NURL 2241Exam 4 Practice Questions With Verified Answers

A nurse evaluates elimination for a client with benign prostatic hyperplasia (BPH). The nurse assess what to BEST determine degree of treatment success? A.Pain during urination B.Frequency of nocturia episodes C.Strength of client's urine stream D.Post-void residual - Answer Answer- D Post void residual will offer the most objective and accurate information related to urinary retention. All the assessments offered are relevant to BPH. However, the priority of treatment in BPH is the prevention of urinary retention which occurs due to the prostate obstructing the bladder outlet flow. The client may experience chronic or acute urinary retention. Chronic urinary stasis leads to UTI and possible bladder calculi. If severe or acute, the retention can result in hydronephrosis, and kidney damage. The health care provider prescribes prazosin (Minipress) for a client newly diagnosed with BPH. The nurse instructs the client to avoid side effects of prazosin by taking the medication how? A.Before exercising B.With a diuretic C.With a full meal D.Before bedtime - Answer Answer-B The nurse advises the client to take prazosin (Minipress) before bedtime to avoid common side effects of syncope, dizziness, and lightheadedness. Prazosin (Minipress), an alpha-1-andrergenic-antagonist that treats BPH as well as HTN, often causes severe hypotension after first dose. Dizziness and otherstatic hypotension are common side effects, even after first dose. The client starts a low dose and titrates up as tolerated. A client returns to the surgical unit after undergoing a transurethral resection of the prostate (TURP). The nurse prepares for continuous bladder irrigation (CBI) using which solution? A.Sterile water B. LR C.NS D.Dakin solution - Answer Answer-C The isotonicity of NS makes it ideal for irrigations, as it will not shift fluids. NS is routinely used for CBI. Following TURP, moderate to large amounts of post operative bleeding is expected. The client will have an indwelling catheter, which must be kept patient to prevent the retention of urine. The catheter will have an irrigation port and CBI to prevent blood clots, which may obstruct drainange. NS is used for CBI because it is isotonic. Urinary output will be monitored, and the nurse calculates actual urine output by subtracting CBI intake from the amount emptied from the catheter bag. Immediately following surgery the drainage may be quite red, but the color will should lighten over the first 24 hours as the bleeding slows. The nurse checks the patency of the catheter hourly by observing urinary flow in the tubing. If the catheter becomes obstructed, irrigate per facility protocol. If unable to regain patency, notify the surgeon immediately. A client with BPH is admitted to the hospital for scheduled TURP. The nurse is aware that TURP is more widely performed than open prostatectomies for which reasons? Select all that apply. A.Reduced risk of urinary incontinence B.Better postoperative hemostatis C.Improved recovery time D.Reduced chance of prostatic regrowth E.Decreased risk of erectile dysfunction - Answer Answer-A,B,C,E TURP is the most widely used technique for prostatic tissue. It requires no incision and has reduced risks when compared to open prostatectomy. During TURP, the enlarged prostates is removed through an endoscopic instrument. A cytoscope is inserted into the urethra and advanced to the prostate. The prostate tissue is excised by the cytoscope, usually in small pieces. When TURP is an option it, it results in better post operative quality of life. An open prostatectomy involves an incision. Possible long term effects of prostatectomy include erectile dysfunction and urinary incontinence. An advantage to open prostatectomy is that the prostate is removed and has less change for regrowth. The health care provider prescribes a mechanical altered diet for a client who is recovering from a cerebrovascular accident (CVA). Which food choices does the nurse offer the client? Select all that apply. A.Diced cooked carrots B.Baked potato with skin C.Raw pineapple chunks D.Pasta with meat sauce E.Peanut butter sandwich - Answer Answer-A, D A client who has suffered a cerebrovascular accident (CVA) may have difficulty swallowing (dysphagia) and require a special diet. The National Dysphagia Diet consists of three stages: Stage I (dysphagia puree) consists of food that is uniform, pureed, cohesive, and pudding-like in texture. Foods included in the puree diet include smooth, hot cereals; mashed potatoes; pureed meat, vegetables, pasta, or rice; applesauce, and yogurt. Stage II (dysphagia mechanically altered) include foods that are moist, soft-textured, and easy form a bolus. Foods included in the Stage II diet include canned fruit (except pineapple); moist ground meat; well-cooked noodles in sauce or gravy; well-cooked diced vegetables. Stage III (dysphagia advanced) includes regular foods, with the exception of hard, sticky, or crunchy foods. A nurse cares for a client with left hemiparesis after an ischemic stroke. The nurse performs which actions? Select All That Apply A.Elevate the client's heels off of the bed surface. B.Create a toileting schedule for the client. C.Reposition the client every two hours while in bed. D.Encourage the client to increase fiber intake. E.Perform range of motion exercises on the client's left side. - Answer Answer A, B, C, D, E Elevating the heels with a pillow placed at the ankles relieves pressure on the site and allows for unrestricted blood flow which reduces the risk of skin breakdown.A toileting schedule helps to prevent incontinence since the client cannot get up independently. Moisture from incontinence macerates the skin and promotes skin breakdown. Clients who cannot reposition themselves are at high risk for skin breakdown. Repositioning should be done every 2 hours when in bed and every hour when sitting in a chair. Constipation is a possible side effect of decreased mobility. Increased fiber intake helps to prevent constipation.Contractures, or rigidity of joints, are possible side effects of decreased mobility. Range of motion (ROM) exercises help to prevent musculoskeletal contractures and should be performed at least fives times per joint and repeated three times per day.