A 72-year-old client is admitted to the medical-surgical unit with a diagnosis of acute pyelonephritis. The client complains of costovertebral tenderness. What it the most appropriate nursing intervention?

Notify the physician since this is a sign of deterioration.

Offer the client back massage to reduce the pain.

Place the client in prone position to limit vesicoureteral reflux.

Offer the client an analgesic if prescribed.

Answer and Explanation

The Correct Answer is D

A.   While costovertebral tenderness is significant and indicates kidney involvement, it is a common symptom of acute pyelonephritis and not necessarily a sign of deterioration. Immediate notification may not be warranted unless other concerning symptoms are present.
B.   Although back massage may seem comforting, it is not indicated in this scenario. The kidneys are inflamed, and massage could exacerbate pain or discomfort. It does not address the underlying condition or the pain effectively.
C.   The prone position is not typically recommended for clients with pyelonephritis. Instead, the client may be more comfortable in a position that does not put pressure on the kidneys, such as sitting up or lying on their back or side. This intervention does not directly address the pain or comfort of the client.
D.   Offering an analgesic is the most appropriate action. Pain management is crucial for the comfort of the client, and an analgesic can help alleviate the discomfort associated with costovertebral tenderness. If the physician has prescribed an analgesic, administering it would be in line with promoting comfort and addressing the client’s needs.

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Correct Answer is D

Explanation

A. While an elastic bandage can provide some compression to control bleeding, its primary purpose post-amputation is not to prevent bleeding but to support the healing process. It does help cover the incision, but this is not its main function in the context of shaping the stump.
B. Phantom limb pain is a common phenomenon after amputation, where the patient feels sensations in the amputated limb. Wrapping the stump may provide some psychological comfort, but the elastic bandage does not directly decrease phantom limb pain.
C. While adequate compression can help with circulation, the primary function of wrapping the stump is not to prevent blood clots. Preventing blood clots is more relevant to immobilization and other measures, particularly in the early postoperative period.
D. The elastic bandage helps to compress the soft tissue of the stump, promoting a well-shaped residual limb. This shaping is important for fitting prosthetics later and helps minimize edema (swelling) in the area post-surgery.

A. 2 to 4 hours. B. 12 to 16 hours. C. 3 to 10 hours. D. 2 to 8 hours.

Correct Answer is A

Explanation

This is the expected peak time for regular insulin. After administration, insulin will generally reach its maximum effectiveness in lowering blood glucose within this timeframe, making it crucial for the client to eat or take carbohydrates to prevent hypoglycemia.

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A 72-year-old client is admitted to the medical-surgical unit with a diagnosis of acute pyelonephritis. The client complains of costovertebral tenderness. What it the most appropriate nursing intervention?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with an above the knee amputation asks the nurse why the stump needs to be wrapped with an elastic bandage. The nurse explains that it:

Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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