Nokea
The client asks, 'What does an elevated PSA test mean?' On which scientific rationale should the nurse base the response?
- A. An elevated PSA can result from several different causes.
- B. An elevated PSA can be only from prostate cancer.
- C. An elevated PSA can be diagnostic for testicular cancer.
- D. An elevated PSA is the only test used to diagnose BPH.
Correct Answer: A
Rationale: Elevated PSA can result from prostate cancer, BPH, prostatitis, or other factors, requiring further evaluation. It is not specific to prostate cancer, testicular cancer, or BPH diagnosis alone.
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Which recommendations by the nurse are most effective in reducing bacterial growth in a female client's bladder? Select all that apply.
- A. Drink a large quantity of fluids.
- B. Change underclothing each day.
- C. Avoid the use of public restrooms.
- D. Use only white toilet tissue.
- E. Urinate after having sexual intercourse.
- F. Drink fluids that are highly acidic.
Correct Answer: A,E
Rationale: Drinking plenty of fluids promotes urine flow, flushing bacteria from the bladder, and urinating after intercourse helps remove bacteria introduced during sexual activity.
Postoperatively, which assessment finding is most suggestive that the client is hemorrhaging?
- A. Acute flank pain
- B. Abdominal distention
- C. Flushed, warm skin
- D. Nausea and vomiting
Correct Answer: B
Rationale: Abdominal distention may indicate internal bleeding, a critical sign of hemorrhage post-nephrectomy.
The client who has undergone an exploratory laparotomy and subsequent removal of a large intestinal tumor has a nasogastric tube (NGT) in place and an IV running at 150 mL/hr via an IV pump. Which data should be reported to the HCP?
- A. The pump keeps sounding an alarm indicating the high pressure has been reached.
- B. Intake is 1,800 mL, NGT output is 550 mL, and Foley output is 950 mL.
- C. On auscultation, crackles and rhonchi in all lung fields are noted.
- D. Client has negative pedal edema and an increasing level of consciousness.
Correct Answer: C
Rationale: Crackles and rhonchi suggest pulmonary edema, a critical complication possibly due to fluid overload, requiring immediate HCP notification. Pump alarms, intake/output, and edema status are less urgent unless associated with other critical findings.
Which information regarding the care of a cutaneous ileal conduit should the nurse discuss with the client?
- A. Teach the client to instill a few drops of vinegar into the pouch.
- B. Tell the client the stoma should be slightly dusky colored.
- C. Inform the client large clumps of mucus are expected.
- D. Tell the client it is normal for the urine to be pink or red in color.
Correct Answer: C
Rationale: Mucus in the urine is expected with an ileal conduit due to intestinal mucosa in the conduit. Vinegar instillation is not standard, a dusky stoma indicates ischemia, and pink/red urine suggests bleeding, which is abnormal.
Which diagnostic test, considered a sensitive indicator of advanced kidney disease, will need to be closely monitored by the nursing team?
- A. Serum creatinine level
- B. Serum sodium level
- C. Uric acid level
- D. Urine specific gravity
Correct Answer: A
Rationale: Serum creatinine is a sensitive indicator of kidney function, as it rises with advanced kidney disease due to impaired filtration.