Nokea
The female client in an outpatient clinic is being sent home with a diagnosis of urinary tract infection (UTI). Which instruction should the nurse teach to prevent a recurrence of a UTI?
- A. Clean the perineum from back to front after a bowel movement.
- B. Take warm tub baths instead of hot showers daily.
- C. Void immediately preceding sexual intercourse.
- D. Avoid coffee, tea, colas, and alcoholic beverages.
Correct Answer: D
Rationale: Avoiding bladder irritants like coffee, tea, colas, and alcohol reduces UTI recurrence risk. Wiping back to front increases infection risk, tub baths are less effective than showers, and voiding before intercourse is less critical than after.
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The client diagnosed with CKD is receiving peritoneal dialysis. Which assessment data warrant immediate intervention by the nurse?
- A. Inability to auscultate a bruit over the fistula.
- B. The client’s abdomen is soft, is nontender, and has bowel sounds.
- C. The dialysate being removed from the client’s abdomen is clear.
- D. The dialysate instilled was 1,500 mL and removed was 1,500 mL.
Correct Answer: A
Rationale: Peritoneal dialysis does not involve a fistula, so inability to auscultate a bruit suggests a documentation error or confusion with hemodialysis, requiring immediate clarification. Soft abdomen, clear dialysate, and equal instill/removal volumes are normal findings.
The nurse and an unlicensed assistive personnel (UAP) are caring for a group of clients. Which nursing intervention should the nurse perform?
- A. Measure the client’s output from the indwelling catheter.
- B. Record the client’s intake and output on the I&O sheet.
- C. Instruct the client on appropriate fluid restrictions.
- D. Provide water for a client diagnosed with diabetes insipidus.
Correct Answer: C
Rationale: Instructing on fluid restrictions requires nursing judgment and education skills, which are outside the UAP’s scope. Measuring output, recording I&O, and providing water are delegable tasks.
The client is 12 hours postoperative renal surgery. Which data warrant immediate intervention by the nurse?
- A. The abdomen is soft, nontender, and rounded.
- B. Pain is not felt with dorsal flexion of the foot.
- C. The urine output is 60 mL for the past two (2) hours.
- D. The client’s trough vancomycin level is 24 mcg/mL.
Correct Answer: D
Rationale: A vancomycin level of 24 mcg/mL is above the therapeutic range (10–20 mcg/mL), risking nephrotoxicity, especially post-renal surgery. Soft abdomen, no pain on dorsiflexion, and 60 mL urine output are normal.
It is most appropriate for the nurse to advise the client that taking this medication will have which effect on the urine?
- A. The urine will look cloudy.
- B. The urine will appear orange.
- C. The urine will become scant.
- D. The urine will have a strong odor.
Correct Answer: B
Rationale: Phenazopyridine (Pyridium) commonly causes the urine to turn orange, which is a harmless side effect that the client should be informed about.
The client who is post-thyroidectomy complains of numbness and tingling around the mouth and the tips of the fingers. Which intervention should the nurse implement first?
- A. Notify the health-care provider immediately.
- B. Tap the cheek about two (2) cm anterior to the earlobe.
- C. Check the serum calcium and magnesium levels.
- D. Prepare to administer calcium gluconate IVP.
Correct Answer: C
Rationale: Numbness and tingling post-thyroidectomy suggest hypocalcemia due to parathyroid injury. Checking serum calcium and magnesium levels confirms the diagnosis before treatment. Notification, Chvostek’s sign, or calcium administration follow confirmation.