A nurse is assisting with the plan of care for a client who is immobile and is experiencing urinary retention. The nurse should plan to monitor the client for which of the following?
Bladder outlet obstruction
Protein in the urine
Neurogenic bladder
Urinary tract infection
The Correct Answer is D
A) Urine retention is a common symptom of bladder outlet obstruction but in this case assessing the patient for a urinary tract infection is the priority.
B) While proteinuria can indicate kidney dysfunction, it's not directly related to urinary retention.
C) This refers to bladder dysfunction due to neurological causes and may not be directly related to urinary retention in an immobile client.
D) Immobility can increase the risk of urinary tract infections Urinary retention can lead to urinary tract infection (UTI) due to bacterial growth in the stagnant urine. The nurse should monitor the client for signs and symptoms of UTI, such as fever, chills, dysuria, hematuria, and foul-smelling urine.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A) This is part of proper body mechanics but not the first action when repositioning a client.
B) Proper body mechanics involve pivoting rather than twisting the spine but is not the first action when repositioning a client.
C) Adjusting the bed height ensures the nurse is working at an optimal level to prevent strain during the repositioning process.
D) Engaging core muscles is important for stability during lifting and repositioning but is not the first action to take.
Correct Answer is D
Explanation
A) Connect muscles to bones and aid in movement but are not fluid-filled capsules.
B) Provides cushioning between bones and aids in smooth movement but is not fluid- filled.
C) Connect bones to other bones and provide stability but are not fluid-filled capsules.
D) Synovial joints are surrounded by a fluid-filled capsule called the synovial membrane, which lubricates the joint and enables movement and flexibility.
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