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
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