Which patients will the nurse determine are in most need of regular perineal care? (Select all that apply.)

A patient who has an indwelling catheter

A patient with urinary and fecal incontinence

A patient with rectal and genital surgical dressings

A bariatric patient

A circumcised male who is ambulatory

Answer and Explanation

Correct Answer : A,B,C,D

A. A patient with an indwelling catheter requires regular perineal care to prevent infection due to increased risk from the catheter.
B. Urinary and fecal incontinence increase the risk of skin breakdown and infection, necessitating frequent perineal care.
C. Surgical dressings in the rectal and genital areas require perineal care to maintain hygiene and prevent wound contamination.
D. Bariatric patients often need regular perineal care due to skin folds and increased risk of moisture-related skin breakdown.
E. A circumcised, ambulatory male typically has a lower risk of infection and may not require as frequent perineal care unless other factors are present.

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Correct Answer is C

Explanation

A. Discontinuing pain medication may not be appropriate, as it can lead to inadequate pain management for the patient. Pain management is crucial for terminally ill patients.
B. While abdominal massage may help relieve mild constipation, it is not a reliable primary intervention for more severe constipation caused by medication.
C. Laxatives are commonly prescribed for constipation related to pain medication and are an effective method to promote bowel movements, making this the best choice.
D. Administering enemas twice daily can be excessive and may cause discomfort or lead to dependency, making this option less favorable than using laxatives.

A. It refers to fire or giving of life to a person. B. It is awareness of one's inner self. C. It is not as essential as physical needs. D. It has a minor effect on health.

Correct Answer is B

Explanation

A. The definition of spirituality does not typically include concepts of fire or giving life; this option does not accurately capture the essence of spirituality.
B. Awareness of one's inner self encompasses the essence of spirituality, focusing on personal beliefs, values, and the search for meaning, which is widely recognized in health care.
C. Spirituality is often considered equally essential to physical needs, especially in holistic approaches to health and well-being, making this statement misleading.
D. Spirituality can have a significant impact on health, influencing coping mechanisms and overall well-being; therefore, labeling it as having a minor effect is not accurate.

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Which patients will the nurse determine are in most need of regular perineal care? (Select all that apply.)

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Naxlex Comprehensive Predictor Exams

A terminally ill patient is experiencing constipation secondary to pain medication. Which is the best method for the nurse to improve the patient's constipation problem?

Correct Answer is C

Explanation

A co-worker asks the nurse to explain spirituality. What is the nurse's best response?

Correct Answer is B

Explanation

The nurse is caring for a patient with hyperkalemia. Which body system assessment is the priority?

An experienced medical-surgical nurse chooses to work in obstetrics. Which level of proficiency is the nurse upon initial transition to the obstetrical floor?

The nurse and the patient have the same religious affiliation. Which action will the nurse take to support the patient spiritually?

Which patients will the nurse determine are in most need of regular perineal care? (Select all that apply.)

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The nurse is evaluating the body alignment of a patient in the sitting position. Which observation by the nurse will indicate a normal finding?