Nokea
A pregnant client tells the nurse, "I am experiencing a burning pain when I urinate." How should the nurse respond?
- A. This means labor will start soon. Prepare to go to the hospital.
- B. You probably have a urinary tract infection. Drink more cranberry juice.
- C. Make an appointment with your provider to have your infection treated.
- D. Your pelvic wall is weakening. Pelvic muscle exercises should help.
Correct Answer: C
Rationale: Pregnant clients with a urinary tract infection require prompt and aggressive treatment because cystitis can lead to acute pyelonephritis during pregnancy. The nurse should encourage the client to make an appointment and have the infection treated. Burning pain when urinating does not indicate the start of labor or weakening of pelvic muscles. Choice A is incorrect because burning pain during urination does not signify the start of labor. Choice B is incorrect because while cranberry juice may help prevent urinary tract infections, it is not a treatment. Choice D is incorrect because burning pain when urinating is not indicative of weakening pelvic muscles.
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A client who underwent surgery and experienced significant blood loss is being cared for by a nurse. Which findings by the nurse should prompt immediate action to prevent acute kidney injury? (Select all that apply.)
- A. Urine output of 100 mL in 4 hours
- B. Large amount of sediment in the urine
- C. A & B
- D. Amber, odorless urine
Correct Answer: C
Rationale: The nurse must monitor for signs of acute kidney injury in a postoperative client who had major blood loss. Low urine output, presence of sediment in the urine, and low blood pressure should raise concerns and be reported to the healthcare provider promptly. Postoperatively, assessing urine characteristics is crucial. Sediment, hematuria, and urine output less than 0.5 mL/kg/hour for 3 to 4 hours should be reported. While a urine output of 100 mL in 4 hours is low, it should be compared to the recommended 0.5 mL/kg/hour over a longer period. Perfusion to the kidneys is a priority, hence the importance of addressing low blood pressure. Amber, odorless urine is considered normal and does not indicate an immediate concern for acute kidney injury, unlike low urine output and presence of sediment.
During nasotracheal suctioning, which of the following observations should be cause for concern to the nurse? Select all that apply.
- A. The client becomes cyanotic.
- B. Secretions are bloody.
- C. The client gags during the procedure.
- D. Clear to opaque secretions are removed.
Correct Answer: C
Rationale: During nasotracheal suctioning, the client gagging during the procedure is a cause for concern as it can indicate discomfort or potential airway obstruction. Cyanosis, bloody secretions, or the removal of clear to opaque secretions are expected observations that the nurse should monitor for, but gagging indicates a need for immediate intervention to ensure the safety and comfort of the client. Cyanosis and bloody secretions can signify oxygenation issues and potential complications, while the removal of secretions is the goal of the suctioning procedure.
A nurse cares for a client with diabetes mellitus who is prescribed metformin (Glucophage) and is scheduled for an intravenous urography. Which action should the nurse take first?
- A. Contact the provider and recommend discontinuing the metformin.
- B. Keep the client NPO for at least 6 hours prior to the examination.
- C. Check the client's capillary artery blood glucose and administer prescribed insulin.
- D. Administer intravenous fluids to dilute and increase the excretion of dye.
Correct Answer: A
Rationale: Metformin can cause lactic acidosis and renal impairment as the result of an interaction with the dye. This drug must be discontinued for 48 hours before the procedure and not started again after the procedure until urine output is well established. The client's health care provider needs to provide alternative therapy for the client until the metformin can be resumed. Keeping the client NPO, checking the client's blood glucose, and administering intravenous fluids should be part of the client's plan of care, but are not the priority, as the examination should not occur while the client is still taking metformin.
A client with a history of calcium phosphate urinary stones is being taught by a nurse. Which statements should the nurse include in this client's dietary teaching? (Select all that apply.)
- A. Limit your intake of food high in animal protein.
- B. Read food labels to help minimize your sodium intake.
- C. A and B
- D. Reduce your intake of milk and other dairy products.
Correct Answer: C
Rationale: For a client with a history of calcium phosphate urinary stones, it is essential to limit the intake of foods high in animal protein to prevent the formation of stones. Additionally, reducing sodium intake is crucial as high sodium levels can contribute to stone formation. Therefore, choices A and B are correct. Choice D, which suggests reducing intake of milk and other dairy products, is not specifically recommended for calcium phosphate stones. Clients with calcium phosphate stones should focus on limiting animal protein, sodium, and calcium intake. Choices A and B address these dietary modifications, making them the correct options for this client. Choices D, which is not directly related to calcium phosphate stones, is incorrect.
A healthcare professional reviews a client's laboratory results. Which results from the client's urinalysis should the healthcare professional identify as normal? (Select all that apply.)
- A. pH: 6
- B. Specific gravity: 1.015
- C. Glucose: negative
- D. All of the above
Correct Answer: D
Rationale: In a urinalysis, a pH of 6 is within the normal range (typically between 4.6 and 8); a specific gravity of 1.015 is considered normal (usually ranging between 1.005 to 1.030); and a negative glucose result is also normal. Therefore, choices A, B, and C are correct as they fall within the normal values for a urinalysis. Choices A, B, and C are the correct answers, as the pH, specific gravity, and glucose levels are within the normal range for a urinalysis. Choice D is correct because all the listed values are normal. Choices A, B, and C are the correct options as they meet the criteria for normal urinalysis values. The other choices do not fall within the normal range for a urinalysis.