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A nurse is collecting data from a client who is 1 day postoperative following a transurethral resection of the prostate. Which of the following findings should the nurse report to the provider?
- A. Urine output of 300 ml over 8 hr.
- B. Occasional small clots in the urine
- C. Dark red urine
- D. Frequent urge to urinate
Correct Answer: C
Rationale: Dark red urine may indicate hemorrhage, a serious complication requiring immediate reporting. Urine output of 300 mL over 8 hours is adequate, small clots are expected, and frequent urge to urinate is common post-procedure.
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A nurse is reinforcing teaching with a client who has a new prescription for prednisone. Which of the following statements by the client indicates an understanding of the teaching?
- A. I should take this medication on an empty stomach.
- B. I might need to take this medication for several weeks.
- C. I can stop taking this medication if I feel better.
- D. I should avoid getting vaccinated while taking this medication.
Correct Answer: B
Rationale: Prednisone often requires weeks of treatment for efficacy, reflecting understanding. It's taken with food, stopping abruptly risks adrenal crisis, and vaccines need provider guidance.
A nurse is caring for a client who is receiving continuous bladder irrigation following a transurethral resection of the prostate. Which of the following actions should the nurse take?
- A. Monitor the client's urine output every 4 hr.
- B. Irrigate the catheter with sterile water every 2 hr.
- C. Check the catheter tubing for blood clots.
- D. Administer an antibiotic prophylactically.
Correct Answer: C
Rationale: Checking for clots ensures catheter patency, critical for irrigation. Output monitoring is secondary, manual irrigation isn't routine, and antibiotics depend on orders.
A nurse is implementing a bladder training program for a client who had a stroke. Which of the following interventions should the nurse take first?
- A. Assist the client with relaxation techniques.
- B. Discourage intake of carbonated beverages.
- C. Offer toileting opportunities every 1 to 2 hr.
- D. Determine the client's pattern for voiding.
Correct Answer: D
Rationale: Assessing the client's voiding pattern first provides baseline data to tailor the bladder training program, ensuring interventions like toileting schedules or dietary changes are effective.
A nurse is reinforcing teaching with a client who has a new prescription for losartan. Which of the following statements should the nurse include?
- A. You should take this medication with a high-potassium meal.
- B. You might experience dizziness while taking this medication.
- C. You need to limit your exercise while taking this medication.
- D. You can take this medication at any time of day.
Correct Answer: B
Rationale: Losartan can cause dizziness due to blood pressure lowering, a key safety concern. Potassium meals, exercise limits, or flexible timing aren't primary considerations.
A nurse is caring for a client who is receiving IV gentamicin. Which of the following actions should the nurse take?
- A. Monitor the client's hearing.
- B. Administer the medication over 15 min.
- C. Check the client's blood glucose levels.
- D. Instruct the client to increase fluid intake.
Correct Answer: A
Rationale: Gentamicin risks ototoxicity, so hearing monitoring is critical. It's infused slowly, glucose isn't affected, and fluid intake depends on condition.