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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Naxlex Comprehensive Predictor Exams

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Free Nursing Study Resources

Correct Answer is D

Explanation

Rationale:
A. "Can you recall the date the Twin Towers in New York were destroyed?": This question assesses memory, specifically long-term memory, rather than judgment. Remembering historical events evaluates cognitive recall ability but does not explore the client’s decision-making process.

B. "What is the difference between a hamster and a rabbit as a pet?": This question primarily assesses abstract thinking and categorization rather than judgment. It helps evaluate how the client organizes concepts but does not directly provide insight into practical decision-making or problem-solving skills.

C. "Should someone who lives in a glass house throw stones?": This proverb assesses abstract thinking and the ability to interpret symbolic meanings, rather than directly evaluating judgment. Interpretation of proverbs reflects cognitive function but not necessarily real-life decision-making capacity.

D. "Do you write checks if you know the bank account is overdrawn?": This question assesses practical judgment by exploring the client's ability to make appropriate decisions regarding real-world financial behavior. It directly addresses reasoning, consequences of actions, and impulse control, which are key elements of judgment evaluation.

A. Multiple yellow lesions with a grainy surface. B. Large, flat, dark red irregular area on the neck. C. Multiple silver striae on the abdomen. D. Bluish discoloration of the nailbeds.

Correct Answer is D

Explanation

Rationale:
A. Multiple yellow lesions with a grainy surface: These may represent seborrheic keratoses, which are common, benign skin growths seen especially in older adults. They typically do not require urgent medical intervention unless changing rapidly or showing signs of malignancy.

B. Large, flat, dark red irregular area on the neck: This finding likely represents a port-wine stain, a type of vascular birthmark. While noticeable, it is generally benign and would not usually necessitate immediate reporting unless there are associated complications or sudden changes.

C. Multiple silver striae on the abdomen: Silver striae (stretch marks) are common and typically result from rapid changes in body size, such as during pregnancy, weight gain, or growth spurts. They are benign and do not require healthcare provider notification unless accompanied by concerning symptoms.

D. Bluish discoloration of the nailbeds: Cyanosis, indicated by bluish nailbeds, suggests decreased oxygenation or possible cardiovascular or pulmonary compromise. It is a significant clinical finding that warrants immediate reporting to the healthcare provider for further evaluation and management.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

While performing a mental status examination, which question should the nurse ask when attempting to evaluate a client's judgment?

Correct Answer is D

Explanation

When assessing a client's skin, which finding should the nurse report to the healthcare provider (HCP)?

Correct Answer is D

Explanation

When assessing a male client's respiratory status, which technique should the nurse use to assess his anterior-posterior (AP) chest diameter?

Following a cerebrovascular accident (CVA), a client's prescriptions include neurologic assessments every 8 hours, and bedrest. The agency assessment tool includes evaluation of the client's posture. Which action should the nurse implement?

Which is the best approach for the nurse to use when interviewing a client about alcohol and substance use?

A mother brings her obese adolescent daughter to the clinic because for the last 6 months her daughter sleeps every day after school, has lost weight, and has not had a period for 3 months. After sending the mother to the waiting room, which assessment is most important for the nurse to implement?

While completing a health assessment for a client being admitted with bilateral pneumonia, the nurse asks the client to describe the sputum. Which communication technique should the nurse use to obtain this information?

The nurse assesses a client with a sleep pattern disturbance. While developing a plan of care (POC), which assessment data should the nurse obtain first?

A client reports episodes of syncope. Which assessment finding should the nurse anticipate?

An older adult client with a recent history of a cerebrovascular accident (CVA) presents with right hemiparesis. The nurse tests the deep tendon reflexes on the right side and elicits a brisk 4+ response. Which interpretation of this finding is accurate?