After her bath, a 62-year-old patient asks the nurse for a perineal pad saying that she uses them because sometimes she leaks urine when she laughs or coughs. Which intervention is most appropriate to include in the care plan for the patient?

Teach the patient how to perform Kegel exercises.

Assist the patient to the bathroom q3hr.

Demonstrate how to perform Crede’s maneuver.

Place commode at the patient’s bedside.

Answer and Explanation

The Correct Answer is A

Kegel exercises are designed to strengthen the pelvic ﬂoor muscles, which can help improve urinary incontinence. By teaching the patient how to perform Kegel exercises, the nurse can provide a non-invasive, eﬀective intervention that the patient can perform on her own to help manage her urinary incontinence.

Assisting the patient to the bathroom q3hr (b) may help reduce the frequency of incontinence episodes but it does not address the underlying issue of weakened pelvic ﬂoor muscles.

Demonstrating how to perform Crede’s maneuver (c) involves applying manual pressure to the bladder to assist with urination and is not appropriate for managing urinary incontinence related to laughing or coughing.

Placing a commode at the patient’s bedside (d) may be appropriate for patients who have difficulty with mobility or accessing the bathroom, but it does not address the underlying issue of weakened pelvic ﬂoor muscles causing urinary incontinence.

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Correct Answer is B

Explanation

Sudden discontinuation of prednisone can result in adrenal insufficiency and can lead to life-threatening complications. The nurse should also instruct the patient to report any symptoms of an infection, such as fever, to the doctor promptly, as prednisone can mask signs of an infection.

Monitoring for mood alterations and daily weight measurement are also important aspects of care, but they are not as crucial as the need to gradually taper oﬀ the medication.

A. Decreasing serum sodium B. Decreasing blood glucose C. Decreasing serum potassium D. Increasing urinary output

Correct Answer is D

Explanation

One of the hallmarks of adrenal insufficiency is dehydration and decreased urinary output, which can lead to electrolyte imbalances such as hyperkalemia and hyponatremia. As treatment begins to take eﬀect, the patient's ﬂuid and electrolyte balance should improve, leading to an increase in urinary output. Acute adrenal insufficiency, also known as the Addisonian crisis, is a life-threatening condition caused by a sudden decrease in cortisol and aldosterone hormones. Treatment usually involves the administration of intravenous glucocorticoids and mineralocorticoids to replace the deficient hormones.
Decreasing serum sodium (a) and decreasing blood glucose (b) are not signs of improvement but rather indicative of continued adrenal insufficiency. Decreasing serum potassium (c) is also not a sign of improvement as it could indicate that the patient is developing hyperkalemia, which is a potential complication of adrenal crisis.

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After her bath, a 62-year-old patient asks the nurse for a perineal pad saying that she uses them because sometimes she leaks urine when she laughs or coughs. Which intervention is most appropriate to include in the care plan for the patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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