Nokea
A nurse is reinforcing teaching with a female client who has a history of urinary tract infections. Which of the following instructions should the nurse include?
- A. Increase milk consumption to make the urine more alkaline.
- B. Urinate before and after sexual intercourse.
- C. Use a vaginal douche once a week.
- D. Empty the bladder at least every 6 hr.
Correct Answer: B
Rationale: Urinating before and after sexual intercourse flushes bacteria from the urethra, a primary UTI prevention strategy, especially in women due to their shorter urethra. Milk consumption may alkalinize urine, but this doesn't prevent infection cranberry juice is more evidence-based, reducing bacterial adhesion. Vaginal douching disrupts normal flora, increasing UTI risk by promoting pathogen growth, contrary to hygiene goals. Emptying the bladder every 6 hours helps, but more frequent voiding (e.g., every 2-3 hours) is ideal; post-coital urination targets the key risk moment. This instruction empowers the client to reduce recurrence, aligns with urologic recommendations, and addresses a common trigger, making it the most effective teaching point.
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A nurse is obtaining a sterile urine specimen from a client who has an indwelling urinary catheter. Identify the sequence the nurse should follow.
- A. Empty the urine into a sterile container labeled with the client identifiers.
- B. Document in the client's electronic medical record that the specimen was sent to the laboratory.
- C. Attach a sterile needleless syringe to the sample port and aspirate the specimen.
- D. Wipe the sample port with an alcohol wipe and let the alcohol dry.
- E. Clamp the catheter tubing distal to the sampling port for 15 min.
Correct Answer: E,D,C,A,B
Rationale: Order: Clamp (E), wipe port (D), aspirate (C), transfer (A), document (B) ensures sterility and proper procedure.
A nurse is caring for a client who has a new diagnosis of tuberculosis (TB). The client asks the nurse why she needs to take four different antituberculotic medications. Which of the following replies should the nurse make?
- A. The organism that causes TB becomes resistant to antituberculotic medications when you only take one medication.
- B. Taking several antituberculotic medications will protect your liver from toxic effects.
- C. People who have a severe form of TB need several antituberculotic medications, but those who have less severe TB need just one medication.
- D. Adverse effects occur more often and are more severe when you take only one antituberculotic medication.
Correct Answer: A
Rationale: Multiple medications prevent resistance in TB treatment, as Mycobacterium tuberculosis can quickly adapt to a single drug, necessitating a combination regimen.
A nurse is collecting data from a client who had a long arm cast applied 2 hr. ago. Which of the following findings of the affected extremity should the nurse report to the provider immediately?
- A. The client's fingers are cool to the touch.
- B. The client reports severe itching under the cast.
- C. The client's capillary refill is 3 seconds.
- D. The client reports increased pain at the area of the fracture.
Correct Answer: A
Rationale: Cool fingers suggest impaired circulation, a potential emergency post-cast application requiring immediate reporting. Itching and pain are common, and 3-second refill is borderline normal.
History and Physical
1000:
Client reports generalized weakness and increased fatigue over the past few months.
Client states they become short of breath after climbing a flight of stairs and are having difficulty keeping up with their grandchildren.
History of rheumatoid arthritis. Reports taking naproxen 500 mg twice a day.
Client reports they follow a vegan diet.
Denies pain or discomfort.
Bilateral breath sounds clear and present throughout.
Mucous membranes pale.
Apical pulse rapid, regular.
Which of the following findings require follow-up? (Client with generalized weakness, vegan diet, pale mucous membranes)
- A. Breath sounds
- B. Activity level
- C. Hematocrit
- D. Blood pressure
- E. Pain level
- F. Temperature
- G. Oxygen saturation
Correct Answer: B,C
Rationale: Decreased activity level and low hematocrit (24%) suggest anemia, requiring follow-up; breath sounds are clear, and other findings are less urgent.
A nurse is assisting in the plan of care for a client who has thrombocytopenia. Which of the following actions should the nurse include in the plan?
- A. Check the client for ecchymosis.
- B. Initiate protective isolation for the client.
- C. Administer ibuprofen for mild headache.
- D. Instruct the client to shave with a disposable razor.
Correct Answer: A
Rationale: Checking for ecchymosis (bruising) monitors for bleeding, a risk in thrombocytopenia due to low platelets. Isolation isn't needed, ibuprofen increases bleeding risk, and razors should be avoided.