Which statement, made by a client being discharged to home after a radical cystectomy, indicates a need for further clarification by the nurse? "I will:

notify the provider if the urine output is absent."

resume voiding normally within one week."

take a stool softener daily to decrease the chance of straining."

monitor the skin around the surgical site for redness."

Answer and Explanation

The Correct Answer is B

A.   After a radical cystectomy, the client may have a urinary diversion (such as a stoma) and should be vigilant about monitoring urine output. Absence of urine output can indicate a serious issue, and notifying the provider is crucial.
B.   This statement indicates a need for further clarification. After a radical cystectomy, clients typically do not resume normal voiding because the bladder is removed. Instead, they may have a urinary diversion or need to learn how to manage their new urinary output. Normal voiding as before surgery is not possible, so this statement reflects a misunderstanding of the procedure's implications.
C.   After surgery, particularly abdominal surgery like a radical cystectomy, patients are often advised to take stool softeners to prevent constipation. Straining can increase the risk of complications and affect the surgical site, so this is a valid precaution.
D.   Monitoring the surgical site for signs of infection, such as redness, swelling, or discharge, is an essential part of post-operative care. Clients should be educated on how to check their surgical site for any concerning changes.

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Correct Answer is ["14"]

Explanation

154 lbs ÷ 2.2 lbs/kg = 70 kg

20 units/kg * 70 kg = 1400 units

1400 units ÷ 25,000 units/250 mL = 14 mL

Therefore, the nurse will administer 14 mL of Heparin.

A. changing the surgical dressing when it becomes saturated with drainage. B. encouraging the client to obtain permanent breast prosthesis as soon as she is discharged from the hospital. C. placing a limb alert bracelet on the right wrist as warning against blood pressure or venipunctures. D. teaching the client to use the prescribed patient-controlled analgesia (PCA) every 20 mintues for the best pain relief.

Correct Answer is C

Explanation

A. While it's important to monitor the surgical dressing, changing it too frequently can increase the risk of infection and disrupt healing. Instead, nurses typically assess the dressing regularly and only change it if it's overly saturated or if ordered by a physician. It’s essential to follow specific protocols regarding dressing changes.
B. A While breast prostheses can be an important part of post-mastectomy care for some clients, it is usually recommended that clients wait until they have fully healed and received counseling regarding their options. Immediate encouragement may be premature, as physical and emotional adjustments take time after surgery.
C. This is an appropriate intervention. After axillary lymph node dissection, there is a risk of lymphedema in the affected arm. Placing a limb alert bracelet serves as a reminder to healthcare providers to avoid taking blood pressure or performing venipunctures on the affected arm, thus helping prevent complications.
D. While PCA can be an effective method for managing postoperative pain, the timing and dosage should be based on the specific prescription and the client's individual needs. It’s crucial to educate the client about the PCA device and its use, but the specific interval may vary based on the medication's parameters and the patient's condition.

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Blood Cell	Normal Ranges
Red blood cells (mature, circulating)	Male: 451-6.01 million/mm3 Female: 4.01-5.51 million/mm3
Hemoglobin	Adult (15-64 yr) Male 14-17.3 g/dL Female 11.7-155 g/dL
Hematocrit	42%-52% in males 36% -48% in females
Reticulocytes	0.5% -2.5% of total RBC count
White blood cells (total)	4.5-11.1 10/mm3
Neutrophils	59% Bands 3% Segs-56%
Eosinophils	2.7%
Basophils	0.5%
Lymphocytes	34%
Monocytes	4%


Platelets	150,000-450,000/mm3

Which statement, made by a client being discharged to home after a radical cystectomy, indicates a need for further clarification by the nurse? "I will:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient is ordered 20 unit/kg IV bolus of Heparin. The patient weighs 154 lbs. Heparin is supplied 25,000 units/250 mL. How many mL will the nurse administer? (round to the nearest whole number)

Correct Answer is ["14"]

Explanation

A client returns to the surgical unit following a right modified radical mastectomy with dissection of axillary lymph nodes. An appropriate nursing intervention in the postoperative care for the client includes:

Correct Answer is C

Explanation

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