Question 1

A nurse is caring for a client with an enlarged prostate. The client has difficulty voiding. Physical assessment notes a distended bladder with residual urine. When performing intermittent catheterization, which of the following is an inappropriate technique to ease the insertion:

A)Using the smallest available catheter in stock
B)Using liberal amounts of water-based lubricant
C)Assisting the client in semi-Fowler's position with the legs spread apart
D)Instructing the client to cough or bear down while maneuvering the catheter

Assisting the client in semi-Fowler's position with the legs spread apart

Accepted Answer

Assisting the client in semi-Fowler's position with the legs spread apart is an inappropriate technique. The patient must be placed in supine position with the legs spread apart as this is the easiest position to gain access for catheterization. To successfully insert the catheter with minimal trauma to the urethral lining, use the smallest available catheter possible, apply liberal amounts of lubricant, and ask the client to cough or bear down while maneuvering the catheter. Do not force the catheter since this can cause traumatic injury to the urethra.

Question 2

Michelle is giving a male client a bed bath. She noticed that the Foley catheter is no longer taped on the client's anterior thigh. Michelle obtains medical tape and secures the catheter back in place. The rationale for lateral or upward anchoring of the urethral catheter in a male is to:

A)Prevent pressure at the penescrotal area.
B)Promote comfort.
C)Secure the catheter well.
D)Provide privacy.

Prevent pressure at the penescrotal area.

Accepted Answer

Lateral or upward techniques of anchoring the urethral catheter in male client prevent pressure at the penescrotal area. This prevents tissue ischemia in the area.

Question 3

The physician has ordered to bladder training for a client with an indwelling catheter. The goal of bladder training is to&#10;A)Remove the catheter.&#10;B)Allow the person to walk to the bathroom.&#10;C)Gain control of urination.&#10;D)Void every 3 to 4 hours.

Accepted Answer

Bladder training programs help some persons with urinary incontinence. Control of urination is the goal. Bladder control promotes comfort and quality of life. You assist with bladder training as directed by the nurse and the care plan.

Question 4

Which of the following types of blood vessels are responsible for the greatest proportion of vascular resistance?&#10;A)Arteries&#10;B)Arterioles&#10;C)Capillaries&#10;D)Venules

Accepted Answer

Arterioles account for the largest proportion of peripheral vascular resistance.

Question 5

A nurse is monitoring a client who was recently admitted to the unit after a cardiac catheterization. Which of the following ordered assignments is the nurse's priority?&#10;A)Assess the client's heart rate&#10;B)Monitor the client's urinary output&#10;C)Assess pulses distal to insertion site&#10;D)Assess pulses proximal to the insertion site

Accepted Answer

After the procedure, the client is at risk of clot formation. Weakened or absent pulses distal to the insertion site may suggest its occurrence. Options A and B are also assessed, but assessment of the pulses distal to the insertion site is the priority. Option D is not correct.

Question 6

Stroke or cerebrovascular accidents are classified as:&#10;A)Ischemic and hemorrhagic&#10;B)Only ischemic&#10;C)Only hemorrhagic&#10;D)None of the above

Accepted Answer

Stroke or cerebrovascular accidents are classified as two types: ischemic and hemorrhagic. Ischemic strokes are those that are caused by interruption of the blood supply, while hemorrhagic strokes are the ones which result from rupture of a blood vessel or an abnormal vascular structure. 87% of strokes are caused by ischemia and the remainder by hemorrhage.

Question 7

A patient was suspected to be having disseminated intravascular coagulation (DIC). His D-dimers were carried out. What finding do you expect from a patient if he is really having DIC?&#10;A)Increased&#10;B)Decreased&#10;C)No change&#10;D)All of the above

Accepted Answer

Increased findings are expected from a patient if he is really having DIC. Numbers of tests are included in the panel of disseminated intravascular coagulation. In these tests materials needed for clotting are decreased and those that measure clotting times are increased. D-dimers are increased in case of DIC. D-dimer is a specific polymer that results when fibrin breaks down, giving a marker to indicate the degree of fibrinolysis.

Question 8

If a patient is anemic, then what do you expect in the cardiovascular examination of the patient?&#10;A)Third heart sound&#10;B)Gallop rhythm&#10;C)Murmurs&#10;D)All of above

Accepted Answer

In cardiovascular examination of the anemic patient, murmurs will be there because the viscosity of blood is decreased in anemia, which results in decreased peripheral resistance. So, more blood is pumped into the heart, and this increased flow can cause turbulence that result in heart murmurs.

Deck 1: Basic Care, Medical Assisting, NBDE, and PCCN