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The nurse is caring for a client with a TURP. Which expected outcome indicates the client’s condition is improving?
- A. The client is using the maximum amount allowed by the PCA pump.
- B. The client’s bladder spasms are relieved by medication.
- C. The client’s scrotum is swollen and tender with movement.
- D. The client has passed a large, hard, brown stool this morning.
Correct Answer: B
Rationale: Relief of bladder spasms indicates reduced irritation and healing post-TURP. Maximum PCA use, scrotal swelling, or hard stools do not reflect improvement and may indicate complications.
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Which signs/symptoms indicate to the nurse the client is in the recovery period of ARF? Select all that apply.
- A. Increased alertness and no seizure activity.
- B. Increase in hemoglobin and hematocrit.
- C. Denial of nausea and vomiting.
- D. Decreased urine-specific gravity.
- E. Increased serum creatinine level.
Correct Answer: A,C,D
Rationale: In the recovery phase, renal function improves, leading to increased alertness (reduced uremia), resolution of nausea/vomiting, and decreased urine-specific gravity as kidneys concentrate urine. Increased hemoglobin/hematocrit is not typical, and elevated creatinine indicates worsening, not recovery.
Which assessment supports the nurse's assumption that the client's sleep disturbance was most likely due to anxiety?
- A. The client was pacing the room before bedtime.
- B. The client's vital signs were stable during the night.
- C. The client requested a sleeping pill earlier.
- D. The client reported feeling rested in the morning.
Correct Answer: A
Rationale: Pacing before bedtime is a behavioral sign of anxiety, supporting the assumption that anxiety caused the sleep disturbance.
The clinic nurse is caring for a client diagnosed with chronic pyelonephritis who is prescribed trimethoprim-sulfamethoxazole (Bactrim), a sulfa antibiotic, twice a day for 90 days. Which statement is the scientific rationale for prescribing this medication?
- A. The antibiotic will treat the bladder spasms that accompany a urinary tract infection.
- B. If the urine cannot be made bacteria free, the Bactrim will suppress bacterial growth.
- C. In three (3) months, the client should be rid of all bacteria in the urinary tract.
- D. The HCP is providing the client with enough medication to treat future infections.
Correct Answer: B
Rationale: Chronic pyelonephritis often requires long-term antibiotics like Bactrim to suppress bacterial growth when complete eradication is not possible. It does not treat spasms, and 90 days may not eliminate all bacteria or be for future use.
The client diagnosed with cancer of the bladder states, 'I have young children. I am too young to die.' Which statement is the nurse’s best response?
- A. This cancer is treatable and you should not give up.'
- B. Cancer occurs at any age. It is just one of those things.'
- C. You are afraid of dying and what will happen to your children.'
- D. Have you talked to your children about your dying?'
Correct Answer: C
Rationale: Reflecting the client’s fear of dying and concern for their children validates emotions and encourages dialogue. Reassurance, generalizing cancer, or prompting child discussions may dismiss the client’s feelings.
After the cystoscopy, which urinary symptom can the nurse expect the client to report?
- A. A sense of urgency
- B. No urinary output
- C. A strong urinary odor
- D. A large volume of urine output
Correct Answer: A
Rationale: A sense of urgency is common after cystoscopy due to urethral irritation from the procedure.