After her bath, a 62-year-old patient asks the nurse for a perineal pad saying that she uses them because sometimes she leaks urine when she laughs or coughs. Which intervention is most appropriate to include in the care plan for the patient?

Teach the patient how to perform Kegel exercises.

Assist the patient to the bathroom q3hr.

Demonstrate how to perform Crede’s maneuver.

Place commode at the patient’s bedside.

Answer and Explanation

The Correct Answer is A

Kegel exercises are designed to strengthen the pelvic ﬂoor muscles, which can help improve urinary incontinence. By teaching the patient how to perform Kegel exercises, the nurse can provide a non-invasive, eﬀective intervention that the patient can perform on her own to help manage her urinary incontinence.

Assisting the patient to the bathroom q3hr (b) may help reduce the frequency of incontinence episodes but it does not address the underlying issue of weakened pelvic ﬂoor muscles.

Demonstrating how to perform Crede’s maneuver (c) involves applying manual pressure to the bladder to assist with urination and is not appropriate for managing urinary incontinence related to laughing or coughing.

Placing a commode at the patient’s bedside (d) may be appropriate for patients who have difficulty with mobility or accessing the bathroom, but it does not address the underlying issue of weakened pelvic ﬂoor muscles causing urinary incontinence.

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Correct Answer is C

Explanation

The patient with primary hyperparathyroidism has high levels of calcium in the blood (hypercalcemia) which can lead to symptoms such as kidney stones, bone pain, and weakness. High urine calcium levels may also be present due to the increased calcium in the blood.

One important intervention for managing hypercalcemia is to encourage ﬂuid intake to promote increased urine output and prevent the formation of kidney stones. Therefore, the nurse should encourage the patient to drink at least 4000 ml of ﬂuids per day.

Seizure precautions (a), range-of-motion exercises (b), and monitoring for positive Chvostek’s or Trousseaus sign (d) are not directly related to managing hypercalcemia and are not necessary in this case.

A. The client's stool is positive for occult blood. B. The client reports abdominal discomfort an hour after each meal. C. The client has had four ulcers in the last 5 years. D. The client's hemoglobin is 13 g/dL and hematocrit is 42%.

Correct Answer is B

Explanation

Abdominal discomfort an hour after a meal is a common symptom of a gastric ulcer because the stomach is where food is initially processed, and stomach acid is most concentrated. In contrast, duodenal ulcers typically cause pain 2-3 hours after meals, as food moves out of the stomach and into the duodenum, where it encounters duodenal acid.

A positive stool occult blood test is a non-specific finding that can be caused by many gastrointestinal conditions, including peptic ulcers. It does not indicate the location of the ulcer.

The number of ulcers the client has had in the past does not indicate the location of the current ulcer.

Normal hemoglobin and hematocrit levels do not provide information about the location of the ulcer.

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After her bath, a 62-year-old patient asks the nurse for a perineal pad saying that she uses them because sometimes she leaks urine when she laughs or coughs. Which intervention is most appropriate to include in the care plan for the patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient with primary hyperparathyroidism has a serum calcium level of 14 mg/dl (3.5 mmol/L), phosphorus of 1.7 mg/dl (55 mmol/L), serum creatinine of 2.2 mg/dl (194 mmol/L). and high urine calcium. While the patient awaits surgery, the nurse should:

Correct Answer is C

Explanation

The nurse is caring for a client with diagnosis of peptic ulcer disease. Which assessment finding indicates to the nurse that the client most likely has an ulcer in the stomach rather than the duodenum?

Correct Answer is B

Explanation

The nurse is caring for a patient with hypothermia and ﬂuid volume excess. Which of the following would be included in the plan of care?

A patient with crushing syndrome is admited to the hospital to have laparoscopic adrenalectomy. During the admission assessment, the patient tells the nurse "The worst thing about this disease is how terrible I look; I feel awful about it.' The best response by the nurse is:

Cardiac monitoring is initiated for a patient with diabetic ketoacidosis. The nurse determines that this measure is important to identify:

A patient with suspected acromegaly is seen at the clinic. To assist in making the diagnosis, which question should the nurse ask?

During the nursing assessment of a patient with Graves' disease. The nurse notes a bounding, rapid pulse and systolic hypertension. Based on these assessment data, which question is important for the nurse to ask the patient?

A nurse is teaching nutritional strategies to a client who has a low calcium level and an allergy to milk. Which of the following statements by the client indicates an understanding of the teaching?

A patient with chronic atrophic gastritis was prescribed monthly Cobalamin (B12) injections The determines that teaching regarding the injections has been eﬀective when the patient States:

A client is taking furosemide (Lasix), a diuretic. and becomes confused. Which potassium level does the nurse correlate with this condition?