GI/GU NCLEX questions
The nurse is providing discharge teaching to a female patient on how to prevent urinary tract infections. Which statement is incorrect? A. "Void immediately after sexual intercourse" B. "Avoid wearing tight fitting underwear" C. "Try to void every 2-3 hours" D. "Use scented sanitary napkins or tampons during menstruation"
D colored clothing can cause irritation and chemicals can disrupt PH
The nurse is doing preoperative teaching with a patient who is about to undergo creation of kock pouch. The nurse interprets that the patient has the best understanding of the nature of the surgery if the patient makes which statement? A. " I will be able to pass stool through my rectum eventually" B. " the drainage from this type of ostomy will be formed" C. "I will need to drain the pouch regally with a catheter." D. "I will need to wear a drainage bag for the rest of my life"
C
Which of the following foods should be encouraged for a patient with constipation? A. Macaroni and cheese B. Fresh fruits and whole wheat toast C. Beef tips and noodles D Pepperoni pizza.
B You want your patients to have a high fiber diet.
Mrs. Jones is alert, ambulatory, older nursing home resident, who frequently has difficulty making it to the bathroom in time. The nurse planning her care is aware of the following? A.Incontinence is to be expected especially in woman and of Mrs. Jones age B.One of every 10 nursing home residents is incontinent C.Kegel exercises performed at regular intervals throughout the day maybe helpful D.An indwelling catheter should be inserted as soon as possible
C
A patient has a new colostomy created 2 days earlier and is beginning to pass malodorous lotus from the stoma. What is the correct interpretation by the nurse? A. This is a normal, expected event B. The patient is experiencing early signs of ischemic bowel C. The patient should have the nasogastric tube removed. D. the indicatives inadequate preoperative bowel preparation
A
The female patient states to the nurse, "I'm so distressed, It seems like every time I laugh hard, I wet myself." The nurse knows that this condition is known as? A.Stress Incontinence B.Urge Incontinence C.Functional Incontinence D.Unconscious Incontinence
A
The unit manager is evaluating the care of a new nurse staff member. Which of the following is an appropriate technique for the nurse to obtain a clean-voided urine sample? A.Restrict fluids before specimen collection B.Apply sterile gloves for the procedure C.Collect the specimen after the initial stream of urine D.Place the specimen in a clean urinalysis container
C
A nurse identifies a clients colostomy stoma is pale. What should the nurse do? A. Notify the healthcare provider B. Listen to bowel sounds C. Wash the area with warm water D. Gently massage around stoma
A Notify the healthcare provider, we are worried about blood supply.
For a patient with an ileostomy, the critical element is A. Skin care B. odor control C. Stoma irritation D. Infection protection
A Skin care is a critical element because the digestive chemicals are harmful to their skin. its present in the stool and can get on their skin. leads to skin breakdown.
A patient with an indwelling catheter report a need to void, what priority intervention should the nurse perform? A. Check to see if the catheter is patent B. Reassurance that patient that it is not possible for her to void C. Re-catheterize the patient with a larger gauge catheter D. Notify the physician
A check to make sure the caterer isn't kinked moved, or obstructed in a way that would not allow the flow of urine.
Straight catheter is done to: Select all that apply. A.Obtain urine samples B.Drain residual urine C.Provides continuous bladder drainage D.Allow for bladder irrigation E.Pass through a constricted urethra
A,B
On your nursing care plan for a patient with a urinary tract infection, Which of the following would be appropriate nursing interventions? (SELECT ALL THAT APPLY) A. Encourage voiding every 2-3 hours while awake B. Restrict fluid intake to 1-2 liters per day C. Monitor intake and output daily. D. Administer antibiotics before urinalysis collection.
A,C, Encourage voiding every 2-3 hours while awake (yes) Restrict fluid intake to 1-2 liters per day (Encourage not restrict) Monitor intake and output daily. (yes) Administer antibiotics before urinalysis collection. (Not before, after.)
What are the expected characteristics of urine? Select all that apply A.Pale yellow urine B.Cloudy C.Fruity Odor D.pH= 6 E.Protein Present F.No glucose
A,D,F
A client is diagnosed with an intestinal infection after traveling abroad. The nurse should encourage the intake of which food to promote healing? A. Yogurt B. Pasta C. Oatmeal D. Broccoli
A. yogurt Is a probiotic]c. we are trying to replace that good bacteria back to the body.
A patient undergoes surgery due to having massive trauma to the kidneys resulting from a fall from a scaffold. Which assessment data obtained postoperatively is most important to communicate to the surgeon. A. Blood pressure is 102/48 B. Urine output is 20 ml/hr for 2 hours C. Crackles are heard at both lung bases D. Incisional pain level is 8/10
Answer is B Min Amt of urine per hour is 30 ml. If we are getting at least 30 we know we are getting sufficient amount of blood to the kidneys.
The healthcare team suspects that a client has an intestinal infection. Which action should the nurse take to help conform diagnosis? A. prepare the client for abdominal plate B.Collect stool specimen that contains about 20-30 ml of liquid stool C. Administer laxative to prepare client for colonscopy D. Test clients stool using fecal occult test
B Prepare the client for abdominal plate( confirm diarrhea) Collect stool specimen that contains about 20-30 ml of liquid stool- yes we need to collect in order to confirm) Administer laxative to prepare client for colonscopy- no Test clients stool using fecal occult test ( this is to test if there is any blood in the stool.)
How can a patient prevent a urinary tract infection? Select all that apply. A.Take bubble baths B.Wear cotton underwear C.Cleanse the perineum from front to back D.Urinate every 2-3 hours E.Cleanse the genital area before intercourse
B,C,D
A male client in the client provides a urine sample that is red orange in color. What action should the nurse take first? A. Notify the clients healthcare provider B. Teach correct midstream urine collection C. Asl the client about current medications D. Question the client about urinary tract infection risk factors
C
A patient taking Phenazopyridine (Pyridium), a urinary tract analgesic, Should be cautioned that her urine may turn what color? A.Pale yellow B.Green C.Orange Red D.Brown
C
The client has been admitted to an acute care unit with a diagnosis of an upper GI bleed. The nurse suspects that the feces will appear? A. Bright red B. Pus filled C. Black and tarry D. White or clay colored.
C Black and tarry stools- upper GI bleed Bright red- lower GI bleed
Following rectal surgery, a client voids about 50 ml of urine every 30 -60 minutes for the first 4 hours. Which nursing action is most appropriate? A. Monitor the clients intake and output over night B. Have the client drink small amounts of fluid frequently C. Use an ultrasound scanner to check the postpaid residual volume D. Reassurance the client that is normal after rectal surgery because of anesthesia
C Best answer because this is an assessment and as a nurse we always assist first, but also we need to check if the patient retaining any urine in the bladder.
A client admitted to the hospital with pneumonia has a history of functional urinary incontinence. Which nursing action will be included in the plan of care? A. Demonstrate the use of the creed maneuver B. Teach kegal exercise to strengthen pelvic floor C. Place a bedside commode close to the clients bed D. use an ultrasound scanner to check for post cord residual's.
C. Place a bedside commode close to the clients bed.
A patient has been experiencing difficulty and straining when expelling feces. Which intervention should the nurse discuss with the patient? A. Explain some blood in the stool with be normal B. Instruct the patient in manual removal of feces C. Encourage the patient use a simulant laxatives on a daily basis D. Place the patient on a high fiber diet
D Encourage the patient use a simulant laxatives on a daily basis ( simulate is a dependent risk drug)- not a good option!!
A 55 year old woman admitted for shoulder surgery asks the nurse for a perineal pad, stating that laughing or couching causes leakage of urine. Which intervention is most appropriate to include in the care plan? A. Assist the client to the bathroom every 3 hours B. Place a commode at the clients bedside C. Demonstrate how to perform the creed maneuver D. Teach the client how to perform Kegal exercise.
D
A patent, who is having spasms and during while urinating due to a UTI, is prescribed "pyridum" (phenazopyridine). Which option below is a normal side effect of drug? A. Hematuria B. Crystalluria C. Urethra mucous D. Orange Colored urine
D
There is a 24- hour urine collection in process for a patient. The nursing assistive personal inadvertently empties one specimen into the toilet instead of the collection "hat." The nurse should: A.Continue with the collection of urine until the 24 hour time period is finished B.Make a note to the lab to inform them that one specimen was missed during collection C.Begin filling a new collection container and take both containers to the lab at the end of the collection period D.Dispose of the urine already collected and begin an entirely new 24 hour collection
D
Which of the following is the least invasive alternative to a urethral catheterization? A.Suprapubic catheterization B.Reinsertion of foley catheter C.Catheter irrigation D.Condom catheterization
D
Which of the following patients presents the most significant risk factors for the development of clostridium difficile infection? A. A 44 year old patient who is paralyzed and whose coccyx ulcer has retired a skin graft B. A patient with renal failure who receives hemodialysis three times weekly C. A 30 year old patient has recently contracted human immunodeficiency virus after engaging in high-risk sexual behavior D. An 81 year old patient who has been receiving multiple antibiotics for the treatment of sepsis
D
Which of the following is not a treatment for C. diff infections? A. Antibiotics B. Probiotics C. Fecal transplant D. Antivirals
D Antivirals would not do anything for them. You use antibiotics to treat c.diff.... yes antibiotics puts you at more risk for c. diff as well.
The patient from a long-term care facility is admitted to the medical unit with fever, hot flushed skin, and clumps of white sediment in the indwelling catheter. Which intervention should the nurse implement first? A. Start IV with a 20- gauge catheter B. Initiate antibiotic thereby IVPB C. Collect urine sample for culture D. Change the indwelling catheter
D Patient possibly have a UTI. We need to collect a sample but the question says there is white sediment in the catheter. so what we need to do first is, to change the indwelling catheter. NEVER FLUSH A CATHETER IF YOU THINK THEY HAVE AN INFECTION. Second: collect specium Third: Iv catheter Fourth: Antibiotic therapy
The nurse identifies a need for additional teaching when the patient with acute infections diarrhea states? A. " I can use A & B ointment or Vaseline jelly around the anal area to protect my skin" B. "Gatorade is a good liquid to drink because is replaces fluid and electrolytes i have lost" C. " I must wash my hands after every bowel movement to prevent spreading the diarrhea to my family" D. "I may use over the counter loperamide (imodium) as needed to control the diarrhea"
D loperamide is an antidiural. which we don't want to give out patent if they have an infectious condition cause it can expose this bacterium to the pt longer.
When obtaining a sterile urine specimenD from an indwelling urinary catheter the nurse should: A. Disconnect the catheter from the drainage tubing B. Withdraw urine from a urinometer C. Open the drainage bag and removing urine D. Use a needle/needless syringe to withdraw urine from the catheter port.
D Urinometer is used for critically ill patients when we want to make sure we are looking at their urine every hour.
