The nurse is examining the abdomen of an older adult male client who expresses suprapubic tenderness on palpation. The client reports that it sometimes feels like there is still pressure in that area after urination. Which additional finding should the nurse expect with continued interview of the client?

An overactive bladder

A cloudy discharge.

A weak urinary stream.

Black tarry stools.

Answer and Explanation

The Correct Answer is C

Rationale:
A. An overactive bladder: Overactive bladder typically presents with urgency, frequency, and sometimes incontinence, but it does not usually cause suprapubic tenderness or the sensation of incomplete bladder emptying. These symptoms are more consistent with urinary retention or bladder outlet obstruction.

B. A cloudy discharge: Cloudy urinary discharge is more indicative of a urinary tract infection (UTI) rather than urinary retention. While infections can cause some bladder discomfort, the client’s description points more specifically to mechanical urinary issues rather than infection.

C. A weak urinary stream: A weak urinary stream is commonly associated with bladder outlet obstruction, often due to benign prostatic hyperplasia (BPH) in older males. The combination of suprapubic tenderness and the feeling of incomplete emptying aligns with urinary retention caused by obstruction, making this the expected additional finding.

D. Black tarry stools: Black tarry stools are usually a sign of gastrointestinal bleeding, particularly from the upper GI tract. They are unrelated to urinary symptoms and would not explain suprapubic tenderness or voiding difficulties described by the client.

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Correct Answer is B

Explanation

Rationale:
A. "I am sorry you feel that way. Perhaps you'd like to return when you have more time.": This response dismisses the client's frustration and offers an exit rather than addressing the emotional barrier that could affect treatment. It risks increasing the client's anger and damages therapeutic communication.

B. "You sound angry. Would you like to tell me about it?": Acknowledging the client's emotions and offering an opportunity to express feelings is therapeutic. It validates the client’s frustration, encourages open communication, and helps build rapport, which can improve cooperation during the health history and subsequent care.

C. Move closer and place a hand on the client's shoulder to demonstrate concern: Physical touch can sometimes comfort clients, but in cases of visible anger or agitation, it can feel intrusive or threatening. Physical contact without permission, especially when emotions are high, may escalate the situation instead of calming it.

D. Ignore the angry outburst and continue with the history questions: Ignoring the emotional outburst misses an important chance to address the client's psychological needs. Continuing without acknowledgment can lead to greater resistance, lack of cooperation, and a breakdown in the therapeutic relationship.

A. Inequality in muscle contraction. B. An intention tremor. C. Slowed capillary refill. D. Loss of peripheral sensation.

Correct Answer is D

Explanation

Rationale:
A. Inequality in muscle contraction: Inequality in muscle contraction suggests a motor or musculoskeletal problem, not a sensory deficit. Monofilament testing specifically assesses for sensory neuropathy rather than muscle strength or contraction differences.

B. An intention tremor: An intention tremor occurs with voluntary movement and typically indicates cerebellar dysfunction. It is unrelated to monofilament testing, which evaluates sensation, not coordination or movement quality.

C. Slowed capillary refill: Capillary refill assesses peripheral perfusion and vascular status, not sensation. While important for overall circulation evaluation, it is not related to the purpose of monofilament testing.

D. Loss of peripheral sensation: Monofilament testing is used to detect peripheral neuropathy, a common complication of diabetes mellitus. An abnormal finding would be the inability to feel the pressure of the monofilament, indicating a loss of protective peripheral sensation and increased risk for foot injuries and ulcers.

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Naxlex Comprehensive Predictor Exams

While the nurse is taking a health history, the client announces, "I don't have time for this. This is a waste of time. I need treatment." Which response is best for the nurse to provide?

Correct Answer is B

Explanation

The nurse is assessing a client with type 2 diabetes mellitus and observes an abnormal response when using a monofilament. Which finding should the nurse document that is consistent with an abnormal finding?

Correct Answer is D

Explanation

When inspecting a client's skin, the nurse observes an area of erythema on the arm. Which follow up assessment should the nurse complete?

When assessing a 24-year-old body-builder, the nurse is unable to palpate an apical pulse. Which action should the nurse implement?

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To assess for the presence of kyphosis, which action should the nurse take?

The nurse is performing a health interview for a client who does not speak fluent English and has obtained an interpreter. Which action should the nurse implement?