the client indicates to the nurse that additional teaching is required?

"I need to use laxatives regularly to prevent constipation."

The nurse is teaching a teenaged client strategies to avoid recurrent ear infections. The nurse understands that further teaching is required when the client states:

"I will dry the inside of my ears thoroughly with cotton-tipped applicators after swimming."

A client reports frequent constipation. The nurse would identify what risk factors as potential contributors? Select all that apply.

- Female gender - Use of anticholinergic drugs - Advanced age

The parent of a 5-year-old child tells the nurse that on two occasions her son has lost control of urination when he had to wait to go to the bathroom at school. What is the appropriate nursing response?

"Let's review the types of fluids that your child drinks in the morning."

A toddler has been diagnosed with otitis media with effusion. The parents tell the nurse, "We really don't understand what that diagnosis means." How should the nurse respond?

"The diagnosis means unwanted fluid is within the middle ear space, and there may or may not be an infection present."

Which of the following is classified as a upper urinary tract infection (UTI)? Select all that apply.

- Acute pyelonephritis -Renal abscess

Routine nasal and rectal swabbing of a newly admitted hospital client has come back positive for methicillin-resistant Staphylococcus aureus (MRSA), indicating that the client is colonized with MRSA. The client is surprised at this finding, since he enjoys generally robust health. What should the client's nurse teach him about this diagnostic finding?

"This means that this organism in present on your skin, but it doesn't necessarily mean that you will become sick."

A client is diagnosed as having serous otitis media. When describing this condition to the client, which of the following would be most accurate?

"You have some fluid that has collected in your middle ear but no infection."

The nurse knows that there are many ways to decrease the risk of constipation. These include which of the following? Select all that apply.

- Partake in daily physical exercise. - Consume food rich in fiber. -Drink 64 to 80 ounces of fluids daily. -Set a routine time and place for daily bowel movement.

Clients must contend with chronic illness daily. Nurses relate more effectively to clients when they understand the following as characteristics of chronic illness. Choose all that apply.

- The management of chronic conditions is a process of discovery. - Managing chronic conditions must be a collaborative process. - Chronic illness affects the entire family.

Sulfonamides are commonly used to treat which of the following types of infections? Select all that apply.

- Ulcerative colitis - Urinary tract infection - Acute otitis media

Which of the following are examples of a secondary infection? Select all that apply.

- Vaginal candidiasis - Oral candidiasis - C. difficile colitis

A child has been diagnosed with acute otitis media. Before the child begins antibiotic treatment, what assessment should the nurse perform?

Assess the child for allergies to penicillins.

You are teaching a class on diseases of the ear. What would you teach the class is the most characteristic symptom of otosclerosis?

A progressive, bilateral loss of hearing

The nurse is caring for a pediatric client whose parent reports that the child has been pulling at her ears, has a fever, and has been crying more than usual. The nurse suspects the client may be experiencing which of the following?

Acute otitis media

A client is evaluated for severe pain in the right upper abdominal quadrant, which is accompanied by nausea and vomiting. The physician diagnoses acute cholecystitis and cholelithiasis. For this client, which nursing diagnosis takes top priority?

Acute pain related to biliary spasms

A client has been diagnosed with acute rhinosinusitis caused by a bacterial organism. What antibiotic of choice for treatment of this disorder does the nurse anticipate educating the client about?

Amoxicillin-clavulanic acid

Which client is suitable for psychiatric transitional care services?

An individual being discharged from hospital with residual symptoms of mania

A nurse at the health care facility needs to administer an otic application for a client with an earache. What should the nurse do after instilling the prescribed eardrops in the client's ear?

Ask the client to remain lying down for at least 5 minutes.

A client reports constipation. Which nursing measure would be most effective in helping the client reduce constipation?

Assist client to increase dietary fiber.

Which instruction should the nurse give to a client with genital herpes to help control the infection?

Avoid sexual contact until sores heal.

Behavioral interventions for urinary incontinence can be coordinated by a nurse. A comprehensive program that incorporates timed voiding and urinary urge inhibition is referred to as what?

Bladder retraining

The nurse is providing care to a client who has had a renal biopsy. The nurse would need to be alert for signs and symptoms of which of the following?

Bleeding

What is the most common presenting objective symptom of a urinary tract infection in older adults, especially in those with dementia?

Change in cognitive functioning

Which objective symptom of a UTI is most common in older adults, especially those with dementia?

Change in cognitive functioning

Which of the following nursing interventions contributes to achieving a client's goal for pain relief?

Collaborate with the client about his or her goal for a level of pain relief.

The nurse is performing data collection on an older adult client brought to the clinic by his daughter. Which finding collected would indicate to the nurse that the client may have a urinary tract infection (UTI)?

Confusion

The nurse is caring for an older client whose chart reveals that the client has a reversible cause of urinary incontinence. The nurse creates a plan of care for which condition?

Constipation

A client is diagnosed with scabies in a long-term care facility. Which type of client care precautions would the nurse institute?

Contact

Several months ago, a 20 year-old male suffered a spinal cord injury brought about by a snowboard trick gone wrong. The lasting effects of his injury include flaccid bowel and bladder and the inability to obtain an erection. While sensation has been completely preserved in his legs and feet, his motor function is significantly impaired. What type of incomplete spinal cord injury has the man most likely experienced?

Conus medullaris syndrome

The nurse is inserting an indwelling catheter. What steps will the nurse distinguish as priority in preventing an infection?

Create an area for sterile field and opening packages

After teaching a group of students about the types of urinary incontinence and possible causes, the instructor determines that the students have understood the material when they identify which of the following as a cause of stress incontinence?

Decreased pelvic muscle tone due to multiple pregnancies

A client with osteoarthritis asks for information concerning activity and exercise. When assisting the client, which concept should be included?

Delaying exercise for at least 1 hour after awakening allows the client to participate in exercise after some of the morning-related stiffness has subsided.

The nurse is instructing a client with advanced kidney disease (AKD) about a dietary regimen. Which restriction should the nurse be sure to include in the treatment plan to decrease the progress of renal impairment in people with AKD?

Dietary protein

Which instruction would be included in a teaching plan for a client diagnosed with a urinary tract infection?

Drink liberal amount of fluids.

In children with otitis media, a procedure known as a myringotomy may be performed. Which statement is most accurate regarding this procedure?

During this procedure, small tubes are inserted into the tympanic membrane.

A 60-year-old woman has begun a course of oral antibiotics for the treatment of a urinary tract infection (UTI). The patient's nurse should recognize that the causative microorganisms most likely originated from:

Fecal contamination from the patient's perineum

A nurse is teaching a client diagnosed with Crohn disease about potential complications. The most appropriate information for the nurse to include would be:

Fistula formation

Crohn disease has a distinguishing pattern in the gastrointestinal (GI) tract. The surface has granulomatous lesions surrounded by normal-appearing mucosal tissue. A complication of the pattern includes:

Fistula formation

A school-age child has just returned home from the family's tropical vacation and is now reporting worsening tenderness in the right ear. When the child is diagnosed with otitis externa, what causative factor of this infection should the nurse focus upon?

Frequent swimming and water sports while the child was on vacation

The health care provider is reviewing laboratory results of a client. Select the diagnostic test that is considered the best measurement of overall kidney function.

Glomerular filtration rate (GFR)

The nurse knows that hypertension can lead to nephrosclerotic damage. Which of the following occurs first in nephrosclerosis?

Glomerular hypoperfusion

A nurse hears a staff member giving incorrect information to the family of a client newly diagnosed with diabetes mellitus who is being discharged to home. The nurse wants to make sure the family has the proper information before the client is discharged. What should the nurse do?

Have the nurse step outside of the room, discuss the situation, and use it as a learning opportunity.

The nurse is caring for a child who has conductive hearing loss. What is true regarding this type of hearing loss?

It is caused by chronic otitis media or another infection.

A client is prescribed methenamine to treat urinary tract symptoms. Which nursing assessment finding would suggest the reason for this medication?

Low grade fever

Which condition is characterized by the formation of abnormal spongy bone around the stapes?

Otosclerosis

A patient is admitted to a hospital with a diagnosis of spastic, neurogenic bladder. The nurse is aware that the pathophysiology of this condition is primarily due to which of the following occurrences?

Patient's inability to exert motor control

If an indwelling catheter is necessary, which nursing intervention should be implemented to prevent infection?

Perform meticulous perineal care daily with soap and water

Which measure should a home health care nurse integrate into routine practice to minimize the potential for lawsuits?

Perform thorough, accurate, and timely documentation.

A client with a diagnosis of acute appendicitis is awaiting surgical intervention. The nurse listens to bowel sounds and hears none and observes that the abdomen is rigid and board-like. What complication does the nurse determine may be occurring at this time?

Peritonitis

A client is scheduled for a colonoscopy in the morning. What laxative would the nurse expect to be prescribed the evening before the procedure?

Polyethylene glycol-electrolyte solution

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)

A client is admitted to the health care facility with abdominal pain, a low-grade fever, abdominal distention, and weight loss. The physician diagnoses acute pancreatitis. What is the primary goal of nursing care for this client?

Relieving abdominal pain

A 5-year-old child is diagnosed with acute otitis media. Which nursing intervention would be priority?

Relieving the child's pain

The nurse is caring for a client with asthma who has been experiencing shortness of breath and who has been administered a medication to cause bronchodilation. What aspect of autonomic nervous function has the nurse most likely influenced?

Stimulation of beta-adrenergic receptors

A physician calls the nurse for an update on his client who underwent abdominal surgery 5 hours ago. The physician asks the nurse for the total amount of drainage collected in the Hemovac since surgery. The nurse reports that according to documentation, no drainage has been recorded. When the nurse finishes on the telephone, she goes to assess the client. Which assessment finding explains the absence of drainage?

The Hemovac drain isn't compressed; instead it's fully expanded.

A client has an indwelling urinary catheter and is prescribed physical therapy. As the client is being placed in a wheelchair, which action by the assistant would need further clarification by the nurse?

The catheter bag is placed on the client's lap for safe transport.

The nurse is providing education to a client who is being discharged to home with an indwelling urinary catheter in place. What information is important for the nurse to discuss with the client?

The catheter can be connected to a smaller leg bag for ambulation.

A nurse practitioner in private practice with a health care provider is providing psychiatric care to a client with a history of being abused by a spouse. During the last visit, the client stated an intent to leave the spouse. In the next visit, the nurse practitioner will reassess the client's commitment to this intended change. What type of assessment is the nurse practitioner implementing?

Time-lapse

Which term describes a fungal infection of the scalp?

Tinea capitis

The nurse is assessing a client with diabetes and notes an area on the client's right foot as inflamed, necrotic, and eroded. The client states he accidentally slammed his foot in a door 2 weeks ago. The nurse would document this finding as a(n):

Ulceration

When discussing diseases of the middle ear, the nursing instructor distinguishes the different types of otitis media. What generally causes purulent otitis media?

Upper respiratory infections

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

The nurse understands that medications, although very beneficial to clients, can have harmful effects. When working with older adult clients the nurse should recognize that which outcome is a common result of potent, fast-acting diuretics?

Urge incontinence

A client is admitted to the hospital with a suspected diagnosis of strangulated bowel. The nurse anticipates the client will need:

surgery to release the bowel.

During electrical cardioversion, the defibrillator is set to synchronize with the electrocardiogram (ECG) so that the electrical impulse discharges during

ventricular depolarization.

Which client is at highest risk for developing a hospital-acquired infection?

a client with an indwelling urinary catheter

A group of students are reviewing information about disorders of the bladder and urethra. The students demonstrate understanding of the material when they identify which of the following as a voiding dysfunction?

Urinary retention

The nurse would be most concerned when the glomerular filtrate contains:

Protein

The nurse is collecting data on a client with a urinary tract infection (UTI). Which statements should the nurse expect the client to make? Select all that apply.

- "I need to urinate frequently." -"It burns when I urinate." -"I need to urinate urgently."

The nurse is attempting to insert a urinary catheter into a female client's bladder and realizes the catheter has been inserted into the vagina. Which action is most appropriate?

Leave the catheter in place as a marker and attempt to insert a new sterile catheter directly above the misplaced catheter.

A client with weakness and tingling in both legs is admitted to the medical-surgical unit with a tentative diagnosis of Guillain-Barré syndrome. On admission, which assessment is most important for this client?

Lung auscultation and measurement of vital capacity and tidal volume

A client with suspected inhalation anthrax is admitted to the emergency department. Which action by the nurse takes the highest priority?

Monitor vital signs and oxygen saturation every 15 to 30 minutes.

The client asks the nurse why he cannot remain on a laxative indefinitely. Which of the following is the correct response?

Chronic use of laxatives can lead to constipation.

A nursing instructor who is teaching students about urinary incontinence in older adults suggests that an easy and effective way to remember the transient and treatable causes of urinary incontinence is to use which acronym?

DIAPPERS

A client arrives at the physician's office stating dyspnea; a productive cough for thick, green sputum; respirations of 28 breaths/minute, and a temperature of 102.8° F. The nurse auscultates the lung fields, which reveal poor air exchange in the right middle lobe. The nurse suspects a right middle lobe pneumonia. To be consistent with this anticipated diagnosis, which sound, heard over the chest wall when percussing, is anticipated?

Dull

Which role is the home health nurse exhibiting when demonstrating how to suction the oropharynx of the client?

Educator

A child is being seen in the emergency department (ED) after ingesting crayons with lead in them. He is disoriented and having seizures. The provider suspects he has which of the following?

Encephalitis

A client suspected of having human immunodeficiency virus (HIV) has blood drawn for a screening test. What is the first test generally run to see if a client is, indeed, HIV positive?

Enzyme-linked immunosorbent assay (ELISA)

Which source of information helps a nurse formulate nursing diagnoses for a specific client?

Essential assessment data

The nurse is obtaining a health history from a client describing urinary complications. Which assessment finding is most suggestive of a malignant tumor of the bladder?

Hematuria

An elderly client diagnosed with diarrhea is taking digoxin. Which electrolyte imbalance should the nurse be alert to?

Hypokalemia

A child returns to the clinic after an episode of external otitis (acute otitis externa or swimmer's ear) that has resolved. What would the nurse emphasize as the priority for preventing future episodes?

Keeping ear canals dry

A patient has serous otitis media with significant hearing loss in the right ear. The patient states, "I have not been able to hear for 2 months." What procedure does the nurse anticipate preparing the patient for?

Myringotomy

A client is admitted with an intestinal obstruction with abdominal bloating. Which type of treatment does the nurse know will help decompress the bowel?

Nasogastric tube to suction

Which nursing observation is an appropriate outcome to indicate effective anti-infective therapy for a urinary tract infection?

Negative urinalysis

The anemia that occurs with end-stage kidney disease is often caused by the kidneys themselves. What loss of function in the kidney results in anemia of end-stage kidney disease?

Produce erythropoietin

Which substance would not be found in glomerular filtrate?

Protein

Which individuals are at risk for developing urinary obstructions? Select all that apply.

- A 29-year-old female, pregnant for the first time - A 70-year-old male with benign prostatic hyperplasia (BPH) -A 58-year-old male with renal calculi -A 28-year-old male with a neurogenic bladder secondary to spinal cord injury

The nurse is caring for a 7-month-old female infant diagnosed with a urinary tract infection (UTI). The parents are upset as this is the infant's second UTI with a fever. Which instruction is most helpful? Select all that apply.

- A fever is commonly noted with a UTI. -Change diapers promptly, especially after bowel movements. -Female urethras are shorter and straighter than males.

A nurse is assessing a client with diarrheal disease and determines that the condition has most likely resulted from a parasitic infection. Which of the following would be a potential cause? Select all that apply.

- Giardia - Cryptosporidium

An adult has been diagnosed with gastroesophageal reflux disease, in which the function of the lower esophageal sphincter is compromised. Which consequence of this condition is most likely?

Protrusion of the stomach or regurgitation of stomach contents into the esophagus.

Which type of incontinence is the involuntary loss of urine through an intact urethra as a result of coughing?

Stress

The nurse is caring for a client who has been experiencing difficulty voiding since her vaginal birth. The client voices concern to the nurse. What information should be provided to the client?

The birth can cause perineal swelling.

A nurse is caring for a client with schizophrenia. Which outcome requires revising the client's care plan?

The client spends more time alone.

A parent of a newborn asks the nurse if there is any way to prevent acute otitis media. What would the nurse state to the parent?

The frequency of otitis media is reduced in breastfed infants.

A client is receiving immunosuppressant therapy. Which adverse effects should the client be educated about regarding these effects?

The importance of keeping the home clean

A nurse is implementing appropriate infection control precautions for a client who is positive for human immunodeficiency virus (HIV). The nurse knows which body fluid is not a means of transmission?

Urine

The nursing instructor is teaching a student about urinary incontinence and realizes that the student needs further instruction when she makes which statement?

"Urinary incontinence is an inevitable problem of aging."

The nurse is preparing to insert an indwelling urinary catheter into a female client's bladder. The nurse has opened the sterile catheterization tray using sterile technique, donned sterile gloves and has opened all sterile supplies. Arrange the following steps in the correct order.

1. Clean each labial fold, then the area directly over the meatus. 2. Insert the lubricated catheter into the urethra. 3. Advance the catheter until there is a return of urine. 4. Inflate the balloon with the correct amount of sterile saline. 5. Discard used supplies.

The nurse is caring for four clients. Which client presents the most susceptibility for infection?

46-year old with a foley catheter following anesthesia

A 26 year-old female is resting after a 1-minute episode during which she lost consciousness while her muscles contracted and extremities extended. This was followed by rhythmic contraction and relaxation of her extremities. On regaining consciousness, she found herself to have been incontinent of urine. What has the woman most likely experienced?

A tonic-clonic seizure

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?

Bran cereal

A nurse is implementing the principles of surgical asepsis while inserting a client's indwelling urinary catheter. Which action should the nurse perform?

Hold sterile objects above waist level to prevent accidental contamination.

Which assessment indicates to the nurse that a client may have a spastic bladder dysfunction?

Incontinence

When assessing a client with rheumatoid arthritis, which statement about joint involvement is most accurate?

Involvement is symmetric and polyarticular, initially starting in the adult client's fingers, hands, and wrists.

What is an advantage of using an external condom catheter for a male client who has frequent episodes of urinary incontinence?

It collects urine into a drainage bag without the risk of infection associated with indwelling urinary catheters.

The nurse is conducting a community health education program on urinary retention and urinary incontinence. The nurse determines that the participants are understanding the education when they state that the most common cause of urinary retention is:

Prostate enlargement

Because they strengthen the pelvic floor muscles, Kegel exercises are most likely to help which urinary problem?

Stress incontinence

An elderly client asks the nurse how to treat chronic constipation. What is the best recommendation the nurse can make?

Take a stool softener such as docusate sodium daily.

When a client with an indwelling urinary catheter wants to walk to the hospital lobby to visit with family members, the nurse teaches the client how to do this without compromising the catheter. Which client action indicates an accurate understanding of this information?

The client keeps the drainage bag below the bladder at all times.

Which goal of therapy would be appropriate for a nurse to establish with a client's family and a client who has a diagnosis of enuresis?

The client remains continent throughout the night.

The nurse is caring for a client who is describing urinary symptoms of needing to go to the bathroom with little notice. When the nurse is documenting these symptoms, which medical term will the nurse document?

Urinary urgency

A client with a new ileal conduit asks what the disadvantages are to this type of stoma. The nurse explains that the client may experience which disadvantage?

Urine drains from it continuously.

A nurse who is right-handed is inserting a woman's indwelling urinary catheter. The nurse will use cotton balls and antiseptic solution to cleanse the woman's meatus and perineum. Which of the nurse's actions is most appropriate?

Use her left hand to spread the woman's labia and keep them spread until the catheter is inserted.

A nurse is assigned to care for a patient with arthritis in a health care facility. The patient has been prescribed celecoxib. Celecoxib is contraindicated in clients with:

allergy to sulfonamides.

Atopic dermatitis, or eczema, occurs at all ages and in all races. What happens in dark-skinned people who have eczema?

loss of pigmentation from lichenified skin

A client admitted to the hospital with abdominal pain, anemia, and bloody stools reports feeling weak and dizzy. The client has rectal pressure and needs to urinate and move their bowels. The nurse should help them:

onto the bedpan.