To which patient should the nurse plan to administer round-the-clock antipyretic
drugs?
A 76-yr-old patient with bacterial meningitis and a temperature of 104.2°F
An 82-yr-old patient after hip replacement surgery and a temperature of 100.4°F
A 14-yr-old patient with infectious mononucleosis and a temperature of 101.6°F
A 59-yr-old patient with an acute myocardial infarction and a temperature of 99.8°F
Give this one a try later!
, A 76-yr-old patient with bacterial meningitis and a temperature of 104.2°F
Rationale:
Moderate fevers (up to 103° F) usually produce few problems in most
patients and do not require antipyretic therapy. If the patient is very young
or very old, is extremely uncomfortable, or has a significant medical
problem (e.g., severe cardiopulmonary disease, brain injury), the use of
antipyretics should be considered. High fevers (above 104° F) should be
treated with antipyretics. High fevers can damage body cells and cause
delirium and seizures.
The nurse is performing an abdominal assessment for a patient. Which assessment
technique by the nurse is mostaccurate?
Palpate the abdomen before auscultation.
Percuss the abdomen before auscultation.
Auscultate the abdomen before palpation.
Perform deep palpation before light palpation.
Give this one a try later!
Auscultate the abdomen before palpation.
Rationale:
During examination of the abdomen, auscultation is done before
percussion and palpation because these latter procedures may alter the
bowel sounds.
Select the most critical question for the nurse to ask an adolescent who has
threatened to take an overdose of pills.
"Do you have access to medications?"
"Why do you want to kill yourself?"
"Have you been taking drugs and alcohol?"
"Did something happen with your parents?"
Give this one a try later!
, "Do you have access to medications?"
Describe three differences between Crohn's disease and Ulcerative colitis.
Give this one a try later!
1. UC is limited to the colon, while Crohn's can occur anywhere between
the mouth and the anus.
2. Crohn's often has a mixture of healthy and inflamed spots; however, UC
does not have breaks between inflammation.
3. When diagnosis Crohn's and UC, Crohn's will often present with mouth
sores, occasional rectal bleeding, weight loss, and nausea. However, UC
often presents with mucous and blood filled stools, frequent diarrhea, and
the urge to use the restroom with no results.
A patient is given a bisacodyl suppository and asks the nurse how long it will take to
work. What is the best response by the nurse?
2 to 5 minutes
15 to 60 minutes
2 to 4 hours
6 to 8 hours
Give this one a try later!
15 to 60 minutes
Rationale:
Bisacodyl suppositories usually are effective within 15 to 60 minutes of
administration, so the nurse should plan accordingly to assist the patient to
use the bedpan or commode.
, A patient after a stroke who primarily uses a wheelchair for mobility has developed
diarrhea with fecal incontinence. What is a priority assessment by the nurse?
Fecal impaction
Perineal hygiene
Dietary fiber intake
Antidiarrheal agent use
Give this one a try later!
Fecal impaction
Rationale:
Patients with limited mobility are at risk for fecal impactions caused by
constipation that may lead to liquid stool leaking around the hardened
impacted feces, so assessing for fecal impaction is the priority. Perineal
hygiene can be assessed at the same time. Assessing the dietary fiber and
fluid intake and antidiarrheal agent use will be assessed and considered
next.
The patient has inflammation and reports feeling tired, nausea, and anorexia. The
nurse explains to the patient that these manifestations are related to inflammation in
what way?
Local response
Systemic response
Infectious response
Acute inflammatory response
Give this one a try later!
Systemic response
Rationale:
The systemic response to inflammation includes the manifestations of a shift
to the left in the WBC count, malaise, nausea, anorexia, increased pulse
and respiratory rate, and fever. The local response to inflammation includes
redness, heat, pain, swelling, or loss of function at the site of inflammation.
There is not an infectious response to inflammation, only an inflammatory
drugs?
A 76-yr-old patient with bacterial meningitis and a temperature of 104.2°F
An 82-yr-old patient after hip replacement surgery and a temperature of 100.4°F
A 14-yr-old patient with infectious mononucleosis and a temperature of 101.6°F
A 59-yr-old patient with an acute myocardial infarction and a temperature of 99.8°F
Give this one a try later!
, A 76-yr-old patient with bacterial meningitis and a temperature of 104.2°F
Rationale:
Moderate fevers (up to 103° F) usually produce few problems in most
patients and do not require antipyretic therapy. If the patient is very young
or very old, is extremely uncomfortable, or has a significant medical
problem (e.g., severe cardiopulmonary disease, brain injury), the use of
antipyretics should be considered. High fevers (above 104° F) should be
treated with antipyretics. High fevers can damage body cells and cause
delirium and seizures.
The nurse is performing an abdominal assessment for a patient. Which assessment
technique by the nurse is mostaccurate?
Palpate the abdomen before auscultation.
Percuss the abdomen before auscultation.
Auscultate the abdomen before palpation.
Perform deep palpation before light palpation.
Give this one a try later!
Auscultate the abdomen before palpation.
Rationale:
During examination of the abdomen, auscultation is done before
percussion and palpation because these latter procedures may alter the
bowel sounds.
Select the most critical question for the nurse to ask an adolescent who has
threatened to take an overdose of pills.
"Do you have access to medications?"
"Why do you want to kill yourself?"
"Have you been taking drugs and alcohol?"
"Did something happen with your parents?"
Give this one a try later!
, "Do you have access to medications?"
Describe three differences between Crohn's disease and Ulcerative colitis.
Give this one a try later!
1. UC is limited to the colon, while Crohn's can occur anywhere between
the mouth and the anus.
2. Crohn's often has a mixture of healthy and inflamed spots; however, UC
does not have breaks between inflammation.
3. When diagnosis Crohn's and UC, Crohn's will often present with mouth
sores, occasional rectal bleeding, weight loss, and nausea. However, UC
often presents with mucous and blood filled stools, frequent diarrhea, and
the urge to use the restroom with no results.
A patient is given a bisacodyl suppository and asks the nurse how long it will take to
work. What is the best response by the nurse?
2 to 5 minutes
15 to 60 minutes
2 to 4 hours
6 to 8 hours
Give this one a try later!
15 to 60 minutes
Rationale:
Bisacodyl suppositories usually are effective within 15 to 60 minutes of
administration, so the nurse should plan accordingly to assist the patient to
use the bedpan or commode.
, A patient after a stroke who primarily uses a wheelchair for mobility has developed
diarrhea with fecal incontinence. What is a priority assessment by the nurse?
Fecal impaction
Perineal hygiene
Dietary fiber intake
Antidiarrheal agent use
Give this one a try later!
Fecal impaction
Rationale:
Patients with limited mobility are at risk for fecal impactions caused by
constipation that may lead to liquid stool leaking around the hardened
impacted feces, so assessing for fecal impaction is the priority. Perineal
hygiene can be assessed at the same time. Assessing the dietary fiber and
fluid intake and antidiarrheal agent use will be assessed and considered
next.
The patient has inflammation and reports feeling tired, nausea, and anorexia. The
nurse explains to the patient that these manifestations are related to inflammation in
what way?
Local response
Systemic response
Infectious response
Acute inflammatory response
Give this one a try later!
Systemic response
Rationale:
The systemic response to inflammation includes the manifestations of a shift
to the left in the WBC count, malaise, nausea, anorexia, increased pulse
and respiratory rate, and fever. The local response to inflammation includes
redness, heat, pain, swelling, or loss of function at the site of inflammation.
There is not an infectious response to inflammation, only an inflammatory
