A nurse is teaching a newly licensed nurse about the function of the large intestine. Which of the following information should the nurse include?
It produces vitamin D.
It absorbs liquid to form stool.
It prevents the reflux of food into the esophagus.
It secretes enzymes to digest food.
The Correct Answer is C
A. The nurse coats the indwelling urinary catheter with lubricant. This is correct procedure and requires no intervention. Lubricating the catheter reduces friction and discomfort during insertion.
B. The nurse applies the sterile drape prior to inserting the urinary catheter. This is correct procedure and requires no intervention. The sterile drape maintains a sterile field.
C. The nurse separates the client's labia with her dominant hand. The nurse should separate the client's labia with her non-dominant hand, which then remains in place as a "dirty" hand. The dominant hand, which remains sterile, is used to insert the catheter.
D. The nurse provides perineal care prior to inserting the urinary catheter. This is correct procedure and requires no intervention. Perineal care reduces the risk of introducing bacteria into the urinary tract.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Have the client breathe into a paper bag. Breathing into a paper bag helps retain CO₂, which can correct respiratory alkalosis caused by hyperventilation.
B. Plan to administer insulin to the client. Insulin is used to manage hyperglycemia or diabetic ketoacidosis, not respiratory alkalosis.
C. Plan to administer sodium bicarbonate to the client. Sodium bicarbonate is used to treat metabolic acidosis, not respiratory alkalosis.
D. Have the client place their head between their knees. This position is not a standard intervention for respiratory alkalosis or hyperventilation.
Correct Answer is B
Explanation
A. "You will wear an external collection bag to drain your urine." An external collection bag is required for an ileal conduit, not a neobladder, where urine is stored internally.
B. "You will have an internal pouch to store your urine." A neobladder is created using a portion of the intestine to form a new bladder, which stores urine internally. The client may be able to void through the urethra.
C. "You will have a stoma that is located in your abdomen." A stoma is associated with an ileal conduit or a urostomy, not with a neobladder. A neobladder does not require an external stoma.
D. "You will not be able to control your urination." Initially, the client may have difficulty controlling urination until they learn how to use the neobladder. Over time, they may regain some control.
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