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?
Irrigate the catheter.
Notify the provider.
Check the tubing for kinks.
Adjust the rate of the bladder irrigant.
The Correct Answer is C
Choice A rationale:
Irrigating the catheter may be necessary, but it is not the first action to take.
Choice B rationale:
Notifying the provider is important, but there are actions the nurse can take first.
Choice C rationale:
Checking the tubing for kinks is the first action because it is a simple and non-invasive intervention.
Choice D rationale:
Adjusting the rate of the bladder irrigant may be necessary, but it is not the first action to take.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The correct answer is: A
Choice A Reason: Hypokalemia refers to a lower-than-normal level of potassium in the bloodstream. Normal potassium levels are typically between 3.5 and 5.0 mEq/L. In the context of nephrotic syndrome and high-dose corticosteroid therapy, hypokalemia can occur due to increased urinary potassium losses caused by corticosteroid-induced alterations in kidney function. Corticosteroids can promote the excretion of potassium, leading to a deficiency.
Choice B Reason: Hypomagnesemia is a condition where there is a magnesium deficiency in the blood, with normal levels usually ranging between 1.7 and 2.2 mg/dL. While it can occur in nephrotic syndrome due to urinary losses of proteins that bind magnesium, it is not typically associated with corticosteroid therapy. Therefore, it is less likely to be monitored in this specific scenario.
Choice C Reason: Hypermagnesemia indicates an abnormally high level of magnesium in the blood. This condition is relatively rare and is not commonly associated with nephrotic syndrome or corticosteroid therapy. It is more often related to renal failure or excessive intake of magnesium-containing medications or supplements.
Choice D Reason: Hyperkalemia is characterized by an elevated level of potassium in the blood, with normal levels being 3.5 to 5.0 mEq/L. While hyperkalemia can occur in nephrotic syndrome due to the loss of albumin in the urine, which can affect calcium and potassium binding, corticosteroid therapy typically causes a decrease in potassium levels, making hypokalemia a more relevant concern in this context.
Correct Answer is C
Explanation
Choice A rationale:
Obesity is a modifiable risk factor for stroke, as it can be controlled through diet and exercise.
Choice B rationale:
History of hypertension is also a modifiable risk factor, as it can be managed with medication and lifestyle changes.
Choice C rationale:
Genetics is a nonmodifiable risk factor for stroke, as individuals cannot change their genetic makeup.
Choice D rationale:
History of smoking is a modifiable risk factor, as individuals can choose to quit smoking.
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