A nurse is providing instructions about bowel cleansing with polyethylene glycol-electrolyte solution (PEG) for a client who is going to have a colonoscopy. Which of the following information should the nurse include?
"Drink 400 ml every hour until bowel movements are clear"
"Expect bowel movements to begin 3 hr following completion of solution. "
"To prevent dehydration, drink an additional liter of fluid during preparation time. "
"Abdominal bloating might occur"
The Correct Answer is D
Answer: D
Rationale:
A. "Drink 400 ml every hour until bowel movements are clear": The standard recommendation for PEG is to drink a specific volume, usually 240 ml every 10 to 15 minutes, rather than 400 ml every hour. The goal is to ensure the bowel is adequately cleansed, and this rate is typically more effective in achieving that.
B. "Expect bowel movements to begin 3 hr following completion of solution": Bowel movements often start within an hour or two after starting the PEG solution rather than waiting for 3 hours after finishing it. The timing can vary, but the onset is generally sooner.
C. "To prevent dehydration, drink an additional liter of fluid during preparation time": While it is important to stay hydrated, the specific recommendation for additional fluid intake beyond the PEG solution can vary. Typically, the instructions focus on the volume of PEG solution to drink rather than specifying a set amount of additional fluid.
D. "Abdominal bloating might occur": Abdominal bloating is a common side effect of bowel cleansing preparations like PEG. It can occur due to the large volume of fluid ingested and the rapid movement of the bowel contents, making it a relevant point to include in the instructions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["0.5"]
Explanation
Let's convert the digoxin dosage from mcg (micrograms) to mg (milligrams) and then divide it by the amount of digoxin per tablet to find out how many tablets are needed.
Steps to solve:
- Convert digoxin dose from mcg to mg:
- We know 1 mg is equal to 1000 mcg.
- Digoxin dose (mg) = Digoxin dose (mcg) / 1000 mcg/mg
- Digoxin dose (mg) = 125 mcg / 1000 mcg/mg
- Digoxin dose (mg) = 0.125 mg
- Calculate the number of tablets required:
- Number of tablets = Digoxin dose (mg) / Digoxin per tablet (mg)
- Number of tablets = 0.125 mg / 0.25 mg/tablet
Since the result is 0.5, we need to round to the nearest tenth.
Answer: The nurse should administer 0.5 tablets per dose.
Correct Answer is A
Explanation
A. Measure the circumference of both upper arms: This is the priority action. Swelling above the PICC insertion site could indicate infiltration or another complication. Measuring the circumference of both upper arms allows the nurse to assess the extent of swelling and monitor for any changes over time, providing valuable information for further intervention and evaluation.
B. Notify the provider who inserted the PICC line: This is an important action, but it may not be the first step. Before notifying the provider, the nurse should gather objective data by assessing the client's condition, such as measuring arm circumference, to provide a comprehensive report to the provider.
C. Remove the PICC line: This is not the first action to take. Removing the PICC line should only be considered after thorough assessment and under the direction of a healthcare provider, especially if there are signs of complications such as swelling.
D. Apply a cold pack to the client's upper arm: While applying a cold pack may help reduce swelling in some cases, it is not the priority action in this situation. The nurse should first assess the extent of swelling and gather additional data before implementing interventions such as cold therapy.
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