Nokea
An elderly client is hospitalized for a transurethral prostatectomy. Which finding should be reported to the doctor immediately?
- A. Hourly urinary output of 40-50 cc
- B. Bright red urine with many clots
- C. Dark red urine with few clots
- D. Requests for pain med q 4 hrs.
Correct Answer: B
Rationale: Bright red urine with many clots indicates significant bleeding, a potential emergency post-transurethral prostatectomy, requiring immediate reporting.
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The client is taking prednisone 7.5 mg po each morning to treat his systemic lupus erythematosis. Which statement best explains the reason for taking the prednisone in the morning?
- A. There is less chance of forgetting the medication if taken in the morning.
- B. There will be less fluid retention if taken in the morning.
- C. Prednisone is absorbed best with the breakfast meal.
- D. Morning administration mimics the body's natural secretion of corticosteroid.
Correct Answer: D
Rationale: Morning dosing aligns with the body's natural cortisol peak, minimizing adrenal suppression.
A client with AIDS asks the nurse why he cannot have a pitcher of water left at his bedside. The nurse should tell the client that:
- A. It would be best for him to drink ice water.
- B. He should drink several glasses of juice instead.
- C. It makes it easier to keep a record of his intake.
- D. He should drink only freshly run water.
Correct Answer: D
Rationale: For clients with AIDS, stagnant water in a pitcher can harbor bacteria, posing an infection risk due to their compromised immune system. Freshly run water minimizes this risk.
A new graduate nurse has an argument with a coworker regarding how the medication cart should be organized. The nurse asks his coworker to step into the break room to discuss their disagreement. This is an example of what type of conflict management?
- A. competing
- B. confronting
- C. accommodating
- D. avoiding
Correct Answer: B
Rationale: Confronting involves directly addressing conflict through discussion, as the nurse does by initiating a private conversation.
The nurse is evaluating cerebral perfusion outcomes for a client with a subdural hematoma. The nurse evaluates which of the following as a favorable outcome for this client?
- A. Arterial blood gas POâ‚‚ of 98
- B. Increase in lethargy
- C. Pupils slow to react to light
- D. Temperature of 101°F
Correct Answer: A
Rationale: An arterial blood gas POâ‚‚ of 98 indicates adequate oxygenation, supporting cerebral perfusion, which is a favorable outcome for a subdural hematoma.
The nurse on the inpatient memory care unit is caring for a client with Alzheimer's who exhibits wandering behavior. The 24-hour observer calls the nurse to report that the client left the unit. It would be most appropriate for the nurse to take which of the following actions?
- A. notify the family
- B. notify security along with a description of the client
- C. ask the observer in what direction the client headed
- D. ask other staff on the unit to assist in finding the client
Correct Answer: B
Rationale: Notifying security with a description ensures a rapid, coordinated response to locate the client and ensure safety.