A client presents to the emergency department with complaints of urinary frequency, dysuria, and fever. Which of the following orders should the nurse carry out first?

Prepare the client for a CT scan

Begin broad spectrum antibiotics

Insert a Foley catheter

Obtain samples for urine culture and urinalysis

Answer and Explanation

The Correct Answer is D

A. Prepare the client for a CT scan is not the first priority in this case. A CT scan might be considered if there is suspicion of complications like a kidney stone or abscess, but it is not the first intervention.
B. Begin broad spectrum antibiotics could be considered if a urinary tract infection (UTI) is suspected, but obtaining urine samples for culture and urinalysis is necessary first to confirm the diagnosis and guide antibiotic therapy.
C. Insert a Foley catheter is not indicated unless the patient is unable to void or there is a need for continuous monitoring of urine output, but it is not the first step.
D. Obtain samples for urine culture and urinalysis is the first step to confirm the diagnosis of a urinary tract infection (UTI) and determine the appropriate treatment. This will help guide the selection of antibiotics.

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Correct Answer is A

Explanation

A. Antihypertensive medication is not a priority intervention for a client with a blood glucose level of 620 mg/dL, which indicates hyperglycemia, likely due to diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS). The focus should be on correcting the hyperglycemia and preventing complications like dehydration or electrolyte imbalances.
B. Fluid replacement is essential to treat dehydration caused by hyperglycemia, as high blood glucose levels cause osmotic diuresis.
C. Potassium laboratory monitoring is crucial because insulin treatment can shift potassium into cells, potentially causing hypokalemia, so monitoring is necessary during treatment.
D. Insulin IV infusion is necessary to lower the blood glucose level in clients with severe hyperglycemia, such as in DKA or HHS.

A. “I should avoid being outside in crowds while on these medications.” B. “It may take several weeks for me to feel the effects of the medications.” C. “I should notify my provider if I experience fevers.” D. “I should go to the emergency room immediately if my urine turns orange.”

Correct Answer is D

Explanation

A. Avoiding crowds is appropriate, as both Sulfasalazine and Azathioprine can suppress the immune system, increasing the risk of infection.
B. It is correct that it may take several weeks for these medications to show effects, especially with Sulfasalazine. This is a reasonable statement.
C. Notifying the provider if the client experiences fevers is important because it could be a sign of infection, which is a potential side effect of Azathioprine, an immunosuppressive drug.
D. Orange urine is a common side effect of Sulfasalazine and is harmless. The client should not go to the emergency room for this symptom, as it is a known and expected side effect. Therefore, the statement about going to the emergency room indicates a need for further teaching.

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A client presents to the emergency department with complaints of urinary frequency, dysuria, and fever. Which of the following orders should the nurse carry out first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client with a blood glucose reading of 620 mg/dL. The nurse would expect all of the following interventions except which?

Correct Answer is A

Explanation

A nurse is providing education to a client newly prescribed Sulfasalazine and Azathioprine for refractory ulcerative colitis. Which of the following statements by the client indicates that further teaching is required?

Correct Answer is D

Explanation

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