A nurse is assessing a client who is 2 days postoperative following a transurethral resection of the prostate and has an indwelling urinary catheter in place. Which of the following findings should the nurse expect?

Small clots with tissue in the urine

Dark red urine

Urinary output 25 mL/hr

Pain of 8 on a scale of 0 to 10

Answer and Explanation

The Correct Answer is A

A. Small clots with tissue in the urine. It is expected for a client 2 days post-TURP to have small clots and tissue debris in the urine as part of the healing process. Continuous bladder irrigation (CBI) often helps clear these.

B. Dark red urine. Bright red or dark red urine can indicate active bleeding, which is not expected 2 days post-op and requires immediate intervention.

C. Urinary output 25 mL/hr. This is too low (normal output should be at least 30 mL/hr) and could indicate catheter blockage, dehydration, or renal impairment, which is not expected.

D. Pain of 8 on a scale of 0 to 10. Mild discomfort is expected, but severe pain (8/10) is abnormal and could indicate bladder spasms, catheter blockage, or another complication requiring intervention.

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Correct Answer is C

Explanation

A. Rotavirus vaccine is for infants, not older adults. It is given to prevent severe diarrhea caused by rotavirus.
B. Human papillomavirus (HPV) vaccine is recommended for adolescents and young adults, typically before age 26, to prevent cervical and other cancers.
C. Herpes zoster (shingles) vaccine is recommended for older adults, usually starting at age 50 or 60, to reduce the risk of shingles and its complications.
D. DTaP is given to infants and young children. Instead, older adults should receive a Td or Tdap booster every 10 years.

A. "The client received morphine around lunch." B. "The client had a lung biopsy 1 hour ago." C. "Vital signs were obtained every 4 hours." D. "The client's partner is at their bedside."

Correct Answer is B

Explanation

A. Stating that the client received morphine "around lunch" is too vague. The exact time, dose, and effect should be included for accurate pain management.
B. A lung biopsy is a significant procedure that requires close monitoring for complications such as pneumothorax or bleeding. The oncoming nurse must be aware to provide appropriate post-procedure care.
C. General information about vital signs being taken every 4 hours is routine and not critical for handoff unless there are abnormalities or changes.
D. The presence of the client’s partner is not essential clinical information unless it impacts care, such as decision-making or emotional support needs.

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A nurse is assessing a client who is 2 days postoperative following a transurethral resection of the prostate and has an indwelling urinary catheter in place. Which of the following findings should the nurse expect?

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