NGN NCLEX RN CASE STUDIES WELL ANSWERED 2023

NGN NCLEX RN CASE STUDIES WELL ANSWERED 2023

NCLEX RN CASE STUDIES WELL ANSWERED
The nurse is providing discharge instructions to a client receiving oxybutynin for
overactive bladder.
Which client statement indicates that further teaching is required?

1. “I am looking forward to our summer vacation at the beach.”
2. “I plan to eat more fruits and vegetables to prevent constipation.”
3. “I should not drive until I know how this drug affects me.”
4. “I will drink at least 6-8 glasses of water daily.”
   The nurse is providing discharge instructions to a client receiving oxybutynin for
   overactive bladder.
   Which client statement indicates that further teaching is required?
5. “I am looking forward to our summer vacation at the beach.”
6. “I plan to eat more fruits and vegetables to prevent constipation.”
7. “I should not drive until I know how this drug affects me.”
8. “I will drink at least 6-8 glasses of water daily.”
   ANSWER: 1
   Oxybutynin (Ditropan) is an anticholinergic medication that is frequently used to
   treat overactive bladder. Common side effects include:

• New-onset constipation
• Dry mouth
• Flushing
• Heat intolerance***
• Blurred vision
• Drowsiness

Decreased sweat production may lead to hyperthermia. The nurse should instruct
the client to be cautious in hot weather and during physical activity.
The public health nurse identifies which of the following clients as being at high risk
for developing colorectal cancer? Select all that apply.

1. A 28-year-old female client with a body mass index of 38 kg/m2
2. A 38-year-old male client with a 15-year history of ulcerative colitis
3. A 48-year-old male client whose father has a history of colorectal cancer
4. A 58-year-old male client who consumes a diet high in fruits and vegetables
5. A 68-year-old female client with a 40-year history of cigarette smoking
   The public health nurse identifies which of the following clients as being at high risk
   for developing colorectal cancer? Select all that apply.
6. A 28-year-old female client with a body mass index of 38 kg/m2
7. A 38-year-old male client with a 15-year history of ulcerative colitis
8. A 48-year-old male client whose father has a history of colorectal cancer
9. A 58-year-old male client who consumes a diet high in fruits and vegetables
10. A 68-year-old female client with a 40-year history of cigarette smoking
    ANSWER: 1, 2, 3, 5
    Colorectal cancer is the third most common cancer and the second leading cause of
    cancer deaths affecting both genders equally. Various risk factors for colorectal
    cancer include:

• Personal or family (first-degree relative) history of colorectal cancer/polyps
• Personal history of inflammatory bowel disease, Crohn’s disease, or ulcerative
  colitis
• History of hereditary non-polyposis colorectal cancer (Lynch syndrome)
• Lifestyle factors such as obesity, a diet high in red meat, cigarette smoking, and
  alcohol consumption

Eating fruits, vegetables, and grains may decrease colorectal cancer risk but diets
high in fat and low in fiber increase this risk.
The nurse is caring for a client who has a postoperative paralytic ileus following a
bowel resection for colon cancer. The client is receiving patient-controlled analgesia
(PCA) with morphine. Which nursing diagnoses (NDs) are appropriate to include in
the client’s care plan. Select all that apply.

1. Acute pain
2. Dysfunctional gastric motility
3. Imbalanced nutrition, less than body requirements
4. Ineffective self health management
5. Risk for infection
   The nurse is caring for a client who has a postoperative paralytic ileus following a
   bowel resection for colon cancer. The client is receiving patient-controlled analgesia
   (PCA) with morphine. Which nursing diagnoses (NDs) are appropriate to include in
   the client’s care plan. Select all that apply.
6. Acute pain
7. Dysfunctional gastric motility
8. Imbalanced nutrition, less than body requirements
9. Ineffective self health management
10. Risk for infection
    ANSWER: 1, 2, 3, 5
    The following NDs are appropriate to include in this client’s care plan:

• Acute pain related to tissue damage as evidenced by the use of PCA with an opioid.
  Pain is usually the most intense 12-36 hours after surgery
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