A nurse is admitting a client who reports recurrent flank pain and nausea for 24 hr. Which of the following actions should the nurse take first?

Monitor intake and output.

Administer pain medication.

Ambulate in hall.

Strain the urine.

Answer and Explanation

The Correct Answer is B

Choice A rationale
Monitoring intake and output is important but not the first priority. The immediate concern is to address the client’s pain.
Choice B rationale

Administering pain medication is the first priority. Managing the client’s pain will help alleviate discomfort and allow for further assessment and treatment.
Choice C rationale
Ambulating in the hall is not appropriate for a client experiencing flank pain and nausea. It could exacerbate the symptoms.
Choice D rationale
Straining the urine is important for identifying any stones, but it is not the first priority. Pain management should be addressed first.

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Correct Answer is B

Explanation

Choice A rationale
Placing a sandbag to the lateral calf is not an effective method to prevent hip dislocation. Sandbags are typically used to provide support and immobilization in other contexts, such as stabilizing fractures. They do not provide the necessary support to prevent hip dislocation after a total hip arthroplasty.
Choice B rationale
Placing a wedge pillow between the legs is an effective method to prevent hip dislocation after a total hip arthroplasty. The wedge pillow helps to maintain proper alignment of the hip joint by keeping the legs abducted (apart) and preventing adduction (bringing the legs together), which can cause dislocation.
Choice C rationale
Placing a trochanter roll against the thigh is not specifically aimed at preventing hip dislocation. Trochanter rolls are used to prevent external rotation of the hip in patients who are immobile, but they do not provide the necessary support to prevent dislocation after hip surgery.

Choice D rationale
Placing a footboard on the bed is not an effective method to prevent hip dislocation. Footboards are used to provide support to the feet and prevent foot drop in bedridden patients, but they do not address the risk of hip dislocation.

A. Elevated creatinine. B. Decreased urine specific gravity. C. Hypokalemia. D. Decreased BUN.

Correct Answer is A

Explanation

Choice A rationale
Elevated creatinine is a common finding in clients with chronic kidney disease due to decreased renal function and impaired clearance of creatinine from the blood.
Choice B rationale
Decreased urine specific gravity is not typically associated with chronic kidney disease. Clients with chronic kidney disease may have an increased or normal urine specific gravity.
Choice C rationale
Hypokalemia is not a typical finding in chronic kidney disease. Clients with chronic kidney disease are more likely to have hyperkalemia due to impaired renal excretion of potassium.
Choice D rationale
Decreased BUN (blood urea nitrogen) is not expected in chronic kidney disease. Elevated BUN levels are more common due to reduced renal clearance of urea.

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A nurse is admitting a client who reports recurrent flank pain and nausea for 24 hr. Which of the following actions should the nurse take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assisting a client who is postoperative following a total hip arthroplasty into a supine position. Which of the following actions is appropriate to prevent hip dislocation?

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Correct Answer is A

Explanation

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