A nurse is assisting an older adult client who sometimes loses their balance while walking. Which of the following devices is most important for the nurse to use when helping the client ambulate?

Powered stand assist

Cane

Gait belt

Four wheel walker

Answer and Explanation

The Correct Answer is C

A. Powered stand assist: Powered stand assist devices are used for clients who cannot bear weight independently, not for balance issues during ambulation.

B. Cane: A cane provides minimal support and is best for clients with mild weakness, not for those with frequent balance loss.

C. Gait belt: A gait belt provides stability and support while allowing the nurse to assist the client safely if they begin to lose balance.

D. Four-wheel walker: A four-wheel walker rolls easily, which may increase fall risk in a client with balance issues. A standard walker (without wheels) would be safer in some cases.

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Correct Answer is C

Explanation

A. Transient incontinence and increased urine production: While increased urine production is expected, transient incontinence is not a typical finding with furosemide unless the client has preexisting bladder control issues.

B. Increased urine concentration: Furosemide is a loop diuretic that promotes the excretion of sodium and water, leading to dilute urine rather than concentrated urine.

C. Increased output of dilute urine: Furosemide blocks sodium reabsorption in the loop of Henle, resulting in increased urine production that is dilute due to excessive water excretion.

D. A risk of urinary tract infections: Furosemide does not directly increase the risk of urinary tract infections (UTIs). UTIs are more common with urinary retention rather than increased urine flow.

A. "Patient with complaints of urinary incontinence." B. "Patient reports urinary retention." C. "Patient reports urinary frequency." D. "Patient has an enlarged prostate."

Correct Answer is B

Explanation

A. "Patient with complaints of urinary incontinence." The patient did not report involuntary leakage of urine, which defines incontinence.
B. "Patient reports urinary retention." Urinary retention refers to the inability to completely empty the bladder, which matches the patient's description.
C. "Patient reports urinary frequency." Urinary frequency means voiding frequently (e.g., every 1-2 hours), but the patient described difficulty emptying.
D. "Patient has an enlarged prostate." While an enlarged prostate (BPH) could cause retention, the nurse should not diagnose—only report symptoms.

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Stoma Assessment	Stoma is protruding 2cm, is red and moist. Peristomal area is clean and intact.
Output	Liquid stool that is malodorous. Gas present in the appliance.
General Status	Patient is avoiding looking at the ileostomy during care.
Laboratory Data	Potassium 3.6 mEq/L (normal 3.5 to 5 mEq/L) Sodium 137 mEq/L (normal 135 to 145 mEq/L) Creatinine 0.9 mg/dL (normal 0.6 to 1.2 mg/dL)

A nurse is assisting an older adult client who sometimes loses their balance while walking. Which of the following devices is most important for the nurse to use when helping the client ambulate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client has developed edema in her lower legs and feet prompting her physician to prescribe furosemide, a diuretic medication. After the client has begun this new medication, what should the nurse anticipate as a normal finding?

Correct Answer is C

Explanation

During a health history interview, a client tells the nurse that they do not feel that they completely empty the bladder when they void. How would the nurse report this findings to the provider?

Correct Answer is B

Explanation

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