Nokea
The client with a history of renal calculi calls the clinic and reports having burning on urination, chills, and an elevated temperature. Which instruction should the nurse discuss with the client?
- A. Increase water intake for the next 24 hours.
- B. Take two (2) Tylenol to help decrease the temperature.
- C. Come to the clinic and provide a urinalysis specimen.
- D. Use a sterile 4×4 gauze to strain the client’s urine.
Correct Answer: C
Rationale: Burning, chills, and fever suggest a UTI, possibly related to calculi. A urinalysis specimen is needed to diagnose and guide treatment. Increasing fluids, taking Tylenol, or straining urine are secondary.
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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.
When applying an external catheter to a male client, which action by the nurse is correct?
- A. I think the nurse is correct applying the catheter.
- B. Measure the length and circumference of the penis.
- C. Leave space between the end of the penis and the catheter's drainage end.
- D. Retract the foreskin before rolling the catheter sheath over the penis.
Correct Answer: C
Rationale: Leaving space between the penis and the catheter's drainage end prevents pressure and irritation, ensuring proper function and comfort.
Which nursing intervention is most important to add to the client's care plan after removal of the suprapubic catheter?
- A. Check the client's urine specific gravity every shift.
- B. Measure the client's abdominal girth daily.
- C. Change wet abdominal dressings as needed.
- D. Perform a credé maneuver every 4 hours.
Correct Answer: C
Rationale: Changing wet dressings prevents infection and promotes healing at the suprapubic site.
When the nurse mistakenly inserts the catheter into the client's vagina rather than the urinary meatus, which action is best to take next?
- A. Wipe the catheter tip with an alcohol swab.
- B. Clean the catheter tip with povidone-iodine solution (Betadine).
- C. Discard the catheter and use another sterile one.
- D. Withdraw the catheter and insert it in the urethra.
Correct Answer: C
Rationale: Inserting the catheter into the vagina contaminates it, so a new sterile catheter must be used to prevent infection.
The nurse is caring for a client with chronic pyelonephritis. Which assessment data support the diagnosis of chronic pyelonephritis?
- A. The client has fever, chills, flank pain, and dysuria.
- B. The client complains of fatigue, headaches, and increased urination.
- C. The client had a group B beta-hemolytic strep infection last week.
- D. The client has an acute viral pneumonia infection.
Correct Answer: B
Rationale: Chronic pyelonephritis presents with subtle symptoms like fatigue, headaches, and polyuria due to long-term renal damage. Acute symptoms (fever, chills) are more typical of acute pyelonephritis. Strep or pneumonia are unrelated.