A client arrives with respiratory muscle weakness, difficulty swallowing and abdominal pain. Which of the following reported by the client's husband is relevant to the client's manifestations?
The client received an influenza vaccine 4 weeks ago
The client is an avid golfer
The client cans jams and preserves
The client has a history of diabetes
The Correct Answer is A
Choice A Rationale: The client receiving an influenza vaccine 4 weeks ago is relevant because Guillain-Barre syndrome can sometimes be triggered by infections or vaccinations, including influenza vaccines.
Choice B Rationale: The client's hobby of golfing is not directly related to the described symptoms.
Choice C Rationale: Canning jams and preserves is not directly related to the described symptoms.
Choice D Rationale: A history of diabetes, while important for the client's overall health, may not be directly related to the current manifestations.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Rationale: Being currently pregnant is a risk factor for developing Bell's Palsy.
Choice B Rationale: Thyroid disease is not a direct risk factor or consistent finding in Bell's Palsy.
Choice C Rationale: Having a seizure disorder is not directly related to Bell's Palsy.
Choice D Rationale: Current smoking is not a risk factor associated with Bell's Palsy
Correct Answer is A
Explanation
Choice A Rationale: The nurse will include instructions on draining the bladder with a clean intermittent catheter at appropriate intervals to prevent urinary retention and complications. This should be done every 3 to 6 hours, depending on the amount of fluid intake and output.
Choice B Rationale: Decreasing fluid intake is not typically recommended for individuals with spinal cord injuries, as adequate hydration is important.
Choice C Rationale: Observing the urine for a foul odor is relevant to monitor for urinary tract infections, but it is not a preventive measure.
Choice D Rationale: Keeping an indwelling catheter in place at all times is not typically recommended due to the increased risk of urinary tract infections and other complications.
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