REX-PN QUESTIONS AND CORRECT
VERIFIED ANSWERS.
the,nurse,is,caring,for,a,client,with,Caron's,disease,who,develops,a,fever,and,symptoms,of,a,urinary,tract,i
nfection,(UTI),with,tan,,feral-
smelling,urine.,which,of,the,following,information,should,the,nurse,teach,the,client?
a.,about,the,effects,of,corticosteroid,use,on,immune,function
b.,to,empty,the,bladder,before,and,after,sexual,intercourse
c.,about,fistula,formation,between,the,bowel,and,bladder
d.,to,clean,the,perineal,area,carefully,after,any,stools,,ANS,-
c.,about,fistula,formation,between,the,bowel,and,bladder
rationale:,fistulas,between,the,bowel,and,bladder,occur,in,chrons,disease,and,can,lead,to,UTI.,there,is,no,i
nformation,indicating,that,the,client's,risk,for,UTI,is,caused,by,poor,cleaning,or,not,voiding,before,and,afte
r,intercourse.,steroid,use,may,increase,the,risk,for,infection,,but,the,characteristics,of,the,client's,urine,in
dicate,that,a,fistula,has,occurred.
during,the,initial,postoperative,assessment,of,a,clients,stoma,formed,from,a,transverse,colostomy.,the,nu
rse,finds,it,to,be,deep,pink,with,moderate,oedema,and,a,small,amount,of,bleeding.,which,of,the,following,
actions,should,the,nurse,take,based,upon,these,findings?
a.,place,an,ice,pack,on,the,stoma,to,reduce,swelling
b.,notify,the,surgeon,about,the,stoma,appearance
c.,document,the,stoma,assessment
d.,monitor,the,stoma,every,30,minutes,,ANS,-c.,document,the,stoma,assessment
rationale:,the,stoma,appearance,indicates,good,circulation,to,the,stoma.,there,is,no,indication,that,surgic
al,intervention,is,needed,or,that,frequent,stoma,monitoring,is,required.,swelling,of,the,stoma,is,normal,fo
r,2-3,weeks,after,surgery,and,an,ice,pack,is,not,needed.
,the,home,health,nurse,is,providing,teaching,a,clients,and,family,about,how,to,use,glargine,and,regular,ins
ulin,safely.,Which,of,the,following,nursing,actions,by,the,client,indicated,that,the,teaching,has,been,succe
ssful?
a.,the,client,administers,glargine,30-45,minutes,before,eating,each,meal
b.,the,client's,family,fills,the,syringes,weekly,and,stores,them,in,the,refrigerator
c.,the,client,draws,up,the,regular,insulin,and,then,glargine,in,the,same,syringe
d.,the,client,disposes,of,the,open,vial,of,glargine,and,regular,insulin,after,4,weeks,,ANS,-
d.,the,client,disposes,the,open,vials,of,glargine,and,regular,insulin,after,4,weeks
rationale:,insulin,can,be,stored,at,room,temperature,for,4,weeks.,glargine,should,not,be,mixed,with,other,
insulins,or,pre-
filled,and,stored.,short,acting,regular,insulin,is,administered,before,meals,,while,glargine,is,given,once,dail
y.
a,client,is,suspected,of,having,a,pituitary,tumour,causing,panhypopituitarism.,during,assessment,of,the,cli
ent,,which,of,the,following,findings,should,the,nurse,anticipate?
a.,high,blood,pressure
b.,changes,in,secondary,sex,characteristics
c.,elevated,blood,glucose,,ANS,-b.,changes,in,secondary,sex,characteristics
which,of,the,following,information,about,a,client,who,has,just,been,admitted,to,the,hospital,with,nausea,
and,vomiting,requires,the,most,rapid,intervention,by,the,nurse?
a.,the,client,has,taken,only,sips,of,water
b.,the,client,has,been,vomiting,for,several,times,a,day,for,the,last,4,days
c.,the,client,is,lethargic,and,difficult,to,arouse
d.,the,clients,chart,indicates,a,recent,reaction,of,the,small,intestine,,ANS,-
c.,the,client,is,lethargic,and,difficult,to,arouse
,rationale:,a,lethargic,client,is,at,risk,for,aspiration,,and,the,nurse,will,need,to,position,the,client,to,decreas
e,aspiration,risk.,the,other,information,also,is,important,to,collect,,but,it,does,not,require,as,quick,action,a
s,the,risk,for,aspiration.
the,nurse,is,caring,for,a,client,with,Crohn's,disease,who,has,megaloblastic,anemia.,which,of,the,following,
medications,should,the,nurse,anticipate,teaching,the,client,about,taking,on,an,ongoing,basis?
a.,regular,blood,transfusions
b.,cobalamin,(B12),nasal,spray,or,injections
c.,oral,ferrous,sulphate,tablets
d.,iron,dextran,(imferon),infusion,,ANS,-b.,cobalamin,(B12),nasal,spray,or,injections
rationale:,Crohn's,disease,frequently,affects,the,ileum.,where,absorption,of,cobalamin,occurs,,and,it,must
,be,administered,regularly,by,nasal,spray,or,IM,to,correct,the,anemia.,iron,deficiency,does,not,cause,mega
loblastic,anemia.,the,client,may,need,occasional,transfusion,but,not,regularly,scheduled,transfusions.
the,health,care,provider,prescribes,antacids,for,treatment,of,a,clients,peptic,ulcer.,which,of,the,following,i
nformation,should,the,nurse,include,in,the,clients,teaching,plan?
a.,sucralfate,and,antacids,together,30,minutes,before,each,meal
b.,antacids,after,eating,and,sucralfate,30,minutes,before,eating
c.,sucralfate,at,bedtime,and,antacids,before,meals
d.,antacids,30,minutes,before,the,sucralfate,,ANS,-
b.,antacids,after,eating,and,sucralfate,30,minutes,before,eating
rationale:,sucralfate,is,most,effective,when,the,pH,is,low,and,should,not,be,given,with,or,soon,after,an,ant
acid.,antacids,are,most,effective,when,taken,after,eating.,administration,of,sucralfate,30,minutes,before,
eating,will,ensure,that,both,drugs,can,be,the,most,effective.,the,other,regimens,will,decrease,the,effectiv
eness,of,the,medications
the,nurse,is,caring,for,a,client,who,has,an,adrenocortical,adenoma,and,hyperaldosteronism.,which,of,the,f
ollowing,actions,should,the,nurse,implement?
, a.,evaluate,blood,glucose,level,every,4,hours
b.,monitor,the,blood,pressure,every,4,hours
c.,maintain,extremities,in,an,elevated,position
d.,provide,a,potassium-restricted,diet,,ANS,-b.,monitor,the,blood,pressure,every,4,hours
hypertension,caused,by,sodium,retention,is,a,common,complication,of,hyperaldosteronism.,hyperaldoste
ronism,does,not,cause,an,elevation,in,blood,glucose.,the,client,will,be,hypokalemic,and,require,potassium
,supplementation,before,surgery.,edema,does,not,usually,occur,hyperaldosteronism.
the,nurse,is,caring,for,an,older-
adult,client,who,is,diagnosed,with,hypothyroidism,and,has,a,prescription,for,levothyroxine.,which,of,the,f
ollowing,assessments,is,most,important,for,the,nurse,to,make,during,initiation,of,thyroid,replacement?
a.,nutritional,intake
b.,apical,pulse
c.,orientation,and,alertness
d.,intake,and,output,,ANS,-b.,apical,pulse,rate,
in,older,clients.,initiation,of,levothyroxine,therapy,can,increase,myocardial,oxygen,demand,and,cause,ang
ina,or,dysrhythmias.,the,medication,is,also,expected,to,improve,mental,status,and,fluid,balance,and,will,i
ncrease,metabolic,rate,and,nutritional,needs,,but,these,changes,will,not,result,in,potentially,life-
threatening,complications.
which,of,the,following,actions,should,be,included,in,the,plan,of,care,for,a,male,client,with,bowel,irregulari
ty,and,a,new,diagnosis,of,irritable,bowel,syndrome,(IBS)?
a.,encourage,the,client,to,express,feelings,and,ask,questions,about,IBS
b.,teach,the,client,to,avoid,using,nonsteroidal,anti-inflammatory,drugs,(NSAIDs)
c.,suggest,that,the,client,increase,the,intake,of,milk,and,other,dairy,products
d.,educate,the,client,about,the,use,of,tegaserod,to,reduce,symptoms,,ANS,-
a.,encourage,the,client,to,express,feelings,and,ask,questions,about,IBS
VERIFIED ANSWERS.
the,nurse,is,caring,for,a,client,with,Caron's,disease,who,develops,a,fever,and,symptoms,of,a,urinary,tract,i
nfection,(UTI),with,tan,,feral-
smelling,urine.,which,of,the,following,information,should,the,nurse,teach,the,client?
a.,about,the,effects,of,corticosteroid,use,on,immune,function
b.,to,empty,the,bladder,before,and,after,sexual,intercourse
c.,about,fistula,formation,between,the,bowel,and,bladder
d.,to,clean,the,perineal,area,carefully,after,any,stools,,ANS,-
c.,about,fistula,formation,between,the,bowel,and,bladder
rationale:,fistulas,between,the,bowel,and,bladder,occur,in,chrons,disease,and,can,lead,to,UTI.,there,is,no,i
nformation,indicating,that,the,client's,risk,for,UTI,is,caused,by,poor,cleaning,or,not,voiding,before,and,afte
r,intercourse.,steroid,use,may,increase,the,risk,for,infection,,but,the,characteristics,of,the,client's,urine,in
dicate,that,a,fistula,has,occurred.
during,the,initial,postoperative,assessment,of,a,clients,stoma,formed,from,a,transverse,colostomy.,the,nu
rse,finds,it,to,be,deep,pink,with,moderate,oedema,and,a,small,amount,of,bleeding.,which,of,the,following,
actions,should,the,nurse,take,based,upon,these,findings?
a.,place,an,ice,pack,on,the,stoma,to,reduce,swelling
b.,notify,the,surgeon,about,the,stoma,appearance
c.,document,the,stoma,assessment
d.,monitor,the,stoma,every,30,minutes,,ANS,-c.,document,the,stoma,assessment
rationale:,the,stoma,appearance,indicates,good,circulation,to,the,stoma.,there,is,no,indication,that,surgic
al,intervention,is,needed,or,that,frequent,stoma,monitoring,is,required.,swelling,of,the,stoma,is,normal,fo
r,2-3,weeks,after,surgery,and,an,ice,pack,is,not,needed.
,the,home,health,nurse,is,providing,teaching,a,clients,and,family,about,how,to,use,glargine,and,regular,ins
ulin,safely.,Which,of,the,following,nursing,actions,by,the,client,indicated,that,the,teaching,has,been,succe
ssful?
a.,the,client,administers,glargine,30-45,minutes,before,eating,each,meal
b.,the,client's,family,fills,the,syringes,weekly,and,stores,them,in,the,refrigerator
c.,the,client,draws,up,the,regular,insulin,and,then,glargine,in,the,same,syringe
d.,the,client,disposes,of,the,open,vial,of,glargine,and,regular,insulin,after,4,weeks,,ANS,-
d.,the,client,disposes,the,open,vials,of,glargine,and,regular,insulin,after,4,weeks
rationale:,insulin,can,be,stored,at,room,temperature,for,4,weeks.,glargine,should,not,be,mixed,with,other,
insulins,or,pre-
filled,and,stored.,short,acting,regular,insulin,is,administered,before,meals,,while,glargine,is,given,once,dail
y.
a,client,is,suspected,of,having,a,pituitary,tumour,causing,panhypopituitarism.,during,assessment,of,the,cli
ent,,which,of,the,following,findings,should,the,nurse,anticipate?
a.,high,blood,pressure
b.,changes,in,secondary,sex,characteristics
c.,elevated,blood,glucose,,ANS,-b.,changes,in,secondary,sex,characteristics
which,of,the,following,information,about,a,client,who,has,just,been,admitted,to,the,hospital,with,nausea,
and,vomiting,requires,the,most,rapid,intervention,by,the,nurse?
a.,the,client,has,taken,only,sips,of,water
b.,the,client,has,been,vomiting,for,several,times,a,day,for,the,last,4,days
c.,the,client,is,lethargic,and,difficult,to,arouse
d.,the,clients,chart,indicates,a,recent,reaction,of,the,small,intestine,,ANS,-
c.,the,client,is,lethargic,and,difficult,to,arouse
,rationale:,a,lethargic,client,is,at,risk,for,aspiration,,and,the,nurse,will,need,to,position,the,client,to,decreas
e,aspiration,risk.,the,other,information,also,is,important,to,collect,,but,it,does,not,require,as,quick,action,a
s,the,risk,for,aspiration.
the,nurse,is,caring,for,a,client,with,Crohn's,disease,who,has,megaloblastic,anemia.,which,of,the,following,
medications,should,the,nurse,anticipate,teaching,the,client,about,taking,on,an,ongoing,basis?
a.,regular,blood,transfusions
b.,cobalamin,(B12),nasal,spray,or,injections
c.,oral,ferrous,sulphate,tablets
d.,iron,dextran,(imferon),infusion,,ANS,-b.,cobalamin,(B12),nasal,spray,or,injections
rationale:,Crohn's,disease,frequently,affects,the,ileum.,where,absorption,of,cobalamin,occurs,,and,it,must
,be,administered,regularly,by,nasal,spray,or,IM,to,correct,the,anemia.,iron,deficiency,does,not,cause,mega
loblastic,anemia.,the,client,may,need,occasional,transfusion,but,not,regularly,scheduled,transfusions.
the,health,care,provider,prescribes,antacids,for,treatment,of,a,clients,peptic,ulcer.,which,of,the,following,i
nformation,should,the,nurse,include,in,the,clients,teaching,plan?
a.,sucralfate,and,antacids,together,30,minutes,before,each,meal
b.,antacids,after,eating,and,sucralfate,30,minutes,before,eating
c.,sucralfate,at,bedtime,and,antacids,before,meals
d.,antacids,30,minutes,before,the,sucralfate,,ANS,-
b.,antacids,after,eating,and,sucralfate,30,minutes,before,eating
rationale:,sucralfate,is,most,effective,when,the,pH,is,low,and,should,not,be,given,with,or,soon,after,an,ant
acid.,antacids,are,most,effective,when,taken,after,eating.,administration,of,sucralfate,30,minutes,before,
eating,will,ensure,that,both,drugs,can,be,the,most,effective.,the,other,regimens,will,decrease,the,effectiv
eness,of,the,medications
the,nurse,is,caring,for,a,client,who,has,an,adrenocortical,adenoma,and,hyperaldosteronism.,which,of,the,f
ollowing,actions,should,the,nurse,implement?
, a.,evaluate,blood,glucose,level,every,4,hours
b.,monitor,the,blood,pressure,every,4,hours
c.,maintain,extremities,in,an,elevated,position
d.,provide,a,potassium-restricted,diet,,ANS,-b.,monitor,the,blood,pressure,every,4,hours
hypertension,caused,by,sodium,retention,is,a,common,complication,of,hyperaldosteronism.,hyperaldoste
ronism,does,not,cause,an,elevation,in,blood,glucose.,the,client,will,be,hypokalemic,and,require,potassium
,supplementation,before,surgery.,edema,does,not,usually,occur,hyperaldosteronism.
the,nurse,is,caring,for,an,older-
adult,client,who,is,diagnosed,with,hypothyroidism,and,has,a,prescription,for,levothyroxine.,which,of,the,f
ollowing,assessments,is,most,important,for,the,nurse,to,make,during,initiation,of,thyroid,replacement?
a.,nutritional,intake
b.,apical,pulse
c.,orientation,and,alertness
d.,intake,and,output,,ANS,-b.,apical,pulse,rate,
in,older,clients.,initiation,of,levothyroxine,therapy,can,increase,myocardial,oxygen,demand,and,cause,ang
ina,or,dysrhythmias.,the,medication,is,also,expected,to,improve,mental,status,and,fluid,balance,and,will,i
ncrease,metabolic,rate,and,nutritional,needs,,but,these,changes,will,not,result,in,potentially,life-
threatening,complications.
which,of,the,following,actions,should,be,included,in,the,plan,of,care,for,a,male,client,with,bowel,irregulari
ty,and,a,new,diagnosis,of,irritable,bowel,syndrome,(IBS)?
a.,encourage,the,client,to,express,feelings,and,ask,questions,about,IBS
b.,teach,the,client,to,avoid,using,nonsteroidal,anti-inflammatory,drugs,(NSAIDs)
c.,suggest,that,the,client,increase,the,intake,of,milk,and,other,dairy,products
d.,educate,the,client,about,the,use,of,tegaserod,to,reduce,symptoms,,ANS,-
a.,encourage,the,client,to,express,feelings,and,ask,questions,about,IBS
