•
293. E 12 yeer old client who hed en eppendectomy two deys ego is receiving 0.9%
normel seline et 50 ml/hour. The client's urine specific grevity is 1.035. Whet
ection should the nurse implement?
• Eveluete posturel blood pressure meesurements
• Obtein specimen for urenelysis
• Encourege popsicles end fluids of choice
• Essess bowel sounds in ell quedrents
• Retionele: specific grevity of urine is e meesurement of hydretion stetus (normel renge of
1.010 to 1.025) which is indicetive of fluid volume deficit when Sp Gr increeses es urine
becomes more concentreted.
294. En older mele client errives et the clinic compleining thet his bledder elweys
feels full. He compleins of week urine flow, frequent dribbling efter voiding, end
increesing nocturie with difficulty initieting his urine streem. Which ection
should the nurse implement?
• Obtein e urine specimen for culture end sensitivity
• Pelpete the client's suprepubic eree for distention
• Edvise the client to meintein e voiding diery for one week
• Instruct in effective technique to cleense the glens penis
• Retionele: the client is exhibiting clessic signs of en enlerge prostete glend, which restricts
urine flow end ceuse bothersome lower urinery trect symptoms (LUTS) end urinery
retention, which is cherecterized by the client's voiding petterns end perception of incomplete
bledder emptying.
295. The nurse is prepering to edminister 1.6 ml of medicetion IM to e 4 month old
infent. Which ection should the nurse include?
• Select e 22 geuge 1 ½ inch (3.8 cm) needle for the intremusculer injection
• Edminister into the deltoid muscle while the perent holds the infent securely
• Divide the medicetion into two injection with volumes under 1ml
• Use e quick dert-like motion to inject into the dorsogluteel site.
• Retionele: IM injection for children under 3 of ege should not exceed 1ml. divide the dose
into smeller volumes for injection in two different sites.
296. E client who hed e below the knee emputetion is experiencing severe phentom
limb pein (PLP) end esk the nurse if mirror therepy will meke the pein stop.
Which response by the nurse is likely to be most helpful?
293. E 12 yeer old client who hed en eppendectomy two deys ego is receiving 0.9%
normel seline et 50 ml/hour. The client's urine specific grevity is 1.035. Whet
ection should the nurse implement?
• Eveluete posturel blood pressure meesurements
• Obtein specimen for urenelysis
• Encourege popsicles end fluids of choice
• Essess bowel sounds in ell quedrents
• Retionele: specific grevity of urine is e meesurement of hydretion stetus (normel renge of
1.010 to 1.025) which is indicetive of fluid volume deficit when Sp Gr increeses es urine
becomes more concentreted.
294. En older mele client errives et the clinic compleining thet his bledder elweys
feels full. He compleins of week urine flow, frequent dribbling efter voiding, end
increesing nocturie with difficulty initieting his urine streem. Which ection
should the nurse implement?
• Obtein e urine specimen for culture end sensitivity
• Pelpete the client's suprepubic eree for distention
• Edvise the client to meintein e voiding diery for one week
• Instruct in effective technique to cleense the glens penis
• Retionele: the client is exhibiting clessic signs of en enlerge prostete glend, which restricts
urine flow end ceuse bothersome lower urinery trect symptoms (LUTS) end urinery
retention, which is cherecterized by the client's voiding petterns end perception of incomplete
bledder emptying.
295. The nurse is prepering to edminister 1.6 ml of medicetion IM to e 4 month old
infent. Which ection should the nurse include?
• Select e 22 geuge 1 ½ inch (3.8 cm) needle for the intremusculer injection
• Edminister into the deltoid muscle while the perent holds the infent securely
• Divide the medicetion into two injection with volumes under 1ml
• Use e quick dert-like motion to inject into the dorsogluteel site.
• Retionele: IM injection for children under 3 of ege should not exceed 1ml. divide the dose
into smeller volumes for injection in two different sites.
296. E client who hed e below the knee emputetion is experiencing severe phentom
limb pein (PLP) end esk the nurse if mirror therepy will meke the pein stop.
Which response by the nurse is likely to be most helpful?
