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The nurse is examining a 15-year-old female who is complaining of pain, frequency, and urgency when urinating. After asking the parent to leave the room, which question should the nurse ask the client?
- A. When was your last menstrual cycle?'
- B. Have you noticed any change in the color of the urine?'
- C. Are you sexually active?'
- D. What have you taken for the pain?'
Correct Answer: C
Rationale: Sexual activity is a risk factor for UTIs in young females due to urethral irritation. Asking this privately ensures honesty and guides diagnosis/treatment. Menstrual cycle, urine color, and pain relief are secondary.
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The nurse is discussing kidney transplants with clients at a dialysis center. Which population is less likely to participate in organ donation?
- A. Caucasian.
- B. African American.
- C. Asian.
- D. Hispanic.
Correct Answer: B
Rationale: African Americans are statistically less likely to participate in organ donation due to cultural beliefs, mistrust in healthcare systems, and lower registration rates. Other groups have higher participation rates, though disparities exist across all populations.
When the nurse interviews the client, which symptoms will the client most likely report if a bladder infection has been acquired? Select all that apply.
- A. Sharp flank pain
- B. Uretrail discharge
- C. Strong-smelling urine
- D. Burning on urination
- E. Urgency
- F. Frequency
Correct Answer: C,D,E,F
Rationale: Symptoms of a bladder infection typically include strong-smelling urine, burning on urination, urgency, and frequency, as these reflect irritation and inflammation of the bladder.
The client receiving hemodialysis is being discharged home from the dialysis center. Which instruction should the nurse teach the client?
- A. Notify the HCP if oral temperature is 102°F or greater.
- B. Apply ice to the access site if it starts bleeding at home.
- C. Keep fingernails short and try not to scratch the skin.
- D. Encourage the significant other to make decisions for the client.
Correct Answer: A
Rationale: A fever of 102°F or higher may indicate infection, a serious complication in hemodialysis patients, requiring prompt HCP notification. Ice may worsen bleeding, short nails are general advice, and encouraging dependency is not therapeutic.
The client with a TURP who has a continuous irrigation catheter complains of the need to urinate. Which intervention should the nurse implement first?
- A. Call the surgeon to inform the HCP of the client’s complaint.
- B. Administer the client a narcotic medication for pain.
- C. Explain to the client this sensation happens frequently.
- D. Assess the continuous irrigation catheter for patency.
Correct Answer: D
Rationale: The urge to urinate may indicate a blocked catheter due to clots. Assessing patency ensures proper function and addresses the cause. Explaining the sensation, notifying the surgeon, or giving narcotics are secondary.
The nurse is caring for a pregnant client diagnosed with acute pyelonephritis. Which scientific rationale supports the client being hospitalized for this condition?
- A. The client must be treated aggressively to prevent maternal/fetal complications.
- B. The nurse can force the client to drink fluids and avoid nausea and vomiting.
- C. The client will be dehydrated and there won’t be sufficient blood flow to the baby.
- D. Pregnant clients historically are afraid to take the antibiotics as ordered.
Correct Answer: A
Rationale: Acute pyelonephritis in pregnancy risks maternal sepsis and fetal complications (e.g., preterm labor). Hospitalization ensures aggressive IV antibiotic treatment and monitoring. Dehydration and antibiotic fears are secondary concerns.