A nurse is caring for a client who is 5 hr postoperative following a transurethral resection of the prostate (TURP). The nurse notes that the client's indwelling urinary catheter has not drained in the past hour. Which of the following actions should the nurse take first?

Notify the provider.

Adjust the rate of the bladder irrigant.

Irrigate the catheter.

Check the tubing for kinks.

Answer and Explanation

The Correct Answer is D

A. Notifying the provider is important if initial interventions do not resolve the issue, but it is not the first action to take.
B. Adjusting the rate of the bladder irrigant may help, but first, it is essential to ensure that there is no mechanical obstruction in the tubing.
C. Irrigating the catheter can help clear any blockages, but the first step is to check for any kinks or obvious obstructions in the tubing.
D. Checking the tubing for kinks is the first action as it is a common and easily rectifiable cause of urinary catheter drainage issues. This should be done before other interventions.

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Correct Answer is D

Explanation

A. Metabolic alkalosis is characterized by an elevated pH and elevated bicarbonate, which is not consistent with these ABG values.
B. Respiratory alkalosis presents with an elevated pH and decreased PaCO2, opposite of the client's findings.
C. Metabolic acidosis would show a decreased pH with a low bicarbonate level, but this client's bicarbonate is within normal range.
D. Respiratory acidosis is indicated by a low pH and elevated PaCO2 due to hypoventilation, which aligns with the client's ABG values and respiratory rate.

A. 4 mm erythema B. 10 mm wheal C. 5 mm induration D. 15 mm induration

Correct Answer is D

Explanation

A. 4 mm erythema is generally considered negative or not indicative of TB exposure.
B. 10 mm wheal is an inadequate measurement; a wheal indicates a local reaction but not the size of induration.
C. 5 mm induration may be considered positive in high-risk individuals but is generally not sufficient for standard TB testing.
D. 15 mm induration is indicative of a positive TB test, suggesting significant exposure and possible infection. This measurement is used for clients at average risk.

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A nurse is caring for a client who is 5 hr postoperative following a transurethral resection of the prostate (TURP). The nurse notes that the client's indwelling urinary catheter has not drained in the past hour. Which of the following actions should the nurse take first?

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Naxlex Comprehensive Predictor Exams

A client is admitted to the emergency room with a respiratory rate of 9/min. Arterial blood gases (ABG) reveal the following values. Which of the following is an appropriate analysis of the ABGs? pH 7.22 PaCO2 68 mm Hg Base excess -2 PaO2 78 mm Hg Saturation 80% Bicarbonate 26 mEq/L

Correct Answer is D

Explanation

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Correct Answer is D

Explanation

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