When caring for older adult clients at a long-term care facility, which of the following assessments should the nurse prioritize when evaluating for the risk and presence of urinary retention? (Select all that apply.)
 

A nurse is reinforcing teaching to a client who has been newly diagnosed with hepatitis C. The client asks how they could have contracted the virus. Which of the following nurse responses best explains how the client may have become infected with hepatitis C?

A male patient is admitted to the hospital with complaints of epigastric pain, which he describes as burning and gnawing. The pain occurs 2-3 hours after eating and is somewhat relieved by food or antacids. He has a history of smoking and occasional alcohol use. Upon assessment, the patient exhibits tenderness in the epigastric region, and his vital signs are stable. The patient is diagnosed with a peptic ulcer disease (PUD). Which of the following is the most appropriate nursing intervention for this patient?

A patient with a history of ulcerative colitis presents to the emergency department with severe abdominal pain, frequent bloody diarrhea, and signs of dehydration. Which medication should the nurse anticipate administering during this exacerbation of ulcerative colitis?

A female client presents to the clinic with complaints of foul-smelling urine, a low-grade fever of 37.7° C (100° F), and dysuria for the past three days. She also reports increased urinary frequency and urgency but states that she has not noticed any blood in her urine. Upon examination. the nurse notes mild CVA tenderness on the right side. The nurse reviews the client's recent medical history, noting that she has a history of recurrent urinary tract infections (UTIs) and is currently taking no medications other than a daily multivitamin.

Vital Signs

blood pressure 120/78 mm Hg

heart rate 88 beats per minute

respiratory rate 18 breaths per minute

temperature 37.7° C (100° F)

A male presents to the emergency department with confusion, lethargy, and a decreased level of consciousness. His friends report that he ingested a large quantity of unknown pills in a suicide attempt. Laboratory results reveal severe metabolic acidosis, high anion gap, and elevated serum creatinine. Which of the following is the most urgent indication for initiating dialysis in this patient?

A patient undergoing chemotherapy reports painful oral ulcers, difficulty eating, and a metallic taste in the mouth. The nurse suspects stomatitis. Which nursing intervention is most appropriate for this patient?

A patient with a nasogastric (NG) tube in place is experiencing respiratory distress. What is the most appropriate initial nursing intervention?

A nurse is caring for a client who is scheduled for a cholecystectomy due to gallstones. The client asks the nurse what caused the gallstones. Which of the following nurse statements best explains the cause of gallstones?

A male patient is being discharged after hospitalization for a bleeding peptic ulcer. The nurse is providing discharge teaching on how to monitor for signs of recurrent bleeding. Which of the following statements by the patient indicates a need for further teaching?

A patient with chronic kidney disease (CKD) is being evaluated for medication management. Which of the following medications should be avoided due to its potential nephrotoxic effects?