Exhibits

Which of the following actions should the nurse assist with? (Click on the exhibit tabs for additional information about the client.)

Start the prescribed antibiotic

Discontinue nasogastric tube

Reinforce preoperative teaching

Provide the client with ice chips

Answer and Explanation

The Correct Answer is C

A. Start the prescribed antibiotic: There is no indication of infection in the current clinical findings; antibiotics are typically used to treat bacterial infections, which are not yet evident.
B. Discontinue nasogastric tube: The nasogastric tube should remain in place as it helps relieve the symptoms of small bowel obstruction (e.g., vomiting and bloating).
C. Reinforce preoperative teaching: The client is on NPO status, which may suggest preparation for a surgical intervention to address the obstruction. Reinforcing preoperative teaching would be beneficial to ensure the client understands the procedure.
D. Provide the client with ice chips: The client is on NPO status, and consuming food or fluids is contraindicated due to the potential for aspiration or worsening of the condition (e.g., bowel obstruction or pancreatitis).

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Correct Answer is A

Explanation

A. Changed mental status: Older adults often exhibit atypical signs of infection, such as confusion, agitation, or other changes in mental status, rather than classic symptoms like fever or dysuria.
B. Temperature 37.3° C (99.1° F): This temperature is within normal range and does not indicate an infection. Older adults may not always mount a fever with infections.
C. WBC count 9,000/mm³ (5,000 to 10,000/mm³): This is within the normal range, so it does not suggest infection. An elevated WBC count (>10,000/mm³) may indicate an infection.
D. Diminished reflexes: This is not a symptom of a bladder infection. It is more commonly associated with neurological or musculoskeletal conditions.

A. "I will lie down for 30 minutes after each meal." B. "I will increase vitamin C intake by drinking orange juice." C. "I will sleep flat on my back at night." D. "I will eat six small meals each day."

Correct Answer is D

Explanation

A. "I will lie down for 30 minutes after each meal.": Lying down after meals increases reflux risk; clients should remain upright for 2–3 hours after eating.
B. "I will increase vitamin C intake by drinking orange juice.": Citrus juices are acidic and can aggravate GERD symptoms.
C. "I will sleep flat on my back at night.": Sleeping flat increases reflux; elevating the head of the bed is recommended.
D. "I will eat six small meals each day.": Smaller, more frequent meals reduce gastric distension and lower the risk of reflux.

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Exhibits Which of the following actions should the nurse assist with? (Click on the exhibit tabs for additional information about the client.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting data from an older adult client. Which of the following findings should indicate to the nurse that the client has a bladder infection?

Correct Answer is A

Explanation

A nurse is reinforcing teaching with a client who has gastroesophageal reflux (GERD). Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer is D

Explanation

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The nurse continues to assist with the care of the client. Exhibits Which of the following findings indicates that the client's condition has improved? Select all that apply.

Exhibits

Which of the following actions should the nurse assist with? (Click on the exhibit tabs for additional information about the client.)