The nurse is caring for a postoperative client who reports difficulty urinating. The client does not have a urinary catheter in place. Which nursing action(s) are most appropriate at this time? Select all that apply.

Run water to assist in the let-down reflex.

Measure urinary output.

Assist to the bathroom.

Place a urinary catheter.

Assist the client to stand.

Answer and Explanation

Correct Answer : A,C,E

A. Run water to assist in the let-down reflex: The sound of running water can stimulate the parasympathetic nervous system, triggering the urge to void. It’s a noninvasive and effective first-line intervention. This helps reduce urinary retention without immediate need for catheterization.
B. Measure urinary output: Measuring output is important once urination occurs but does not assist with initiating voiding. It is a monitoring step, not an intervention to promote urination. It should follow once the client successfully voids.
C. Assist to the bathroom: Walking to the bathroom creates a familiar and private setting, promoting comfort and relaxation. These factors help stimulate the natural urge to void. It also supports mobility and patient independence postoperatively.
D. Place a urinary catheter: Catheterization is invasive and should only be done if noninvasive methods fail. It increases the risk of infection and discomfort. Nurses should try simpler interventions first to promote spontaneous voiding.
E. Assist the client to stand: Postural positioning, such as standing, helps mimic the client’s usual urination habits. This can help engage the bladder’s normal neurological pathways. It is especially helpful in male clients to initiate urination.

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Correct Answer is D

Explanation

A. Increased cardiac output: Mitral stenosis typically reduces cardiac output due to impaired left ventricular filling. Increased output would be unusual but not immediately concerning compared to pressure-related complications.
B. Decreased pulmonary pressure: Pulmonary pressure often increases, not decreases, in mitral stenosis due to blood backing up from the left atrium. Decreased pressure is not a critical concern in this condition.
C. Decreased right ventricular pressure: This is not commonly associated with mitral stenosis. The right ventricle may experience increased pressure if pulmonary hypertension develops, but a decrease is less concerning.
D. Increased left atrial pressure: Mitral valve narrowing impairs blood flow into the left ventricle, leading to blood accumulation and elevated pressure in the left atrium. This can cause pulmonary congestion and is the most critical finding.

A. Increased exposure to industrial pollutants B. Increase in women smokers C. Few early symptoms D. Increased incidence among the elderly

Correct Answer is C

Explanation

A. Increased exposure to industrial pollutants: While environmental factors like industrial pollutants increase the risk of developing lung cancer, they do not directly explain the high mortality rate. Early detection plays a larger role in outcomes.
B. Increase in women smokers: Though smoking among women contributes to rising lung cancer rates, it does not explain why the disease is so deadly. Mortality is more closely tied to late-stage diagnosis.
C. Few early symptoms: Lung cancer often progresses silently with vague or absent symptoms until it reaches an advanced stage. This delay in detection reduces the effectiveness of treatment and contributes significantly to high mortality.
D. Increased incidence among the elderly: Older adults are more likely to develop cancer due to age-related factors, but mortality rates remain high primarily because lung cancer is typically diagnosed late, not just because of age.

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The nurse is caring for a postoperative client who reports difficulty urinating. The client does not have a urinary catheter in place. Which nursing action(s) are most appropriate at this time? Select all that apply.

Nursing Test Bank

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