Med- Surge Urinary/Repo

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The nurse is providing dietary teaching to a 40-year-old client who is receiving hemodialysis. The nurse should encourage the client to include what in the client's dietary plan?

1 Rice

After a nephrectomy a client arrives in the post-anesthesia care unit in the supine position. Which action should be employed by the nurse to assess the client for signs of hemorrhage?

1 Turn the client to observe the dressings.

A female client has a history of recurrent urinary tract infections. What should the nurse include in the teaching plan when teaching the client about health practices that may help decrease future urinary tract infections?

1 Wear cotton underpants

An older adult client states, "I walk 2 miles a day for exercise, but now that the weather is hot, I am worried about becoming dehydrated." What should the nurse teach the client?

3 Fluids should be increased if the urine is getting darker.

A nurse is caring for a client with complications associated with peritoneal dialysis. For which signs and symptoms should the nurse monitor the client? (Select all that apply.)

3 Tachycardia 4 Cloudy outflow 5 Abdominal pain

A nurse evaluates that a client understands the side effects of hydrochlorothiazide (HCTZ) therapy when the client states, "I should call my health care provider if I develop:

4 Generalized weakness."

The nurse providing postoperative care for a client who had kidney surgery reviews the client's urinalysis results. The nurse concludes that the presence of what substance in the urine needs to be reported to the health care provider?

4 Large proteins

A nurse is reviewing the laboratory reports of a client with a diagnosis of end-stage renal disease. What test result should the nurse anticipate?

4 Potassium of 6.3 mEq/L

A nurse is caring for a client with glomerulonephritis. What should the nurse instruct the client to do to prevent recurrent attacks?

4 Seek early treatment for respiratory tract infections.

A lithotripsy to break up renal calculi is unsuccessful, and a nephrolithotomy is performed. Which postoperative clinical indicator should the nurse report to the health care provider?

4 Urine output of 20 to 30 mL/hr

A diet that contains restricted amounts of protein, sodium, and potassium has been prescribed for a client with end-stage renal disease who is receiving dialysis. The nurse is providing dietary instructions and evaluates that the teaching is effective when the client says:

1 "I should avoid using salt substitutes."

Which statement regarding treatment with interferon indicates that the client understands the nurse's teaching?

1 "I will drink two to three quarts of fluid a day."

A client with end-stage renal disease is hospitalized. For what signs and symptoms of complications should the nurse monitor the client? (Select all that apply.)

1 Anemia 2 Dyspnea 4 Anasarca

The nurse reviews the medical records of four male clients and concludes that the client that is at highest risk of developing prostate cancer is the:

1 Black 55-year-old

A client with acute renal failure moves into the diuretic phase after one week of therapy. For which signs during this phase should the nurse assess the client? (Select all that apply.)

1 Dehydration 2 Hypovolemia

The most essential nursing intervention for a client with a nephrostomy tube is to:

1 Ensure free drainage of urine

A nurse is caring for a client who had a kidney transplant. What sign indicates that the client may be rejecting the transplanted kidney?

1 Fever

A client with a history of benign prostatic hypertrophy asks whether cranberry juice prevents bladder infections. The nurse replies that cranberry juice may be helpful because it:

1 Increases acidity of the urine

An obese client who is mildly hypertensive is hospitalized with a diagnosis of ureteral colic and hematuria. What is the immediate focus of nursing care for this client?

1 Pain

A nurse is teaching the importance of annual physical examinations to an adult health and wellness class. The nurse reinforces that it is important for men who are middle-aged and older to have what laboratory test annually?

1 Prostate-specific antigen (PSA)

A client has undergone surgery with general anesthesia. Within how many hours after surgery should the nurse notify the health care provider if the client does not void?

2 8 hours

A client is admitted to the hospital from the emergency department with a diagnosis of urolithiasis. The nurse reviews the client's clinical record and performs an admission assessment. What is the priority nursing action?

2 Administer the prescribed morphine.

A client with a history of chronic kidney disease is hospitalized. The nurse assesses the client for signs of related kidney insufficiency, which include:

2 Edema and pruritus

A client with acute kidney failure is to receive peritoneal dialysis and asks why the procedure is necessary. The nurse's best response is, "It:

2 Helps perform some of the work usually done by the kidneys."

A nurse is caring for a client who is being treated with continuous ambulatory peritoneal dialysis (CAPD) for chronic glomerulonephritis. What dietary need should the nurse discuss with the client?

2 High-quality protein

A nurse is assessing a client who is scheduled for a liver biopsy. What assessment finding needs to be reported immediately because it warrants a postponement of the liver biopsy?

2 International normalized ratio (INR) of 4.0

A nurse is caring for a client with chronic kidney failure. Which clinical findings should the nurse expect when assessing this client? (Select all that apply.)

2 Lethargy 4 Muscle twitching

A postmenopausal woman who has cancer of the breast decides to have a lumpectomy followed by chemotherapy. After receiving chemotherapy for several weeks, she says to a nurse at the clinic, "I don't feel well." The nurse reviews the medical record. Based on this information, what does the nurse conclude is the client's priority need?

2 Preventing infection

A nurse is caring for a client with chronic kidney failure. What should the nurse teach the client to limit the intake of to help control uremia associated with end stage renal disease (ESRD)?

2 Protein

A nurse is caring for a client who has a radium implant for cancer of the cervix. What is the priority nursing intervention?

2 Restrict visitors to a 10-minute stay.

A nurse is caring for a client who had a kidney transplant. Which test is most important for determining whether a client's newly transplanted kidney is working effectively?

2 Serum creatinine

A nurse is providing postoperative care to a client who had a kidney transplant. What assessment is the best indicator of the functioning of the newly transplanted kidney?

2 Serum creatinine

A client who has been on hemodialysis for several weeks asks the nurse what substances are being removed by the dialysis. The nurse informs the client that one of the substances passing through the membrane is:

2 Sodium

The nurse determines that which genitourinary factor contributes to urinary incontinence in older adults

2 Urinary tract infection

During the postoperative period after surgery for a kidney transplant, the client's creatinine level is 3.1 mg/dL. What should the nurse do first in response to this laboratory result?

3 Assess for decreased urine output.

Twenty-four hours after a penile implant the client's scrotum is edematous and painful. The nurse should:

3 Elevate the scrotum using a soft support

A nurse teaches the signs of organ rejection to a client who had a kidney transplant. What should be included in the education?

3 Elevated blood pressure

A nurse obtains a health history from a client with the diagnosis of renal calculi. The nurse concludes that the factor that most likely contributed to the calculi development is the client's:

3 Excess ingestion of antacids

A client is receiving furosemide (Lasix) to relieve edema. The nurse should monitor the client for which response to the medication?

3 Excessive loss of potassium ions

A client with uremic syndrome has the potential to develop many complications. Which complication should the nurse anticipate?

3 Flapping hand tremors

A client who is to begin continuous ambulatory peritoneal dialysis (CAPD) asks the nurse what this treatment entails. What information should the nurse include in the explanation?

3 The peritoneal membrane allows passage of toxins into the dialysate.

A client is suspected of having late-stage (tertiary) syphilis. When obtaining a health history, the nurse determines that the client statement that most supports this diagnosis is:

4 "I'm having trouble keeping my balance."

A client with chronic kidney disease is admitted to the hospital with severe infection and anemia. The client is depressed and irritable. The client's spouse asks the nurse about the anticipated plan of care. What is an appropriate nursing response?

4 "The intake of meat, eggs, and cheese will be restricted so the kidneys can clear the body of waste products."

A client with acute kidney failure becomes confused and irritable. Which does the nurse determine is the most likely cause of this behavior?

4 An increased blood urea nitrogen level

To facilitate micturition in a male client, the nurse should instruct him to:

4 Assume the standing position for voiding

A client with the diagnosis of chronic kidney disease develops hypocalcemia. Which clinical manifestations should the nurse expect the client with hypocalcemia to exhibit? (Select all that apply.)

4 Chvostek sign 5 Muscle cramps

Which nursing action can best prevent infection from a urinary retention catheter?

4 Cleansing around the meatus routinely

A client who has been told she needs a hysterectomy for cervical cancer is upset about being unable to have a third child. What is the next nursing action?

4 Ensure that other treatment options for her will be explored.


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