A nurse is caring for a client who is 6hrs 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.

Check the tubing for kinks.

Notify the provider.

Adjust the rate of the bladder irrigant.

Answer and Explanation

The Correct Answer is B

A. Irrigating the catheter may be necessary, but the nurse should first assess for a simpler cause of the obstruction, such as a kink.
B. Checking for kinks is the priority, as it is a common cause of catheter obstruction and can be easily corrected.
C. Notifying the provider is unnecessary unless troubleshooting measures fail to resolve the issue.
D. Adjusting the bladder irrigant rate may be considered, but only after ensuring the tubing is free from kinks.

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Correct Answer is C

Explanation

A. A sonogram may help identify kidney abnormalities but is not the initial test for suspected infection.
B. A CT scan may be needed for further evaluation but is typically not the first test ordered.
C. A midstream urine culture is often the initial diagnostic test for suspected urinary tract infections or pyelonephritis, based on symptoms of chills, fever, and flank pain.
D. An intravenous pyelogram is used to detect structural abnormalities, such as renal calculi, but is not the initial test for infection symptoms.

A. Omit the KCL dose and document that it was not given. B. Give the ordered KCL as prescribed. C. Hold the prescribed dose and notify the provider of the serum potassium level. D. Call the lab to verify the client's results.

Correct Answer is B

Explanation

A. Omitting the KCL dose would be inappropriate, as the client's potassium level is low and requires correction.
B. A potassium level of 3.0 mEq/L is below the normal range (3.5-5.0 mEq/L), and administering the prescribed potassium supplement is appropriate to prevent symptoms of hypokalemia.
C. There is no need to hold the dose and notify the provider, as the KCL is prescribed to correct low potassium levels.
D. The lab results do not need to be verified unless there is suspicion of error, as 3.0 mEq/L is consistent with hypokalemia requiring treatment.

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A nurse is caring for a client who is 6hrs 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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is reporting chills, fever, and left costovertebral pain. Which diagnostic test should the nurse expect the healthcare provider to prescribe first?

Correct Answer is C

Explanation

A nurse is preparing to administer potassium chloride (KCL) to a client who is receiving diuretic therapy. The nurse reviews the client's serum potassium level results and discovers the client's potassium level is 3.0 mEq/L. Which of the following actions should the nurse take?

Correct Answer is B

Explanation

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