Question

What is the name of a pelvic floor exercise you can instruct your patient to do to help with incontinence?

Answer 1

Correct Answers:

Kegel exercises

Rationale :

🔵 Kegel exercises involve repetitive contraction and relaxation of the pelvic floor muscles, which support the bladder, uterus, and rectum.

🔵 They strengthen the urethral sphincter and pelvic muscles, improving bladder control and reducing episodes of stress and urge incontinence.

🔵 These exercises can be done discreetly, anywhere, and are effective for both men and women with urinary incontinence.

🔵 Bicep curls, abdominal crunches, and squats strengthen other muscle groups but do not directly target pelvic floor muscles.

🔵 Teaching clients Kegel exercises is a first-line, noninvasive intervention for managing incontinence.

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Answer 2

Correct Answers:

Increase the client's fluid intake.

Rationale :

🟢 Increased fluid intake helps soften stool, making it easier to pass and reducing constipation in clients on bedrest.

🟢 Adequate hydration promotes normal bowel function by supporting peristalsis and preventing hard, dry stools.

🟢 A high-fiber diet with fluids is the recommended combination; a low-fiber diet would worsen constipation.

🟢 Mineral oil is not recommended because it can interfere with absorption of fat-soluble vitamins (A, D, E, K) and carries aspiration risks.

🟢 Cold fluids do not specifically relieve constipation; warm fluids (like warm water or tea) may be more effective in stimulating peristalsis.

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Answer 3

Correct Answers:

Left forearm

Rationale :

💎 The forearm veins are commonly used for peripheral IV access due to easy visibility, accessibility, and safety.

💎 The thigh is less preferred due to risk of infection and difficulty in monitoring.

💎 The neck (jugular veins) is used only for central venous access, not routine peripheral IVs.

💎 The lower back does not contain accessible veins suitable for IV insertion.

💎 Peripheral IVs should be placed in sites that allow easy monitoring, mobility, and reduced risk of complications.

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Answer 4

Correct Answers:

Respiratory alkalosis

Rationale :

💎 Alveolar hyperventilation causes excessive exhalation of CO₂, which reduces carbonic acid levels in the blood.

💎 The decrease in H⁺ concentration raises blood pH, resulting in alkalosis.

💎 Because the primary issue originates from the lungs’ excessive CO₂ loss, it is classified as respiratory rather than metabolic.

💎 Common causes include anxiety, pain, hypoxia, or fever, which increase respiratory rate and depth.

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Answer 5

Correct Answers:

7.35 to 7.45

Rationale :

💎 The normal arterial blood pH range is 7.35–7.45, which is slightly alkaline.

💎 pH below 7.35 indicates acidosis, and pH above 7.45 indicates alkalosis.

💎 The body maintains this narrow range through buffer systems, respiratory regulation, and renal function.

💎 Maintaining normal pH is critical for enzyme function, cellular metabolism, and overall homeostasis.

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Answer 6

Correct Answers:

Overflow incontinence

Rationale :

💎 Overflow incontinence occurs when the bladder is unable to empty completely, leading to constant dribbling of urine.

💎 A distended, palpable bladder is a key clinical sign of urinary retention, which is characteristic of overflow incontinence.

💎 This type often results from obstruction, weak detrusor muscles, or neurologic impairment.

💎 Clients may not feel the urge to urinate because the bladder is overfilled but underactive, differentiating it from other types of incontinence.

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Answer 7

Correct Answers:

Check the client's medical record for the provider's prescription.

Rationale :

🖌 The nurse must verify that a valid provider prescription exists before performing any procedure.

🖌 Checking the medical record ensures client safety and legal compliance, preventing unauthorized interventions.

🖌 Administering an enema without a prescription could be considered battery or negligence.

🖌 Once verified, the nurse can educate the client and obtain informed consent before proceeding.

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Answer 8

Correct Answers:

Small intestine

Rationale :

✦ An ileostomy is created from the ileum, the terminal portion of the small intestine, and brought to the abdominal wall as a stoma.

✦ It is usually located in the right lower quadrant of the abdomen, allowing fecal material to bypass the colon completely.

✦ Because the colon’s water-absorbing function is skipped, the output is liquid to semi-liquid and contains digestive enzymes that can irritate peristomal skin.

✦ Indications for an ileostomy include inflammatory bowel disease (Crohn’s disease, ulcerative colitis), colorectal cancer, trauma, or congenital conditions requiring bowel diversion.

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Answer 9

Correct Answers:

U waves on electrocardiogram

Rationale :

♦️Hypokalemia is defined as a serum potassium level below 3.5 mEq/L, and it directly affects cardiac conduction because potassium is vital for repolarization of myocardial cells.

♦️One of the hallmark ECG changes in hypokalemia is the presence of prominent U waves, which follow the T wave and represent delayed ventricular repolarization.

♦️Other ECG changes may include flattened or inverted T waves, ST-segment depression, and prolonged QT interval, all of which increase the risk of dysrhythmias.

♦️Clinically, hypokalemia can also present with muscle weakness, cramps, constipation, and arrhythmias, but the ECG finding of U waves is the most specific diagnostic association.

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Answer 10

Correct Answers:

Monitor neurologic status

Rationale :

👉 Hyponatremia occurs when serum sodium falls below 135 mEq/L, leading to disturbances in fluid shifts across cell membranes.

👉 The brain is most vulnerable, as low sodium can cause water to move into brain cells, resulting in cerebral edema.

👉 This places the client at risk for confusion, seizures, decreased level of consciousness, and coma, making neurologic assessment the top priority.

👉 While lab values and urine output are important, the nurse’s immediate action must be to monitor neurological status to detect and prevent life-threatening complications early.

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QLexNursing

1 :
What is the name of a pelvic floor exercise you can instruct your patient to do to help with incontinence?

2 :
A nurse is caring for a client who is on bedrest and is experiencing constipation. Which of the following interventions should the nurse implement?

3 :
What area on the body can a nurse place IV access?

4 :
What can a patient develop when they have alveolar hyperventilation; the lungs excrete too much carbonic acid (CO2 and water)?

5 :
What is the body's normal pH balance?

6 :
A nurse assessing a client notes that the client has a constant leakage of small amounts of urine and a bladder that is distended and palpable. The nurse should associate these findings with which of the following types of urinary incontinence?

7 :
A nurse is preparing to administer a soap suds enema to a client who has constipation. As the nurse explains the procedure, the client states, "The doctor didn't tell me I was supposed to receive an enema." Which of the following nursing actions is appropriate at this time?

8 :
Where is an ileostomy located?

9 :
A nurse is caring for a client who has hypokalemia. Which of the following findings should the nurse associate with hypokalemia?

10 :
A nurse is planning care for a client who has hyponatremia. Which of the following actions is the priority to include in the plan of care?

QLexNursing

1 : What is the name of a pelvic floor exercise you can instruct your patient to do to help with incontinence?

2 : A nurse is caring for a client who is on bedrest and is experiencing constipation. Which of the following interventions should the nurse implement?

3 : What area on the body can a nurse place IV access?

4 : What can a patient develop when they have alveolar hyperventilation; the lungs excrete too much carbonic acid (CO2 and water)?

5 : What is the body's normal pH balance?

6 : A nurse assessing a client notes that the client has a constant leakage of small amounts of urine and a bladder that is distended and palpable. The nurse should associate these findings with which of the following types of urinary incontinence?

7 : A nurse is preparing to administer a soap suds enema to a client who has constipation. As the nurse explains the procedure, the client states, "The doctor didn't tell me I was supposed to receive an enema." Which of the following nursing actions is appropriate at this time?

8 : Where is an ileostomy located?

9 : A nurse is caring for a client who has hypokalemia. Which of the following findings should the nurse associate with hypokalemia?

10 : A nurse is planning care for a client who has hyponatremia. Which of the following actions is the priority to include in the plan of care?

1 :
What is the name of a pelvic floor exercise you can instruct your patient to do to help with incontinence?

2 :
A nurse is caring for a client who is on bedrest and is experiencing constipation. Which of the following interventions should the nurse implement?

3 :
What area on the body can a nurse place IV access?

4 :
What can a patient develop when they have alveolar hyperventilation; the lungs excrete too much carbonic acid (CO2 and water)?

5 :
What is the body's normal pH balance?

6 :
A nurse assessing a client notes that the client has a constant leakage of small amounts of urine and a bladder that is distended and palpable. The nurse should associate these findings with which of the following types of urinary incontinence?

7 :
A nurse is preparing to administer a soap suds enema to a client who has constipation. As the nurse explains the procedure, the client states, "The doctor didn't tell me I was supposed to receive an enema." Which of the following nursing actions is appropriate at this time?

8 :
Where is an ileostomy located?

9 :
A nurse is caring for a client who has hypokalemia. Which of the following findings should the nurse associate with hypokalemia?

10 :
A nurse is planning care for a client who has hyponatremia. Which of the following actions is the priority to include in the plan of care?