NURSING 201 Saunders Review Test 1

A. Limiting fiber is necessary to avoid diarrhea. Correct B. I should empty my bladder when I feel the urge. C. Avoiding pain medication will prevent constipation. Correct D. I should drink plenty of liquids like iced tea or coffee. Correct E. I should continue with my physical therapy and walking. Rationale: Constipation is common after surgery due to pain medication, decreased movement, and anesthesia. Fiber intake should be encouraged as it promotes the prevention of stool retention. Although pain medication can cause constipation, it should not be avoided in the post-operative period. Drinking plenty of fluids is encouraged for both bowel and bladder maintenance, but the client should choose non-caffeinated options. Physical therapy, walking, and exercise will help prevent constipation. Emptying the bladder when the urge is present can help prevent urinary tract infections. Test taking strategy: Note the strategic words need for further teaching. These words indicate a negative event query and the need to select the incorrect client statements. Think about the measures needed for bowel and bladder control to answer correctly. Review: bowel and bladder maintenance. Level of Cognitive Ability: Evaluating Client Need: Physiological Integrity Integrated Process: Teaching and Learning Content Area: Fundamentals of Care: Perioperative Care Giddens Concepts: Client Education, Health Promotion HESI Concepts: Health Promotion, Teaching and Learning/Patient Education References: Giddens, J. (2013). Concepts for nursing practice. (p. 143). St. Louis, MO: Mosby. Lewis, S., Dirksen, S., Heitkemper, M., & Bucher, L. (2014). Medical-surgical nursing: Assessment and management of clinical problems (9th ed., pp. 969, 1089-1090). St. Louis: Mosby. Awarded 3.0 points out of 3.0 possible points. 2.ID: 8The nurse is caring for a Vietnamese client diagnosed with tuberculosis. The client speaks limited English. What should the nurse do to ensure the client and family receives the most accurate information? Select all that apply. A. Provide culturally sensitive education. Correct B. Encourage family members to obtain a tuberculosis skin test. Correct C. Provide written instructions in English for the client to reference. D. Encourage the client and family to wash all dishes by hand to prevent the spread of infection. Incorrect E. Urge all family and close contact community members to seek and complete treatment to enhance compliance. Correct Rationale: As always, the nurse must provide culturally sensitive education. Because tuberculosis is highly contagious, all family members and close community members should have a tuberculosis skin test, seek treatment, and remain compliant. A full course of 6-9 months of treatment is needed to prevent re-infection. Instructions written in English are not helpful for the client with limited English skills. Washing dishes by hand is not the best way to prevent infection; rather a dishwasher should be used if available. Test Taking Strategy: Focus on the strategic word most to select correct options that relate to appropriate teaching for both the client and family members. Also, focusing on the data in the question will assist in answering. Review: Tuberculosis Level of Cognitive Ability: Applying Client Needs: Safe and Effective Care Environment Integrated Process: Nursing Process: Implementation Content Area: Fundamentals of Care: Infection Control Priority Concepts: Client Education, Infection HESI Concepts: Infection, Teaching and Learning/Patient Education References: Giger, J. (2013). Transcultural nursing assessment & intervention. (6th ed. p. 445, 455). St. Louis: Mosby. Lewis, S., Dirksen, S., Heitkemper, M., & Bucher, L. (2014). Medical-surgical nursing: Assessment and management of clinical problems (9th ed., p. 533). St. Louis: Mosby. Awarded 1.0 points out of 3.0 possible points. 3.ID: 4 A client with anxiety has just been seen by the health care provider and has been prescribed alprazolam. The client asks the nurse how long it will take forthe medication to build up a steady state in her body. If the half life of this medication is approximately 11 hours, approximately how long will it take for this medication to build up and reach a steady state? _____ hours Incorrect Correct Responses A. 55 Rationale: The half life of a medication is the amount of time it takes for 50% of the medication to leave the system. Steady state is the point where the concentration of the medication is equal based on the medication leaving the body system and new medication entering the system. Alprazolam has a half life of 11 hours. For all medications, it takes approximately five times the half life to reach steady state. Therefore the steady state for this medication is 55 hours (11 x 5 = 55) []