A nurse is watching a nursing assistive personnel (AP) perform a postvoid bladder scan on a female with a previous hysterectomy. Which action will require the nurse to follow up?

Wipes scanner head with alcohol pad.

Palpate the patient's symphysis pubis.

Sets the scanner to female.

Applies a generous amount of gel

Answer and Explanation

The Correct Answer is C

A. Wipes scanner head with alcohol pad: Correct technique to prevent infection.

B. Palpates the patient's symphysis pubis: Helps position the scanner correctly over the bladder.

C. Sets the scanner to female: After a hysterectomy, the client should be set to "male" mode because the removal of the uterus alters pelvic anatomy, affecting scan accuracy.

D. Applies a generous amount of gel: Ensures proper ultrasound transmission and a clear image.

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Correct Answer is D

Explanation

A. A 5-year-old child who ignores the urge to defecate owing to embarrassment. Ignoring the urge to defecate slows peristalsis, leading to constipation.

B. A 40-year-old female with major depressive disorder. Depression is more likely to cause decreased peristalsis and constipation.

C. An 80-year-old male in an assisted-living environment. Aging typically slows peristalsis, leading to constipation.

D. A 21-year-old female with three final examinations on the same day. Stress and anxiety stimulate the sympathetic nervous system, increasing peristalsis and leading to diarrhea.

A. Urine output of 80 mL/hr B. Specific gravity of 1.036 C. pH of 6.4 D. Protein level of 2 mg/100 mL

Correct Answer is B

Explanation

A. Urine output of 80 mL/hr: Normal urine output is 30–50 mL/hr. A urine output of 80 mL/hr is within an acceptable range and does not indicate a problem.

B. Specific gravity of 1.036: Normal urine specific gravity ranges from 1.005 to 1.030. A level of 1.036 indicates dehydration or concentrated urine, which requires further assessment.

C. pH of 6.4: Normal urine pH ranges from 4.5 to 8.0, with an average around 6.0. A pH of 6.4 is within normal limits and does not require follow-up.

D. Protein level of 2 mg/100 mL: Normal urine protein is less than 8 mg/100 mL, so 2 mg/100 mL is within normal limits and does not indicate a concern.

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A nurse is watching a nursing assistive personnel (AP) perform a postvoid bladder scan on a female with a previous hysterectomy. Which action will require the nurse to follow up?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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