A nurse is reinforcing teaching about renal transplant with a newly licensed nurse. Which of the following clients should the nurse identify as having a contraindication for this procedure?

A client who has a pacemaker

A client who has a history of IV drug abuse

A client who has a body mass index (BMI) of 25

A client who is 65 years old

Answer and Explanation

The Correct Answer is B

A. A client who has a pacemaker: Having a pacemaker is not a contraindication for renal transplantation. As long as the patient is otherwise healthy and able to tolerate surgery, a pacemaker does not preclude the procedure.

B. A client who has a history of IV drug abuse: IV drug abuse is a contraindication for renal transplant due to the potential for poor compliance with post-transplant care and higher risk for recurrent infections and complications.

C. A client who has a body mass index (BMI) of 25: A BMI of 25 is within the normal to slightly overweight range. A BMI of 30 or higher may be a concern due to increased risks during surgery, but a BMI of 25 is not a contraindication.

D. A client who is 65 years old: Age alone is not a contraindication for a renal transplant. While younger patients may have better outcomes, transplants are performed on older patients if they are otherwise good candidates and able to tolerate the surgery and long-term immunosuppressive therapy.

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Correct Answer is D

Explanation

A. Apply a heating pad to the abdomen: This is incorrect and potentially harmful, as applying heat to the abdomen can increase blood flow and worsen inflammation or risk rupture of the appendix.

B. Administer a cleansing enema: Enemas should not be administered for suspected appendicitis as they may cause irritation and increase the risk of perforation.

C. Administer oral analgesics as needed: Oral analgesics are contraindicated since the patient should be NPO, and strong pain relief might mask the symptoms of a ruptured appendix.

D. Place the patient on NPO status: The highest priority preoperative intervention is to place the patient on NPO (nothing by mouth) status to prevent aspiration during anesthesia, a standard preoperative practice, especially for abdominal surgeries.

A. increased fluid intake and patient education on hydration B. Blood cultures C. Urine culture and sensitivity testing D. Repeat urinalysis after antibiotic treatment completion. E. Foley catheter placement F. Oral antibiotics, such as trimethoprim-sulfamethoxazole or ciprofloxacin

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

Explanation

A. Increased fluid intake and patient education on hydration: Encouraging increased fluid intake helps to flush bacteria from the urinary tract and prevent further infection. Hydration is a key component of managing UTIs, as it dilutes urine and promotes frequent urination, reducing bacterial colonization.

B. Blood cultures: Blood cultures are not typically indicated for uncomplicated UTIs, especially in a patient without signs of systemic infection or sepsis (e.g., high fever, hypotension, tachycardia). Blood cultures are more relevant in severe or complicated UTIs, or when there is concern for urosepsis.

C. Urine culture and sensitivity testing: A urine culture and sensitivity is essential for identifying the specific bacteria causing the infection and determining the appropriate antibiotic for treatment. This is especially important for patients with a history of recurrent UTIs to ensure the right antibiotic is selected and to avoid antibiotic resistance.

D. Repeat urinalysis after antibiotic treatment completion: A repeat urinalysis after antibiotic treatment is often ordered to ensure that the infection has been resolved, particularly in patients with recurrent infections.

E. Foley catheter placement: A Foley catheter is not appropriate for this patient, as there is no indication of urinary retention, and catheterization increases the risk of introducing new infections.

F. Oral antibiotics, such as trimethoprim-sulfamethoxazole or ciprofloxacin: Oral antibiotics like trimethoprim-sulfamethoxazole (TMP-SMX) or ciprofloxacin are commonly prescribed for treating uncomplicated UTIs. Given the patient’s history of recurrent UTIs, empiric antibiotic therapy is appropriate pending urine culture results.

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A nurse is reinforcing teaching about renal transplant with a newly licensed nurse. Which of the following clients should the nurse identify as having a contraindication for this procedure?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient with suspected appendicitis is being prepared for surgery. Which of the following preoperative interventions should the nurse prioritize?

Correct Answer is D

Explanation

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

Explanation

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