A nurse is collecting data on a client who is two days postoperative following creation of an ileal conduit. The nurse should report which of the following findings?
Urine in the drainage appliance
Feces in the drainage appliance
Mild edema of the stoma
Redness of the stoma
The Correct Answer is B
a. Urine in the drainage appliance: The presence of urine in the drainage appliance is expected in a client with an ileal conduit, as this is the route for urine to exit the body.
b. Feces in the drainage appliance: An ileal conduit is created for urinary diversion, and feces
should not be present in the drainage appliance. This finding could indicate a complication and should be reported.
c. Mild edema of the stoma: Mild edema of the stoma may be expected in the early postoperative period and may not require immediate reporting unless it worsens.
d. Redness of the stoma: Some redness is normal around a stoma, and it may not require immediate reporting unless there are signs of infection or worsening inflammation.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
a. Pleural friction rub: Pleural friction rub is a grating sound heard during inspiration and
expiration and is associated with inflammation of the pleura. It is not typically associated with asthma exacerbation.
b. Fine rales: Fine rales (crackles) are usually heard during inspiration and can be associated with conditions such as pneumonia or pulmonary fibrosis. They are not the typical lung sounds in
asthma exacerbation.
c. Rhonchi: Rhonchi are low-pitched wheezes heard during inspiration and expiration. While they can be associated with asthma, expiratory wheezes are more specific to asthma
exacerbation.
d. Expiratory wheeze: Expiratory wheezes are high-pitched, musical sounds heard during
expiration and are characteristic of asthma exacerbation. They result from narrowed airways and increased airway resistance.
Correct Answer is A
Explanation
a. Bradycardia: Atenolol is a beta-blocker that can slow down the heart rate, leading to
bradycardia. Monitoring the client for signs of bradycardia, such as dizziness, fatigue, or fainting, is important.
b. Anemia: Atenolol is not known to cause anemia. Monitoring for anemia is not a specific concern with this medication.
c. Hypokalemia: Atenolol is not associated with causing hypokalemia. However, beta-blockers in general may affect potassium levels indirectly.
d. Neutropenia: Atenolol is not typically associated with causing neutropenia. Monitoring for neutropenia is not a specific concern with this medication.
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