A client comes to the primary healthcare clinic and reports that her current sexual partner was recently diagnosed with gonorrhea.
Which treatment would you expect the client and her partner to receive?

Choice A rationale

Following a Transurethral Resection of the Prostate (TURP), the continuous bladder irrigation is intended to flush out blood and prevent clot formation. The presence of small blood clots is common and expected as a result of surgical trauma and is not typically an immediate priority unless they cause obstruction.

Choice B rationale

The presence of bright red urine (frank hematuria) or dark clots suggests active arterial bleeding in the prostatic bed, which is a significant and potentially life-threatening complication following a TURP. Maintaining continuous bladder irrigation and notifying the healthcare provider immediately is the priority to prevent hemorrhage, potential hypovolemic shock, and ensure proper clot evacuation.

Choice C rationale

A continuous urge to void (bladder spasms) is a common, though uncomfortable, finding post-TURP due to the irritation of the bladder mucosa from the catheter balloon or the surgical procedure itself. While it requires intervention (e.g., antispasmodic medication), it is not a direct threat to life or organ function and is therefore a lower priority than active bleeding.

Choice D rationale

Burning around the urinary catheter insertion site can indicate localized irritation, inflammation, or a potential urinary tract infection (UTI). Although requiring assessment and intervention, signs of local irritation or potential infection are less immediately life-threatening than active arterial hemorrhage, making it a lower priority than bright red urine.

Choice A rationale

Applying cold packs, or cryotherapy, is primarily indicated for acute soft tissue injuries to induce vasoconstriction, thereby decreasing local blood flow, metabolism, and inflammation, which reduces pain and swelling. For chronic or recurring lower back pain prevention, heat is often more effective, as it promotes vasodilation, increasing blood flow to relax muscles and reduce stiffness, making cold less suitable as a frequent preventative strategy.

Choice B rationale

Prolonged static postures, like sitting, increase intradiscal pressure and muscle tension in the lumbar region, leading to muscle fatigue and reduced blood flow to the supporting structures, which exacerbates back pain. Regular movement and changing positions is crucial to maintain flexibility, promote circulation, and distribute mechanical stress across different structures, minimizing sustained strain on the spinal ligaments and discs.

Choice C rationale

Sleeping on a mattress that is too soft fails to provide adequate support for the spine's natural curvature (lumbar lordosis), allowing the trunk to sink, which can lead to spinal misalignment and increased strain on the back muscles and ligaments. A medium-firm mattress is generally recommended to maintain proper spinal alignment during sleep, which reduces mechanical stress and prevents morning stiffness and pain.

Choice D rationale

Asking for help when moving clients ensures the nurse can use proper body mechanics, which involves keeping the load close to the body, maintaining a wide base of support, and lifting with the legs, not the back. This principle minimizes the mechanical stress and sheer forces applied to the intervertebral discs and paraspinal muscles, significantly lowering the risk of acute muscle strains or chronic cumulative trauma to the lumbar spine.

Choice E rationale

Partial sit-ups with the knees bent strengthen the abdominal and oblique muscles, which are key components of the body's core musculature. A strong core acts as a stabilizer for the lumbar spine, increasing intra-abdominal pressure to support the vertebral column and reducing the load and mechanical strain on the lower back structures during movement and daily activities, thereby preventing injury recurrence.