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A nurse is caring for an adult client who has a developmental disability. The client requires an emergency appendectomy, and the staff cannot reach the appointed guardian. Which of the following is an appropriate action for the nurse to take?

Postpone the procedure until the staff contacts the guardian.

Obtain consent from the client.

Prepare the client for surgery with implied consent.

Request that the provider sign the consent form.

Answer and Explanation

The Correct Answer is C

Rationale:

A. Postponing the procedure could put the client at risk if the appendicitis worsens.

B. Obtaining consent from the client may not be possible due to the client's developmental disability.

C. Preparing the client for surgery with implied consent is appropriate when the client is unable to provide consent and the procedure is urgent.

D. Requesting that the provider sign the consent form is not appropriate because the provider cannot provide consent on behalf of the client.

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Correct Answer is B

Explanation

Rationale:

A. Drinking an average of 2,000 milliliters of water daily is a healthy habit that promotes bowel elimination.

B. Taking a prescribed opioid pain medication at bedtime can cause constipation and impaired bowel elimination.

C. Eating apples and black-eyed peas is a healthy dietary choice that promotes bowel elimination.

D. Drinking two hot cups of coffee each morning can promote bowel elimination for some individuals.

A. Episiotomy approximated, 3 cm (1.18 in) in length. B. Client instructed on self-care needs. C. Client drank adequate amounts of fluid with meals. D. Oral temperature elevated at 0800.

Correct Answer is A

Explanation

Rationale:

A. Documenting the status of the episiotomy, including its size and approximation, is important for monitoring wound healing and ensuring appropriate postpartum care.

B. While providing self-care instructions is important, it is not a specific documentation related to the postpartum condition.

C. Fluid intake with meals is important for overall health but may not be specifically related to the postpartum condition.

D. Documenting an elevated oral temperature may be relevant for assessing the client's health status but is not specific to the postpartum condition.

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A nurse is caring for an adult client who has a developmental disability. The client requires an emergency appendectomy, and the staff cannot reach the appointed guardian. Which of the following is an appropriate action for the nurse to take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting data from a client about bowel elimination. Which of the following statements by the client indicates a risk for impaired bowel elimination?

Correct Answer is B

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Correct Answer is A

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