The nurse is preparing to test a patient for postvoid residual with a bladder scan. Which action will the nurse take?
Measure bladder before the patient voids.
Measure bladder with head of bed raised to 90 degrees.
Measure bladder with head of bed raised to 60 degrees.
Measure bladder within 15 minutes after the patient voids.
The Correct Answer is D
Choice A rationale
Measuring the bladder before the patient voids would not provide an accurate measurement of postvoid residual, which is the amount of urine left in the bladder after voiding.
Choice B rationale
The position of the head of the bed does not directly impact the measurement of postvoid residual. However, the patient should be in a comfortable position during the procedure.
Choice C rationale
Similar to Choice B, the position of the head of the bed does not directly impact the measurement of postvoid residual.
Choice D rationale
Measuring the bladder within 15 minutes after the patient voids allows for an accurate measurement of postvoid residual, which can help assess bladder function.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale: Wet-to-dry dressings are a form of mechanical debridement. This method involves applying a wet dressing to the wound and allowing it to dry. When the dressing is removed, it also removes some of the dead or damaged tissue from the wound, helping to clean the wound and promote healing. This method can be painful and is not selective, meaning it can also remove healthy tissue. However, it is often used for wounds with a large amount of debris or necrotic tissue.
Choice B rationale: Surgical debridement is another method of wound debridement, but it is not a form of mechanical debridement. This method involves using surgical instruments to remove dead or damaged tissue. It is the fastest method of debridement and is often used for wounds that are infected or have a large amount of necrotic tissue. However, it requires a skilled practitioner and can be painful.
Choice C rationale: Enzymatic debridement involves applying a topical ointment that contains enzymes to the wound. These enzymes help to break down dead or damaged tissue. This method is selective and only removes necrotic tissue, leaving healthy tissue intact. However, it is not a form of mechanical debridement.
Choice D rationale: Autolytic debridement is a method that uses the body’s own enzymes and moisture to break down dead or damaged tissue. This is the slowest method of debridement but is also the least painful and is selective for necrotic tissue. Like enzymatic debridement, autolytic debridement is not a form of mechanical debridement.
Correct Answer is D
Explanation
Choice A rationale
Fresh vegetables are generally not considered bladder irritants. They are part of a healthy diet and do not typically cause bladder irritation.
Choice B rationale
Red meat is not typically associated with bladder irritation. While some individuals may have specific dietary sensitivities, red meat is not commonly known to irritate the bladder.
Choice C rationale
Dairy products are not typically associated with bladder irritation. However, some individuals may have lactose intolerance or other specific sensitivities to dairy products.
Choice D rationale
Caffeinated beverages can irritate the bladder. Caffeine is a diuretic, which means it can increase urine production and potentially lead to bladder irritation.
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