MDC 3 Rasmussen Module 3 Renal/Urinary/Kidney D/O's

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.

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

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

A client is undergoing diagnostics due to a significant drop in renal output. The physician has scheduled an angiography. What postprocedural assessment will the nurse perform on the client? a.All options are correct. b.Monitor site condition. c.Palpate pedal pulses. d.Monitor hypersensitivity response.

a.All options are correct.

The nurse is teaching a group of older adult women about the signs and symptoms of urinary tract infection (UTI). Which concepts does the nurse explain in the presentation? Select all that apply. a.Dysuria b.Enuresis c.Frequency d.Nocturia e.Urgency f.Polyuria

a.Dysuria c.Frequency d.Nocturia e.Urgency

A 64-year-old man is seeing his urologist for an annual check-up, post prostatectomy. The health care provider is concerned with the symptom he finds because it is considered diagnostic for bladder cancer. Which of the following signs/symptoms is diagnostic for bladder cancer? a.Painless, gross hematuria b.Deep flank and abdominal pain c.Muscle spasm and abdominal rigidity over the flank d.Decreasing kidney function associated with fever and hematuria

a.Painless, gross hematuria

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 28-year-old with urolithiasis who has been receiving morphine sulfate and has not voided for 8 hours c.A 32-year-old admitted with hematuria and possible bladder cancer who is scheduled for cystoscopy d.A 40-year-old with noninfectious urethritis who is reporting "burning" and has estrogen cream prescribed

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

Which nursing diagnosis is appropriate for the client with a new ileal conduit? Select all that apply. a.Urinary retention b.Deficient knowledge: management of urinary diversion c.Disturbed body image d.Risk for impaired skin integrity d.Chronic pain

b.Deficient knowledge: management of urinary diversion c.Disturbed body image d.Risk for impaired skin integrity

A group of students are reviewing the phases of acute renal failure. The students demonstrate understanding of the material when they identify which of the following as occurring during the second phase? a.Diuresis b.Oliguria c.Acute tubular necrosis d.Restored glomerular function

b.Oliguria

The nurse cares for a client with acute kidney injury (AKI). The client is experiencing an increase in the serum concentration of urea and creatinine. The nurse determines the client is experiencing which phase of AKI? a.Initiation b.Oliguria c.Diuresis d.Recovery

b.Oliguria

Which instruction would be included in a teaching plan for a client diagnosed with a urinary tract infection? a.Use tub baths as opposed to showers. b.Drink coffee or tea to increase diuresis. c.Drink liberal amount of fluids. d.Void every 4 to 6 hours.

c.Drink liberal amount of fluids.

The nurse is obtaining a health history from a client describing urinary complications. Which assessment finding is most suggestive of a malignant tumor of the bladder? a.Incontinence b.Dysuria c.Hematuria d.Frequency

c.Hematuria

The nurse is questioning a female client with a urinary tract infection (UTI) about her antibiotic drug regimen. Which statement by the client indicates a need for further instruction? a."I take my medication only when I have symptoms." b."I always wipe front to back." c."I don't use bubble baths and other scented bath products." d."I try to drink 3 liters of fluid a day."

a."I take my medication only when I have symptoms."

Which of the following accounts for the majority of ureteral injuries? a.Crashes, falls, and assaults b.Preexisting conditions c.Knife wounds d.Work injuries

a.Crashes, falls, and assaults

Which value does the nurse recognize as the best clinical measure of renal function? a.Creatinine clearance b.Circulating ADH concentration c.Volume of urine output d.Urine-specific gravity

a.Creatinine clearance

Which type of voiding dysfunction is seen in clients diagnosed with Parkinson disease? a.Incontinence b.Urinary retention c.Urgency d.Incomplete bladder emptying

a.Incontinence

The nurse is conducting a history and assessment related to a client's incontinence. Which element should the nurse include in the assessment before beginning a bladder training program? a.Medication usage b.History of allergies c.Occupational history d.Smoking habits

a.Medication usage

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

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

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)

Which clinical finding should a nurse look for in a client with chronic renal failure? a.Hypotension b.Uremia c.Metabolic alkalosis d.Polycythemia

b.Uremia

When describing the functions of the kidney to a client, which of the following would the nurse include? a.Regulation of white blood cell production b.Synthesis of vitamin K c.Control of water balance d.Secretion of enzymes

c.Control of water balance

A client with chronic renal failure complains of generalized bone pain and tenderness. Which assessment finding would alert the nurse to an increased potential for the development of spontaneous bone fractures? a.Elevated serum creatinine b.Hyperkalemia c.Hyperphosphatemia d.Elevated urea and nitrogen

c.Hyperphosphatemia

Which type of incontinence is the involuntary loss of urine through an intact urethra as a result of coughing? a.Reflex b.Urge c.Stress d.Overflow

c.Stress

A nurse assesses a client shortly after living donor kidney transplant surgery. Which postoperative finding must the nurse report to the physician immediately? a.Serum potassium level of 4.9 mEq/L b.Serum sodium level of 135 mEq/L c.Temperature of 99.2° F (37.3° C) d.Urine output of 20 ml/hour

d.Urine output of 20 ml/hour

The nurse is caring for a patient with dementia in the long-term care facility when the patient has a change in cognitive function. What should the nurse suspect this patient may be experiencing? a.A UTI b.A stroke c.An aneurysm d.Fecal impaction

a.A UTI

Which type of medication may be used to inhibit bladder contraction in a client with incontinence? a.Anticholinergic agent b.Estrogen hormone c.Tricyclic antidepressants d.Over-the-counter decongestant

a.Anticholinergic agent

Sympathomimetics have which of the following effects on the body? a.Relaxation of bladder wall b.Decrease of heart rate c.Constriction of bronchioles d.Constriction of pupils

a.Relaxation of bladder wall

Common tests of renal function include which of the following? Select all that apply. a.Renal concentration test b.Creatinine clearance c.Serum creatinine d.Blood urea nitrogen (BUN) e.Arterial blood gas analysis

a.Renal concentration test b.Creatinine clearance c.Serum creatinine d.Blood urea nitrogen (BUN)

A client comes to the clinic for a follow-up visit. During the interview, the client states, "Sometimes when I have to urinate I can't control it, and do not reach the bathroom in time." The nurse suspects that the client is experiencing which type of incontinence? a.Stress b.Urge c.Overflow d.Functional

b.Urge

A client with chronic renal failure (CRF) is admitted to the urology unit. Which diagnostic test results are consistent with CRF? a.Increased pH with decreased hydrogen ions b.Increased serum levels of potassium, magnesium, and calcium c.Blood urea nitrogen (BUN) 100 mg/dL and serum creatinine 6.5 mg/dL d.Uric acid analysis 3.5 mg/dL and phenolsulfonphthalein (PSP) excretion 75%

c.Blood urea nitrogen (BUN) 100 mg/dL and serum creatinine 6.5 mg/dL

The nurse is caring for a client with a history of sickle cell anemia. The nurse understands that this predisposes the client to which renal or urologic disorder? a.Kidney stone formation b.Proteinuria c.Chronic kidney disease d.Neurogenic bladder

c.Chronic kidney disease

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

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

A cognitively impaired client has urge incontinence. Which method for achieving continence does the nurse include in the client's care plan? a.Bladder training b.Credé method c.Habit training d.Kegel exercises

c.Habit training

The nurse advises the patient with chronic pyelonephritis that he should: a.Limit his fluid intake to 1.5 L/day to minimize bladder fullness, which could cause backward pressure on the kidneys. b.Decrease his sodium intake to prevent fluid retention. c.Increase fluids to 3 to 4 L/24 hours to dilute the urine. d.Decrease his intake of calcium rich foods to prevent kidney stones.

c.Increase fluids to 3 to 4 L/24 hours to dilute the 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)

A nurse who is taking care of a patient with a spinal cord injury documents the frequency of reflex incontinence. The nurse understands that this is most likely due to: a.Compromised ligament and pelvic floor support of the urethra. b.Uninhibited detrusor contractions. c.Loss of motor control of the detrusor muscle. d.A stricture or tumor in the bladder.

c.Loss of motor control of the detrusor muscle.

Retention of which electrolyte is the most life-threatening effect of renal failure? a.Calcium b.Sodium c.Potassium d.Phosphorous

c.Potassium

A 32-year-old female with a urinary tract infection (UTI) reports urinary frequency, urgency, and some discomfort upon urination. Her vital signs are stable except for a temperature of 100°F (37.8°C). Which drug does the primary health care provider prescribe? a.Nitrofurantoin (Macrodantin) after intercourse b.Estrogen (Premarin) c.Trimethoprim/sulfamethoxazole (Bactrim) d.Phenazopyridine (Pyridium) with intercourse

c.Trimethoprim/sulfamethoxazole (Bactrim)

When the bladder contains 400 to 500 mL of urine, this is referred to as a.anuria. b.specific gravity. c.functional capacity. d.renal clearance.

c.functional capacity.

A client presents at the clinic with reports of urinary retention. What question should the nurse ask to obtain additional information about the client's report? a. "Have you had a fever and chills?" b. "How much fluid are you drinking?" c. "Do you get up at night to urinate?" d. "When did you last urinate?"

d. "When did you last urinate?"

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."Blood in my urine has become less noticeable, so maybe I don't need this procedure." b."I have been taking cephalexin (Keflex) for an infection." c."I previously had several ESWL procedures performed." d."I take over-the-counter naproxen (Aleve) twice a day for joint pain."

d."I take over-the-counter naproxen (Aleve) twice a day for joint pain."

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

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

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

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

Behavioral interventions for urinary incontinence can be coordinated by a nurse. A comprehensive program that incorporates timed voiding and urinary urge inhibition is referred to as what? a.Voiding at given intervals b.Prompted voiding c.Interval voiding d.Bladder retraining

d.Bladder retraining

A client has undergone diagnostic testing that involved the insertion of a lighted tube with a telescopic lens. The nurse identifies this test as which of the following? a.Renal angiography b.Intravenous pyelography c.Excretory urogram d.Cystoscopy

d.Cystoscopy

A nurse has been asked to speak to a local women's group about preventing cystitis. Which of the following would the nurse include in the presentation? a.Need to wear underwear made from synthetic material b.Importance of urinating every 4 to 6 hours while awake c.Suggestion to take tub baths instead of showers d.Need to urinate after engaging in sexual intercourse

d.Need to urinate after engaging in sexual intercourse

The nurse is caring for a client with a cystoscopy tube draining urine from the bladder. When reviewing the client's history prior to administering care, which is of most concern? a.Diagnostic studies reporting bladder stones b.Crusted drainage around the cystoscopy tube c.A white blood count of 12,000 cells/mm3 d.New diagnosis of urosepsis

d.New diagnosis of urosepsis

When caring for a client with hemorrhage secondary to kidney trauma, the nurse provides volume expansion. Which element does the nurse anticipate will be used? a.Fresh-frozen plasma b.Platelet infusions c.5% dextrose in water d.Normal saline solution (NSS)

d.Normal saline solution (NSS)

The nurse is reviewing the results of a urinalysis on a client with acute pyelonephritis. Which of the following would the nurse most likely expect to find? a.High specific gravity b.Slightly acidic pH c.Absent proteinuria d.Pyuria

d.Pyuria

A client with chronic kidney disease asks the nurse about the relationship between the disease and high blood pressure. What is the nurse's best response? a."Because the kidneys cannot get rid of fluid, blood pressure goes up." b."The damaged kidneys no longer release a hormone that prevents high blood pressure." c."The waste products in the blood interfere with other mechanisms that control blood pressure." d."This is a compensatory mechanism that increases blood flow through the kidneys in an effort to get rid of some of the waste products."

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

Which of the following occurs late in chronic glomerulonephritis? a.Peripheral neuropathy b.Nosebleed c.Stroke d.Seizure

a.Peripheral neuropathy

A client is undergoing diagnostics due to a significant drop in renal output. The physician has scheduled an angiography. This test will reveal details about: a.renal circulation. b.kidney function. c.kidney structure. d.urine production.

a.renal circulation.

A client who has a history of neurogenic bladder presents with fever, burning, and suprapubic pain. What would the nurse suspect is the problem? a.urinary tract infection b.urinary incontinence c.urinary retention d.urethral strictures

a.urinary tract infection

A patient has stage 3 chronic kidney failure. What would the nurse expect the patient's glomerular filtration rate (GFR) to be? a.A GFR of 90 mL/min/1.73 m2 b.A GFR of 30-59 mL/min/1.73 m2 c.A GFR of 120 mL/min/1.73 m2 d.A GFR of 85 mL/min/1.73 m2

b.A GFR of 30-59 mL/min/1.73 m2

What is the most common presenting objective symptom of a urinary tract infection in older adults, especially in those with dementia? a.Incontinence b.Change in cognitive functioning c.Hematuria d.Back pain

b.Change in cognitive functioning

When assessing a client with acute pyelonephritis, which findings does the nurse anticipate will be present? Select all that apply. a.Suprapubic pain b.Vomiting c.Chills d.Dysuria e.Oliguria

b.Vomiting c.Chills d.Dysuria

The nurse is caring for a patient with severe pain related to ureteral colic. What medication can the nurse administer with a physician's order that will inhibit the synthesis of prostaglandin E, thereby reducing swelling and facilitating passage of the stone? a.Morphine sulfate b.Aspirin c.Ketoralac (Toradol) d.Meperidine (Demerol)

c.Ketoralac (Toradol)

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."If I restrict my oral intake of fluids, the adjustment will be easier." b"I must go to the restroom more often because my urine will be excreted through my anus." c."I need to wear loose-fitting pants so the urine can flow into my ostomy bag." d."I will have to drain my pouch with a catheter."

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

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

An older adult client is being evaluated for suspected pyelonephritis and is ordered kidney, ureter, and bladder (KUB) x-ray. The nurse understands the significance of this order is related to which rationale? a.Shows damage to the kidneys b.If risk for chronic pyelonephritis is likely c.Reveals causative microorganisms d.Detects calculi, cysts, or tumors

d.Detects calculi, cysts, or tumors

What does the nurse teach a client to do to decrease the risk for urinary tract infection (UTI)? a.Limit fluid intake. b.Increase caffeine consumption. c.Limit sugar intake. d.Drink about 3 liters of fluid daily.

d.Drink about 3 liters of fluid daily.

A client comes to the emergency department complaining of severe pain in the right flank, nausea, and vomiting. The physician tentatively diagnoses right ureterolithiasis (renal calculi). When planning this client's care, the nurse should assign the highest priority to which nursing diagnosis? a.Acute pain b.Risk for infection c.Impaired urinary elimination d.Imbalanced nutrition: Less than body requirements

a.Acute pain

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 4 mg IV. b.Begin an infusion of metoclopramide (Reglan) 10 mg IV. c.Obtain a urine specimen for urinalysis. d.Start an infusion of 0.9% normal saline at 100 mL/hr.

a.Administer morphine sulfate 4 mg IV.

The nurse is providing care to a client who has had a renal biopsy. The nurse would need to be alert for signs and symptoms of which of the following? a.Bleeding b.Infection c.Dehydration d.Allergic reaction

a.Bleeding

A patient admitted with electrolyte imbalance has carpopedal spasm, ECG changes, and a positive Chvostek sign. What deficit does the nurse suspect the patient has? a.Calcium b.Magnesium c.Phosphorus d.Sodium

a.Calcium

Diet modifications are part of nutritional therapy for the management of ARF. Select the high-potassium food that should be restricted. a.Citrus fruits b.White rice c.Salad oils d.Butter

a.Citrus fruits

Which of the following is the most common symptom of bladder cancer? a.Painless gross hematuria b.Pelvic pain c.Back pain d.Altered voiding

a.Painless gross hematuria

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

b.30 to 50 mL/hr

A history of infection specifically caused by group A beta-hemolytic streptococci is associated with which disorder? a.Acute renal failure b.Acute glomerulonephritis c.Chronic renal failure d.Nephrotic syndrome

b.Acute glomerulonephritis

The nurse anticipates that a client who develops hypotension and oliguria post nephrectomy may need the addition of which element to the regimen? a.Increase in analgesics b.Addition of a corticosteroid c.Administration of a diuretic d.Course of antibiotic therapy

b.Addition of a corticosteroid

A client diagnosed with urge incontinence is started on tolterodine (Detrol). What interventions does the nurse suggest to alleviate the side effects of this anticholinergic drug? Select all that apply. a.Take the drug at bedtime. b.Encourage increased fluids. c.Increase fiber intake. d.Limit the intake of dairy products. e.Use hard candy for dry mouth.

b.Encourage increased fluids. c.Increase fiber intake. e.Use hard candy for dry mouth.

The nurse recognizes which condition as an integumentary manifestation of chronic renal failure? a.Asterixis b.Gray-bronze skin color c.Tremors d.Seizures

b.Gray-bronze skin color

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

Which factor is an indicator for a diagnosis of hydronephrosis? a.History of nocturia b.History of urinary stones c.Recent weight loss d.Urinary incontinence

b.History of urinary stones

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."After 12 hours, your toilet should be cleaned with a 10% solution of bleach." b."Do not share your toilet with family members for the next 24 hours." c."Please be sure to stand when you are urinating." d."Your underwear worn during the procedure and for the first 12 hours afterward should be bagged and discarded."

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

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."A small-lumen catheter will help prevent injury to my urethra." b."I will use a new, sterile catheter each time I do the procedure." c."My family members can be taught to help me if I need it." d."Proper handwashing before I start the procedure is very important."

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

A client undergoes extracorporeal shock wave lithotripsy. Before discharge, the nurse should provide which instruction? a."Take your temperature every 4 hours." b."Increase your fluid intake to 2 to 3 L per day." c."Apply an antibacterial dressing to the incision daily." d."Be aware that your urine will be cherry-red for 5 to 7 days."

b."Increase your fluid intake to 2 to 3 L per day."

The nurse is caring for a client who is scheduled for the creation of an ileal conduit. Which statement by the client provides evidence that client teaching was effective? a. "I will not need to worry about being incontinent of urine." b."My urine will be eliminated through a stoma." c. "My urine will be eliminated with my feces." d. "A catheter will drain urine directly from my kidney."

b."My urine will be eliminated through a stoma."

The RN is working with unlicensed assistive personnel (UAP) in caring for a group of clients. Which action is best for the RN to delegate to UAP? 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.Helping the primary health care provider with a kidney biopsy for a client admitted with acute glomerulonephritis d.Palpating for bladder distention on a client recently admitted with a ureteral stricture

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

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

The nurse is assisting in the preoperative planning for stoma placement in a client scheduled for urinary diversion surgery. Where should the nurse plan for the stoma to be located? a.Over a bony prominence b.Away from skin folds c.At the belt line d.At the umbilicus

b.Away from skin folds

The nurse is teaching a client how to perform self-catheterization. Which direction should the nurse include? a.Peroxide is recommended for cleaning the urinary catheter. b.Catheterization should occur every 4 to 6 hours and before bedtime. c.The nurse uses nonsterile technique in the hospital setting. d.The catheter is rinsed with sterile normal saline after soaking in a cleaning solution.

b.Catheterization should occur every 4 to 6 hours and before bedtime.

A patient has been diagnosed with a UTI and is prescribed an antibiotic. What first-line fluoroquinolone antibacterial agent for UTIs has been found to be significantly effective? a.Bactrim b.Cipro c.Macrodantin d.Septra

b.Cipro

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

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

b.Crackles throughout the lung fields

After teaching a group of students about the types of urinary incontinence and possible causes, the instructor determines that the students have understood the material when they identify which of the following as a cause of stress incontinence? a.Increased urine production due to metabolic conditions b.Decreased pelvic muscle tone due to multiple pregnancies c.Bladder irritation related to urinary tract infections d.Obstruction due to fecal impaction or enlarged prostate

b.Decreased pelvic muscle tone due to multiple pregnancies

Which clinical manifestation in a client with pyelonephritis indicates that treatment has been effective? a.Decreased urine output b.Decreased white blood cells in urine c.Increased red blood cell count d.Increased urine specific gravity

b.Decreased white blood cells in urine

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 passes out medications while a client prepares for hemodialysis. The client is ordered to receive numerous medications including antihypertensives. What is the best action for the nurse to take? a.Administer the medications as ordered. b.Hold the medications until after dialysis. c.Check with the dialysis nurse about the medications. d.Ask if the client wants to take the medications.

b.Hold the medications until after dialysis.

A client in chronic renal failure becomes confused and complains of abdominal cramping, racing heart rate, and numbness of the extremities. The nurse relates these symptoms to which of the following lab values? a.Elevated urea levels b.Hyperkalemia c.Hypocalcemia d.Elevated white blood cells

b.Hyperkalemia

The nurse is caring for a patient after kidney surgery. What major danger should the nurse closely monitor for? a.Abdominal distention owing to reflex cessation of intestinal peristalsis b.Hypovolemic shock caused by hemorrhage c.Paralytic ileus caused by manipulation of the colon during surgery d.Pneumonia caused by shallow breathing because of severe incisional pain

b.Hypovolemic shock caused by hemorrhage

Which type of incontinence refers to the involuntary loss of urine due to extrinsic medical factors, particularly medications? a.Reflex b.Iatrogenic c.Overflow d.Urge

b.Iatrogenic

What is a characteristic of the intrarenal category of acute kidney injury (AKI)? a.Decreased creatinine b.Increased BUN c.High specific gravity d.Decreased urine sodium

b.Increased BUN

The nurse performs a physical examination on a client diagnosed with acute pyelonephritis to assist in determining which of the following? a.Abnormalities in urine b.Location of discomfort c.Elevated calcium levels d.Structural defects in the kidneys

b.Location of discomfort

Examination of a client's bladder stones reveals that they are primarily composed of uric acid. The nurse would expect to provide the client with which type of diet? a.Low oxalate b.Low purine c.High protein d.High sodium

b.Low purine

A client is scheduled for a renal angiography. Which of the following would be appropriate before the test? a.Monitor the client for signs of electrolyte and water imbalance. b.Monitor the client for an allergy to iodine contrast material. c.Assess the client's mental changes. d.Evaluate the client for periorbital edema.

b.Monitor the client for an allergy to iodine contrast material.

A client is treated for renal calculi and suspected hydronephrosis. Therefore, the nurse should maintain a record of the kidney's function. Which measure can the nurse take to help achieve the objective? a.Note the nail beds and mobility of the fingers b.Monitor the patient's intake and output c.Palpate for a thrill over the vascular access d.Inspect the skin over the fistula or graft for signs of infection

b.Monitor the patient's intake and output

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 following catheterization procedures are used to treat clients with urinary retention. Which procedure would the nurse identify as carrying the greatest risk to the client? a.Suprapubic cystostomy tube b.Permanent drainage with a urethral catheter c.Clean intermittent catheterization d.Credé voiding procedure

b.Permanent drainage with a urethral catheter

Which medication may be ordered to relieve discomfort associated with a UTI? a.Nitrofurantoin b.Phenazopyridine c.Ciprofloxacin d.Levofloxacin

b.Phenazopyridine

The nurse is preparing to assess a client's new stoma. Which finding would the nurse include in the documentation of a healthy stoma? a.Pain b.Pink color c.Black color d.Dry in appearance

b.Pink color

What is a hallmark of the diagnosis of nephrotic syndrome? a.Hyponatremia b.Proteinuria c.Hyperalbuminemia d.Hypokalemia

b.Proteinuria

Which interventions are helpful in preventing bladder cancer? Select all that apply. a.Drinking 2½ liters of fluid a day b.Showering after working with or around chemicals c.Stopping the use of tobacco d.Using pelvic floor muscle exercises e.Wearing a lead apron when working with chemicals f.Wearing gloves and a mask when working around chemicals and fumes

b.Showering after working with or around chemicals c.Stopping the use of tobacco f.Wearing gloves and a mask when working around chemicals and fumes

The nurse is educating a female patient with a UTI on the pharmacologic regimen for treatment. What is important for the nurse to instruct the patient to do? a.Take the antibiotic as well as an antifungal for the yeast infection she will probably have. b.Take the antibiotic for 3 days as prescribed. c.Understand that if the infection reoccurs, the dose will be higher next time. d.Be sure to take the medication with grapefruit juice.

b.Take the antibiotic for 3 days as prescribed.

The nurse is caring for a client who has presented to the walk-in clinic. The client verbalizes pain on urination, feelings of fatigue, and diffuse back pain. When completing a head-to-toe assessment, at which specific location would the nurse assess the client's kidneys for tenderness? a.The upper abdominal quadrants on the left and right side b.The costovertebral angle c.Above the symphysis pubis d.Around the umbilicus

b.The costovertebral angle

The nurse is assisting in the transport of a client with an indwelling catheter to the diagnostic studies unit. Which action made by the nursing assistant would require instruction? a.The nursing assistant keeps the catheter and drainage bag together when moving the client. b.The nursing assistant places the drainage bag on the client's abdomen for transport. c.The nursing assistant places the drainage bag on the lower area of the wheelchair for transport. d.The nursing assistant holds the drainage bag while the client moves to the wheelchair.

b.The nursing assistant places the drainage bag on the client's abdomen for transport.

Which sign or symptom, when assessed in a client with chronic glomerulonephritis (GN), warrants a call to the primary health care provider? a.Mild proteinuria b.Third heart sound (S3) c.Serum potassium of 5.0 mEq/L (5.0 mmol/L) d.Itchy skin

b.Third heart sound (S3)

The nurse in the urology clinic is providing teaching for a female client with cystitis. Which instructions does the nurse include in the teaching plan? Select all that apply. a.Cleanse the perineum from back to front after using the bathroom. b.Try to take in 64 ounces (2 liters) of fluid each day. c.Be sure to complete the full course of antibiotics. d.If urine remains cloudy, call the clinic. e.Expect some flank discomfort until the antibiotic has worked.

b.Try to take in 64 ounces (2 liters) of fluid each day. c.Be sure to complete the full course of antibiotics. d.If urine remains cloudy, call the clinic.

The nurse advises a patient with renal stones to avoid eating shellfish, asparagus, and organ meats. She emphasizes these foods because she knows that his renal stones are composed of which of the following substances? a.Calcium b.Uric acid c.Struvite d.Cystine

b.Uric acid

Which statement describing urinary incontinence in an older adult client is true? a.Urinary incontinence is a normal part of aging. b.Urinary incontinence isn't a disease. c.Urinary incontinence in the elderly population can't be treated. d.Urinary incontinence is a disease.

b.Urinary incontinence isn't a disease.

The nurse recognizes that test results that most likely indicate a urinary tract infection include: a.proteinuria b.WBC 50 c.RBC 3 d.glucose trace

b.WBC 50

A male client has doubts about performing peritoneal dialysis at home. He informs the nurse about his existing upper respiratory infection. Which of the following suggestions can the nurse offer to the client while performing an at-home peritoneal dialysis? a.Perform deep-breathing exercises vigorously. b.Wear a mask when performing exchanges. c.Auscultate the lungs frequently. d.Avoid carrying heavy items.

b.Wear a mask when performing exchanges.

A change that occurs during chronic glomerulonephritis is termed a.hypokalemia. b.anemia. c.metabolic alkalosis. d.hypophosphatemia.

b.anemia.

A client with renal dysfunction of acute onset comes to the emergency department complaining of fatigue, oliguria, and coffee-colored urine. When obtaining the client's history to check for significant findings, the nurse should ask about: a.chronic, excessive acetaminophen use. b.recent streptococcal infection. c.childhood asthma. d.family history of pernicious anemia.

b.recent streptococcal infection.

A client is diagnosed with polycystic kidney disease and requires teaching on the management of the disorder. Which statement made by the client indicates a need for further teaching? a."I inherited this disorder from one of my parents." b. "The cysts can get quite large in size." c. "As long as I have one normal kidney, I should be fine." d. "If renal failure develops, I may need to consider dialysis."

c. "As long as I have one normal kidney, I should be fine."

A female client presents to the health clinic for a routine physical examination. The nurse observes that the client's urine is bright yellow. Which question is most appropriate for the nurse to ask the client? a. "Have you noticed any vaginal bleeding?" b. "Do you take phenytoin daily?" c. "Do you take multiple vitamin preparations?" d. "Have you had a recent urinary tract infection?"

c. "Do you take multiple vitamin preparations?"

A client with chronic renal failure comes to the clinic for a visit. During the visit, he complains of pruritus. Which suggestion by the nurse would be most appropriate? a."Try washing clothes with a strong detergent to ensure that all impurities are gone." b. "When you shower, use really warm water and an antibacterial soap." c. "Keep your showers brief, patting your skin dry after showering." d."Liberally apply alcohol to the areas of your skin where you itch the most."

c. "Keep your showers brief, patting your skin dry after showering."

A client with newly diagnosed renal cancer is questioning why detection was delayed. Which is the best response by the nurse? a. "Squamous cell carcinomas do not present with detectable symptoms." b. "You should have sought treatment earlier." c. "Very few symptoms are associated with renal cancer." d. "Painless gross hematuria is the first symptom in renal cancer."

c. "Very few symptoms are associated with renal cancer."

A client is scheduled for a renal ultrasound. Which of the following would the nurse include when explaining this procedure to the client? a. "An x-ray will be done to view your kidneys, ureters, and bladder." b. "A contrast medium will be used to help see the structures better." c. "You don't need to do any fasting before this noninvasive test." d."You'll have a pressure dressing on your groin after the test."

c. "You don't need to do any fasting before this noninvasive test."

The nurse is instructing an older adult female client about interventions to decrease the risk for cystitis. Which client comment indicates that the teaching was effective? a."I must avoid drinking carbonated beverages." b."I need to douche vaginally once a week." c."I need to drink 2½ liters of fluid every day." d."I will not drink fluids after 8 PM each evening."

c."I need to drink 2½ liters of fluid every day."

A 53-year-old postmenopausal woman reports "leaking urine" when she laughs and is diagnosed with stress incontinence. What does the nurse tell the client about how certain drugs may be able to help with her stress incontinence? a."They can relieve your anxiety associated with incontinence." b."They help your bladder to empty." c."They may be used to improve urethral resistance." d."They decrease your bladder's tone."

c."They may be used to improve urethral resistance."

The nurse is educating a female client about hygiene measures to reduce her risk for urinary tract infection (UTI). What does the nurse instruct the client to do? a."Douche—but only once a month." b."Use only white toilet paper." c."Wipe from front to back." d."Wipe with the softest toilet paper available."

c."Wipe from front to back."

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.

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

c.Blood urea nitrogen (BUN) and creatinine

The nurse working with a client after an ileal conduit notices that the pouching system is leaking small amounts of urine. What is the appropriate nursing intervention? a.Secure or patch it with tape. b.Empty the pouch. c.Change the wafer and pouch. d.Secure or patch it with barrier paste.

c.Change the wafer and pouch.

A 24-year-old patient was admitted to the emergency room after a water skiing accident. The X-rays revealed two fractured vertebrae, T-12 and L1. Based on this information, the nurse would know to perform which of the following actions? a.Keep the patient on bed rest for 72 hours. b.Place a bed board under the mattress to add support. c.Check the patient's urine for hematuria. d.Apply moist heat, every 4 hours for the first 48 hours to aid healing.

c.Check the patient's urine for hematuria.

After teaching a group of students about malignant bladder tumors, the instructor determines that the teaching was successful when the students identify which of the following clients as having the greatest risk for developing a malignant bladder tumor? a.Client with a history of untreated gonorrhea b.Client with a history of bladder inflammation c.Client with a history of cigarette smoking d.Client with a history of a sexually transmitted disease

c.Client with a history of cigarette smoking

A patient comes to the clinic suspecting a possible UTI. What symptoms of a UTI would the nurse recognize from the assessment data gathered? a.Rebound tenderness at McBurney's point b.An output of 200mL with each voiding c.Cloudy urine d.Urine with a specific gravity of 1.005-1.022

c.Cloudy urine

The nurse is caring for an older client whose chart reveals that the client has a reversible cause of urinary incontinence. The nurse creates a plan of care for which condition? a.Asthma b.Bladder cancer c.Constipation d.Decreased progesterone levels

c.Constipation

A nurse who works in a clinic sees many patients with a variety of medical conditions. The nurse understands that a risk factor for UTIs is which of the following? a.Hyperuricemia b.Pancreatitis c.Diabetes mellitus d.Hyperparathyroidism

c.Diabetes mellitus

A nurse identifies a nursing diagnosis of risk for ineffective breathing pattern related to incisional pain and restricted positioning for a client who has had a nephrectomy. Which of the following would be most appropriate for the nurse to include in the client's plan of care? a.Administer isotonic fluid therapy as ordered. b.Keep the drainage catheter below the level of insertion. c.Encourage use of incentive spirometer every 2 hours. d.Monitor temperature every 4 hours.

c.Encourage use of incentive spirometer every 2 hours.

A client has end-stage renal failure. Which of the following should the nurse include when teaching the client about nutrition to limit the effects of azotemia? a.Increase fat intake and limit carbohydrates. b.Eliminate fat intake and increase protein intake. c.Increase carbohydrates and limit protein intake. d.Increase protein, carbohydrates, and fat intake.

c.Increase carbohydrates and limit protein intake.

A nurse is reviewing the laboratory test results of a client with renal disease. Which of the following would the nurse expect to find? a.Decreased blood urea nitrogen (BUN) b.Increased serum albumin c.Increased serum creatinine d.Decreased potassium

c.Increased serum creatinine

A client reports urinary frequency, urgency, and dysuria. Which of the following would the nurse most likely suspect? a.Obstruction of the lower urinary tract b.Acute renal failure c.Infection d.Nephrotic syndrome

c.Infection

A client comes to the emergency department complaining of a sudden onset of sharp, severe flank pain. During the physical examination, the client indicates that the pain, which comes in waves, travels to the suprapubic region. He states, "I can even feel the pain at the tip of my penis." Which of the following would the nurse suspect? a.Acute glomerulonephritis b.Ureteral stricture c.Urinary calculi d.Renal cell carcinoma

c.Urinary calculi

A nurse is providing postprocedure care for a client who underwent percutaneous lithotripsy. In this procedure, an ultrasonic probe inserted through a nephrostomy tube into the renal pelvis generates ultra-high-frequency sound waves to shatter renal calculi. The nurse should instruct the client to: a.limit oral fluid intake for 1 to 2 weeks. b.report the presence of fine, sandlike particles through the nephrostomy tube. c.notify the physician about cloudy or foul-smelling urine. d.report bright pink urine within 24 hours after the procedure.

c.notify the physician about cloudy or foul-smelling urine.

A client with urinary retention needs to undergo a procedure to insert an indwelling catheter. Before catheterization, the nurse would discuss with the physician information about a.insertion of a nasogastric tube. b.placement of IV and central venous pressure lines. c.the type and size of the catheter to be used. d.administering cleansing enemas.

c.the type and size of the catheter to be used.

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

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

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 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."Limit your exercises to 5 minutes twice a day, or you will injure yourself." c."Results should be visible to you within 72 hours." d."You know that you are exercising correct muscles if you can stop urine flow in midstream."

d."You know that you are exercising correct muscles if you can stop urine flow in midstream."

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

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

The nurse is reviewing the potassium level of a patient with kidney disease. The results of the test are 6.5 mEq/L, and the nurse observes peaked T waves on the ECG. What priority intervention does the nurse anticipate the physician will order to reduce the potassium level? a.Administration of an insulin drip b.Administration of a loop diuretic c.Administration of sodium bicarbonate d.Administration of sodium polystyrene sulfonate [Kayexalate])

d.Administration of sodium polystyrene sulfonate [Kayexalate])

A client with a history of chronic renal failure receives hemodialysis treatments three times per week through an arteriovenous (AV) fistula in the left arm. Which intervention should the nurse include in the care plan? a.Keep the AV fistula site dry. b.Keep the AV fistula wrapped in gauze. c.Take the client's blood pressure in the left arm. d.Assess the AV fistula for a bruit and thrill.

d.Assess the AV fistula for a bruit and thrill.

A client is frustrated and embarrassed by urinary incontinence. Which measure should the nurse include in a bladder retraining program? a.Establishing a predetermined fluid intake pattern for the client b.Encouraging the client to increase the time between voidings c.Restricting fluid intake to reduce the need to void d.Assessing present voiding patterns

d.Assessing present voiding patterns

A female client who suffers from urethral strictures undergoes a dilation procedure and experiences a burning sensation while voiding. Which nursing instruction would be most helpful? a.Encourage a visit to a local ostomy support group. b.Advise cleansing of the perineum frequently. c.Urge the application of moisture sealants. d.Instruct the use of warm sitz baths.

d.Instruct the use of warm sitz baths.

Which staff member does the charge nurse assign to a client who has benign prostatic hyperplasia (BPH) and hydronephrosis and needs an indwelling catheter inserted? a.RN float nurse who has 10 years of experience with pediatric clients b.LPN/LVN who has worked in the hospital's kidney dialysis unit until recently c.RN without recent experience who has just completed an RN refresher course d.LPN/LVN with 5 years of experience in an outclient urology surgery center

d.LPN/LVN with 5 years of experience in an outclient urology surgery center

If an indwelling catheter is necessary, which nursing intervention should be implemented to prevent infection? a.Use a clean technique during insertion b.Use a sterile technique to disconnect the catheter from the tubing to obtain urine specimens c.Place the catheter bag on the client's abdomen when moving the client d.Perform meticulous perineal care daily with soap and water

d.Perform meticulous perineal care daily with soap and water

Which nursing intervention or practice is most effective in helping to prevent urinary tract infection (UTI) in hospitalized clients? a.Encouraging them to drink fluids b.Irrigating all catheters daily with sterile saline c.Recommending that catheters be placed in all clients d.Periodically reevaluating the need for indwelling catheters

d.Periodically reevaluating the need for indwelling catheters

The nurse is caring for a postoperative client who has a Kock pouch. Nursing assessment findings reveal abdominal pain, absence of bowel sounds, fever, tachycardia, and tachypnea. The nurse suspects which of the following? a.Stoma ischemia b.Postoperative pneumonia c.Stoma retraction d.Peritonitis

d.Peritonitis

When preparing a client for nephrostomy tube insertion, it is essential for the nurse to monitor which factor before the procedure? a.Blood urea nitrogen (BUN) and creatinine b.Hemoglobin and hematocrit (H&H) c.Intake and output (I&O) d.Prothrombin time (PT) and international normalized ratio (INR)

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

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.

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."

What information will the nurse provide to a client who is scheduled for extracorporeal shock wave lithotripsy? Select all that apply. a."Your urine will be strained after the procedure." b."Be sure to finish all of your antibiotics." c."Immediately call the primary health care provider if you notice bruising." d."Remember to drink at least 3 liters of fluid a day to promote urine flow." e."You will need to change the incisional dressing once a day."

a."Your urine will be strained after the procedure." b."Be sure to finish all of your antibiotics." d."Remember to drink at least 3 liters of fluid a day to promote urine flow."

Which clients with long-term urinary problems does the nurse refer to community resources and support groups? Select all that apply. a.A 32-year-old with a cystectomy b.A 44-year-old with a Kock pouch c.A 48-year-old with urinary calculi d.A 78-year-old with urinary incontinence e.An 80-year-old with dementia

a.A 32-year-old with a cystectomy b.A 44-year-old with a Kock pouch d.A 78-year-old with urinary incontinence

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

When caring for a client with nephrotic syndrome, which intervention would be included in the plan of care? a.Administering angiotensin-converting enzyme (ACE) inhibitors to decrease protein loss b.Administering heparin to prevent deep vein thrombosis (DVT) c.Providing antibiotics to decrease infection d.Providing transfusion of clotting factors

a.Administering angiotensin-converting enzyme (ACE) inhibitors to decrease protein loss

A 24-hour urine collection is scheduled to begin at 8:00 am. When should the nurse initiate the procedure? a.After discarding the 8:00 am specimen b.At 8:00 am, with or without a specimen c.6 hours after the urine is discarded d.With the first specimen voided after 8:00 am

a.After discarding the 8:00 am specimen

The nurse is employed in a urologist's office. Which classification of medication is anticipated for clients having difficulty with urinary incontinence? a.Anticholinergic b.Diuretics c.Anticonvulsant d.Cholinergic

a.Anticholinergic

The nurse is assessing a patient upon admission to the hospital. What significant nursing assessment data is relevant to renal function? Select all that apply. a.Any voiding disorders b.The patient's occupation c.The presence of hypertension or diabetes d.The patient's financial status e.The ability of the patient to manage activities of daily living

a.Any voiding disorders b.The patient's occupation c.The presence of hypertension or diabetes

An ileal conduit is created for a client after a radical cystectomy. Which of the following would the nurse expect to include in the client's plan of care? a.Application of an ostomy pouch b.Intermittent catheterizations c.Exercises to promote sphincter control d.Irrigating the urinary diversion

a.Application of an ostomy pouch

A patient has undergone a renal biopsy. After the test, while the patient is resting, the patient reports severe pain in the back, arms, and shoulders. Which intervention should be offered by the nurse? a.Assess the patient's back and shoulder areas for signs of internal bleeding. b.Distract the patient's attention from the pain. c.Provide analgesics to the patient. d.Enable the patient to sit up and ambulate.

a.Assess the patient's back and shoulder areas for signs of internal bleeding.

Which of the following is a term used to describe excessive nitrogenous waste in the blood, as seen in acute glomerulonephritis? a.Azotemia b.Proteinuria c.Hematuria d.Bacteremia

a.Azotemia

The nurse is caring for a client who has just returned to the surgical unit after a radical nephrectomy. Which assessment information alarms the nurse? a.Blood pressure is 98/56 mm Hg heart rate is 118 beats/min. b.Urine output over the past hour was 80 mL. c.Pain is at a level 4 (on a 0-to-10 scale). d.Dressing has a 1-cm area of bleeding.

a.Blood pressure is 98/56 mm Hg; heart rate is 118 beats/min.

The presence of prerenal azotemia is a probable indicator for hospitalization for CAP. Which of the following is an initial laboratory result that would alert a nurse to this condition? a.Blood urea nitrogen (BUN)-to-creatinine ratio (BUN:Cr) >20. b.BUN of 18 mg/dL. c.Serum creatinine of 1.2 mg/dL. d.Glomerular filtration rate (GFR) of 100 mL/min.

a.Blood urea nitrogen (BUN)-to-creatinine ratio (BUN:Cr) >20.

When caring for a client 24 hours after a nephrectomy, the nurse notes that the client's abdomen is distended. Which action does the nurse perform next? a.Check vital signs. b.Notify the surgeon. c.Continue to monitor. d.Insert a nasogastric (NG) tube.

a.Check vital signs.

The client asks the nurse about the functions of the kidney. Which should the nurse include when responding to the client? Select all that apply. a.Secretion of prostaglandins b.Vitamin B production c.Regulation of blood pressure d.Vitamin D synthesis e.Secretion of insulin

a.Secretion of prostaglandins c.Regulation of blood pressure d.Vitamin D synthesis

Which condition may predispose a client to chronic pyelonephritis? a.Spinal cord injury b.Cardiomyopathy c.Hepatic failure d.Glomerulonephritis

a.Spinal cord injury

Hyperkalemia is a serious side effect of acute renal failure. Identify the electrocardiogram (ECG) tracing that is diagnostic for hyperkalemia. a.Tall, peaked T waves b.Shortened QRS complex c.Multiple spiked P waves d.Prolonged ST segment

a.Tall, peaked T waves

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)

Which of the following diagnostic tests would the nurse expect to be ordered to determine the details of the arterial supply to the kidneys? a.Radiography b.Angiography c.Computed tomography (CT scan) d.Cystoscopy

b.Angiography

When caring for a client with polycystic kidney disease, which goal is most important? a.Preventing progression of the disease b.Performing genetic testing c.Assessing for related causes d.Consulting with the dialysis unit

a.Preventing progression of the disease

Which term refers to inflammation of the renal pelvis? a.Pyelonephritis b.Cystitis c.Urethritis d.Interstitial nephritis

a.Pyelonephritis

When taking the health history of a client with acute glomerulonephritis (GN), the nurse questions the client about which related cause of the problem? a.Recent respiratory infection b.Hypertension c.Unexplained weight loss d.Neoplastic disease

a.Recent respiratory infection

The client with polycystic kidney disease asks the nurse, "Will my kidneys ever function normally again?" The best response by the nurse is: a. "As the disease progresses, you will most likely require renal replacement therapy." b. "Dietary changes can reverse the damage that has occurred in your kidneys." c. "Draining of the cysts and antibiotic therapy will cure your disease." d. "Genetic testing will determine the best treatment for your condition."

a. "As the disease progresses, you will most likely require renal replacement therapy."

The nurse is providing instructions to the client prior to an intravenous pyelogram. Which statement by the client indicates teaching was effective? a. "I will feel a warm sensation as the dye is injected." b."I should remove all jewelry before the test." c. "I should let the staff know if I feel claustrophobic." d. "I will need to drink all of the dye as quickly as possible."

a. "I will feel a warm sensation as the dye is injected."

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. a."Be certain to wear sunscreen and protective clothing." b."Drink at least 3 liters of fluids every day." c."Take this drug with 8 ounces (236 ml) of water." d."Try to urinate frequently to keep your bladder empty." e."You will need to take all of this drug to get the benefits."

a."Be certain to wear sunscreen and protective clothing." b."Drink at least 3 liters of fluids every day." c."Take this drug with 8 ounces (236 ml) of water." e."You will need to take all of this drug to get the benefits."

A client with end-stage renal disease is scheduled to undergo a kidney transplant using a sibling donated kidney. The client asks if immunosuppressive drugs can be avoided. Which is the best response by the nurse? a."Even a perfect match does not guarantee organ success." b."Immunosuppressive drugs guarantee organ success." c."The doctor may decide to delay the use of immunosuppressant drugs." d."Let's wait until after the surgery to discuss your treatment plan."

a."Even a perfect match does not guarantee organ success."

The nurse is giving discharge instructions to the client following a bladder ultrasound. Which statement by the client indicates the client understands the instructions? a."I can resume my usual activities without restriction." b."I should increase my fluid intake for the rest of the day." c."If I have difficulty urinating, I should contact my physician." d."It is normal for my urine to be blood-tinged."

a."I can resume my usual activities without restriction."

The school nurse is counseling a teenage student about how to prevent kidney trauma. Which statement by the student indicates a need for further teaching? a."I can't play any type of contact sports because my brother had kidney cancer." b."I avoid riding motorcycles." c."I always wear pads when playing football." d."I always wear a seat belt in the car."

a."I can't play any type of contact sports because my brother had kidney cancer."

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

a."I need to be drinking at least 1.5 to 2.5 liters of fluids every day."

The nurse has been asked to provide health information to a female patient diagnosed with a urinary tract infection. What appropriate instructions will the nurse provide? Select all that apply. a.Cleanse around the perineum and urethral meatus after each bowel movement to reduce pathogens. b.Drink caffeinated beverages twice a day to increase urination. c.Drink liberal amounts of fluid to flush out bacteria. d.Void every 2-3 hours to prevent overdistention of the bladder e.Bathe in warm water to soak the affected area.

a.Cleanse around the perineum and urethral meatus after each bowel movement to reduce pathogens. c.Drink liberal amounts of fluid to flush out bacteria. d.Void every 2-3 hours to prevent overdistention of the bladder

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

When caring for the patient with acute glomerulonephritis, which of the following assessment findings should the nurse anticipate? a.Cola-colored urine b.Left upper quadrant pain c.Pyuria d.Low blood pressure

a.Cola-colored urine

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

During the diuresis period of acute kidney injury (AKI), the nurse should observe the client closely for what complication? a.Dehydration b.Hypokalemia c.Oliguria d.Renal calculi

a.Dehydration

An older adult client diagnosed with urge incontinence is prescribed the medication oxybutynin (Ditropan). Which side effects does the nurse tell the client to expect? Select all that apply. a.Dry mouth b.Increased blood pressure c.Constipation d.Increased intraocular pressure e.Reddish-orange urine color

a.Dry mouth c.Constipation d.Increased intraocular pressure

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

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

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.

Which assessment findings does the nurse expect in a client with kidney cancer? Select all that apply. a.Erythrocytosis b.Hypokalemia c.Hypercalcemia d.Hepatic dysfunction e.Increased sedimentation rate

a.Erythrocytosis c.Hypercalcemia d.Hepatic dysfunction e.Increased sedimentation rate

Which of the following is a cause of a calcium renal stone? a.Excessive intake of vitamin D b.Gout c.Neurogenic bladder d.Foreign bodies

a.Excessive intake of vitamin D

Which of the following causes should the nurse suspect in a client diagnosed with intrarenal failure? a.Glomerulonephritis b.Hypovolemia c.Ureteral calculus d.Dysrhythmia

a.Glomerulonephritis

The nurse cares for a client after extensive abdominal surgery. The client develops an infection that is treated with IV gentamicin. After 4 days of treatment, the client develops oliguria, and laboratory results indicate azotemia. The client is diagnosed with acute tubular necrosis and transferred to the ICU. The client is hemodynamically stable. Which dialysis method would be most appropriate for the client? a.Hemodialysis b.Peritoneal dialysis c.Continuous arteriovenous hemofiltration (CAVH) d.Continuous venovenous hemofiltration (CVVH)

a.Hemodialysis

Which metabolic defects are associated with stone formation? a.Hyperparathyroidism b.Hypoparathyroidism c.Hypouricemia d.Hyperthyroidism

a.Hyperparathyroidism

Patients with urolithiasis need to be encouraged to: a.Increase their fluid intake so that they can excrete up to 4 liters every day. b.Participate in strenuous exercises so that the tone of smooth muscle in the urinary tract can be strengthened to help propel calculi. c.Supplement their diet with calcium needed to replace losses to renal calculi. d.Limit their voiding to every 6 to 8 hours so that increased volume can increase hydrostatic pressure, which will help push stones along the urinary system.

a.Increase their fluid intake so that they can excrete up to 4 liters every day.

A client diagnosed with acute kidney injury (AKI) has developed congestive heart failure. The client has received 40 mg of intravenous push (IVP) Lasix and 2 hours later, the nurse notes that there are 50 mL of urine in the Foley catheter bag. The client's vital signs are stable. Which health care order should the nurse anticipate? a.Lasix 80 mg IVP b.Normal saline bolus of 500 mL c.Chest x-ray d.Mannitol 12.5 g IVP

a.Lasix 80 mg IVP

Nursing assessment for the patient receiving peritoneal dialysis would include which of the following to detect the most serious complication of this procedure? a.Palpate the abdominal wall for rebound tenderness. b.Inspect the catheter site for leakage of dialysate. c.Observe for evidence of bleeding. d.Measure fluid drainage to estimate incomplete recovery of fluid.

a.Palpate the abdominal wall for rebound tenderness.

A client has been admitted for an outpatient cystoscopy because of a suspected interstitial cystitis. Which statement best describes the pathology of this disorder? a.The bladder wall contains multiple pinpoint hemorrhagic areas that join and form larger hemorrhagic areas that may progress to fissuring and scarring of the bladder mucosa. b.It is caused by infection with Chlamydia trachomatis. c.It is caused by bacterial infection. The surface of the bladder becomes edematous and reddened, and ulcerations may develop. d.The bladder can contract without warning, fail to accommodate adequate volumes of urine, or fail to empty completely.

a.The bladder wall contains multiple pinpoint hemorrhagic areas that join and form larger hemorrhagic areas that may progress to fissuring and scarring of the bladder mucosa.

Which nursing assessment finding indicates the client has not met expected outcomes? a.The client voids 75 cc four hours post cystoscopy. b.The client reports a pain rating of 3 two hours post-kidney biopsy. c.The client has blood-tinged urine following brush biopsy. d.The client consumes 75% of lunch following an intravenous pyelogram.

a.The client voids 75 cc four hours post cystoscopy.

The nurse is caring for a client with recurrent urinary tract infections. Which of the following body structures would the nurse instruct as the most frequent cause of women's urinary tract infections? a.The urethra b.The bladder c.The rectum d.The ureters

a.The urethra

Which clients with an indwelling urinary catheter does the nurse reassess to determine whether the catheterization needs to be continued or can be discontinued? Select all that apply. a.Three-day postoperative client b.Client in the step-down unit c.Comatose client with careful monitoring of intake and output (I&O) d.Incontinent client with perineal skin breakdown e.Incontinent older adult in long-term care

a.Three-day postoperative client b.Client in the step-down unit e.Incontinent older adult in long-term care

Which is the procedure of choice for men with recurrent or complicated UTIs? a.Transrectal ultrasonography b.IV urogram c.CT d.MRI

a.Transrectal ultrasonography

Which of the following is the procedure of choice for men with recurrent or complicated urinary tract infections (UTIs)? a.Transrectal ultrasonography b.IV urogram c.Computed tomography (CT) scan d.Magnetic resonance imaging (MRI)

a.Transrectal ultrasonography

The most frequent reason for admission to skilled care facilities includes which of the following? a.Urinary incontinence b.Congestive heart failure c.Stroke d.Myocardial infarction

a.Urinary incontinence

Which of the following is a strategy to promote urinary continence? a.Void regularly, 5 to 8 times a day b.Take diuretics after 4 PM c.Use caffeine in moderation d.Implement a low fiber diet

a.Void regularly, 5 to 8 times a day

Which of the following is used to identify vesicoureteral reflux? a.Voiding cystourethrography b.IV urography c.Renal angiography d.Bladder ultrasonography

a.Voiding cystourethrography

The nurse is assigned to care for a patient in the oliguric phase of kidney failure. When does the nurse understand that oliguria is said to be present? a.When the urine output is less than 30 mL/h b.When the urine output is about 100 mL/h c.When the urine output is between 300 and 500 mL/h d.When the urine output is between 500 and 1,000 mL/h

a.When the urine output is less than 30 mL/h

The nurse is administering calcium acetate (PhosLo) to a patient with end-stage renal disease. When is the best time for the nurse to administer this medication? a.With food b.2 hours before meals c.2 hours after meals d.At bedtime with 8 ounces of fluid

a.With food

The nurse is caring for a client who has a type of urinary diversion that requires an external ostomy bag to collect the urine. This client has: a.an incontinent urinary diversion. b.a continent urinary diversion. c.a urethroplasty. d.a cystectomy.

a.an incontinent urinary diversion.

Although the primary function of the urinary system is the transport of urine, the kidneys perform several functions. Which is NOT a function of the kidneys? a.excreting protein b.excreting nitrogen waste products c.regulating blood pressure d.stimulating RBC production

a.excreting protein

A client is experiencing some secretion abnormalities, for which diagnostics are being performed. Which substance is typically reabsorbed and not secreted in urine? a.glucose b.potassium c.creatinine d.chloride

a.glucose

A client who has just undergone an appendectomy reports the need to urinate but is unable to do so. What is the nurse's response to this client's situation as ordered by the physician? a.intermittent catheterization b.indwelling catheterization c.clean intermittent catheterization d.All options are correct.

a.intermittent catheterization

A client has been diagnosed with acute glomerulonephritis. This condition causes: a.proteinuria. b.pyuria. c.polyuria. d.No option is correct.

a.proteinuria.

After teaching a group of students about how to perform peritoneal dialysis, which statement would indicate to the instructor that the students need additional teaching? a. "It is important to use strict aseptic technique." b. "It is appropriate to warm the dialysate in a microwave." c. "The infusion clamp should be open during infusion." d. "The effluent should be allowed to drain by gravity."

b. "It is appropriate to warm the dialysate in a microwave."

An investment banker with chronic renal failure informs the nurse of the choice for continuous cyclic peritoneal dialysis. Which is the best response by the nurse? a. "The risk of peritonitis is greater with this type of dialysis." b. "This type of dialysis will provide more independence." c. "Peritoneal dialysis will require more work for you." d. "Peritoneal dialysis does not work well for every client."

b. "This type of dialysis will provide more independence."

After undergoing retropubic prostatectomy, a client returns to his room. The client is on nothing-by-mouth status and has an IV infusing in his right forearm at a rate of 100 ml/hour. The client also has an indwelling urinary catheter that's draining light pink urine. While assessing the client, the nurse notes that his urine output is red and has dropped to 15 ml and 10 ml for the last 2 consecutive hours. How can the nurse best explain this drop in urine output? a.It's a normal finding caused by blood loss during surgery. b.It's a normal finding associated with the client's nothing-by-mouth status. c.It's an abnormal finding that requires further assessment. d.It's an abnormal finding that will correct itself when the client ambulates.

c.It's an abnormal finding that requires further assessment.

The nurse helps a client to correctly perform peritoneal dialysis at home. The nurse must educate the client about the procedure. Which educational information should the nurse provide to the client? a.Wear a mask while handling any dialysate solutions b.Keep the catheter stabilized to the abdomen, below the belt line c.Keep the dialysis supplies in a clean area, away from children and pets d.Clean the catheter insertion site daily with soap

c.Keep the dialysis supplies in a clean area, away from children and pets

A client undergoes surgery to remove a malignant tumor, followed by a urinary diversion procedure. Which postoperative procedure should the nurse perform? a.Determine the client's ability to manage stoma care b.Show photographs and drawings of the placement of the stoma c.Maintain skin and stoma integrity d.Suggest a visit to a local ostomy group

c.Maintain skin and stoma integrity

The nurse cares for a client with a right-arm arteriovenous fistula (AVF) for hemodialysis treatments. Which nursing action is contraindicated? a.Obtaining blood samples from the left arm b.Palpating the fistula for a "thrill" c.Obtaining a blood pressure reading from the right arm d.Placing the client's watch on the left wrist

c.Obtaining a blood pressure reading from the right arm

A client has developed urinary incontinence after having a urinary catheter in place for a few weeks. What is the initial nursing intervention the nurse should use to start the client with bladder training? a.Immediately after voiding, perform a bladder scan. b.Instruct the client to drink more fluids at night for a full bladder in the morning. c.Place client on a timed voiding schedule. d.Perform straight catheterizations at specific times each day.

c.Place client on a timed voiding schedule.

Which nursing activity illustrates proper aseptic technique during catheter care? a.Applying Betadine ointment to the perineal area after catheterization b.Irrigating the catheter daily c.Positioning the collection bag below the height of the bladder d.Sending a urine specimen to the laboratory for testing

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

A patient with a UTI is having burning and pain when urinating. What urinary analgesic is prescribed for relief of these symptoms? a.Bactrim b.Levaquin c.Pyridium d.Septra

c.Pyridium

A newly admitted client who is diabetic and has pyelonephritis and prescriptions for intravenous antibiotics, blood glucose monitoring every 2 hours, and insulin administration would be cared for by which staff member? a.RN whose other assignments include a client receiving chemotherapy for renal cell carcinoma b.RN who is caring for a client who just returned after having renal artery balloon angioplasty c.RN who has just completed preoperative teaching for a client who is scheduled for nephrectomy d.RN who is currently admitting a client with acute hypertension and possible renal artery stenosis

c.RN who has just completed preoperative teaching for a client who is scheduled for nephrectomy

A woman comes to her health care provider's office with signs and symptoms of kidney stones. Which of the following should be the primary medical management goal? a.Determine the stone type. b.Relieve any obstruction. c.Relieve the pain. d.Prevent nephron destruction.

c.Relieve the pain.

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. a.Liberal sodium b.Low fat c.Restricted fluids d.Restricted protein e.Low potassium

c.Restricted fluids d.Restricted protein e.Low potassium

A client with renal failure is undergoing continuous ambulatory peritoneal dialysis. Which nursing diagnosis is the most appropriate for this client? a.Impaired urinary elimination b.Toileting self-care deficit c.Risk for infection d.Activity intolerance

c.Risk for infection

Following a nephrectomy, which assessment finding is most important in determining nursing care for the client? a.Urine output of 35 to 40 mL/hour b.Pain of 3 out of 10, 1 hour after analgesic administration c.SpO2 at 90% with fine crackles in the lung bases d.Blood tinged drainage in Jackson-Pratt drainage tube

c.SpO2 at 90% with fine crackles in the lung bases

The certified Wound, Ostomy, and Continence Nurse or enterostomal therapist teaches a client who has had a cystectomy about which care principles for the client's postdischarge activities? a.Nutritional and dietary care b.Respiratory care c.Stoma and pouch care d.Wiping from front to back (asepsis)

c.Stoma and pouch care

Which of the following nursing actions is most important in caring for the client following lithotripsy? a.Monitor the continuous bladder irrigation. b.Administer allopurinol (Zyloprim). c.Strain the urine carefully for stone fragments. d.Notify the physician of hematuria.

c.Strain the urine carefully for stone fragments.

Which type of incontinence benefits from pelvic floor muscle (Kegel) exercise? a.Functional b.Overflow c.Stress d.Urge

c.Stress

Which nursing intervention should the nurse caring for the client with pyelonephritis implement? a.Straight catheterize the client every 4 to 6 hours. b.Administer acetaminophen (Tylenol). c.Teach client to increase fluid intake up to 3 liters per day. d.Restrict fluid intake to 1 liter per day.

c.Teach client to increase fluid intake up to 3 liters per day.

When caring for a client who had a nephrostomy tube inserted 4 hours ago, which is essential for the nurse to report to the primary health care provider? a.Dark pink-colored urine b.Small amount of urine leaking around the catheter c.Tube that has stopped draining d.Creatinine of 1.8 mg/dL (160 mcmol/L)

c.Tube that has stopped draining

A nurse receives her client care assignment. Following the report, she should give priority assessment to the client: a.with pinkish mucus discharge in the appliance bag 2 days after an ileal conduit. b.who has a sodium level of 135 mEq/L and a potassium level of 3.7 mEq/L 7 days after a kidney transplant. c.who, following a kidney transplant, has returned from hemodialysis with a sodium level of 110 mEq/L and a potassium level of 2.0 mEq/L. d.who is experiencing mild pain from urolithiasis.

c.who, following a kidney transplant, has returned from hemodialysis with a sodium level of 110 mEq/L and a potassium level of 2.0 mEq/L.

The nurse is performing discharge teaching for a client after a nephrectomy for renal cell carcinoma. Which statement by the client indicates that teaching has been effective? a."Because renal cell carcinoma usually affects both kidneys, I'll need to be watched closely." b."I'll eventually require some type of renal replacement therapy." c."I'll need to decrease my fluid intake to prevent stress to my remaining kidney." d."My remaining kidney will provide me with normal kidney function now."

d."My remaining kidney will provide me with normal kidney function now."

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 client who is 6 months pregnant comes to the prenatal clinic with a suspected urinary tract infection (UTI). What action does 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 liters of fluids, especially water, every day to "flush out" bacteria c.Recommends that the client refrain from having sexual intercourse until after she has delivered her baby 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

Following percutaneous nephrolithotomy, the client is at greatest risk for which nursing diagnosis? a.Risk for altered urinary elimination b.Risk for deficient knowledge: self-catherization c.Risk for fluid volume excess d.Risk for infection

d.Risk for infection

A client is admitted with nausea, vomiting, and diarrhea. His blood pressure on admission is 74/30 mm Hg. The client is oliguric and his blood urea nitrogen (BUN) and creatinine levels are elevated. The physician will most likely write an order for which treatment? a.Encourage oral fluids. b.Administer furosemide (Lasix) 20 mg IV c.Start hemodialysis after a temporary access is obtained. d.Start IV fluids with a normal saline solution bolus followed by a maintenance dose.

d.Start IV fluids with a normal saline solution bolus followed by a maintenance dose.

A client has undergone a renal transplant and returns to the health care agency for a follow-up evaluation. Which finding would lead to the suspicion that the client is experiencing rejection? a.Hypotension b.Weight loss c.Polyuria d.Tenderness over transplant site

d.Tenderness over transplant site

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 admitted with a gunshot wound to the abdomen is transferred to the intensive care unit after an exploratory laparotomy. IV fluid is being infused at 150 mL/hour. Which assessment finding suggests that the client is experiencing acute renal failure (ARF)? a.Blood urea nitrogen (BUN) level of 22 mg/dl b.Serum creatinine level of 1.2 mg/dl c.Temperature of 100.2° F (37.8° C) d.Urine output of 250 ml/24 hours

d.Urine output of 250 ml/24 hours

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 (unlicensed assistive personnel [UAP])? a.Assisting the client in developing a schedule for when to take prescribed antibiotics 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.Using a bladder scanner (with training) to check residual bladder volume after the client voids

d.Using a bladder scanner (with training) to check residual bladder volume after the client voids

The nurse recognizes that which risk factor does NOT predispose a client to the development of kidney stones? a.immobilization b.gout c.hyperparathyroidism d.hypoparathyroidism

d.hypoparathyroidism

The term used to describe total urine output less than 0.5 mL/kg/hour is a.anuria. b.nocturia. c.dysuria. d.oliguria.

d.oliguria.

A client who was previously diagnosed with a urinary tract infection (UTI) and started on antibiotics returns to the clinic 3 days later with the same symptoms. When asked about the previous UTI and medication regimen, the client states, "I only took the first dose because after that, I felt better." How does the nurse respond? a."Not completing your medication can lead to return of your infection." b."That means your treatment will be prolonged with this new infection." c."This means you will now have to take two drugs instead of one." d."What you did was okay, however, let's get you started on something else."

however, let's get you started on something else." ; a."Not completing your medication can lead to return of your infection."