[App] SHRM-CP Offline Exam on All PC version 2025 - 1000 + Question
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NCLEX-RN Exam Questions - Part 20
1. Dietary planning is an essential part of the diabetic clients regimen. The American Diabetes Association recommends which of the following caloric guidelines for daily meal planning?
A) 50% complex carbohydrate, 20% - 25% protein, 20% - 25% fat
B) 45% complex carbohydrate, 25% - 30% protein, 30% - 35% fat
C) 70% complex carbohydrate, 20% - 30% protein, 10% - 20% fat
D) 60% complex carbohydrate, 12% - 15% protein, 20% - 25% fat
2. A 74-year-old female client is 3 days postoperative. She has an indwelling catheter and has been progressing well. While the nurse is in the room, the client states, 'Oh dear, I feel like I have to urinate again!' Which of the following is the most appropriate initial nursing response?
A) Assure her that this is most likely the result of bladder spasms.
B) Check the collection bag and tubing to verify that the catheter is draining properly.
C) Instruct her to do Kegel exercises to diminish the urge to void.
D) Ask her if she has felt this way before.
3. In cleansing the perineal area around the site of catheter insertion, the nurse would:
A) Wipe the catheter toward the urinary meatus
B) Wipe the catheter away from the urinary meatus
C) Apply a small amount of talcum powder after drying the perineal area
D) Gently insert the catheter another 1â?2 inch after cleansing to prevent irritation from the balloon
4. Nursing interventions designed to decrease the risk of infection in a client with an indwelling catheter include:
A) Cleanse area around the meatus twice a day
B) Empty the catheter drainage bag at least daily
C) Change the catheter tubing and bag every 48 hours
D) Maintain fluid intake of 1200 - 1500 mL every day
5. A client tells the nurse that she has had a history of urinary tract infections. The nurse would do further health teaching if she verbalizes she will:
A) Drink at least 8 oz of cranberry juice daily
B) Maintain a fluid intake of at least 2000 mL daily
C) Wash her hands before and after voiding
D) Limit her fluid intake after 6 PM so that there is not a great deal of urine in her bladder while she sleeps
A) 50% complex carbohydrate, 20% - 25% protein, 20% - 25% fat
B) 45% complex carbohydrate, 25% - 30% protein, 30% - 35% fat
C) 70% complex carbohydrate, 20% - 30% protein, 10% - 20% fat
D) 60% complex carbohydrate, 12% - 15% protein, 20% - 25% fat
2. A 74-year-old female client is 3 days postoperative. She has an indwelling catheter and has been progressing well. While the nurse is in the room, the client states, 'Oh dear, I feel like I have to urinate again!' Which of the following is the most appropriate initial nursing response?
A) Assure her that this is most likely the result of bladder spasms.
B) Check the collection bag and tubing to verify that the catheter is draining properly.
C) Instruct her to do Kegel exercises to diminish the urge to void.
D) Ask her if she has felt this way before.
3. In cleansing the perineal area around the site of catheter insertion, the nurse would:
A) Wipe the catheter toward the urinary meatus
B) Wipe the catheter away from the urinary meatus
C) Apply a small amount of talcum powder after drying the perineal area
D) Gently insert the catheter another 1â?2 inch after cleansing to prevent irritation from the balloon
4. Nursing interventions designed to decrease the risk of infection in a client with an indwelling catheter include:
A) Cleanse area around the meatus twice a day
B) Empty the catheter drainage bag at least daily
C) Change the catheter tubing and bag every 48 hours
D) Maintain fluid intake of 1200 - 1500 mL every day
5. A client tells the nurse that she has had a history of urinary tract infections. The nurse would do further health teaching if she verbalizes she will:
A) Drink at least 8 oz of cranberry juice daily
B) Maintain a fluid intake of at least 2000 mL daily
C) Wash her hands before and after voiding
D) Limit her fluid intake after 6 PM so that there is not a great deal of urine in her bladder while she sleeps
1. Right Answer: D
Explanation: (A) The percentage of carbohydrates is too low to maintain blood sugar levels. The percent range of protein is too high and may cause extra workload on the kidney as it is metabolized. (B) The percentage of carbohydrates is too low to maintain blood sugar levels. The percent range of protein is too high and may cause extra workload on the kidney. (C) The percentage of carbohydrates is too high; the percent range of protein is too high, and of fat, too low. (D) This combination provides enough carbohydrates to maintain blood glucose levels, enough protein to maintain body repair, and enough fat to ensure palatability.
2. Right Answer: B
Explanation: (A) Although this may be an appropriate response, the initial response would be to assure the patency of the catheter. (B) The most frequent reason for an urge to void with an indwelling catheter is blocked tubing. This response would be the best initial response. (C) Kegel exercises while a retention catheter is in place would not help to prevent a voiding urge and could irritate the urethral sphincter. (D) Though the nurse would want to ascertain whether the client has felt the same urge to void before, the initial response should be to assure the patency of the catheter.
3. Right Answer: B
Explanation: (A) Wiping toward the urinary meatus would transport microorganisms from the external tubing to the urethra, thereby increasing the risk of bladder infection. (B)Wiping away from the urinary meatus would remove microorganisms from the point of insertion of the catheter, thereby decreasing the risk of bladder infection. (C)Talcum powder should not be applied following catheter care, because powders contribute to moisture retention and infection likelihood. (D) The catheter should never be inserted further into the urethra, because this would serve no useful purpose and would increase the risk of infection.
4. Right Answer: A
Explanation: (A) Catheter site care is to be done at least twice daily to prevent pathogen growth at the catheter insertion site. (B) Catheter drainage bags are usually emptied every 8 hours to prevent urine stasis and pathogen growth. (C) Tubing and collection bags are not changed this often, because research studies have not demonstrated the efficacy of this practice. (D) Fluid intake needs to be in the 20002500 mL range if possible to help irrigate the bladder and prevent infection.
5. Right Answer: D
Explanation: (A) Cranberry juice helps to maintain urine acidity, thereby retarding bacterial growth. (B) A generous fluid intake will help to irrigate the bladder and to prevent bacterial growth within the bladder. (C) Hand washing is an effective means of preventing pathogen transmission. (D) Restricting fluid intake would contribute to urinary stasis, which in turn would contribute to bacterial growth.
Explanation: (A) The percentage of carbohydrates is too low to maintain blood sugar levels. The percent range of protein is too high and may cause extra workload on the kidney as it is metabolized. (B) The percentage of carbohydrates is too low to maintain blood sugar levels. The percent range of protein is too high and may cause extra workload on the kidney. (C) The percentage of carbohydrates is too high; the percent range of protein is too high, and of fat, too low. (D) This combination provides enough carbohydrates to maintain blood glucose levels, enough protein to maintain body repair, and enough fat to ensure palatability.
2. Right Answer: B
Explanation: (A) Although this may be an appropriate response, the initial response would be to assure the patency of the catheter. (B) The most frequent reason for an urge to void with an indwelling catheter is blocked tubing. This response would be the best initial response. (C) Kegel exercises while a retention catheter is in place would not help to prevent a voiding urge and could irritate the urethral sphincter. (D) Though the nurse would want to ascertain whether the client has felt the same urge to void before, the initial response should be to assure the patency of the catheter.
3. Right Answer: B
Explanation: (A) Wiping toward the urinary meatus would transport microorganisms from the external tubing to the urethra, thereby increasing the risk of bladder infection. (B)Wiping away from the urinary meatus would remove microorganisms from the point of insertion of the catheter, thereby decreasing the risk of bladder infection. (C)Talcum powder should not be applied following catheter care, because powders contribute to moisture retention and infection likelihood. (D) The catheter should never be inserted further into the urethra, because this would serve no useful purpose and would increase the risk of infection.
4. Right Answer: A
Explanation: (A) Catheter site care is to be done at least twice daily to prevent pathogen growth at the catheter insertion site. (B) Catheter drainage bags are usually emptied every 8 hours to prevent urine stasis and pathogen growth. (C) Tubing and collection bags are not changed this often, because research studies have not demonstrated the efficacy of this practice. (D) Fluid intake needs to be in the 20002500 mL range if possible to help irrigate the bladder and prevent infection.
5. Right Answer: D
Explanation: (A) Cranberry juice helps to maintain urine acidity, thereby retarding bacterial growth. (B) A generous fluid intake will help to irrigate the bladder and to prevent bacterial growth within the bladder. (C) Hand washing is an effective means of preventing pathogen transmission. (D) Restricting fluid intake would contribute to urinary stasis, which in turn would contribute to bacterial growth.
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