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Questions 158

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Question 1 of 5

A client had a transurethral resection of the prostate yesterday. He is concerned about the small amount of blood that is still in his urine. The nurse explains that the blood in his urine:

Correct Answer: C

Rationale: Some hematuria is usual for several days after surgery. The client should not be concerned about it unless it increases.

Question 2 of 5

A client with a history of chronic venous insufficiency is admitted with complaints of leg ulcers. The nurse should give priority to:

Correct Answer: A

Rationale: Wound care is critical for leg ulcers in chronic venous insufficiency to promote healing and prevent infection.

Question 3 of 5

The first action that the nurse should take if she finds the client has an O2 saturation of 68% is:

Correct Answer: C

Rationale: An O2 saturation of 68% indicates severe hypoxemia requiring immediate oxygen administration (e.g. via mask) to restore oxygenation. Elevating the head rechecking later or assessing heart rate are secondary to correcting hypoxia.

Question 4 of 5

The client is admitted with a diagnosis of acute renal failure. Which laboratory value is most expected?

Correct Answer: A

Rationale: Elevated creatinine is a hallmark of acute renal failure, reflecting impaired kidney filtration. Hyperkalemia, decreased hemoglobin, and elevated BUN are more common than low potassium or BUN.

Question 5 of 5

The client is receiving a blood transfusion. Which finding indicates a possible transfusion reaction?

Correct Answer: D

Rationale: Itching and rash are signs of a possible allergic transfusion reaction, requiring immediate cessation of the transfusion. A slight temperature increase, mild hypotension, or tachypnea may occur but are less specific without other symptoms.

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