Which long-term outcome is most important for the nurse to include in the plan of care for an older adult client with chronic pyelonephritis?

Manages activities of daily living independently.

Measures oral temperature daily.

Maintains blood pressure within normal limits.

Restricts fluid intake to 1 L/day.

Answer and Explanation

The Correct Answer is C

Rationale:

A. Manages activities of daily living independently: Preserving functional independence is not a direct clinical outcome related to managing chronic pyelonephritis. The primary concern with this condition is preserving renal function and preventing long-term complications like hypertension.

B. Measures oral temperature daily: Monitoring temperature can help detect infections early, but chronic pyelonephritis may not always present with fever. It’s a short-term strategy and less critical than preventing progression to renal damage or cardiovascular complications.

C. Maintains blood pressure within normal limits: Chronic pyelonephritis can lead to kidney scarring, which often contributes to secondary hypertension. Controlling blood pressure is vital in slowing renal deterioration and preventing cardiovascular events, making it the most important long-term goal.

D. Restricts fluid intake to 1 L/day: Fluid restriction is not appropriate unless the client is in advanced kidney failure with fluid overload. Adequate hydration is usually encouraged to help flush bacteria from the urinary tract and support renal function.

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Correct Answer is ["B","D"]

Explanation

Rationale:

A. Lentils: Lentils are high in fiber and are not part of a full liquid diet because they require chewing and contain residue. They are appropriate for a soft or regular diet, not a full liquid one.

B. Tea: Tea is a clear liquid and is included in a full liquid diet. It requires no chewing and leaves no residue, making it suitable postoperatively.

C. Whole grain breads: Breads are solid foods and not permitted on a full liquid diet. They require chewing and do not meet the consistency guidelines for this diet type.

D. Potato soup: Smooth, blended soups like potato soup are appropriate for a full liquid diet as long as there are no chunks. They provide calories and are easy to swallow.

E. Cheese: Cheese is a solid food and is not permitted on a full liquid diet.

A. Any antianxiety medications. B. Over-the-counter oral antipyretics. C. Nonsteroidal antiinflammatory drugs. D. Other beta-adrenergic blocker agents. E. Oral and subcutaneous anticoagulants.

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

Explanation

Rationale:
A. Any antianxiety medications: Antianxiety medications are not contraindicated with ophthalmic timolol. Unless they directly impact heart rate or blood pressure significantly, they are generally safe to continue in clients with glaucoma using topical beta blockers.

B. Over-the-counter oral antipyretics: Oral antipyretics like acetaminophen are not known to interact adversely with timolol. These medications can be used safely unless otherwise contraindicated for specific patient conditions like liver disease.

C. Nonsteroidal antiinflammatory drugs: NSAIDs such as ibuprofen, when used long-term with beta blockers like timolol or carvedilol, may blunt the antihypertensive effect and increase renal risk, especially in clients on diuretics like spironolactone. This triple combination increases the chance of nephrotoxicity.

D. Other beta-adrenergic blocker agents: Using timolol with systemic beta blockers like carvedilol increases the risk of bradycardia, hypotension, and heart block. Though timolol is topical, systemic absorption can still occur, requiring caution when combining with other beta-blockers.

E. Oral and subcutaneous anticoagulants: There is no direct contraindication between timolol and anticoagulants. Unless the client has bleeding risks associated with other therapies or conditions, concurrent use is generally acceptable.

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Which long-term outcome is most important for the nurse to include in the plan of care for an older adult client with chronic pyelonephritis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When conducting diet teaching for a client who is on a postoperative full liquid diet, which food(s) should the nurse encourage the client to eat? Select all that apply.

Correct Answer is ["B","D"]

Explanation

The nurse administers ophthalmic timolol to a client with glaucoma. The client routinely takes carvedilol, spironolactone, and ibuprofen daily. Which medication(s) should the nurse withhold? Select all that apply.

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

Explanation

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