A nurse is caring for a patient who attacked a friend and is now admitted to the psychiatric unit. Which of the following actions should the nurse take first?

Establish a patient relationship.

Explore the truth of the patient’s statements.

Set behavioral limits for the patient.

Explain to the patient that the behavior was unacceptable.

Answer and Explanation

The Correct Answer is C

Choice A rationale

Establishing a patient relationship is important, but it’s not the first action the nurse should take. The nurse must first ensure safety for all involved.

Choice B rationale

Exploring the truth of the patient’s statements is a part of the therapeutic process, but it’s not the first step. The immediate concern should be to ensure safety.

Choice C rationale

Setting behavioral limits for the patient is the first action the nurse should take. This is crucial in managing a patient who has shown aggressive behavior. It helps to establish boundaries and expectations, which can prevent further aggressive incidents.

Choice D rationale

While it’s important to explain to the patient that the behavior was unacceptable, this is not the first action. The immediate priority is to ensure safety by setting behavioral limits.

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Free Nursing Study Resources

Correct Answer is ["5"]

Explanation

Step 1 is: Calculate the volume of metoprolol to administer using the formula: Volume = Dose ÷ Concentration

Step 2 is: Substitute the given values into the formula: Volume = 5 mg ÷ 1 mg/mL

Step 3 is: Perform the calculation: Volume = 5 mL. So, the nurse should administer 5 mL of metoprolol per dose.

A. Urinary retention B. Urinary incontinence C. Urinary tract infection D. Urinary frequency

Correct Answer is C

Explanation

Choice A rationale

Urinary retention refers to the inability to empty the bladder completely. While it can cause discomfort and bloating, it does not typically result in dark amber, cloudy urine with an unpleasant odor.

Choice B rationale

Urinary incontinence is the loss of bladder control, leading to the involuntary leakage of urine. It does not cause the urine to become dark amber, cloudy, or have an unpleasant odor.

Choice C rationale

A urinary tract infection (UTI) is an infection in any part of the urinary system — kidneys, bladder, urethra. Most UTIs are caused by bacteria, but they can also be caused by viruses or fungi. Symptoms of a UTI often include cloudy, dark, or strong-smelling urine.

Choice D rationale

Urinary frequency refers to needing to urinate more often than usual. It can be a symptom of many different issues, including a UTI, but on its own, it does not cause the urine to become dark amber, cloudy, or have an unpleasant odor.

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A nurse is caring for a patient who attacked a friend and is now admitted to the psychiatric unit. Which of the following actions should the nurse take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["5"]

Explanation

A nurse is caring for a patient and notices that the patient’s urine is dark amber, cloudy, and has an unpleasant odor. Which of the following conditions should the nurse associate these findings with?

Correct Answer is C

Explanation

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