A nurse is evaluating a patient who is suffering from prostatic hypertrophy.
What symptoms associated with urinary retention should the nurse anticipate? (Choose all that apply)

Choice A rationale

Establishing a patient relationship is important, but it’s not the first action the nurse should take. The nurse must first ensure safety for all involved.

Choice B rationale

Exploring the truth of the patient’s statements is a part of the therapeutic process, but it’s not the first step. The immediate concern should be to ensure safety.

Choice C rationale

Setting behavioral limits for the patient is the first action the nurse should take. This is crucial in managing a patient who has shown aggressive behavior. It helps to establish boundaries and expectations, which can prevent further aggressive incidents.

Choice D rationale

While it’s important to explain to the patient that the behavior was unacceptable, this is not the first action. The immediate priority is to ensure safety by setting behavioral limits.

Choice A rationale

Acute laryngotracheobronchitis, also known as croup, is a common childhood condition that is usually caused by a viral infection. The main symptom is a distinctive barking cough. A cool mist tent can help to soothe the inflamed airways and reduce stridor, which is a high-pitched,

wheezing sound caused by disrupted airflow. Therefore, decreased stridor would indicate that the treatment has been effective.

Choice B rationale

While a decreased temperature might indicate a resolution of any underlying infection, it is not directly related to the effectiveness of a cool mist tent in treating acute laryngotracheobronchitis.

Choice C rationale

A barking cough is a symptom of acute laryngotracheobronchitis and does not indicate treatment effectiveness.

Choice D rationale

Improved hydration is important but is not a direct indicator of the effectiveness of the cool mist tent.