A nurse is caring for a client.

Nurses' Notes 0900:

Client reports a 3-month history of intermittent diarrhea and abdominal pain. Reports unintentional weight loss of 5.5 kg (12 lb) in 3 months.

0930:

Stool sample obtained for fecal occult blood test. Fatty appearance and foul odor noted.

For each assessment finding, click to specify if the finding is consistent with ulcerative colitis, diverticulitis, or Crohn's disease. Each finding may support more than 1 disease process.

Weight loss

Steatorrhea

Anemia

Diarrhea

Fever

Answer and Explanation

The Correct Answer is {"A":{"answers":"A,C"},"B":{"answers":"C"},"C":{"answers":"A,C"},"D":{"answers":"A,C"},"E":{"answers":"C"}}

A. Weight loss - Consistent with: Ulcerative colitis, Crohn's disease

B. Steatorrhea - Consistent with: Crohn's disease

C. Anemia - Consistent with: Ulcerative colitis, Crohn's disease

D. Diarrhea - Consistent with: Ulcerative colitis, Crohn's disease

E. Fever - Consistent with: Crohn's disease

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Free Nursing Study Resources

Correct Answer is ["A","C","D"]

Explanation

A. Correct. Reinforcing orientation to time, place, and person helps ground the client in reality, even if their memory is impaired.

B. Incorrect. While it's important to provide the client with some choices, too many options can be overwhelming and confusing.

C. Correct. Providing one simple direction at a time helps prevent confusion and frustration for clients with dementia.

D. Correct. Establishing eye contact while communicating can enhance the client's focus and understanding.

E. Incorrect. It's generally not effective to try to refute a client's delusions using logic.

Redirecting or validating their feelings might be more appropriate.

A. Headache B. Shortness of breath C. Dizziness D. Epistaxis

Correct Answer is C

Explanation

A. Incorrect. Headache can be associated with various conditions, but it is not a specific manifestation of hypovolemia.
B. Incorrect. Shortness of breath can occur in conditions affecting the respiratory system, such as pneumonia or asthma, but it is not a primary manifestation of hypovolemia.
C. Correct. Dizziness is a common manifestation of hypovolemia due to decreased blood volume and inadequate perfusion to the brain.
D. Incorrect. Epistaxis (nosebleed) might not be directly related to hypovolemia. It could be associated with other factors, such as dry air or nasal irritation.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is planning care for an older adult client who has dementia. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.)

Correct Answer is ["A","C","D"]

Explanation

A nurse is assessing a client who is experiencing hypovolemia. Which of the following manifestations should the nurse expect?

Correct Answer is C

Explanation

A nurse is caring for a client who is receiving total parenteral nutrition (TPN). The bag has 20 mL remaining to infuse, but a new bag is not readily available. Which of the following actions should the nurse take?

A nurse is caring for a client in the medical-surgical unit. Exhibits Which of the following actions should the nurse take to decrease the risks for urinary tract infection for this client? Select all that apply.

A nurse is assessing a 2-year-old toddler. Which of the following findings should the nurse expect?

A nurse is preparing an in-service for a group of nurses about malpractice issues in nursing. Which of the following examples should the nurse include in the teaching as an example of malpractice?

A nurse is caring for a client who has given informed consent for electroconvulsive therapy. Just before the procedure, the client tells the nurse she is considering not going forward with the treatment. Which of the following statements by the nurse is appropriate?

A nurse is caring for a client who is receiving penicillin G via intermittent IV piggyback. Which of the following actions should the nurse take?

A nurse is providing teaching to an older adult client about methods to promote nighttime sleep. Which of the following instructions should the nurse include?

A nurse is planning care for a client who is experiencing benzodiazepine toxicity.The nurse should plan to administer which of the following medications?