The nurse assesses a risk for constipation related to pain because of the presence of conditions such as ______________________________. (Select all that apply.)
a. hemorrhoids.
b. anal fissures.
c. reduction of bowel mucus.
d. diminished abdominal muscle tone.
e. slowed peristalsis.
ANS: A, B, C
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How can the nurse help the mother who is nursing and has engorged breasts?
a. Suggest that she switch to bottled formula just for today. b. Assist her to remove her bra, making her more comfortable. c. Apply heat to her breasts between feeding and cold to the breasts just before feedings. d. Instruct and assist the mother to massage her breasts.
A 72-year-old client who is diligent in maintaining good health has told the nurse of the plan to begin a 2-day cleansing fast. What teaching point should the nurse prioritize?
A) "Fasting has a significant cleansing effect, but is unlikely to influence your immune system.". B) "Fasting has a lot of benefits, but it's best to get an assessment from your doctor before you begin.". C) "This is a great idea; just make sure that you reintroduce food and fluids very slowly once you're finished.". D) "It's okay to skip up to two meals, but anything beyond that is usually not recommended for older adults.".
A nurse is reviewing a client's laboratory test results after being on statin therapy for several months. Which of the following would the nurse interpret as indicating effectiveness of the drug? Select all that apply
A) Total cholesterol 220 mg/dL B) LDL cholesterol 80 mg/dL C) HDL cholesterol 30 mg/dL D) LDL cholesterol 165 mg/dL E) HDL cholesterol 60 mg/dL
A positive outcome of the client goal, "client will verbalize decrease in peripheral discomfort (intermittent claudication)" would be that the client:
a. verbalizes his medication regime related to use of peripheral vasodilators. b. does not experience injury related to side effects of peripheral vasodilators. c. verbalizes that he is able to walk around the block without leg pain. d. reports episodes of anginal pain to the health care provider.