a nurse is caring for a client who has an indwelling urinary catheter what should the nurse identify as a catheter occlusion
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Nursing Elites

ATI LPN

PN ATI Capstone Proctored Comprehensive Assessment 2020 B

1. A nurse is caring for a client who has an indwelling urinary catheter. What should the nurse identify as a catheter occlusion?

Correct answer: B

Rationale: The correct answer is B: Bladder distention. Bladder distention indicates that the bladder is full and there is impaired elimination, which could be caused by catheter occlusion. Pain during urination (choice A) is not typically associated with catheter occlusion but may indicate a urinary tract infection. Cloudy urine (choice C) can be a sign of infection but is not specific to catheter occlusion. Blood in the catheter tube (choice D) may indicate trauma during catheter insertion but is not a typical finding in catheter occlusion.

2. A nurse is planning care for a client who has chronic kidney disease. Which finding indicates the need for hemodialysis?

Correct answer: C

Rationale: The correct answer is C. A serum creatinine level of 5 mg/dL is significantly elevated and indicates the need for hemodialysis to help filter waste products from the blood. Elevated creatinine levels suggest impaired kidney function and the inability to effectively filter waste from the body. Choices A, B, and D are within normal ranges and do not indicate the need for immediate hemodialysis in a client with chronic kidney disease.

3. A nurse is reviewing laboratory results for a client receiving chemotherapy. Which result should the nurse report to the provider?

Correct answer: A

Rationale: The correct answer is A: WBC 3,000/mm³. A WBC count of 3,000/mm³ indicates neutropenia, which is a condition characterized by a low level of white blood cells, specifically neutrophils. Neutropenia increases the risk of infection and requires immediate medical attention, especially in clients undergoing chemotherapy. Reporting this result to the provider promptly is crucial for further evaluation and intervention. Choices B, C, and D are within normal ranges and do not pose an immediate risk to the client's health. Hemoglobin of 12 g/dL, platelet count of 250,000/mm³, and serum sodium of 140 mEq/L are all normal values and would not typically require immediate reporting unless there are specific concerns related to the individual client's condition.

4. A client has a new prescription for metformin. Which of the following should the nurse educate the client about?

Correct answer: B

Rationale: The correct answer is B: 'It should be taken with meals.' Metformin should be taken with meals to minimize gastrointestinal side effects and improve absorption. Choice A is incorrect because metformin is actually associated with weight loss or weight neutrality. Choice C is incorrect as metformin is typically taken orally and not via injection. Choice D is also incorrect because metformin is not known to cause hypoglycemia as a primary side effect.

5. A healthcare provider is teaching a client about the use of prednisone. Which of the following should be included?

Correct answer: B

Rationale: The correct answer is B. Prednisone can cause weight gain and other side effects, so clients should be informed about these potential risks. Choice A is incorrect because prednisone should not be stopped abruptly to prevent withdrawal symptoms. Choice C is incorrect because prednisone can have various side effects. Choice D is incorrect because prednisone is usually prescribed with specific dosing instructions and should not be taken irregularly or only when symptoms occur.

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