A nurse is caring for a client who is 12 hours postoperative following a transurethral resection of the prostate (TURP) and has a 3-way urinary catheter with continuous irrigation. The nurse notes there have not been any urinary output in the last hour. Which of the following actions should the nurse perform first?

Administer antispasmodic medications.

Notify the provider.

Offer oral fluids.

Determine the patency of the tubing.

Answer and Explanation

The Correct Answer is D

Choice A Reason: Administering antispasmodic medications is not the first action that the nurse should perform, as it may not resolve the problem of urinary output or irrigation flow.

Choice B Reason: Notifying the provider is not the first action that the nurse should perform, as it may delay the intervention and worsen the outcome.

Choice C Reason: Offering oral fluids is not the first action that the nurse should perform, as it may increase fluid overload or bladder pressure.

Choice D Reason: Determining the patency of the tubing is the first action that the nurse should perform, as it may identify and correct any obstruction or kinking that prevents urinary output or irrigation flow.

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Free Nursing Study Resources

Correct Answer is C

Explanation

Choice A Reason: Cold skin is not a common finding in hyperthyroidism, but it may indicate hypothyroidism or other conditions such as hypothermia or shock.

Choice B Reason: Weight gain is not a common finding in hyperthyroidism, but it may indicate hypothyroidism or other conditions such as Cushing's syndrome or edema.

Choice C Reason: Tachycardia is a common finding in hyperthyroidism, as the increased thyroid hormone level causes the heart rate and cardiac output to increase.

Choice D Reason: Anorexia is not a common finding in hyperthyroidism, but it may indicate other conditions such as depression, infection, or cancer.

A. High glucose level B. Low protein concentration C. Decreased CSF pressure D. Cloudy CSF

Correct Answer is D

Explanation

Choice A Reason: High glucose level is not a finding that confirms bacterial meningitis, but it may indicate other conditions such as diabetes mellitus or hyperglycemia.

Choice B Reason: Low protein concentration is not a finding that confirms bacterial meningitis, but it may indicate other conditions such as malnutrition or liver disease.

Choice C Reason: Decreased CSF pressure is not a finding that confirms bacterial meningitis, but it may indicate other conditions such as dehydration or spinal cord injury.

Choice D Reason: Cloudy CSF is a finding that confirms bacterial meningitis, as it indicates that there is an infection and inflammation in the meninges that surround the brain and spinal cord.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is completing a health assessment of a client suspected of hyperthyroidism. Which of the following clinical manifestations should the nurse expect?

Correct Answer is C

Explanation

A lumbar puncture is performed on a client with suspected bacterial meningitis, and cerebrospinal fluid (CSF) is obtained for analysis. The nurse determines that the diagnosis is confirmed if which findings are noted?

Correct Answer is D

Explanation

A nurse is reinforcing teaching about TNM staging with a client who has cancer. Which of the following information should the nurse include in the teaching?

A nurse is reinforcing teaching about an endoscopy with a client who has dysphagia. Which of the following statements should the nurse include in the teaching?

The nurse is caring for a client who has a fractured tibia and is in a cast. Which of the following findings is a manifestation of compartment syndrome?

A client's stool is clay in color. What additional information should the nurse obtain from this client? Select all that apply.

Which of the following would be the most appropriate nursing diagnosis for a client admitted with Addison's disease?

A client has been diagnosed with hypothyroidism. What information should the nurse obtain when conducting a focused assessment? Select all that apply.

A nurse is monitoring a client for findings related to diabetes insipidus following a craniotomy. Which of the following findings should indicate a manifestation of this condition to the nurse?

A client with chronic renal failure asks the nurse the effects of losing erythropoietin. Which of the following statements best explains the loss of this hormone?