The nurse is caring for a client who has a continuous bladder irrigation (CBI) infusing. At the end of the shift, the nurse calculates the urine output. The client received a total of 2700 mL of the irrigation and emptied a total of 3375 ml from the urine catheter. What should the nurse record as the client's true urine output?

-625 mL

+675 mL

+375 mL

-300 mL

Answer and Explanation

The Correct Answer is B

A. A negative output would imply that the client has produced less urine than the irrigation received, which is not the case here.
B.   The true urine output is 675 mL, calculated by subtracting the irrigation amount from the total urine collected.
C.   The calculation does not support this value, as it does not accurately reflect the total urine output after accounting for the irrigation.
D.   Similar to option A, a negative value does not apply here since the urine output exceeds the irrigation amount.

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Correct Answer is D

Explanation

A. While it's true that ulcers can be a serious complication of PAD and require careful management, exercise is generally encouraged in patients with PAD as long as it is safe and supervised. Patients should consult their healthcare provider about appropriate exercise, but not exercising altogether can worsen their condition.
B. Buying shoes in the afternoon is advisable because feet can swell throughout the day. It helps ensure a better fit and reduces the risk of blisters or skin breakdown, which is particularly important for clients with PAD.
C. This statement is generally correct, as dangling the legs can help improve circulation in some cases. Clients with PAD often experience relief when their legs are in a dependent position, as it may help increase blood flow to the extremities. However, they should also be encouraged to avoid prolonged periods of sitting.
D. This statement may indicate a misunderstanding. Compression stockings are typically used for venous issues rather than arterial diseases like PAD. In patients with PAD, wearing compression stockings may not be appropriate and could potentially compromise arterial blood flow.

A. reduce the risk of blood vessel spasm. B. prevent platelet aggregation. C. dissolve the blood clot. D. prevent infection in the brain.

Correct Answer is C

Explanation

A. While blood vessel spasms can occur after a stroke, t-PA does not directly affect them.
B. Platelet aggregation is the process by which platelets stick together to form a clot. t-PA dissolves clots, but it does not prevent their formation.
C. Tissue plasminogen activator (t-PA) is a medication that can dissolve blood clots. In the case of a thrombotic stroke, a blood clot has blocked blood flow to the brain. By dissolving the clot, t-PA can restore blood flow and limit brain damage.
D. t-PA does not have any direct effect on the risk of infection in the brain.

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Blood Cell	Normal Ranges
Red blood cells (mature, circulating)	Male: 451-6.01 million/mm3 Female: 4.01-5.51 million/mm3
Hemoglobin	Adult (15-64 yr) Male 14-17.3 g/dL Female 11.7-155 g/dL
Hematocrit	42%-52% in males 36% -48% in females
Reticulocytes	0.5% -2.5% of total RBC count
White blood cells (total)	4.5-11.1 10/mm3
Neutrophils	59% Bands 3% Segs-56%
Eosinophils	2.7%
Basophils	0.5%
Lymphocytes	34%
Monocytes	4%


Platelets	150,000-450,000/mm3

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client with peripheral arterial disease. Which statement, by the client, indicates that they need additional teaching?

Correct Answer is D

Explanation

The nurse is caring for a client who had a thrombotic stroke in the Emergency Department. It has been less than 3 hours since the onset of symptoms. The rationale for using tissue plasminogen activator (t-PA) for this client is to:

Correct Answer is C

Explanation

The client is diagnosed with a transient ischemic attack (TIA) and is prescribed clopidogrel. Which statement would indicate the medication education has been effective for this client? The client states, "Clopidogrel

The nurse is caring for the client who has dysphagia following an ischemic stroke. The client is ordered a pureed diet starting today. Which intervention would be appropriate for this client?

A nurse is caring for a client who asks to be screened for cervical cancer because a relative has been diagnosed with it. Which of the following tests should the nurse expect the provider to use?

A client returns to the surgical unit following a right modified radical mastectomy with dissection of axillary lymph nodes. An appropriate nursing intervention in the postoperative care for the client includes:

The nurse is teaching a client about early detection for penile cancer. The nurse knows the teaching is effective when the client states, "I will:

The client is admitted with complaints of photosensitivity, neck stiffness, and a "thunderclap" headache. The nurse recognizes that these clinical manifestations would present with which type of stroke?

Which initial assessment finding(s) would the nurse expect in a client diagnosed with acute lymphocytic leukemia (ALL)?