A nurse is caring for a client who is 6 hr postoperative following a bowel resection. Which of the following findings is the priority for the nurse to report?

The client arouses easily but quickly falls back asleep.

There is 20 mL of dark red drainage from the wound drainage device over the past 4 hr.

There is 60 mL of dark yellow urine from the indwelling urinary catheter over the past 4 hr.

The client reports a pain level of 6 on a scale from 0 to 10 at the incision site.

Answer and Explanation

The Correct Answer is A

A. The client arouses easily but quickly falls back asleep. This could indicate a potential complication, such as a postoperative haemorrhage, hypovolemia which can lead to decreased perfusion and oxygenation.
B. 20 mL of dark red drainage over 4 hours: This is expected postoperative output.
C. 60 mL of dark yellow urine over 4 hours: This is a low output but not immediately critical compared to potential hypoxia.
D. Pain level of 6/10 at the incision site: Pain is expected and manageable with interventions, making it less critical.

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Correct Answer is A

Explanation

A. Changed mental status: Older adults often exhibit atypical signs of infection, such as confusion, agitation, or other changes in mental status, rather than classic symptoms like fever or dysuria.
B. Temperature 37.3° C (99.1° F): This temperature is within normal range and does not indicate an infection. Older adults may not always mount a fever with infections.
C. WBC count 9,000/mm³ (5,000 to 10,000/mm³): This is within the normal range, so it does not suggest infection. An elevated WBC count (>10,000/mm³) may indicate an infection.
D. Diminished reflexes: This is not a symptom of a bladder infection. It is more commonly associated with neurological or musculoskeletal conditions.

A. Hct B. INR C. BUN D. LDL

Correct Answer is B

Explanation

A. Hct: Hematocrit measures red blood cell concentration but is not directly affected by warfarin therapy.
B. INR: The international normalized ratio (INR) is the key lab value to monitor in clients taking warfarin, as it reflects the drug’s effect on blood clotting and helps ensure the dose is therapeutic (target INR typically 2-3 for atrial fibrillation).
C. BUN: Blood urea nitrogen assesses kidney function and is unrelated to warfarin monitoring.
D. LDL: Low-density lipoprotein levels assess cardiovascular risk but are not affected by warfarin.

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A nurse is caring for a client who is 6 hr postoperative following a bowel resection. Which of the following findings is the priority for the nurse to report?

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Naxlex Comprehensive Predictor Exams

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