Nokea
The nurse understands that which of the following are complications of acute tubular necrosis (ATN)? Select all that apply.
- A. Metabolic acidosis
- B. High thyroxine levels
- C. Hyponatremia
- D. Decreased parathyroid levels
- E. Electrolyte imbalances
Correct Answer: A,C,E
Rationale: ATN causes metabolic acidosis, hyponatremia, and electrolyte imbalances due to impaired renal function.
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Which nursing assessment finding are consistent with hypocalcemia? Select all that apply.
- A. Chvostek's sign
- B. Grey-Turner's sign
- C. Homan's sign
- D. Trousseau's sign
- E. Numbness and tingling of the fingers and toes
Correct Answer: A,D,E
Rationale: Hypocalcemia causes Chvostek's sign, Trousseau's sign, and numbness/tingling due to neuromuscular irritability.
As a nurse, you are administering intravenous fluids to a client. Which of the following types of IV fluids would be classified as isotonic? Select all that apply.
- A. Normal saline
- B. 1/2 Normal saline
- C. Lactated ringers
- D. D10W
- E. 3% NaCl
Correct Answer: A,C
Rationale: Normal saline and lactated ringers are isotonic, matching plasma osmolality, unlike hypotonic (1/2 NS) or hypertonic (D10W, 3% NaCl) fluids.
The nurse has obtained a physician's order to obtain a clean catch urine specimen from a client. The nurse should instruct the client to obtain the urine sample
- A. from the first stream of urine from the bladder.
- B. midstream from the bladder.
- C. from the final stream of urine from the bladder.
- D. by emptying the entire volume of urine in the specimen cup.
Correct Answer: B
Rationale: Midstream urine collection minimizes contamination for accurate testing.
The nurse is educating a client about a transurethral resection of the prostate (TURP). Which of the following statements should the nurse make to the client regarding this surgery?
- A. This surgery will remove your entire prostate.
- B. You will have a nasogastric tube (NGT) left in place following this surgery.
- C. You will need to complete a bowel prep the night before this surgery.
- D. A urinary catheter will remain in place following this procedure.
Correct Answer: D
Rationale: A urinary catheter is used post-TURP to manage bleeding and ensure bladder drainage.
The following scenario applies to the next 1 items
The nurse in the medical-surgical unit is caring for a client following a transurethral resection of the prostate (TURP).
Item 1 of 1
Nurses’ Notes
1241: The client arrived at the medical-surgical unit six hours post-operative from a TURP. The client was alert and oriented to person, place, time, and situation. The client has a three-way indwelling urinary catheter and is continuously irrigated with isotonic saline. Urine output is ketchup-like with medium to large clots. The client reports the need to urinate and reported pressure in the pelvic region, described as spasms.
Intake and Output
Intake – Continuous bladder irrigation: 550 mL
Output – Indwelling catheter: 975 mL
Vital Signs
1257:
Blood Pressure 100/60 mm Hg
Temperature 98° F (36.7° C)
Heart rate 110/min
Respiratory rate 19 breaths per minute
Oxygen saturation 95% on room air
The client is demonstrating signs and symptoms of.
- A. urinary catheter obstruction
- B. hyponatremia
- C. shock
- D. urinary tract infection
Correct Answer: A
Rationale: Ketchup-like urine with clots and pelvic pressure post-TURP indicate catheter obstruction.