medium · NCLEX-RN Basic Care and Comfort

A nurse is assessing a client for urinary retention. Which finding would provide the most objective evidence that the client requires an intervention?

  1. The client reports a feeling of 'fullness' in the lower abdominal area.
  2. A bladder scan shows 450 mL of urine remaining after the client voided.
  3. The client's intake for the shift was 1,200 mL with an output of 800 mL.
  4. The client has voided 30 mL of amber-colored urine every hour for three hours.

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