A nurse is admitting a client to the emergency department after a gunshot wound to the abdomen. Which of the following actions should the nurse take to help prevent the onset of acute kidney failure?

Insert a urinary catheter.

Prepare the client for an intravenous pyelogram.

Administer IV fluids to the client.

Initiate beta blocker therapy.

Answer and Explanation

The Correct Answer is C

A. Insert a urinary catheter: While a urinary catheter may be necessary for monitoring urine output, it does not directly prevent acute kidney failure. Maintaining adequate perfusion and hydration is the primary concern in preventing kidney injury.

B. Prepare the client for an intravenous pyelogram: An intravenous pyelogram (IVP) involves contrast dye, which can be nephrotoxic and potentially worsen kidney function. It is not appropriate in a client at risk for acute kidney injury.

C. Administer IV fluids to the client: Fluid resuscitation helps maintain adequate renal perfusion and prevents hypovolemia-induced acute kidney failure. Clients with significant blood loss are at high risk for prerenal kidney injury due to decreased perfusion.

D. Initiate beta blocker therapy: Beta blockers are used for cardiovascular conditions but do not prevent acute kidney failure. In this situation, maintaining blood volume and renal perfusion is the priority.

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Correct Answer is D

Explanation

A. "I have trouble urinating if I eat acidic foods.": Difficulty urinating after consuming acidic foods is not associated with latex allergy. This symptom may be related to bladder irritation or interstitial cystitis rather than an immune response to latex-related proteins.

B. "I often have diarrhea after eating scrambled eggs.": Diarrhea after consuming eggs suggests a food intolerance or an allergy to egg proteins. However, egg allergy is not linked to an increased risk of latex allergy.

C. "I sometimes start to wheeze when I eat peanuts.": Wheezing after peanut consumption suggests a peanut allergy, which is not directly associated with latex allergy. However, individuals with multiple allergies may be at higher risk for allergic reactions in general.

D. "I break out in a rash when I eat strawberries.": A history of allergic reactions to strawberries suggests a possible latex-fruit syndrome. Certain fruits, such as strawberries, bananas, avocados, and kiwis, contain proteins similar to those found in latex, increasing the risk of latex hypersensitivity.

A. Inspect the mouth once each week for sores. B. Use text or pictures to communicate needs postoperatively. C. Rinse with an alcohol-based mouthwash instead of brushing. D. Increase intake of dense, high-fiber foods.

Correct Answer is B

Explanation

A. Inspect the mouth once each week for sores: Frequent oral assessments are necessary, especially after a partial glossectomy, to monitor for infection, healing complications, or signs of malignancy recurrence. Checking only once per week is insufficient for early detection of issues.

B. Use text or pictures to communicate needs postoperatively: A partial glossectomy can impair speech, making communication difficult. Using alternative methods such as writing, text, or pictures helps ensure effective communication, especially in the immediate postoperative period.

C. Rinse with an alcohol-based mouthwash instead of brushing: Alcohol-based mouthwashes can cause irritation and delay healing. Instead, gentle oral hygiene with a soft toothbrush and non-alcoholic rinses like saline or chlorhexidine is recommended to maintain cleanliness without irritation.

D. Increase intake of dense, high-fiber foods: Soft, easy-to-swallow foods are preferred after a partial glossectomy to prevent irritation and facilitate healing. Dense, high-fiber foods can be difficult to chew and may cause discomfort, increasing the risk of aspiration or delayed wound healing.

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A nurse is admitting a client to the emergency department after a gunshot wound to the abdomen. Which of the following actions should the nurse take to help prevent the onset of acute kidney failure?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a preoperative client for allergies. Which of the following client statements would the nurse identify as a risk for an allergy to latex?

Correct Answer is D

Explanation

A nurse is providing teaching to a client who is postoperative following a partial glossectomy. Which of the following instructions should the nurse include in the teaching?

Correct Answer is B

Explanation

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