Which patient is most at risk for diarrhea?

A 40-year-old female with major depressive disorder

A 21-year-old female with three final examinations on the same day

A 5-year-old child who ignores the urge to defecate owing to embarrassment

An 80-year-old male in an assisted-living environment

Answer and Explanation

The Correct Answer is B

A. Major depressive disorder can affect bowel habits, but it is more commonly associated with constipation rather than diarrhea.

B. Stress, such as that experienced by the 21-year-old female with multiple final exams, can lead to gastrointestinal symptoms like diarrhea due to the effect of stress hormones on the digestive system.

C. Ignoring the urge to defecate typically leads to constipation rather than diarrhea.

D. Older adults are at risk for constipation due to reduced intestinal motility rather than diarrhea, unless they are taking medications that can cause diarrhea.

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Free Nursing Study Resources

Correct Answer is ["D","E"]

Explanation

A. Using powder can cause skin irritation and dryness and is not recommended for preventing skin breakdown.

B. Clients should be repositioned at least every 2 hours, not every 4 hours, to prevent pressure ulcers.

C. Massaging over erythematous areas can damage fragile tissue and increase the risk of skin breakdown.

D. Using pillows to keep heels off the bed surface helps relieve pressure on bony prominences, reducing the risk of pressure ulcers.

E. Minimizing skin exposure to moisture prevents maceration and skin breakdown, especially in incontinent clients.

A. Cover the wound with a moist, sterile gauze dressing B. Check the client's vital signs C. Assess the client's pain level D. Obtain a culver culture and sensitivity of the wound drainage

Correct Answer is A

Explanation

A. The first priority is to protect the wound by covering it with a moist, sterile dressing to prevent further contamination and to stabilize the area until further intervention.

B. Checking the client's vital signs is important, but stabilizing the wound takes precedence.

C. Assessing pain is necessary but not the immediate priority in this situation.

D. A wound culture can be taken later, after covering the wound and ensuring immediate safety.

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Which patient is most at risk for diarrhea?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is developing a plan of care to prevent skin breakdown for a client with a spinal cord injury and paralysis. Which of the following nursing actions are appropriate? (Select all that apply.)

Correct Answer is ["D","E"]

Explanation

A nurse is assessing a client who has had staples removed from an abdominal wound postoperatively. The nurse notes a wide separation of the wound edges with light serosanguineous drainage. Which of the following actions should the nurse perform first?

Correct Answer is A

Explanation

A nurse is caring for a client who had abdominal surgery 3 days ago. Exhibits Select words from the choices below to fill in each blank in the following sentence. The client is at risk for developing Target 1 dropdown Target 2 dropdown and ___Target 3 dropdown .

The nurse is completing an assessment of the patient's skin's integrity. Which assessment is the priority?

A nurse is planning care for a client who is confined to bed. Which of the following actions should the nurse include in the plan?

A nurse is implementing a bowel training program for a client. For the program to be effective, the nurse should take the client to the toilet at which of the following times?

A nurse is assessing a client's wound dressing, and observes a watery red drainage. The nurse should document this drainage as which of the following?

A nurse is caring for a client who is postoperative following abdominal surgery. Which of the following findings should indicate to the nurse the client's peristalsis is returning?

A nurse is caring for a client who has a wound infection. Which of the following actions should the nurse take when obtaining a wound-drainage specimen for culture?

A patient with a hip fracture is having difficulty defecating into a bedpan while lying in bed. Which action by the nurse will assist the patient in having a successful bowel movement?