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If the client makes the following statements, which information is most important to report to the physician before the client undergoes an intravenous pyelography (IVP)?
- A. The barium they give me to drink causes me to have concentration.
- B. I have a low tolerance for pain during procedures.
- C. I had a reaction when my gallbladder was X-rayed before.
- D. I get claustrophobic when I am put into that big round machine.
Correct Answer: C
Rationale: A previous reaction to a contrast dye, as implied by the gallbladder X-ray reaction, indicates a potential allergy risk, which must be reported before IVP.
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When documenting the client's urine output in the medical record, which measurement is correct for the nurse to record?
- A. Only the output from the urethral catheter
- B. Only the output from the wound catheter
- C. The outputs from each catheter separately
- D. The combined output from both catheters
Correct Answer: D
Rationale: The combined output from both catheters provides the total urine output, which is essential for accurate monitoring.
Which statement by the client provides the best evidence that he understands the potential side effects associated with hormonal therapy? Select all that apply.
- A. My breasts may enlarge.
- B. I may have spontaneous erections.
- C. My sperm count will be higher.
- D. I'll have strong sexual urges.
- E. My voice may become higher.
- F. I may have a rapid weight gain.
Correct Answer: A,F
Rationale: Estradiol can cause gynecomastia (breast enlargement) and weight gain, which are expected side effects.
The client from a long-term care facility is admitted to the medical unit with a fever, hot flushed skin, and clumps of white sediment in the indwelling catheter. Which intervention should the nurse implement first?
- A. Start an IV with a 20-gauge catheter.
- B. Initiate antibiotic therapy IVPB.
- C. Collect a urine specimen for culture.
- D. Change the indwelling catheter.
Correct Answer: C
Rationale: Symptoms suggest a catheter-associated UTI. Collecting a urine culture first identifies the causative organism, guiding antibiotic therapy. Starting an IV, antibiotics, or changing the catheter are secondary to obtaining a diagnostic sample.
When administering the bladder instillation containing the chemotherapeutic drug, which safety precaution is most important for the nurse to take?
- A. Wear two pairs of latex gloves.
- B. As a mass syringe for the drug.
- C. Avoid wearing clothing with long sleeves.
- D. Limit contact time with the client.
Correct Answer: A
Rationale: Wearing two pairs of latex gloves protects the nurse from exposure to the chemotherapeutic drug during instillation.
The nurse is assessing a client diagnosed with urethral strictures. Which data support the diagnosis?
- A. Complaints of frequency and urgency.
- B. Clear yellow drainage from the urethra.
- C. Complaints of burning during urination.
- D. A diminished force and stream during voiding.
Correct Answer: D
Rationale: Urethral strictures obstruct urine flow, causing a diminished force and stream. Frequency, urgency, and burning suggest UTI, and clear drainage is unrelated.