GU Test

Which laboratory test will the nurse assess as the best indicator of kidney function? A. Creatinine B. Blood urea nitrogen (BUN) C. Aspartate aminotransferase (AST) D. Alkaline phosphatase

A. Creatinine

14. A client with chronic kidney disease has been prescribed calcium carbonate. What is the rationale for this particular medication? 1. Diminishes incidence of gastric ulcer formation 2. Alleviates constipation 3. Binds with phosphorus to lower concentrations 4. Increases tubular reabsorption of sodium

3. Binds with phosphorus to lower concentrations

20. Which client is at the highest risk for developing chronic kid-ney disease? 1. Client with severe acute glomerulonephritis 2. Client with placenta previa and hemorrhage at delivery 3. Client with poorly controlled long-term hypertension 4. Client who received IV aminoglycosides for an infection

3. Client with poorly controlled long-term hypertension

To prevent prerenal acute kidney injury, which person will the nurse encourage to increase fluid consumption? A. Office secretary B. Construction worker C. School teacher D. Taxicab driver

B. Construction worker

The nurse is questioning a female client with a urinary tract infection (UTI) about her antibiotic drug regimen. Which client statement requires further teaching? A. "I try to drink 3 L of fluid a day." B. "I take my medication when I have symptoms." C. "I don't use bubble baths." D. "I wipe front to back."

B. "I take my medication when I have symptoms."

3. Which lab finding is indicative of renal function alterations and not dehydration? Select all that apply. A.​BUN 20 ml/dL B.​Creatinine 2.3 ml/dL C.​Hemoglobin 14 g/dL D.​Cystatin-c 105 mg/mL E.​BUN - creatinine ratio 10 F.​Creatinine clearance 175 ml/min

B.​Creatinine 2.3 ml/dL D.​Cystatin-c 105 mg/mL F.​Creatinine clearance 175 ml/min

A nurse administered captopril to a client during a renal scan. Which of the following actions should the nurse take? A. Assess for hypertension. B. Limit the client's fluid intake. C. Monitor for orthostatic hypotension. D. Encourage early ambulation

C. Monitor for orthostatic hypotension.

Which nursing intervention or practice is effective in helping to prevent urinary tract infection (UTI) in hospitalized clients? A. Recommending that catheters be placed in all clients B. Encouraging fluid intake C. Irrigating all catheters daily with sterile saline D. Reevaluating the need for indwelling catheters

D. Reevaluating the need for indwelling catheters

A client who is 6 months pregnant comes to the prenatal clinic with a suspected urinary tract infection (UTI). What action will the nurse take with this client? A. Discharges the client to her home for strict bedrest for the duration of the pregnancy. B. Instructs the client to drink a minimum of 3 L of fluids daily to "flush out" bacteria. C. Recommends that the client refrain from having sexual intercourse until after delivery. D. Refers the client to the clinic nurse practitioner for immediate follow-up.

D. Refers the client to the clinic nurse practitioner for immediate follow-up.

4. Which symptom(s) in a client during the first 12 hours after a kidney biopsy indicates to the nurse a possible complication from the procedure? A. The client experiences nausea and vomiting after drinking juice. B. The biopsy site is tender to light palpation. C. The abdomen is distended and the client reports abdominal discomfort. D. The heart rate is 118, blood pressure is 108/50, and peripheral pulses are thready.

D. The heart rate is 118, blood pressure is 108/50, and peripheral pulses are thready.

When performing bladder scanning to detect residual urine in a female client, the nurse must first assess which factor? A. History of hysterectomy B. Abdominal girth C. Hematuria D. Presence of urinary infection

A. History of hysterectomy

Which instruction by the nurse will help a client with chronic kidney disease prevent renal osteodystrophy? A. Increasing dairy products enriched with vitamin D B. Drinking cola beverages only once daily C. Consuming a low-calcium diet D. Avoiding peas, nuts, and legumes

D. Avoiding peas, nuts, and legumes

9. The nurse is discussing the prevention of urinary tract infec-tions with a female client. What would be important to include in the discussion? 1. Decrease fluid intake to decrease burning on urination. 2. Take warm sitz baths with a mild bubble bath. 3. Avoid spermicides with nonoxynol-9. 4. Drink only acidic fluids such as orange juice

3. Avoid spermicides with nonoxynol-9.

The nurse is caring for a male client 8 hours after a nephrectomy. Which assessment data requires immediate nursing intervention? A.​Abdominal distension B.​Urine output 38 ml in the last hour C.​Blood pressure 108/64 mmHg D.​Hemoglobin 14 g/dL

A.​Abdominal distension

1. The client has had a right nephrostomy tube placed after a nephrolithotomy for removal of a kidney stone. When the client returns to the room, what is a priority nursing action? 1. Irrigate the tube with 30 mL of normal saline solution four times a day. 2. Clamp the tube if drainage is excessive. 3. Advance the tube 1 inch every 8 hours. 4. Ensure that the tube is draining freely.

4. Ensure that the tube is draining freely.

8. What will the nurse identify as the goal of treatment for a client with chronic renal insufficiency? 1. Increase the urine output by increasing liver and renal perfusion. 2. Prevent the loss of electrolytes across the basement membrane. 3. Increase the concentration of electrolytes in the urine. 4. Maintain present renal function and decrease renal workload

4. Maintain present renal function and decrease renal workload

19. During peritoneal dialysis treatment, the nurse continually evaluates the client for poor dialysate flow. How will this com-plication be identified? 1. Increased urine albumin level 2. Decreased plasma osmolality 3. An increase in sodium transfer to serum 4. Outflow is intermittent

4. Outflow is intermittent

15. Which is an appropriate nursing action for a child with acute glomerulonephritis? 1. Initiating contact isolation precautions 2. Encouraging increased fluid intake 3. Encouraging ambulation, as tolerated 4. Providing a fluid-restricted, low-sodium diet

4. Providing a fluid-restricted, low-sodium diet

Which assessment data in a client with chronic glomerulonephritis (GN) warrants the nurse to contact the primary health care provider? A. Itchy skin B. Serum potassium of 5.0 mEq/L (5.0 mmol/L) C .Mild proteinuria D .Third heart sound (S3)

D. Third heart sound (S3)

The nurse is caring a client who had a nephrostomy tube inserted 4 hours ago. Which assessment requires nursing action? A. Small amount of urine leaking around the catheter B. Creatinine of 1.8 mg/dL (160 mcmol/L) C. Dark pink-colored urine D. Tube that has stopped draining

D. Tube that has stopped draining

While assisting a client during peritoneal dialysis, the nurse observes the drainage stop after 200 mL of peritoneal effluent drains into the bag. What action will the nurse implement? A. Document the effluent as output. B. Instruct the client to cough. C. Reposition the catheter. D. Turn the client to the opposite side.

D. Turn the client to the opposite side.

A client with a recently created vascular access for hemodialysis is being discharged. Which discharge teaching will the nurse include? A. Do not allow blood pressure measurements in the affected arm. B. Elevate the affected arm allowing for total rest of the extremity. C. Assess for a bruit in the affected arm on a daily basis. D. Sleep on the affected side to protect the access device.

A. Do not allow blood pressure measurements in the affected arm.

17. What is significant about the development of proteinuria in a client with type 1 diabetes mellitus? 1. Chronic kidney disease may eventually develop. 2. It indicates that the client's diabetes is uncontrolled. 3. Serum creatinine will diminish as albuminuria increases. 4. Insulin maintenance dose should be lowered.

1. Chronic kidney disease may eventually develop.

7. What nursing measure would be included in the plan of care for a client with acute kidney injury? 1. Observe for signs of a secondary infection. 2. Provide a high-protein, low-carbohydrate diet. 3. In-and-out catheterization for residual urine 4. Encourage fluids to 2000 mL in 24 hours.

1. Observe for signs of a secondary infection.

12. The nurse is evaluating a client's response to hemodialysis. Which laboratory values will indicate the dialysis was effective? Select all that apply. 1. Serum potassium level decreases from 5.4 to 4.6 mEq/L. (5.4 to 4.6 mmol/L) 2. Serum creatinine level decreases from 1.6 to 0.8 mg/dL. (111.44-70.72 umol/L) 3. Hemoglobin increases from 10 to 12 g/dL. (100-120 g/L) 4. White blood cells increase from 5000 to 8000/mm3. (5.00-8.00 3 109/L) 5. BUN decreases from 110 to 90 mg/dL. (39.27-32.13 mmol/L

1. Serum potassium level decreases from 5.4 to 4.6 mEq/L. (5.4 to 4.6 mmol/L) 2. Serum creatinine level decreases from 1.6 to 0.8 mg/dL. (111.44-70.72 umol/L) 5. BUN decreases from 110 to 90 mg/dL. (39.27-32.13 mmol/L

11. Which nursing observations indicate that a male client with a kidney stone is experiencing renal colic? 1. Severe flank pain radiating toward the testicles 2. Stress incontinence with full bladder 3. Hematuria and severe burning on urination 4. Enuresis with hyperalbuminuria

1. Severe flank pain radiating toward the testicles

4. The nurse understands that the following clinical findings are indications for dialysis. Select all that apply. 1. Volume overload 2. Blood urea nitrogen level of 18 mg/dL (6.43 mmol/L) 3. Potassium level of 6.8 mEq/L (mmol/L) 4. Glomerular filtration rate of 25 mL/min 5. Metabolic acidosis 6. Creatinine level of 5.0 mg/dL (442.0 umol/L

1. Volume overload 3. Potassium level of 6.8 mEq/L (mmol/L) 5. Metabolic acidosis 6. Creatinine level of 5.0 mg/dL (442.0 umol/L

3. A client has had a kidney stone removed, and the nurse instructs him in measures to decrease kidney stone formation in the fu-ture. Which statement by the client indicates to the nurse that he understood the teaching? 1. "I can continue to drink soda if it is sugar free." 2. "I should consume at least 3000 mL of fluid daily." 3. "I should report nocturia that occurs once a night." 4. "I will ingest megadoses of vitamins C and D daily.

2. "I should consume at least 3000 mL of fluid daily."

10. At 9:00 a.m. a 24-hour (composite) urine collection is started. What instructions will the nurse provide to the client? 1. Place the first voided specimen in the container and con-tinue to collect the urine until 9:00 a.m. the following day. 2. Discard the first morning specimen, collect urine for the next 24 hours, and make sure to void before the collection is completed at 9:00 a.m. the following day. 3. Discard the first morning specimen because it may contain concentrated abnormal components. 4. Collect all urine from 9:00 a.m. onward in separate contain-ers that are labeled for time and amount of voiding

2. Discard the first morning specimen, collect urine for the next 24 hours, and make sure to void before the collection is completed at 9:00 a.m. the following day.

13. Which are signs and symptoms of cystitis? Select all that apply. 1. Increased bladder capacity 2. Frequency 3. Dysuria 4. Nocturia 5. Urgency 6. Polydipsia

2. Frequency 3. Dysuria 4. Nocturia 5. Urgency

5. A client in kidney failure is to have a serum blood urea nitrogen level determined. What will this diagnostic test measure? 1. Concentration of the urine osmolarity and electrolytes 2. Serum level of the end products of protein metabolism 3. Ability of the kidneys to concentrate urine 4. Levels of C-reactive protein to determine inflammation

2. Serum level of the end products of protein metabolism

16. The nurse understands that a client may experience pain during peritoneal dialysis because of which of the following? Select all that apply. 1. Warming the dialysate solution before administration 2. Too-rapid instillation of the dialysate 3. Infiltration of solution into the bloodstream 4. Increased intraabdominal pressure 5. Too-rapid outflow rate of the dialysate solution

2. Too-rapid instillation of the dialysate 4. Increased intraabdominal pressure

18. A client with acute kidney injury develops severe hyperkale-mia. What prescription would the nurse anticipate? 1. Furosemide 2. Calcium carbonate 3. 50% glucose and regular insulin 4. Epoetin alfa

3. 50% glucose and regular insulin

6. A client with chronic kidney disease has an internal venous access site for hemodialysis on their left forearm. What action will the nurse take to protect this access site? 1. Irrigate with heparin and normal saline solution every 8 hours. 2. Apply warm moist packs to the area after hemodialysis. 3. Do not use the left arm to take blood pressure readings. 4. Keep the arm elevated above the level of the heart

3. Do not use the left arm to take blood pressure readings.

2. The nurse is infusing dialysate during peritoneal dialysis. What is a nursing action to make the client more comfortable at this time? 1. Increase the rate of flow. 2. Raise the head of the bed. 3. Turn the client from side to side. 4. Refrigerate the fluid before infusion

3. Turn the client from side to side.

A client with a urinary tract infection is prescribed trimethoprim/sulfamethoxazole (Bactrim). What information does the nurse provide to this client about taking this drug? (Select all that apply.) Select all that apply. A ."You will need to take all of these drugs to get the benefits." B. "Drink at least 3 L of fluids every day." C. "Be certain to wear sunscreen and protective clothing." D. "Take this drug with 8 ounces (236 mL) of water." E. "Try to urinate frequently to keep your bladder empty."

A ."You will need to take all of these drugs to get the benefits." B. "Drink at least 3 L of fluids every day." C. "Be certain to wear sunscreen and protective clothing." D. "Take this drug with 8 ounces (236 mL) of water."

A client with end-stage kidney disease has been placed on fluid restrictions. Which assessment data indicates to the nurse that the fluid restriction has not been followed? A. Dyspnea and anxiety at rest B. Blood pressure of 118/78 mm Hg C. Central venous pressure (CVP) of 6 mm Hg D. Weight loss of 3 lb (1.4 kg) during hospitalization

A. Dyspnea and anxiety at rest

The nurse is teaching a group of older adult women about the signs and symptoms of urinary tract infection (UTI). What teaching will the nurse include? (Select all that apply.) Select all that apply. A. Dysuria B. Enuresis C. Frequency D. Polyuria E. Urgency F. Nocturia

A. Dysuria C. Frequency E. Urgency F. Nocturia

When assisting with dietary protein needs for a client on peritoneal dialysis, the nurse recommends which food selection? A. Eggs B. Ham C. Eggplant D. Macaroni

A. Eggs

An older adult woman who reports a change in bladder function says, "I feel like a child who sometimes pees her pants." What is the bestnursing response? A. "Have you tried using the toilet every couple of hours?" B. "How does that make you feel?" C. "We can fix that." D. "That happens when we get older."

A. "Have you tried using the toilet every couple of hours?"

A client is scheduled to undergo kidney transplant surgery. Which teaching point does the nurse include in the preoperative teaching session? A. "It is essential for you to wash your hands and avoid people who are ill." B. "The new kidney will be placed directly below one of your old kidneys." C. "You will receive dialysis the day before surgery and for about a week after." D. "Your diseased kidney will be removed when the transplant is performed."

A. "It is essential for you to wash your hands and avoid people who are ill."

An older adult woman confides to the nurse, "I am so embarrassed about buying adult diapers for myself." How does the nurse respond? A. "That is tough. What do you think might help?" B. "Tell everyone that they are for your husband." C. "Shop at night, when stores are less crowded." D. "Don't worry about it. You need them."

A. "That is tough. What do you think might help?"

The nurse is caring for a 38 year old male with hypertension and Stage 1 CKD. The client reports lifestyle changes and feeling "better" and has stopped taking a prescribed diuretic. What is the appropriate nursing response? A. "The diuretic will reduce your blood pressure which may slow or prevent progression of your chronic kidney disease." B. "Your primary health care provider prescribed the diuretic because it will reverse the damage caused by kidney disease." C. "Taking medications is a personal decision, and you have the right to decline this prescription." D. "Since you have implemented lifestyle changes the diuretic is likely not needed."

A. "The diuretic will reduce your blood pressure which may slow or prevent progression of your chronic kidney disease."

What is the appropriate range of urine output for the client who has just undergone a nephrectomy? A. 30 to 50 mL/hr B. 50 to 70 mL/hr C. 23 to 30 mL/hr D. 41 to 60 mL/hr

A. 30 to 50 mL/hr

The nurse is caring for client who is receiving erythropoietin. Which assessment finding indicates a positive response to the medication? A. A decrease in fatigue B. Potassium within normal range C. Absence of spontaneous fractures D. Hematocrit of 26.7%

A. A decrease in fatigue

A client who is admitted with urolithiasis reports "spasms of intense flank pain, nausea, and severe dizziness." Which intervention does the nurse implement first? A. Administer morphine sulfate as prescribed. B. Infuse 0.9% normal saline at 100 mL/hr as prescribed C. Obtain a urine specimen for urinalysis as prescribed. D. Begin an infusion of metoclopramide as prescribed.

A. Administer morphine sulfate as prescribed.

The nurse is using a bladder scanner on a female client to estimate bladder volume. Which action will the nurse take? (Select all that apply.) Select all that apply. A. Aim the scanner toward the client's coccyx to visualize the bladder. B. Select the female icon since the client has had a hysterectomy. C. Two readings should be completed for best accuracy. D. Gently insert the scanner probe into the vagina. E. Place a gel pad over the client's pubic area.

A. Aim the scanner toward the client's coccyx to visualize the bladder. C. Two readings should be completed for best accuracy. E. Place a gel pad over the client's pubic area.

1. Which client being managed for dehydration does the nurse consider at greatest risk for possible reduced kidney function? A. An 80-year-old man who has benign prostatic hyperplasia B. A 62-year-old woman with a known allergy to contrast media C. A 48-year-old woman with established urinary incontinence D. A 45-year-old man receiving oral and intravenous fluid therapy

A. An 80-year-old man who has benign prostatic hyperplasia

A nurse is assessing a client who has end-stage kidney disease. Which of the following findings should the nurse expect? (Select all that apply.) A. Anuria B. Marked C. Crackles in the lungs D. Increased calcium level E. Proteinuria

A. Anuria B. Marked C. Crackles in the lungs E. Proteinuria

The nurse is caring for a client who has just returned to the surgical unit after a radical nephrectomy. Which assessment data requires further nursing action? (Select all that apply.) Select all that apply. A. Blood pressure is 98/56 mm Hg. B. Urine output over the past hour was 80 mL. C. Heart rate is 118 beats/min. D. Dressing has a 1-cm area of bleeding. E. Abdominal distention. F. Pain is at a level 4 (on a 0--10 scale).

A. Blood pressure is 98/56 mm Hg. C. Heart rate is 118 beats/min. E. Abdominal distention. F. Pain is at a level 4 (on a 0--10 scale).

When caring for a client with a left forearm arteriovenous fistula created for hemodialysis, which nursing actions are required? (Select all that apply.) Select all that apply. A. Ensure that no blood pressures are taken in that arm. B. Teach the client to palpate for a thrill over the site. C. Elevate the arm above heart level. D. Auscultate for a bruit every 8 hours. E. Check brachial pulses daily.

A. Ensure that no blood pressures are taken in that arm. B. Teach the client to palpate for a thrill over the site. D. Auscultate for a bruit every 8 hours.

A nurse is planning postprocedure care for a client who received hemodialysis. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.) A. Check BUN and serum creatinine. B. Administer medications the nurse withheld prior to dialysis. C. Observe for signs of hypovolemia. D. Assess the access site for bleeding. E. Evaluate blood pressure on the arm with AV access.

A. Check BUN and serum creatinine. B. Administer medications the nurse withheld prior to dialysis. C. Observe for signs of hypovolemia. D. Assess the access site for bleeding.

Which client will the nurse assess as at risk for acute kidney injury (AKI)? (Select all that apply.) Select all that apply. A. Client in the intensive care unit on high doses of antibiotics B. Football player in preseason practice C. Accident victim recovering from a severe hemorrhage D. Accountant with poorly controlled diabetes mellitus E. Client who underwent contrast dye radiology F. Client recovering from gastrointestinal influenza

A. Client in the intensive care unit on high doses of antibiotics B. Football player in preseason practice C. Accident victim recovering from a severe hemorrhage E. Client who underwent contrast dye radiology F. Client recovering from gastrointestinal influenza

The nurse is caring for the following clients who are scheduled for a computed tomography (CT) scan with contrast. For which clients will the nurse communicate safety concerns to the health care provider (HCP)? (Select all that apply.) Select all that apply. A. Client who took metformin 4 hours ago B. Client with an allergy to shrimp C. Client who requests morphine sulfate every 3 hours D. Client with a history of asthma E. Client with a blood urea nitrogen of 62 mg/dL (22.1 mmol/L) and a creatinine of 2.0 mg/dL (177 umol/L)

A. Client who took metformin 4 hours ago B. Client with an allergy to shrimp D. Client with a history of asthma E. Client with a blood urea nitrogen of 62 mg/dL (22.1 mmol/L) and a creatinine of 2.0 mg/dL (177 umol/L)

After receiving change-of-shift report on the urology unit, which client will the nurse assess first? A. Client who was involved in a motor vehicle collision and has hematuria. B. Client with nephrotic syndrome who has gained 2 kg since yesterday. C. Client with glomerulonephritis who has cola-colored urine. D. Client postradical nephrectomy whose temperature is 99.8° F (37.6° C).

A. Client who was involved in a motor vehicle collision and has hematuria.

The charge nurse is making client assignments for the day shift. Which client is best to assign to an LPN/LVN? A. Client with polycystic kidney disease who is having a kidney ultrasound. B. Client with glomerulonephritis who is having a kidney biopsy. C. Client who is going for a cystoscopy and cystourethroscopy. D. Client who has just returned from having a kidney artery angioplasty.

A. Client with polycystic kidney disease who is having a kidney ultrasound.

The nurse is caring for a client following a kidney transplant. Which assessment data indicate to the nurse possible rejection of the kidney? (Select all that apply.) Select all that apply. A. Crackles in the lung fields B. Temperature of 98.8° F (37.1° C) C. Blood pressure of 164/98 mm Hg D. Blood urea nitrogen (BUN) 21 mg/dL (7.5 mmol/L), creatinine 0.9 mg/dL (80 mcmol/L) E. 3+ edema of the lower extremities

A. Crackles in the lung fields C. Blood pressure of 164/98 mm Hg E. 3+ edema of the lower extremities

When obtaining a health history and physical assessment from a 68 year-old male client who has a history of an enlarged prostate, which finding does the nurse consider significant?Select all that apply? A. Distended bladder B. Absence of a bruit C. Frequency of urination D. Dribbling urine after voiding E. Chemical exposure in the workplace

A. Distended bladder C. Frequency of urination D. Dribbling urine after voiding

A nurse has a client who has type 2 diabetes mellitus and will have excretory urography. Prior to the procedure, which of the following actions should the nurse take? (Select all that apply.) A. Identify an allergy to seafood. B. Withhold metformin for 24 hr. C. Administer an enema. D. Obtain a serum coagulation profile. E. Assess for asthma.

A. Identify an allergy to seafood. B. Withhold metformin for 24 hr. C. Administer an enema. E. Assess for asthma.

Which client assessment data indicates to the nurse that the client has a potential need for fluids? A. Increased blood urea nitrogen B. Increased creatinine C. Decreased sodium D. Pale-colored urine

A. Increased blood urea nitrogen

An older adult client diagnosed with urge incontinence is prescribed oxybutynin. Which side effects will the nurse tell the client to expect? (Select all that apply.) Select all that apply. A. Increased intraocular pressure B. Dry mouth C. Reddish-orange urine color D. Constipation E .Increased blood pressure

A. Increased intraocular pressure B. Dry mouth D. Constipation

Which assessment findings does the nurse expect in a client with kidney cancer? (Select all that apply.) Select all that apply. A. Increased sedimentation rate B. Hepatic dysfunction C. Erythrocytosis D. Hypercalcemia E. Hypokalemia

A. Increased sedimentation rate B. Hepatic dysfunction C. Erythrocytosis D. Hypercalcemia

A nurse is planning care for a client who will undergo peritoneal dialysis. Which of the following actions should the nurse take? (Select all that apply.) A. Monitor serum glucose levels. B. Report cloudy dialysate return. C. Warm the dialysate in a microwave oven. D. Assess for shortness of breath. E. Check the access site dressing for wetness. F. Maintain medical asepsis when accessing the catheter insertion site.

A. Monitor serum glucose levels. B. Report cloudy dialysate return. D. Assess for shortness of breath. E. Check the access site dressing for wetness.

The nurse is caring for a client with uremia. What assessment data will the nurse anticipate? A. Nausea and vomiting B. Insomnia C. Cyanosis of the skin D. Tenderness at the costovertebral angle (CVA)

A. Nausea and vomiting

A client is scheduled for a cystoscopy later this morning. The consent form is not signed, and the client has not had any preoperative medication. The nurse notes that the health care provider (HCP) visited the client the day before. What action will the nurse take? A. Notifies the department and the HCP. B. Asks the client's spouse to sign the form. C. Cancels the procedure. D. Asks the client to sign the informed consent.

A. Notifies the department and the HCP.

Which assessment finding would require the nurse to take immediate action in a client who is one hourpost kidney biopsy? Select all that apply. A. Pink-tinged urine B. Nausea and vomiting C. Increased bowel sounds D. Reports of flank pain E. The patient is ambulating to the bathroom

A. Pink-tinged urine

A client had a computed tomography (CT) scan with contrast dye 8 hours ago. Which nursing intervention is the priority for this client? A. Promoting fluid intake B. Medicating for pain C. Monitoring for hematuria D. Maintaining bedrest

A. Promoting fluid intake

A nurse is preparing to initiate hemodialysis for a client who has acute kidney injury. Which of the following actions should the nurse take? (Select all that apply.) A. Review the medications the client currently takes. B. Assess the AV fistula for a bruit. C. Calculate the client's hourly urine output. D. Measure the client's weight. E. Check serum electrolytes. F. Use the access site area for venipuncture.

A. Review the medications the client currently takes. B. Assess the AV fistula for a bruit. D. Measure the client's weight. E. Check serum electrolytes.

The nurse is caring for client who has just returned from the operating room for cystoscopy performed under conscious sedation. Which assessment finding requires immediate nursing action? A. Temperature of 100.8° F (38.2° C) B. Lethargy C. Pink-tinged urine D. Urinary frequency

A. Temperature of 100.8° F (38.2° C)

When caring for a client who receives peritoneal dialysis (PD), which finding does the nurse report to the provider (HCP) immediately? A. Temperature of 101.2° F (38.4° C) B. Sinus bradycardia, rate of 58 beats/min C. Pulse oximetry reading of 95% D. Blood pressure of 148/90 mm Hg

A. Temperature of 101.2° F (38.4° C)

3. When providing care to a client who has undergone a nephrostomy for hydronephrosis, which observation alerts the nurse to a possible complication? (Select all that apply.) A. Urine output of 15 mL for the first hour and then diminishes B. Tenderness at the surgical site C. Pink-tinged urine draining from the nephrostomy D. A hematocrit value 3% lower than the preoperative value E. Sudden onset of abdominal pain that worsens after abdominal palpation F. Blood pressure of 180/90 that persists despite administration of pain medication

A. Urine output of 15 mL for the first hour and then diminishes D. A hematocrit value 3% lower than the preoperative value E. Sudden onset of abdominal pain that worsens after abdominal palpation F. Blood pressure of 180/90 that persists despite administration of pain medication

A client is referred to a home health agency after being hospitalized with overflow incontinence and a urinary tract infection. Which nursing action can the home health RN delegate to the home health aide (assistive personnel [AP])? A. Using a bladder scanner to check residual bladder volume after the client voids B. Inserting a straight catheter as necessary if the client is unable to empty the bladder C. Teaching the client how to use the Credé maneuver to empty the bladder more fully D. Assisting the client in developing a schedule for when to take prescribed antibiotics

A. Using a bladder scanner to check residual bladder volume after the client voids

For which client would the nurse expect to teach intermittent catheterization? A.​ 35-year-old woman who has multiple sclerosis and incontinence B.​ 48-year-old man who is admitted for pneumonia and is on complete bedrest C.​ 61-year-old woman who is admitted following a fall at home and has new-onset dysrhythmia D.​ 74-year-old man who has lung cancer with brain metastasis and has advanced dementia.

A.​ 35-year-old woman who has multiple sclerosis and incontinence

A client with diabetes has the following assessment changes after a percutaneous nephrolithotomy procedure. Which change requires immediate nursing intervention? A.​ Difficulty breathing and an oxygen saturation of 88% on 2 L of oxygen by nasal cannula B.​ A point-of-care blood glucose of 150 mg/dL and client report of thirst C.​ A decreased hematocrit by 1% (compared with preoperative values and hematuria) D.​ An oral temperature of 38° C (101° F) and cloudiness of urine draining from the nephrostomy tube after IV administration of a broad-spectrum antibiotic

A.​ Difficulty breathing and an oxygen saturation of 88% on 2 L of oxygen by nasal cannula

Which assessment data would the nurse anticipate in a client with acute pyelonephritis? Select all that apply. A.​Urinary frequency B.​Dysuria C.​Oliguria D.​Heart rate 120 E.​Uremia F.​Costovertebral angle tenderness

A.​Urinary frequency B.​Dysuria D.​Heart rate 120 F.​Costovertebral angle tenderness

A client with a recently created vascular access for hemodialysis is being discharged. Which teaching will the nurse include in the discharge instructions? A. How to practice proper nutrition? B. Avoiding venipuncture and blood pressure measurements in the affected arm C. How to assess for a bruit in the affected arm? D. Modifications to allow for complete rest of the affected arm

B. Avoiding venipuncture and blood pressure measurements in the affected arm

A client is on a 24-hour urine collection. At midpoint during the collection, the client tells the nurse that some of the urine was discarded. What action will the nurse take? Select all that apply. A.​No action is required. B.​Reinforce client education C.​Notify the laboratory staff D.​Restart the urine collection E.​Document the discarded urine F.​Notify the healthcare provider

B.​Reinforce client education C.​Notify the laboratory staff E.​Document the discarded urine F.​Notify the healthcare provider

While managing care for a client with chronic kidney disease, which action does the registered nurse (RN) plan to delegate to assistive personnel (AP)? (Select all that apply.) Select all that apply. A. Explain the components of a low-sodium diet. B. Document the amount the client drinks throughout the shift. C. Auscultate the client's lung sounds every 4 hours. D. Check the arteriovenous (AV) fistula for a thrill and bruit. E. Obtain the client's prehemodialysis weight.

B. Document the amount the client drinks throughout the shift. E. Obtain the client's prehemodialysis weight.

The nurse is teaching a client how to provide a clean-catch urine specimen. Which client statement indicates that teaching was effective? A. "I will have to drink 2 L of fluid before providing the sample." B. "I'll start to urinate in the toilet, stop, and then urinate into the cup." C. "It is best to provide the sample while I am bathing." D. "I must clean with the wipes and then urinate directly into the cup."

B. "I'll start to urinate in the toilet, stop, and then urinate into the cup."

The RN is working with assistive personnel (AP) in caring for a group of clients. Which action is best for the RN to delegate to AP? A. Assessing the vital signs of a client who was just admitted with blunt flank trauma and hematuria B. Assisting a client who had a radical nephrectomy 2 days ago to turn in bed C. Palpating for bladder distention on a client recently admitted with a ureteral stricture D. Helping the primary health care provider with a kidney biopsy for a client admitted with acute glomerulonephritis

B. Assisting a client who had a radical nephrectomy 2 days ago to turn in bed

A client, who is a mother of two, has autosomal dominant polycystic kidney disease (ADPKD). Which client statement indicates to the nurse that the client needs further education? A. "My children have a 50% chance of inheriting the ADPKD gene that causes the disease." B. "By maintaining a low-salt diet in our house, I can prevent ADPKD in my children." C. "Even though my children don't have symptoms at the same age I did, they can still have ADPKD." D. "If my children have the ADPKD gene, they will have cysts by the age of 30."

B. "By maintaining a low-salt diet in our house, I can prevent ADPKD in my children."

The nurse is teaching a client who needs a clean-catch urine specimen. What teaching will the nurse include? A. "Save all urine for 24 hours." B. "Do not touch the inside of the container." C. "Use the sponges to cleanse the urethra, and then initiate voiding directly into the cup." D. "You will receive an isotope injection, then I will collect your urine."

B. "Do not touch the inside of the container."

2. When assessing a client with acute glomerulonephritis, which question will the nurse ask to determine whether the client is following best practices to slow progression of kidney damage? A. "Do you avoid contact sports while you are taking cyclosporine?" B. "How are you evaluating the amount of daily fluid you drink?" C. "Have you contacted anyone from our dialysis support services?" D. "Have you increased your protein intake to promote healing of the damaged nephrons?"

B. "How are you evaluating the amount of daily fluid you drink?"

The school nurse is counseling a teenage student about how to prevent kidney trauma. Which student statement indicates a need for further teaching? A. "I always wear pads when playing football." B. "I can't play contact sports since my brother had kidney cancer." C ."I will avoid riding motorcycles." D. "I always wear a seat belt in the car."

B. "I can't play contact sports since my brother had kidney cancer."

The nurse is preparing a client with stage 3 CKD for discharge. Which client statement indicates the need for further teaching? A. "I will be sure to attend my follow up appointment with my nephrologist." B. "I will increase my protein intake so my body can heal." C. "I will weigh myself daily and call the doctor if my weight increases by 2 pounds or more. D. "I will take my blood pressure each day and keep a daily log."

B. "I will increase my protein intake so my body can heal."

The nurse is teaching the importance of a low purine diet to a client admitted with urolithiasis consisting of uric acid. Which client statement indicates that teaching was effective? A. "I will quit growing rhubarb in my garden since I'm not supposed to eat it anymore." B. "I will no longer be able to have red wine with my dinner." C. "I am so relieved that I can continue eating my fried fish meals every week." D. "My wife will be happy to know that I can keep enjoying her liver and onions recipe."

B. "I will no longer be able to have red wine with my dinner."

The nurse is performing discharge teaching for a client after a nephrectomy for renal cell carcinoma. Which client statement indicates that teaching has been effective? A. "Since renal cell carcinoma usually affects both kidneys, I'll need frequent biopsies." B. "My remaining kidney will provide normal kidney function in a few days or weeks." C. "I need to decrease my fluid intake to prevent stress to my remaining kidney." D. "I'll eventually require some type of renal replacement therapy."

B. "My remaining kidney will provide normal kidney function in a few days or weeks."

The nurse is teaching a client about pelvic muscle exercises. What information does the nurse include? A. "For the best effect, perform all of your exercises while you are seated on the toilet." B. "You are exercising correct muscles if you can stop urine flow in midstream." C. "Limit your exercises to 5 minutes twice a day, or you may injure yourself." D. "Results should be visible to you within 72 hours."

B. "You are exercising correct muscles if you can stop urine flow in midstream."

Which client will the nurse identify at risk for acute kidney injury? Select all that apply. A. 68 year old male with diabetes mellitus. B. 16 year old male football player in preseason practice. C. 27 year old female recovering from shock following a car accident. D. 52 year old male with newly diagnosed hypertension. E. 30 year old female in intensive care receiving multiple intravenous antibiotics

B. 16 year old male football player in preseason practice. C. 27 year old female recovering from shock following a car accident. E. 30 year old female in intensive care receiving multiple intravenous antibiotics

nursing action is appropriate? Select all that apply. A. Assess creatinine clearance using a 24 hour urine collection test. B. Assess for co-existing conditions of diabetes, heart failure, and kidney disease. C. Collaborate with the provider about whether IV fluids should be infused before the test D. Notify the provider regarding changes in serum creatinine from 0.2 to 0.4 mg/dL in 24 hours. E. Alert the provider to a glomerular filtration rate (GFR) < 60 mL/min/1.73 m2

B. Assess for co-existing conditions of diabetes, heart failure, and kidney disease. C. Collaborate with the provider about whether IV fluids should be infused before the test E. Alert the provider to a glomerular filtration rate (GFR) < 60 mL/min/1.73 m2

The nurse receives report on a client with hydronephrosis. Which laboratory study does the nurse monitor? A. Lipid levels B. Blood urea nitrogen (BUN) and creatinine C. White blood cell (WBC) count D. Hemoglobin and hematocrit (H&H)

B. Blood urea nitrogen (BUN) and creatinine

When assessing a client with acute glomerulonephritis, which assessment finding causes the nurse to notify the primary health care provider? A. Purulent wound on the leg B. Crackles throughout the lung fields C. Cola-colored urine D. History of diabetes

B. Crackles throughout the lung fields

The nurse is teaching a class about kidney and urinary changes that occur with age. What teaching will the nurse include? (Select all that apply.) Select all that apply. A. Drug clearance is often increased which produces more drug reactions. B. Glomerular filtration rate decreases which increases the risk for fluid overload. C. Urinary sphincters lose tone and weaken with age. D. Blood flow to the kidneys increases promoting nocturia. E. The ability to concentrate urine decreases which creates urgency.

B. Glomerular filtration rate decreases which increases the risk for fluid overload. C. Urinary sphincters lose tone and weaken with age. E. The ability to concentrate urine decreases which creates urgency.

A client with cognitive impairment has urge incontinence. Which method for achieving continence does the nurse include in the client's care plan? A. Kegel exercises B. Habit training C. Credé method D. Bladder training

B. Habit training

A client is receiving immune-suppressive therapy after kidney transplantation. Which measure for infection control is important for the nurse to implement? A. Adherence to therapy B. Handwashing C. Monitoring for low-grade fever D. Strict clean technique

B. Handwashing

A nurse is monitoring a client who had a kidney biopsy for postoperative complications. Which of the following complications should the nurse identify as causing the greatest risk to the client? A. Infection B. Hemorrhage C. Hematuria D. Pain

B. Hemorrhage

1. Which question will the nurse ask the client who has a urinary tract infection to assess the risk for pyelonephritis? A. What drugs do you take for asthma? B. How long have you had diabetes? C. How much fluid do you drink daily? D. Do you take your antihypertensive drugs at night or in the morning?

B. How long have you had diabetes?

The nurse teaches a client who is recovering from acute kidney injury to avoid which type of medication? A. Opioids B. Nonsteroidal anti-inflammatory drugs (NSAIDs) C. Calcium channel blockers D. Angiotensin-converting enzyme (ACE) inhibitors

B. Nonsteroidal anti-inflammatory drugs (NSAIDs)

The nurse is teaching dietary modification to a client with acute kidney injury (AKI). What dietary teaching will the nurse include? (Select all that apply.) Select all that apply. A. Liberal sodium B. Low fat C. Restricted fluids D. Restricted protein E. Low potassium

C. Restricted fluids D. Restricted protein E. Low potassium

The nurse is preparing a client for nephrostomy tube insertion. Which factor must be assessed by the nurse before the procedure? A .Blood urea nitrogen (BUN) and creatinine B. Prothrombin time (PT) and international normalized ratio (INR) C. Intake and output (I&O) D. Hemoglobin and hematocrit (H&H)

B. Prothrombin time (PT) and international normalized ratio (INR)

The nurse is admitting a client undergoing a CT scan with contrast. Which finding does the nurse report as a possible immediate hypersensitivity reaction? Select all that apply. A. Nausea B. Pruritis C. Urticaria D. Laryngeal stridor E. Flushing of the skin

B. Pruritis C. Urticaria D. Laryngeal stridor E. Flushing of the skin

A 62-year-old client was admitted 2 days ago with traumatic injuries and hypovolemic shock. Which lab result is most important for the nurse to report to the health care provider immediately? A. Serum sodium 132 mEq/L (mmol/L) B. Serum potassium 6.9 mEq/L (mmol/L) C. Blood urea nitrogen 24 mg/dL (mmol/L) D. Hematocrit 32% (0.32 volume fraction); hemoglobin 9.2 g/dL (92 g/L)

B. Serum potassium 6.9 mEq/L (mmol/L)

The nurse is caring for a client with acute kidney injury and a temporary subclavian hemodialysis catheter. Which assessment finding requires nursing action? A. Mild discomfort at the insertion site B. Temperature 100.8° F (38.2° °C) C. Anorexia D. 1+ ankle edema

B. Temperature 100.8° F (38.2° °C)

A client diagnosed with urge incontinence is started on tolterodine. What interventions will the nurse suggest to alleviate the side effects of this drug? (Select all that apply.) Select all that apply. A. Limit the intake of dairy products. B. Use hard candy for dry mouth. C. Encourage increased fluids. D. Increase fiber intake. E. Take the drug at bedtime.

B. Use hard candy for dry mouth. C. Encourage increased fluids. D. Increase fiber intake.

When assessing a client with acute pyelonephritis, which finding does the nurse anticipate? (Select all that apply.) Select all that apply. A. Oliguria B. Vomiting C. Dysuria D. Chills E. Suprapubic pain

B. Vomiting C. Dysuria D. Chills

The nurse is reviewing the client's laboratory data prior to a nephrostomy tube insertion. Which data requires the nurse to take action? A.​White blood cells in the urine B.​INR of 2.1 C.​Hematocrit 44% D.​Creatinine 0.8 mg/dL

B. ​INR of 2.1

2. Which client assessment data is essential for the nurse to report to the healthcare provider before a renal scan is performed? A.​Pink-tinged urine B.​Reports pregnancy C.​Reports claustrophobia D.​History of an aneurysm clip

B.​ Reports pregnancy

During discharge teaching for a client with kidney disease, what does the nurse teach the client to do? A. "Eat breakfast and go to bed at the same time every day." B. "Drink 2 L of fluid and urinate at the same time every day." C ."Weigh yourself and take your blood pressure." D. "Check your blood sugar and do a urine dipstick test."

C ."Weigh yourself and take your blood pressure."

The nurse educates a group of women who have had frequent urinary tract infections (UTIs) about how to avoid recurrences. Which client statement shows understanding of the teaching? A. "Trying to get to the bathroom to urinate every 6 hours is important for me." B. "Urinating 1000 mL on a daily basis is a good amount for me." C. "I need to be drinking at least 1.5 to 2.5 L of fluids every day." D. "It is a good idea for me to reduce germs by taking a tub bath daily."

C. "I need to be drinking at least 1.5 to 2.5 L of fluids every day."

A client is hesitant to talk to the nurse about genitourinary dysfunction symptoms. What is the best nursing response? A ."Why are you hesitant?" B. "You need to tell me so we can determine what is wrong." C. "Take your time. What is bothering you the most?" D. "Don't worry, no one else will know."

C. "Take your time. What is bothering you the most?"

The nurse is providing discharge teaching to a client recovering from kidney transplantation. Which client statement indicates understanding? A. "I can stop my medications when my kidney function returns to normal." B. "If my urine output decreases I will increase my fluids." C. "The antirejection medications will be taken for life." D. "I will drink 8 ounces (236 ml) of water with my medications."

C. "The antirejection medications will be taken for life."

Which client does the nurse manager on the medical unit assign to an experienced LPN/LVN? A. A 46 year old scheduled for cystectomy who needs help in selecting a stoma site. B. A 48 year old receiving intravesical chemotherapy for bladder cancer. C. A 55 year old with incontinence who has intermittent catheterization prescribed. D. A 42 year old with painless hematuria who needs an admission assessment.

C. A 55 year old with incontinence who has intermittent catheterization prescribed.

A nurse is caring for a client who develops disequilibrium syndrome after receiving hemodialysis. Which of the following actions should the nurse take? A. Administer an opioid medication. B. Monitor for hypertension. C. Assess level of consciousness. D. Increase the dialysis exchange rate.

C. Assess level of consciousness.

A client with chronic kidney disease reports chest pain. The nurse notes tachycardia and low-grade fever. Which additional assessment is warranted? A. Monitor for decreased peripheral pulses. B. Determine if the client is able to ambulate. C. Auscultate for pericardial friction rub. D. Assess for crackles.

C. Auscultate for pericardial friction rub.

When caring for a client 24 hours after a nephrectomy, the nurse assesses abdominal distention. Which action will the nurse perform next? A. Insert a nasogastric (NG) tube. B. Notify the surgeon. C. Check vital signs. D. Continue to monitor.

C. Check vital signs.

The nurse is preparing to obtain a sterile urine specimen from a client with a Foley catheter. What technique will the nurse use? A. Disconnect the Foley catheter from the drainage tube and collect urine directly from the Foley. B. Use a sterile syringe to withdraw urine from the urine collection bag. C. Clamp the tubing, attach a syringe to the specimen, and withdraw at least 5 mL of urine. D. Remove the existing catheter and obtain a sample during the process of inserting a new Foley.

C. Clamp the tubing, attach a syringe to the specimen, and withdraw at least 5 mL of urine.

The nurse is caring for a client with kidney failure. Which assessment data indicates the need for increased fluids? A. Decreased sodium level B. Pale-colored urine C. Increased blood urea nitrogen (BUN) D. Increased creatinine level

C. Increased blood urea nitrogen (BUN)

The nurse is caring for a client with hemorrhage secondary to kidney trauma. Which element does the nurse anticipate will be used for volume expansion? A. Platelet infusions B. 5% dextrose in water C. Normal saline solution D. Fresh-frozen plasma

C. Normal saline solution

A nurse is reviewing the results of a client's urinalysis. The findings indicate the urine is positive for leukocyte esterase and nitrites. Which of the following actions should the nurse take? A. Repeat the test early the next morning. B. Start a 24‑hr urine collection for creatinine clearance. C. Obtain a clean‑catch urine specimen for culture and sensitivity. D. Insert an indwelling catheter urinary catheter to collect a urine specimen.

C. Obtain a clean‑catch urine specimen for culture and sensitivity.

A client who performs home continuous ambulatory peritoneal dialysis reports that the drainage (effluent) has become cloudy in the past 24 hours. What is the priority nursing action? A. Remove the peritoneal catheter. B. Notify the nephrology health care provider. C. Obtain a sample of effluent for culture and sensitivity. D. Teach the client that effluent should be clear or slightly yellow.

C. Obtain a sample of effluent for culture and sensitivity.

The nurse is performing catheter care. Which nursing action demonstrates proper aseptic technique? A. Sending a urine specimen to the laboratory for testing B. Irrigating the catheter daily C. Positioning the collection bag below the height of the bladder D. Applying Betadine ointment to the perineal area after catheterization

C. Positioning the collection bag below the height of the bladder

The nurse is teaching a class about cancer prevention. Which interventions will the nurse include that can prevent bladder cancer? (Select all that apply.) Select all that apply. A. Using pelvic floor muscle exercises B. Drinking 2½ L of fluid a day C. Stopping the use of tobacco D. Wearing a lead apron when working with chemicals E. Wearing gloves and a mask when working around chemicals and fumes D. Showering after working with or around chemicals

C. Stopping the use of tobacco E. Wearing gloves and a mask when working around chemicals and fumes D. Showering after working with or around chemicals

A 68-year-old male client is seeing the primary care provider for an annual examination. Which assessment finding alerts the nurse to an increased risk for bladder cancer? A.​ A five-pack year history of smoking 45 years ago B.​ Difficulty starting and stopping the urine stream C.​ A 30-year occupation as a long-distance truck driver D.​ A recent colon cancer diagnosis in his 72-year-old brother

C.​ A 30-year occupation as a long-distance truck driver

The nurse is caring for an 80-year-old female client with recurrent cystitis. Which teaching will the nurse include in the plan of care? Select all that apply. A.​ Drink citrus juices daily. B.​ Douche regularly; a minimum of two times weekly. C.​ Encourage fluid intake of 2-3 L of fluid throughout the day. D.​ Instruct her to always wipe the perineum from front to back after each toilet use. E.​ Reinforce that she should complete the entire course of antibiotics as prescribed. F.​ Instruct her to empty her bladder immediately before and after having intercourse.

C.​ Encourage fluid intake of 2-3 L of fluid throughout the day. D.​ Instruct her to always wipe the perineum from front to back after each toilet use. E.​ Reinforce that she should complete the entire course of antibiotics as prescribed.

When a client with diabetes returns to the medical unit after a computed tomography (CT) scan with contrast dye, all of these interventions are prescribed. Which intervention will the nurse implement first? A. Administer captopril. B. Request a breakfast tray for the client. C. Administer lispro (Humalog) insulin, 10 units subcutaneously. D. Infuse 0.45% normal saline at 125 mL/hr.

D. Infuse 0.45% normal saline at 125 mL/hr.

A client with chronic kidney disease asks the nurse about the relationship between the disease and high blood pressure. What is the most appropriate nursing response? A. "The damaged kidneys no longer release a hormone that prevents high blood pressure." B. "The waste products in the blood interfere with mechanisms that control blood pressure." C. "There is a compensatory mechanism that increases blood flow through the kidneys in an effort to get rid of some of the waste products." D. "Because the kidneys cannot get rid of fluid, blood pressure goes up."

D. "Because the kidneys cannot get rid of fluid, blood pressure goes up."

A male client being treated for bladder cancer has a live virus compound instilled into his bladder as a treatment. What instruction does the nurse provide for post procedure home care? A. "Underwear worn during the procedure and for 12 hours afterward should be discarded." B. "Please be sure to stand when you are urinating." C. "After 12 hours, your toilet should be cleaned with a 10% solution of bleach." D. "Do not share your toilet with family members for the next 24 hours."

D. "Do not share your toilet with family members for the next 24 hours."

The nurse is instructing an older adult female client about interventions to decrease the risk for cystitis. Which client statement indicates that the teaching was effective? A. "I need to douche vaginally once a week." B. "I will not drink fluids after 8 p.m. each evening." C. "I need to drink 2½ L of fluid every day." D. "I must avoid drinking carbonated beverages."

D. "I must avoid drinking carbonated beverages."

A client is admitted for extracorporeal shock wave lithotripsy (ESWL). What information obtained on admission is most critical for a nurse to report to the primary health care provider before the ESWL procedure begins? A. "I have been taking cephalexin for an infection." B. "I previously had several ESWL procedures performed." C. "Blood in my urine has decreased, so maybe I don't need this procedure." D. "I take over-the-counter naproxen twice a day for joint pain."

D. "I take over-the-counter naproxen twice a day for joint pain."

The nurse is teaching a client who is scheduled for a neobladder and a Kock pouch. Which client statement indicates a correct understanding of these procedures? A. "I need to wear loose-fitting pants so the urine can flow into my ostomy bag." B. "If I restrict my oral intake of fluids, the adjustment will be easier." C. "I must go to the restroom more often because my urine will be excreted through my anus." D. "I will have to drain my pouch with a catheter."

D. "I will have to drain my pouch with a catheter."

The nurse is teaching a client with a neurogenic bladder to use intermittent self-catheterization for bladder emptying. Which client statement indicates a need for further clarification? A. "Proper handwashing before I start the procedure is very important." B. "My family members can be taught to help me if I need it." C. "A small-lumen catheter will help prevent injury to my urethra." D. "I will use a new, sterile catheter each time I do the procedure."

D. "I will use a new, sterile catheter each time I do the procedure."

Discharge teaching has been provided for a client recovering from kidney transplantation. Which client statement indicates understanding of the teaching? A. "I will drink 8 ounces (236 mL) of water with my medications." B. "I can stop my medications when my kidney function returns to normal." C. "If my urine output is decreased, I should increase my fluids." D. "The antirejection medications will be taken for life."

D. "The antirejection medications will be taken for life."

A nurse is teaching a client who will have an x‑ray of the kidneys, ureters, and bladder. Which of the following statements should the nurse include in the teaching? A. "you will receive contrast dye during the procedure." B. "An enema is necessary before the procedure." C. "you will need to lie in a prone position during the procedure." D. "The procedure determines whether you have a kidney stone."

D. "The procedure determines whether you have a kidney stone."

A client is being treated for kidney failure. Which nursing statement encourages the client to express his or her feelings? A. "All of this is new. What can't you do?" B. "How are you doing this morning?" C. "Are you afraid of dying?" D. "What concerns do you have about your kidney disease?"

D. "What concerns do you have about your kidney disease?"

The nurse receives the change-of-shift report on four clients. Which client does the nurse decide to assess first? A. A 26 year old admitted 2 days ago with urosepsis with an oral temperature of 99.4° F (37.4° C). B. A 32 year old admitted with hematuria and possible bladder cancer who is scheduled for cystoscopy. C. A 40 year old with noninfectious urethritis who is reporting "burning" and has estrogen cream prescribed. D. A 28 year old with urolithiasis who has been receiving morphine sulfate and has not voided for 8 hours.

D. A 28 year old with urolithiasis who has been receiving morphine sulfate and has not voided for 8 hours.

The RN has just received change-of-shift report. Which client will the nurse assess first? A. Client with azotemia whose blood urea nitrogen and creatinine are increasing. B. Client with kidney insufficiency who is scheduled to have an arteriovenous fistula inserted. C. Client receiving peritoneal dialysis who needs help changing the dialysate bag. D. Client with chronic kidney failure who was just admitted with shortness of breath.

D. Client with chronic kidney failure who was just admitted with shortness of breath.

Which client will the nurse encourage to consume 2 to 3 L of fluid each day? A. Client with heart failure B. Client with chronic kidney disease C. Client with complete bowel obstruction D. Client with hyperparathyroidism

D. Client with hyperparathyroidism

A nurse is teaching a client who has chronic kidney disease and is to begin hemodialysis. Which of the following information should the nurse include in the teaching? A. Hemodialysis restores kidney function. B. Hemodialysis replaces hormonal function of the renal system. C. Hemodialysis allows an unrestricted diet. D. Hemodialysis returns a balance to serum electrolytes.

D. Hemodialysis returns a balance to serum electrolytes.

The nurse assesses blood clots in a client's urinary catheter after a cystoscopy. What initial nursing intervention is appropriate? A. Administer heparin intravenously. B. Remove the urinary catheter. C. Irrigate the catheter with sterile saline. D. Notify the health care provider (HCP).

D. Notify the health care provider (HCP).

A client admitted to the medical unit with a history of vomiting and diarrhea and an increased blood urea nitrogen requires 1 L of normal saline infused over 2 hours. Which staff member would be assigned to care for the client? A. LPN/LVN with experience working on the medical unit. B. New graduate RN who just finished a 6-week orientation. C. RN who has floated from pediatrics for this shift. D. RN who usually works on the general surgical unit.

D. RN who usually works on the general surgical unit.

1. Which adverse drug effects will the nurse assess for in a hospitalized client who is prescribed an anticholinergic drug to manage incontinence? (Select all that apply.) a. Insomnia b. Blurred vision c. Constipation d. Dry mouth e. Loss of sphincter control f. Increased sweating g. Worsening mental function

b. Blurred vision c. Constipation d. Dry mouth g. Worsening mental function

2. A 28-year-old female client states, "I don't know why I get cystitis every year, I don't drink much at work so I can avoid using the public toilet." Which teaching by the nurse is most likely to reduce her risk for cystitis? Select all that apply. a. Reinforce her choice to avoid using a public toilet b. Teach her to shower immediately after having sexual intercourse c. Suggest that she drink at least 2-3 L of fluid throughout the day d. Urge her to change her method of birth control from oral contraceptives to a barrier method e. Instruct her to always wipe her perineum from front to back after each toilet use f. Reinforce that she should complete the entire course of antibiotics as prescribed g. Instruct her to empty her bladder immediately before intercourse

c. Suggest that she drink at least 2-3 L of fluid throughout the day e. Instruct her to always wipe her perineum from front to back after each toilet use f. Reinforce that she should complete the entire course of antibiotics as prescribed g. Instruct her to empty her bladder immediately before intercourse

4. For which hospitalized client does the nurse recommend the ongoing use of a urinary catheter? a. A 35-year-old woman who was admitted with a splenic laceration and femur fracture (closed repair completed) following a car crash b. A 48-year-old man who has established paraplegia and is admitted for pneumonia c. A 61-year-old woman who is admitted following a fall at home and has new-onset dysrhythmia d. A 74-year-old man who has lung cancer with brain metastasis and is bring transitioned to hospice

d. A 74-year-old man who has lung cancer with brain metastasis and is bring transitioned to hospice

3. A client is diagnosed with renal colic. What would the nurse do first? a.​Prepare the client for lithotripsy. b.​Encourage oral intake of fluids. c.​Strain the urine and send for urinalysis. d.​Administer opioids as prescribed.

d.​Administer opioids as prescribed.