A nurse in an emergency department is caring for a client who has suspected appendicitis. Which of the following actions should the nurse plan to take?
Monitor the client for an elevated RBC count.
Instruct the client to not eat food or drink liquids.
Administer an enema to the client.
Maintain the client in a supine position.
The Correct Answer is B
A. Monitor the client for an elevated RBC count.: While an elevated white blood cell count (WBC) is more indicative of appendicitis, an elevated RBC count is not typically used to diagnose appendicitis.
B. Instruct the client to not eat food or drink liquids.: This is important as it prepares the client for a potential surgical procedure. If the appendix is inflamed and surgery is necessary, the client should not eat or drink to prevent complications related to anesthesia and surgery.
C. Administer an enema to the client.: Administering an enema is not recommended as it can increase the risk of perforation of the appendix, which is a serious complication.
D. Maintain the client in a supine position.: While maintaining a supine position may be necessary, it is not as critical as ensuring the client remains NPO (nil per os) in preparation for possible surgery. The position is less of a priority compared to dietary restrictions in this scenario.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) Consume a diet low in cholesterol: A diet low in cholesterol is beneficial for preventing cholelithiasis (gallstones), as high cholesterol levels can contribute to the formation of cholesterol stones in the gallbladder. By reducing dietary cholesterol, the risk of gallstone formation can be minimized.
B) Increase your intake of refined carbohydrates: Increasing the intake of refined carbohydrates can lead to higher levels of triglycerides and cholesterol in the blood, which can promote the formation of gallstones. This dietary change is not recommended for preventing cholelithiasis.
C) Consume a diet high in calories: A high-calorie diet, especially if it leads to obesity, increases the risk of developing gallstones. Obesity is a significant risk factor for cholelithiasis, and a high-calorie diet can contribute to weight gain and the development of gallstones.
D) Reduce your dietary fiber intake: Dietary fiber helps in reducing cholesterol levels by binding bile acids in the intestines, which in turn can prevent the formation of cholesterol gallstones. Reducing fiber intake would be counterproductive and increase the risk of cholelithiasis.
Correct Answer is B
Explanation
A) Hematuria:
While hematuria is a concerning symptom, it is not a commonly recognized adverse effect of buspirone. Hematuria might indicate other underlying conditions that need evaluation but is not typically linked to the use of buspirone.
B) Insomnia:
Insomnia is a potential adverse effect of buspirone. It can significantly impact the client’s quality of life and overall well-being. Reporting insomnia to the healthcare provider is important as it may necessitate adjustments in medication or additional interventions to help manage sleep disturbances.
C) Arthralgia:
Arthralgia, or joint pain, is not commonly associated with buspirone use. If the client experiences joint pain, it is more likely to be related to other causes rather than the medication. However, all symptoms should still be discussed with a healthcare provider.
D) Hypoglycemia:
Hypoglycemia is not a known adverse effect of buspirone. This medication does not typically influence blood glucose levels. If the client experiences symptoms of low blood sugar, other factors or conditions should be considered as potential causes.
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