Nokea
A nurse is collecting data on a client who is postoperative following a transurethral resection of the prostate (TURP). The nurse should recognize which of the following findings is the priority?
- A. The client has small blood clots in his urinary catheter.
- B. The client reports a continuous urge to void.
- C. The client reports burning around the urinary catheter.
- D. The client has bright red urine in his urinary catheter.
Correct Answer: D
Rationale: Bright red urine indicates active bleeding, a serious complication requiring immediate attention to prevent hemorrhage.
You may also like to solve these questions
A nurse is preparing to administer ondansetron 4 mg IM stat. The amount available is ondansetron for injection 2 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. (Do not use a trailing zero))
Correct Answer: 2 mL
Rationale: 4 mg ÷ 2 mg/mL = 2 mL. The nurse should administer 2 mL.
A nurse is contributing to the plan of care for an older adult client who has a WBC of 2000/mm³ after three rounds of chemotherapy. Which of the following interventions should the nurse include in the plan?
- A. Serve cooked fruit with meals.
- B. Report temperatures greater than 39.5°C (102.3°F) lasting more than 4 hours.
- C. Place the client in a room with negative-pressure airflow.
- D. Instruct client to use an incentive spirometer every 4 hours.
Correct Answer: A
Rationale: Serving cooked fruit reduces infection risk by eliminating pathogens, appropriate for a client with low WBC counts.
A nurse is preparing to administer levothyroxine 275 mcg PO to a client. The amount available is levothyroxine 137 mcg/tablet. How many tablets should the nurse administer?
- A. 2 tablets
- B. 1 tablet
- C. 3 tablets
- D. 4 tablets
Correct Answer: A
Rationale: 275 mcg ÷ 137 mcg/tablet = 2.007 tablets, rounded to 2 tablets.
A nurse is assisting a client who is postoperative following a total hip arthroplasty into a supine position. Which of the following actions is appropriate to prevent hip dislocation?
- A. Place a sandbag to the lateral calf.
- B. Place a wedge pillow between the legs.
- C. Place a trochanter roll against the thigh.
- D. Place a footboard on the bed.
Correct Answer: B
Rationale: Placing a wedge pillow between the legs maintains hip abduction, preventing adduction and reducing the risk of dislocation after hip arthroplasty.
A nurse is preparing to administer levothyroxine 275 mcg PO to a client. The amount available is levothyroxine 137 mcg/tablet. How many tablets should the nurse administer?
- B. 1 tablet
- C. 3 tablets
- D. 4 tablets
Correct Answer: 2 tablets
Rationale: 275 mcg ÷ 137 mcg/tablet = 2.007 tablets, rounded to 2 tablets.