Which outcome is expected for a client who has a diagnosis of constipation? The client:.
Takes a laxative daily.
Has a return to their normal bowel habits.
Requests a bedpan every four hours.
Has a bowel movement within 72 hours.
The Correct Answer is B
This outcome indicates that the client has resolved their constipation and has a regular pattern of defecation without difficulty or discomfort.
Choice A is wrong because taking a laxative daily can worsen constipation by causing dependency and reducing the natural peristalsis of the colon.
Choice C is wrong because requesting a bedpan every four hours does not necessarily mean that the client has bowel movements. It may indicate that the client has difficulty passing stool or has a sensation of incomplete emptying.
Choice D is wrong because having a bowel movement within 72 hours is still considered constipation. Constipation is diagnosed when bowel movements are associated with at least two of the following symptoms, occurring in the past three months with an onset of symptoms of at least six months: Less than three spontaneous bowel movements per week, Lumpy or hard stools from at least 25% of bowel movements.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["E"]
Explanation
A private room with negative air pressure is required to care for a client with suspected or confirmed tuberculosis (TB) disease, as this is part of the airborne precautions recommended by the CDC.
A private room with negative air pressure prevents the spread of infectious droplet nuclei that contain the TB bacteria.
Choice A is wrong because gloves, masks, and gowns are not sufficient to protect against TB transmission.
Gloves and gowns are used for contact precautions, which are not indicated for TB.
A regular mask is also not effective in filtering out the small droplet nuclei that carry the TB bacteria.
Choice B is wrong because an N95 mask is not a precaution for the client, but for the healthcare personnel who are in close contact with the client.
An N95 mask is a type of respirator that can filter out at least 95% of airborne particles, including TB bacteria. Health care personnel should wear an N95 mask when entering the client’s room or performing aerosol-generating procedures on the client.
Choice C is wrong because droplet precautions are not indicated for TB.
Droplet precautions are used for infections that are spread by large respiratory droplets that do not remain suspended in the air, such as influenza or pertussis. Droplet precautions require wearing a regular mask and eye protection when within 6 feet of the client.
Choice D is wrong because contact precautions are not indicated for TB.
Contact precautions are used for infections that are spread by direct or indirect contact with the client or the client’s environment, such as Clostridium difficile or MRSA. Contact
Correct Answer is D
Explanation
Cleanse from the innermost point outwards with a circular movement. This technique reduces the risk of contaminating the wound with bacteria from the surrounding skin.
Some possible explanations for the other choices are:
Choice A is wrong because hydrogen peroxide and betadine solution can damage healthy tissue and delay wound healing.
Choice B is wrong because cleansing the wound from the outer edges towards the center can introduce bacteria from the skin into the wound.
Choice C is wrong because using 4x4 gauze to the wound and surrounding skin three times can cause trauma and bleeding to the wound.
Normal ranges for pressure ulcer stages are:
- Stage I: A reddened, painful area on the skin that does not turn white when pressed.
- Stage II: The skin blisters or forms an open sore. The area around the sore may be red and irritated.
- Stage III: The skin develops an open, sunken hole called a crater or ulcer. The tissue below the skin is damaged.
- Stage IV: The pressure ulcer has become so deep that there is damage to the muscle and bone, and sometimes to tendons and joints.
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