NCLEX Daily Ten Question Practical Exercise 11


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6. A 60-year-old female patient with a recent colostomy is adjusting to her new lifestyle. She expresses concerns to the nurse about the inability to control the passage of gas, especially in social situations. The patient is seeking advice on dietary modifications to help manage this issue. What should the nurse suggest to the patient to help control the passage of gas from the colostomy?

Correct Answer: C

Answer Explanation:

Foods that bothered a person preoperatively will continue to do so after a colostomy.

Option A: Cellulose is just one of the several types of dietary fiber that naturally occur in food sources. Examples are green, leafy vegetables, Brussels sprouts, and green peas.
Option B: Increased fluid intake aids in the easy passage of stools and improves the consistency of colostomy stools.
Option D: Bland foods such as broccoli, cabbage, cauliflower, cucumber, green peppers, and corn increase passage of gas.

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7. A 56-year-old male patient who recently underwent surgery for a colostomy is learning colostomy irrigation techniques from the nurse. The patient is anxious about managing his colostomy independently and is attentive to the instructions. The nurse wants to ensure that the patient has understood the process correctly. Which of the following statements by the patient would indicate to the nurse that the instructions for colostomy irrigation have been understood correctly?

Correct Answer: B

Answer Explanation:

This height permits the solution to flow slowly with little force so that excessive peristalsis is not immediately precipitated.

Option A: The client must turn on the appropriate side to allow the nurse to do the procedure without difficulty.
Option C: Ask the physician how much water is needed to irrigate.
Option D: Cramping during an irrigation may mean that the water is too cold, the irrigation bag is too high, or the water is going too fast. Clamp off the tubing if this occurs.

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8. A 62-year-old male patient, in the oliguric phase of acute tubular necrosis, presents with fluid and electrolyte imbalances. The patient exhibits confusion, nausea, and muscle weakness. As part of the medical management to correct these imbalances, the nurse is preparing to administer the prescribed therapy. Which of the following interventions would the nurse expect to be part of the prescribed therapy to correct the electrolyte imbalance in this patient?

Correct Answer: A

Answer Explanation:

Kayexalate, a potassium exchange resin, permits sodium to be exchanged for potassium in the intestine, reducing the serum potassium level.

Option B: Higher protein intake can increase intraglomerular pressure, which is useful in the short term when the client eats a large protein meal with high-protein content so that one can ensure effective clearance of nitrogenous end products that are produced from eating too much protein.
Option C: Phosphorus, which is abundant in dairy products, draws calcium out of the bones when it builds up in the blood. Clients with renal diseases may eat some of these foods in very small amounts.
Option D: Although 0.9% saline and balanced fluids can both lead to renal volume expansion, interstitial fluid retention, and adverse intra-renal microvascular effects are more pronounced with 0.9% saline infusion.

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9. Mario has a burn injury. After 48 hours, the physician orders for Mario 2 liters of IV fluid to be administered q12 h. The drop factor of the tubing is 10 gtt/ml. The nurse should set the flow to provide:

Correct Answer: B

Answer Explanation:

This is the correct flow rate; multiply the amount to be infused (2000 ml) by the drop factor (10) and divide the result by the amount of time in minutes (12 hours x 60 minutes)

Option A: This amount is inadequate according to the formula used.
Option C: 32 gtts/min is more than the prescribed gtts/min given.
Option D: This amount is incorrect according to the formula used to get the correct flow rate.

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10. A 40-year-old male patient suffered a burn injury in a household accident. The burns cover his face, neck, right upper arm, and upper trunk. The nurse is using the rule of nines to estimate the total body surface area (TBSA) affected by the burns to guide treatment planning. According to the rule of nines, which area has the largest percent of burns?

Correct Answer: D

Answer Explanation:

The percentage designated for each burned part of the body using the rule of nines: Head and neck 9%; Right upper extremity 9%; Left upper extremity 9%; Anterior trunk 18%; Posterior trunk 18%; Right lower extremity 18%; Left lower extremity 18%; Perineum 1%.

Option A: The face and neck is 9%.
Option B: The right upper arm is 9% and the penis is only 1%.
Option C: The right thigh is 9% and the penis is 1%.

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