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A client recovering from a urologic procedure is being assessed by a nurse. Which assessment finding indicates an obstruction of urine flow?
- A. Severe pain
- B. Overflow incontinence
- C. Hypotension
- D. Blood-tinged urine
Correct Answer: B
Rationale: The correct answer is 'B: Overflow incontinence.' The most common manifestation of urethral stricture after a urologic procedure is obstruction of urine flow. This obstruction can lead to overflow incontinence, which is the involuntary loss of urine when the bladder is distended. Severe pain is not typically associated with an obstruction of urine flow. Hypotension is unrelated to this issue. Blood-tinged urine is not a direct indication of an obstruction of urine flow but may indicate other conditions like trauma or infection.
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The healthcare professional is preparing to give a dose of trimethoprim-sulfamethoxazole (TMP-SMX) and learns that the patient takes warfarin (Coumadin). The healthcare professional will request an order for
- A. a decreased dose of TMP-SMX.
- B. a different antibiotic.
- C. an increased dose of warfarin.
- D. coagulation studies.
Correct Answer: D
Rationale: Sulfonamides, like trimethoprim-sulfamethoxazole (TMP-SMX), can potentiate the anticoagulant effects of warfarin (Coumadin). To monitor the patient's response and prevent adverse effects, the healthcare professional should request coagulation studies, such as International Normalized Ratio (INR) levels. Choosing a decreased dose of TMP-SMX would not address the potential drug interaction between TMP-SMX and warfarin. Opting for a different antibiotic is not necessary if the interaction can be managed by monitoring. Increasing the dose of warfarin without monitoring could lead to excessive anticoagulation and adverse events, so it's not the appropriate action in this scenario.
A client is scheduled to undergo computerized tomography (CT) with contrast for evaluation of an abdominal mass. The nurse should tell the client that:
- A. The test may be painful
- B. The test takes 2 to 3 hours
- C. Food and fluids are not allowed for 4 hours after the test
- D. Dye is injected and may cause a warm flushing sensation
Correct Answer: D
Rationale: The correct answer is D. A contrast-aided CT scan involves the injection of dye to enhance the images obtained. The dye may cause a warm flushing sensation when injected, which is a common side effect. Choices A, B, and C are incorrect. CT with contrast is generally not a painful procedure, the duration of the test does not usually take 2 to 3 hours, and restrictions on food and fluids are typically before the test, not afterward.
The patient has a heart rate of 98 beats per minute and a blood pressure of 82/58 mm Hg, is lethargic, complaining of muscle weakness, and has had gastroenteritis for several days. Based on these findings, which sodium value would the nurse expect?
- A. 126 mEq/L
- B. 140 mEq/L
- C. 145 mEq/L
- D. 158 mEq/L
Correct Answer: A
Rationale: The patient's presentation of tachycardia, hypotension, lethargy, muscle weakness, and gastroenteritis suggests hyponatremia. Hyponatremia is characterized by a serum sodium level below the normal range of 135-145 mEq/L. A serum sodium level of 126 mEq/L falls significantly below this range, indicating hyponatremia. Choice B (140 mEq/L) and Choice C (145 mEq/L) are within the normal range for serum sodium levels and would not explain the patient's symptoms. Choice D (158 mEq/L) is above the normal range and would indicate hypernatremia, which is not consistent with the patient's presentation.
A client recovering from extracorporeal shock wave lithotripsy for renal calculi has an ecchymotic area on the right lower back. What action should the nurse take?
- A. Administer fresh-frozen plasma.
- B. Apply an ice pack to the site.
- C. Place the client in the prone position.
- D. Obtain serum coagulation test results.
Correct Answer: B
Rationale: After extracorporeal shock wave lithotripsy, ecchymosis can occur due to bleeding into the tissues from the shock waves. Applying an ice pack helps reduce the extent and discomfort of bruising. Administering fresh-frozen plasma and obtaining coagulation test results are not necessary as ecchymosis after this procedure is common and does not indicate a bleeding disorder that requires immediate intervention. Placing the client in the prone position will not address the bleeding or bruising in this situation.
A client expresses difficulty voiding in public places. How should the nurse respond?
- A. Offer to turn on the faucet in the bathroom to help stimulate urination.
- B. Suggest a prescription for a diuretic to increase urine output.
- C. Propose moving to a room with a private bathroom to enhance comfort.
- D. Close the curtain to provide maximum privacy.
Correct Answer: D
Rationale: The nurse should prioritize the client's privacy when addressing issues related to voiding discomfort in public places. Closing the curtain in the current room would offer immediate privacy and support the client's needs. Turning on the faucet is not an evidence-based intervention for voiding difficulties. Prescribing a diuretic is not appropriate without further assessment. While moving to a room with a private bathroom might be ideal, it may not be immediately feasible, making ensuring privacy in the current setting the most appropriate action.