Nokea
A nurse is caring for a client who is receiving continuous bladder irrigation following a TURP. Which of the following findings should the nurse report to the provider?
- A. The client reports bladder spasms.
- B. The irrigation fluid is slightly pink.
- C. The client's urine output is bright red with clots.
- D. The client's catheter is draining freely.
Correct Answer: C
Rationale: Bright red urine with clots indicates potential hemorrhage, requiring immediate reporting. Spasms and pink fluid are expected, and free drainage is normal.
You may also like to solve these questions
A nurse is reinforcing teaching with a client who has a new prescription for nitroglycerin sublingual tablets. Which of the following statements should the nurse include?
- A. Take one tablet every 10 min for chest pain.
- B. You might feel a headache after taking this medication.
- C. Swallow the tablet with water for best results.
- D. Store the tablets in a clear plastic bag.
Correct Answer: B
Rationale: Nitroglycerin often causes headaches due to vasodilation. It's taken every 5 minutes, dissolved under the tongue, and stored in a dark, airtight container.
A nurse is reinforcing teaching with a client who has a new prescription for fluoxetine. Which of the following statements should the nurse include?
- A. You should take this medication at bedtime.
- B. You might experience weight loss while taking this medication.
- C. You need to avoid tyramine-rich foods while taking this medication.
- D. You can expect symptom improvement within 24 hours.
Correct Answer: A
Rationale: Fluoxetine is often taken at bedtime to minimize daytime side effects like agitation. Weight changes vary, tyramine isn't a concern, and effects take weeks.
A nurse is reinforcing teaching with a client who has hypertension and a new prescription for hydrochlorothiazide. Which of the following instructions should the nurse include?
- A. Increase your intake of potassium-rich foods.
- B. Take the medication at bedtime.
- C. Monitor for leg cramps.
- D. Limit your fluid intake to 1 liter daily.
Correct Answer: C
Rationale: Hydrochlorothiazide can cause hypokalemia, leading to leg cramps, which should be monitored. Potassium intake may need adjustment, it's taken in the morning, and fluid limits aren't standard.
A nurse is caring for a client who is postoperative following a spinal fusion. Which of the following actions should the nurse take?
- A. Encourage the client to ambulate with a back brace.
- B. Instruct the client to twist at the waist when turning.
- C. Apply a heating pad to the surgical site.
- D. Allow the client to sit for 2 hr at a time.
Correct Answer: A
Rationale: A back brace supports ambulation, promoting stability. Twisting risks injury, heating pads may increase swelling, and prolonged sitting strains the spine.
A nurse is reinforcing teaching with a client who has a new prescription for escitalopram. Which of the following statements by the client indicates an understanding of the teaching?
- A. I should take this medication at bedtime.
- B. I might sweat more while taking this medication.
- C. I need to avoid dairy products.
- D. I can expect my symptoms to go away right away.
Correct Answer: B
Rationale: Escitalopram can cause sweating, showing understanding. Timing is flexible, dairy isn't restricted, and symptom relief takes weeks.