Tuesday, 5 January 2021

F&E AND ELIMINATION

The nurse is preparing to care for a patient with a potassium deficit. The nurse reviews the patient’s record and determines that the client was at risk for developing the potassium deficit because of which situation?

0/1

Sustained tissue damage

Requires nasogastric suction

Has a history of Addison’s disease

 

Is taking a potassium-retaining diuretic

Correct answer

Requires nasogastric suction

 

The nurse is reading a health care provider’s ( HCP) progress notes in the patient’s record and reads that the HCP has documented “ insensible fluid loss of approx 800 ml daily”. The nurse interprets that this type of fluid loss can occur through which route?

0/1

The skin

Urinary output

Wound drainage

The gastrointestinal tract

 

Correct answer

The skin

 

How many cups of fluid do we need every day to keep us well hydrated?

1/1

1 to 2

2 to 4

4 to 6

6 to 8

 

 

The human body is made up of approximately what proportion of water?

0/1

50%

 

60%

70%

80%

Correct answer

60%

 

Concentration of electrolytes within the body vary depending on the compartment within which they are contained. Extracellular fluid has a high concentration of which of the following?

0/1

Potassium

Chloride

 

Sodium

Magnesium

Correct answer

Sodium

 

Dehydration is of particular concern in ill health. If a patient is receiving intravenous (IV) fluid replacement and is having their fluid balance recorded, which of the following statements is true of someone said to be in a positive fluid balance?

0/1

The fluid output has exceeded the input

The doctor may consider increasing the IV drip rate

 

The fluid balance chart can be stopped as positive in this instance means good

The fluid input has exceeded the output

Correct answer

The fluid input has exceeded the output

 

Dehydration can be corrected by using intravenous fluids and electrolytes or oral rehydration solutions. The person who has diarrhoea will require an additional:

1/1

100 mL for each loose stool

200 mL for each loose stool

 

300 mL for each loose stool

400 mL for each loose stool

 

Untreated dehydration will quickly lead to a drop in blood pressure and a rise in heart rate to compensate for the fall in blood pressure. All but one is an outcome of hypotension:

1/1

Increase in metabolic acidosis

Decrease in renal perfusion

Increase in metabolic alkalosis

 

Decrease in glomerular filtration

 

If your patient is having positive balance. How will you find out dehydration is balanced?

1/1

Input exceeds output

 

Output exceeds input

Optimally hydrated

Optimally dehydrated

 

First sign of dehydration

0/1

Bounding pulse

Hypertension

Jugular distension

Hypotension

 

Correct answer

Bounding pulse

 

When should a penile sheath be considered as a means of managing incontinence?

0/1

When other methods of continence management have failed

Following the removal of a catheter

 

When the patient has a small or retracted penis

When a patient requests it

 

Correct answer

When other methods of continence management have failed

 

Which of the following techniques is advisable when obtaining a urine specimen in order to minimize the contamination of a specimen?

0/1

·        Clean around the urethral meatus prior to sample collection and get a midstream/clean catch urine specimen

 

·        Clean around the urethral meatus prior to sample collection and collect the first portion of urine as this is where the most bacteria will be

 

·        Do not clean the urethral meatus as we want these bacteria to analyse as well

 

·        Dip the urinalysis strip into the urine in a bedpan mixed with stool

 

Correct answer

Clean around the urethral meatus prior to sample collection and get a midstream/clean catch urine specimen

 

Promotion and treatment of incontinence should be the primary concern of the nurse, the use of penile sheaths are only considered once other methods of promoting continence have failed. Which of the following is not part of the common problems associate with penile sheaths?

0/1

·        Difficulty fitting as penile sheaths are contraindicated for very large or retracted penis

 

·        Difficulty fitting as penile sheaths may cause them to kink and result to urine leaking

 

·        Difficulty fitting as penile sheaths has the potential to falling off as a result of the skin sensitivities

 

·        None of the above

 

Correct answer

Difficulty fitting as penile sheaths are contraindicated for very large or retracted penis

 

Urine free cortisol test is done for 24 hours because:

1/1

Cortisol is secreted in constant amount throughout the day this needing the whole 24 hour collection

 

Cortisol level peaks in the morning and fluctuates in the evening

 

Cortisol level peaks in the evening and fluctuates in the morning

 

Cortisol level is sometimes not secreted in the urine this needing the 24 hour collection

 

What is positive fluid balance?

0/1

A deficit in fluid volume

 

A state when fluid intake is greater than output

 

Retention of both electrolytes and water in proportion to the levels in the extracellular fluid

 

A state where the body has less water than it needs to function properly

 

Correct answer

A state when fluid intake is greater than output

 

What are the steps for the proper urine collection? 1. Clean meatus with soap and water; 2. Catch midstream; 3. Dispatch sample to laboratory immediately (within 6 hours); 4. Ask the patient to void her remaining urine into the toilet or bedpan.

0/1

1, 2, and 3

 

2, 3, and 4

1, 2, and 4

1, 3, and 4

 

Correct answer

1, 2, and 4

 

It is a condition in which you wake up during the night because you have to urinate.

0/1

Polyuria

Oliguria

 

Nocturia

Dysuria

 

Correct answer

Nocturia

 

Patient usually urinates at night. Nurse identifies this as:

0/1

Polyuria

Oliguria

 

Dysuria

Nocturia

 

Correct answer

Nocturia

 

Mr Marriott, 21 years old, has been complaining of foul smelling urine, pain on urination and night sweats. What further assessment should be done to check if he has Urinary Tract Infection?

0/1

Assess his blood pressure

Take a urine sample and send it to the lab

Do the buccal swab and send the specimen to the lab

Check his prothrombin time and signs of bleeding

 

Correct answer

Take a urine sample and send it to the lab

 

Alan appears to be very confused today. He seems to be quite verbally aggressive towards staff. His urine has also got a bit of foul smell. How would you assess this resident?

0/1

Check his papillary response to light

Collect a urine sample for MSU

Carry out the urine dipstick

 

B and C

None of the above

 

Correct answer

B and C

 

How much urine should someone void an hour?

0/1

05 – 1ml/Kg/hr of the patient’s body weight

2mls/KG/hr of the patient’s body weight

 

30mls

50mls

 

Correct answer

05 – 1ml/Kg/hr of the patient’s body weight

 

When collecting an MSU from a male patient, what should they do prior to the specimen being collected?

0/1

Clean the meatus and catch a specimen from the last of the urine voided

 

Clean the meatus and catch a specimen from the first stream of urine (approx 30mls)

 

Clean the meatus and catch a specimen of the urine midstream

 

Ask the patient to void into a bottle and pour urine specimen into the specimen container

 

Correct answer

Clean the meatus and catch a specimen of the urine midstream

 

What is the most important guiding principle when choosing the correct size of catheter?

1/1

The biggest size tolerable

The smallest size necessary

 

The potential length of use of the catheter

The build of the patient

 

When carrying out a catheterization, on which patients would you use anaesthetic lubricating gel prior to catheter insertion?

1/1

·        Male patients to aid passage, as the catheter is longer

 

·        Female patients as there is an absence of lubricating glands in the female urethra, unlike the male urethra

 

·        Male and female patients require anaesthetic lubricating gel

 

·        The use of anaesthetic lubricating gel is not advised due to potential adverse reactions

 

On removing your patient's catheter, what should you encourage your patient to do?

1/1

·        Rest and drink 2-3 litres of fluid per day

·        Rest and drink in excess of 5 litres of fluid per day

·        Exercise and drink 2-3 litres of fluid per day

 

·        Exercise and drink their normal amount of fluid intake

 

What are the principles of positioning a urine drainage bag?

1/1

·        Above the level of the bladder to improve visibility and access for the health professional

·        Above the level of the bladder to avoid contact with the floor

·        Below the level of the patient's bladder to reduce backflow of urine

 

·        Where the patient finds it most comfortable

 

The use of anaesthetic lubricating gel is well recognised for male catheterisation, but there is more controversy over their use for female catheterisation. What is the most important principle that underpins the use of anaesthetic lubricant in catheterisation?

0/1

·        Trauma can occur during catheterisation of female patients which in turn can increase their risk of infection and using single-use lubricating gels with antiseptic properties can reduce these risks

·        Trauma can occur during catheterisation of male patients which in turn can increase their risk of infection and using single-use lubricating gels with antiseptic properties can reduce these risks

 

·        Based on empirical or biological evidence, the differences in practice imply that catheterisation is a painful procedure for women as compared to men and the use of lubricating gel prior to catheterisation made insertion easier for the nurse

 

·        Based on empirical or biological evidence, the differences in practice imply that the use of lubricating gel prior to catheterisation dilates the urethral meatus making the procedure less painful in men as compared to women

 

Correct answer

Trauma can occur during catheterisation of male patients which in turn can increase their risk of infection and using single-use lubricating gels with antiseptic properties can reduce these risks

 

Your patient has had Diverticulitis for about a decade now. You have assessed her to be having soft stools of Type 4/5. Which of the following will need urgent intervention?

0/1

She is losing a lot of electrolytes in her body, and this needs to be replaced

 

There is no urgency in this case, because patients with Diverticulitis are expected to have soft to loose stools

 

She needs to be prescribed with fluid retention pills

 

There is no urgency in this case because the stool is quite hard, and it should be fine

 

Correct answer

There is no urgency in this case, because patients with Diverticulitis are expected to have soft to loose stools

 

Your patient has undergone a formation of a loop colostomy. What important considerations should be borne in mind when selecting an appropriate stoma appliance for your patient?

0/1

·        Dexterity of the patient, consistency of effluent, type of stoma

·        Patient preference, type of stoma, consistence of effluent, state of peristomal skin, dexterity of patient

 

·        Patient preference, lifestyle, position of stoma, consistency of effluent, state of peristomal skin, dexterity of patient, type of stoma

 

·        Cognitive ability, lifestyle, patient dexterity, position of stoma, state of peristomal skin, type of stoma, consistency of effluent, patient preference

 

Correct answer

Cognitive ability, lifestyle, patient dexterity, position of stoma, state of peristomal skin, type of stoma, consistency of effluent, patient preference

 

When selecting a stoma appliance for a patient who has undergone a formation of a loop colostomy, what factors would you consider?

0/1

·        Patient dexterity, consistency of effluent, type of stoma

 

·        Patient preference, type of stoma, consistency of effluent, state of peristomal skin, dexterity of the patient

 

·        Patient preference, lifestyle, position of stoma, consistency of effluent, state of peristomal skin, patient dexterity, type of stoma

 

·        Cognitive ability, lifestyle, patient dexterity, position of stoma, state of peristomal skin, type of stoma, consistency of effluent, patient preference

 

Correct answer

Cognitive ability, lifestyle, patient dexterity, position of stoma, state of peristomal skin, type of stoma, consistency of effluent, patient preference

 

What type of diet would you recommend to your patient who has a newly formed stoma?

1/1

·        Encourage high fibre foods to avoid constipation

·        Encourage lots of vegetables and fruit to avoid constipation

·        Encourage a varied diet as people can react differently

 

·        Avoid spicy foods because they can cause erratic function

 

What would be your main objectives in providing stoma education when preparing a patient with a stoma for discharge home?

0/1

·        That the patient can independently manage their stoma, and can get supplies

 

·        That the patient has had their appliance changed regularly, and knows their community stoma nurse

 

·        That the patient knows the community stoma nurse, and has a prescription

 

·        That the patient has a referral to the District Nurses for stoma care

 

·         Correct answer

That the patient can independently manage their stoma, and can get supplies

 

In choosing the right size of stoma appliances, it is important that its angles snugly around the stoma within of the stoma edge

0/1

0.3cm

0.4cm

0.5cm

 

0.6cm

 

Correct answer

0.3cm

No comments:

Post a comment