Medsurg Renal
A nurse is instructing a client who is scheduled for a transurethral resection of the prostate (TURP) about his postoperative care. Which of the following information should the nurse include in the teaching? A. "You may have a continuous sensation of needing to void even though you have a catheter." B. "You will be on bed rest for the first 2 days after the procedure." C. "You will be instructed to limit your fluid intake after the procedure." D. "Your urine should be clear yellow the evening after the surgery."
a
A nurse is planning postprocedure care for a client who received hemodialysis. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.) A. Check BUN and serum creatinine. B. Administer medications the nurse withheld prior to dialysis. C. Observe for signs of hypovolemia. D. Assess the access site for bleeding. E. Evaluate blood pressure on the arm with AV access.
abcd
A nurse has a client who has type 2 diabetes mellitus and will have excretory urography. Prior to the procedure, which of the following actions should the nurse take? (Select all that apply.) A. Identify an allergy to seafood. B. Withhold metformin for 24 hr. C. Administer an enema. D. Obtain a serum coagulation profile. E. Assess for asthma.
abce
A nurse is planning care for a client who will undergo peritoneal dialysis. Which of the following actions should the nurse take? (Select all that apply.) A. Monitor serum glucose levels. B. Report cloudy dialysate return. C. Warm the dialysate in a microwave oven. D. Assess for shortness of breath. E. Check the access site dressing for wetness. F. Maintain medical asepsis when accessing the catheter insertion site.
abd
A nurse is caring for several clients. Which of the following clients are at risk for developing pyelonephritis? (Select all that apply.) A. A client who is at 32 weeks of gestation B. A client who has kidney calculi C. A client who has a urine pH of 4.2 D. A client who has a neurogenic bladder E. A client who has diabetes mellitus
abde
A nurse is preparing to initiate hemodialysis for a client who has acute kidney injury. Which of the following actions should the nurse take? (Select all that apply.) A. Review the medications the client currently takes. B. Assess the AV fistula for a bruit. C. Calculate the client's hourly urine output. D. Measure the client's weight. E. Check serum electrolytes. F. Use the access site area for venipuncture.
abde
A nurse is reviewing discharge instructions with a client who had spontaneous passage of a calcium phosphate kidney stone. Which of the following should be included in the teaching? (Select all that apply.) A. Limit intake of food high in animal protein. B. Reduce sodium intake. C. Strain urine for 48 hr. D. Report burning with urination to the provider. E. Increase fluid intake to 3 L/day.
abde
which of these systems specific assessments would indicate the client might have a lower urinary tract infection (cystitis)? SATA a burning and dysuria b costovertebral tenderness c bladder cramping d foul smelling urine e inability to void
acd
A nurse is planning care for a client who has chronic pyelonephritis. Which of the following actions should the nurse take? (Select all that apply) A. Provide a referral for nutrition counseling B. Encourage daily fluid intake of 1 L C. Palpate the costovertebral angle D. Monitor urinary output E. Administer antibiotics
acde
A nurse is preparing educational material to present to a female client who has frequent urinary tract infections. Which of the following information should the nurse include? (Select all that apply.) A. Avoid sitting in a wet bathing suit B. Wipe the perineal area back to front following elimination C. Empty the bladder when there is an urge to void D. Wear synthetic underwear. E. Take a shower daily
ace
A nurse is completing the admission assessment of a client who has a kidney stone. Which of the following is an expected finding? A. Bradycardia B. Diaphoresis C. Nocturia D. Bradypnea
b
A nurse is monitoring a client who had a kidney biopsy for postoperative complications. Which of the following complications should the nurse identify as causing the greatest risk to the client? A. Infection B. Hemorrhage C. Hematuria D. Pain
b
A nurse is providing discharge instructions to a client who is postoperative from a TURP. Which of the following instructions should the nurse include? (Select all that apply.) A. Avoid sexual intercourse for 3 months after the surgery. B. If urine appears bloody, stop activity and rest. C. Avoid drinking caffeinated beverages. D. Take a stool softener once a day. E. Treat pain with ibuprofen (Motrin).
b
A nurse is reviewing urinalysis results for four clients. Which of the following urinalysis results indicates a urinary tract infection? A. Positive for hyaline casts B. Positive for leukocyte esterase C. Positive for ketones D. Positive for crystals
b
which intervention is appropriate to implement for an ambulatory client who is receiving bladder training a bedpan or urinal at regular intervals b regular routine for elimination c increase caffeine intake d increase fluid intake at bedtime
b
which one of these clinical findings indicates the development of a potential complication for a client in a long term care facility with urinary incontinence a 3 incontinent episodes in 24 hours b 2 cm red non blanchable circular area on the thigh c foul strong odor of soaked linens d refuses to accept assistance from UAP
b
A nurse in a provider's office is obtaining a history from a client who is being evaluated for benign prostatic hyperplasia (BPH). Which of the following findings are indicative of this condition? (Select all that apply.) A. Backache B. Frequent urinary tract infections C. Weight loss D. Hematuria E. Urinary incontinence
bde
A nurse is completing discharge instructions with a client who has spontaneously passed a calcium oxalate stone. Which of the following foods should the nurse instruct the client to avoid? (Select all that apply.) A. Red meat B. Black tea C. Cheese D. Whole grains E. Spinach
be
A nurse administered captopril to a client during a renal scan. Which of the following actions should the nurse take? A. Assess for hypertension. B. Limit the client's fluid intake. C. Monitor for orthostatic hypotension. D. Encourage early ambulation
c
A nurse is caring for a client who develops disequilibrium syndrome after receiving hemodialysis. Which of the following actions should the nurse take? A. Administer an opioid medication. B. Monitor for hypertension. C. Assess level of consciousness. D. Increase the dialysis exchange rate.
c
A nurse is caring for a client who has a left renal calculus and an indwelling urinary catheter. Which of the following assessment findings requires immediate intervention by the nurse? A. Flank pain that radiates to the lower abdomen B. Client report of nausea C. Absent urine output for 2 hr D. Client report of feeling sweaty
c
A nurse is reviewing the results of a client's urinalysis. The findings indicate the urine is positive for leukocyte esterase and nitrites. Which of the following actions should the nurse take? A. Repeat the test early the next morning. B. Start a 24‑hr urine collection for creatinine clearance. C. Obtain a clean‑catch urine specimen for culture and sensitivity. D. Insert an indwelling catheter urinary catheter to collect a urine specimen.
c
the appropriate response for a client with calcium oxalate stones who asks why he needs to see the dietician before he goes home, would be a reducing weight and salt intake will dec stones b your stone requires a high calcium diet c diet instructions based on kidney stone analysis may help prevent future stones d you would need to follow high protein diet to prevent renal calculi
c
what would be the priority to report to the HCP for a client with a renal calculus who is receiving 1000 ml of .9% NS IV at 125 ml/hr has a HR that was 76 and is now 98 a client reports feeling sweaty b flank pain that radiates to the lower abdomen c no UO for 4 hours d nausea controlled with meds
c
which of the following statements by a 25 yo female being discharged following a UTI indicates an understanding of how to prevent future UTIs a i should take frequent baths to avoid re infection b i will change all my undergarments to synthetic c i will void before and after sex d i will avoid cranberry juice
c
which one of these clinical assessments for a client who is post TURP would require intervention by the nurse? a UO is light red to red during the first post op day b UO has 2 blood clots during the first post op day c UO is dark red 2nd post op day d UO is pale pink during 3rd post op day
c
which statement would be of most concern stated by the daughter who brought her 88 yo mom to urgent care a complaining of constipation b very hungry lately c has not been herself lately, is never confused d complaining of itching
c
A nurse is caring for a client who has a new diagnosis of benign prostatic hyperplasia (BPH). The nurse should anticipate a prescription for which of the following medications? A. Oxybutynin (Ditropan) B. Diphenhydramine (Benadryl) C. Ipratropium (Atrovent) D. Tamsulosin (Flomax)
d
A nurse is caring for a client who has a urinary tract infection (UTI). Which of the following is the priority intervention by the nurse? A. Offer a warm sitz bath B. Recommend drinking C. Encourage increased fluids D. Administer an antibiotic
d
A nurse is completing teaching for a client who is scheduled for extracorporeal shock wave lithotripsy (ESWL). Which of the following statements made by the client indicates understanding of the teaching? A. "I will be fully awake during the procedure." B. "Lithotripsy will reduce my chances of having stones in the future." C. "I will report any bruising that occurs to my doctor." D. "Straining my urine following the procedure is important."
d
A nurse is teaching a client who has chronic kidney disease and is to begin hemodialysis. Which of the following information should the nurse include in the teaching? A. Hemodialysis restores kidney function. B. Hemodialysis replaces hormonal function of the renal system. C. Hemodialysis allows an unrestricted diet. D. Hemodialysis returns a balance to serum electrolytes.
d
A nurse is teaching a client who will have an x‑ray of the kidneys, ureters, and bladder. Which of the following statements should the nurse include in the teaching? A. "you will receive contrast dye during the procedure." B. "An enema is necessary before the procedure." C. "you will need to lie in a prone position during the procedure." D. "The procedure determines whether you have a kidney stone."
d
priority nursing action for a client with an indwelling catheter whose SSA include oral temp of 102.2, has hot flushed skin, and dark cloudy urine in the collection bag a limit PO fluid intake to 1000 ml per day b document and continue to monitor the client c irrigate the catheter immediately d obtain urine specimen for C&S as ordered
d
which of these actions would be appropriate for the RN delegate to the UAP for a client with urethral stones a encourage bed rest until the stone has passed b remind about fluid restrictions c give milk for a snack d strain and record UO
d
1. The elderly client being seen in the clinic has complaints of urinary frequency, urgency, and "leaking." Which priority intervention should the nurse implement when interviewing the client? 1. Ensure communication is nonjudgmental and respectful. 2. Set the temperature for comfort in the examination room. 3. Speak loudly to ensure the client understands the nurse. 4. Ensure the examining room has adequate lighting.
1
18. The nurse is caring for the client recovering from a percutaneous renal biopsy. Which data indicate the client is complying with client teaching? 1. The client is lying flat in the supine position. 2. The client continues oral fluids restriction while on bedrest. 3. The client uses the bedside commode to urinate. 4. The client refuses to ask for any pain medication.
1
3. Which information indicates to the nurse the client teaching about treatment of urinary incontinence has been effective? 1. The client prepares a scheduled voiding plan. 2. The client verbalizes the need to increase fluid intake. 3. The client explains how to perform pelvic floor exercises. 4. The client attempts to retain the vaginal cone in place the entire day.
1
41. The client is reporting chills, fever, and left costovertebral pain. Which diagnostic test should the nurse expect the HCP to prescribe first? 1. A midstream urine for culture. 2. A sonogram of the kidney. 3. An intravenous pyelogram for renal calculi. 4. A CT scan of the kidneys.
1
44. The nurse is caring for a pregnant client diagnosed with acute pyelonephritis. Which scientific rationale supports the client being hospitalized for this condition? 1. The client must be treated aggressively to prevent maternal/fetal complications. 2. The nurse can force the client to drink fluids and avoid nausea and vomiting. 3. The client will be dehydrated and there won't be sufficient blood flow to the baby. 4. Pregnant clients historically are afraid to take the antibiotics as ordered.
1
52. Which intervention should the nurse include when preparing a teaching plan for the client with chronic prostatitis? 1. Sit in a warm sitz bath for 10 to 20 minutes several times daily. 2. Sit in the chair with the feet elevated for two (2) hours daily. 3. Drink at least 3,000 mL of oral fluids, especially tea and coffee, daily. 4. Stop broad-spectrum antibiotics as soon as the symptoms subside.
1
54. Which statement indicates discharge teaching has been effective for the client who is postoperative TURP? 1. "I will call the surgeon if I experience any difficulty urinating." 2. "I will take my Proscar daily, the same as before my surgery." 3. "I will continue restricting my oral fluid intake." 4. "I will take my pain medication routinely even if I do not hurt."
1
58. The client asks, "What does an elevated PSA test mean?" On which scientific rationale should the nurse base the response? 1. An elevated PSA can result from several different causes. 2. An elevated PSA can be only from prostate cancer. 3. An elevated PSA can be diagnostic for testicular cancer. 4. An elevated PSA is the only test used to diagnose BPH.
1
68. Which statement indicates the client diagnosed with calcium phosphate renal calculi understands the discharge teaching for ways to prevent future calculi formation? 1. "I should increase my fluid intake, especially in warm weather." 2. "I should eat foods containing cocoa and chocolate." 3. "I will walk about a mile every week and not exercise often." 4. "I should take one (1) vitamin a day with extra calcium."
1
93. The elderly client presents to the emergency department complaining of burning on urination with an urgency to void, and a temperature of 99.8°F. Which intervention should the nurse implement first? 1. Ask the client to provide a clean voided midstream urine for culture. 2. Insert an 18-gauge peripheral IV catheter and start normal saline fluids. 3. Arrange for the client to be admitted to the medical unit. 4. Initiate the ordered intravenous antibiotic medication.
1
A patient has urolithiasis and is passing the stones into the lower urinary tract. What is the priority nursing concern for the patient at this time? 1. pain 2. infection 3. injury 4. anxiety
1
A patient with incontinence will be taking oxybutynin chloride 5 mg by mouth three times a day after discharge. Which information would a nurse be sure to teach this patient before discharge? 1. "Drink fluids or use hard candy when you experience a dry mouth." 2. "Be sure to notify your health care provider (HCP) if you experience a dry mouth." 3. "If necessary, your HCP can increase your dose up to 40 mg/day." 4. "You should take this medication with meals to avoid stomach ulcers."
1
After a radical prostatectomy, a client is ready to be discharged. Which nursing action included in the discharge plan should be assigned to an experienced LPN/LVN? 1. Reinforcing the client's need to check his temperature daily 2. Teaching the client how to care for his retention catheter 3. Documenting a discharge assessment in the client's chart 4. Instructing the client about the prescribed narcotic analgesic
1
The RN is supervising a senior nursing student who is caring for a 78-year-old patient scheduled for an intravenous pyelography test. What information would the RN be sure to stress about this procedure to the nursing student? 1. "After the procedure, monitor urine output because contrast dye increases the risk for kidney failure in older adults." 2. "The purpose of this procedure is to measure kidney size." 3. "Because this procedure assesses kidney function, there is no need for a bowel prep." 4. "Keep the patient NPO after the procedure because during the procedure the patient will receive drugs that affect the gag reflex."
1
The charge nurse would assign the nursing care of which patient to an LPN/LVN, working under the supervision of an RN? 1. A 48-year-old patient with cystitis who is taking oral antibiotics 2. A 64-year-old patient with kidney stones who has a new order for lithotripsy 3. A 72-year-old patient with urinary incontinence who needs bladder training 4. A 52-year-old patient with pyelonephritis who has severe acute flank pain
1
The nurse is caring for a patient with risk for kidney disease for whom a urinalysis has been ordered. What time would the nurse instruct the unlicensed assistive personnel is best to collect this sample? 1. With first morning void 2. Before any meal 3. At bedtime 4. Immediately
1
The nurse is evaluating a patient who is receiving trimethoprim-sulfamethoxazole (TMP-SMX) as a treatment for pneumonia. Which information is most important to communicate to the health care provider? 1. The patient reports a blistering rash. 2. The patient's fluid intake is 2 L/day. 3. The patient's potassium is 3.4 mg/dL (3.4 mmol/L). 4. The patient enjoys spending time outside in the sun.
1
65. The client diagnosed with renal calculi is scheduled for a 24-hour urine specimen collection. Which interventions should the nurse implement? Select all that apply. 1. Check for the ordered diet and medication modifications. 2. Instruct the client to urinate, and discard this urine when starting collection. 3. Collect all urine during 24 hours and place in appropriate specimen container. 4. Insert an indwelling catheter in client after having the client empty the bladder. 5. Instruct the UAP to notify the nurse when the client urinates.
123
The nurse is providing care for a patient after a kidney biopsy. Which actions should the nurse delegate to an experienced unlicensed assistive personnel (UAP)? Select all that apply. 1. Check vital signs every 4 hours for 24 hours. 2. Remind the patient about strict bed rest for 2 to 6 hours. 3. Reposition the patient by log-rolling with supporting backroll. 4. Measure and record urine output. 5. Assess the dressing site for bleeding and check complete blood count results. 6. Teach the patient to resume normal activities after 24 hours if there is no bleeding.
1234
91. The nurse identifies the concepts of elimination and immunity for a female client diagnosed with a urinary tract infection. Which discharge instructions should the nurse provide the client? Select all that apply. 1. Teach the client to wipe from front to back after voiding. 2. Encourage the client to drink cranberry juice each morning. 3. Inform the client that frequent episodes of incontinence are expected. 4. Discuss the signs and symptoms of a recurrent infection. 5. Have the client fill a container of water to sip until at least 2,000 mL is consumed. 6. Request that the client sit in a tub of warm water twice a day for 25 minutes.
1245
59. The client returned from surgery after having a TURP and has a P 110, R 24, BP 90/40, and cool and clammy skin. Which interventions should the nurse implement? Select all that apply. 1. Assess the urine in the continuous irrigation drainage bag. 2. Decrease the irrigation fluid in the continuous irrigation catheter. 3. Lower the head of the bed while raising the foot of the bed. 4. Contact the surgeon to give an update on the client's condition. 5. Check the client's postoperative creatinine and BUN.
134
38. The nurse is inserting an indwelling catheter into a female client. Which interventions should be implemented? Rank in the order of performance. 1. Explain the procedure to the client. 2. Set up the sterile field. 3. Inflate the catheter bulb. 4. Place absorbent pads under the client. 5. Clean the perineum from clean to dirty with Betadine.
14235
2. The client is experiencing urinary incontinence. Which intervention should the nurse implement? 1. Teach the client to drink prune juice weekly. 2. Encourage the client to eat a high-fiber diet. 3. Discuss the need to urinate every six (6) hours. 4. Explain the importance of wearing cotton underwear.
2
42. The nurse is caring for a client with chronic pyelonephritis. Which assessment data support the diagnosis of chronic pyelonephritis? 1. The client has fever, chills, flank pain, and dysuria. 2. The client complains of fatigue, headaches, and increased urination. 3. The client had a group B beta-hemolytic strep infection last week. 4. The client has an acute viral pneumonia infection.
2
48. The clinic nurse is caring for a client diagnosed with chronic pyelonephritis who is prescribed trimethoprim-sulfamethoxazole (Bactrim), a sulfa antibiotic, twice a day for 90 days. Which statement is the scientific rationale for prescribing this medication? 1. The antibiotic will treat the bladder spasms that accompany a urinary tract infection. 2. If the urine cannot be made bacteria free, the Bactrim will suppress bacterial growth. 3. In three (3) months, the client should be rid of all bacteria in the urinary tract. 4. The HCP is providing the client with enough medication to treat future infections.
2
50. The nurse observes red urine and several large clots in the tubing of the normal saline continuous irrigation catheter for the client who is one (1) day postoperative TURP. Which intervention should the nurse implement? 1. Remove the indwelling catheter. 2. Titrate the NS irrigation to run faster. 3. Administer protamine sulfate IVP. 4. Administer vitamin K slowly.
2
55. The client is one (1) day postoperative TURP. Which task should the nurse delegate to the UAP? 1. Increase the irrigation fluid to clear clots from the tubing. 2. Elevate the scrotum on a towel roll for support. 3. Change the dressing on the first postoperative day. 4. Teach the client how to care for the continuous irrigation catheter.
2
60. The nurse is caring for a client with a TURP. Which expected outcome indicates the client's condition is improving? 1. The client is using the maximum amount allowed by the PCA pump. 2. The client's bladder spasms are relieved by medication. 3. The client's scrotum is swollen and tender with movement. 4. The client has passed a large, hard, brown stool this morning.
2
62. The client diagnosed with renal calculi is admitted to the medical unit. Which intervention should the nurse implement first? 1. Monitor the client's urinary output. 2. Assess the client's pain and rule out complications. 3. Increase the client's oral fluid intake. 4. Use a safety gait belt when ambulating the client.
2
64. Which clinical manifestations should the nurse expect to assess for the client diagnosed with a ureteral renal stone? 1. Dull, aching flank pain and microscopic hematuria. 2. Nausea; vomiting; pallor; and cool, clammy skin. 3. Gross hematuria and dull suprapubic pain with voiding. 4. The client will be asymptomatic.
2
69. Which intervention is most important for the nurse to implement for the client diagnosed with rule-out renal calculi? 1. Assess the client's neurological status every two (2) hours. 2. Strain all urine and send any sediment to the laboratory. 3. Monitor the client's creatinine and BUN levels. 4. Take a 24
2
9. The nurse is caring for an elderly client who has an indwelling catheter. Which data warrant further investigation? 1. The client's temperature is 98ÅãF. 2. The client has become confused and irritable. 3. The client's urine is clear and light yellow. 4. The client feels the need to urinate.
2
The nurse is admitting a 66-year-old male patient suspected of having a urinary tract infection (UTI). Which part of the patient's medical history supports this diagnosis? 1. Patient's wife had a UTI 1 month ago 2. Followed for prostate disease for 2 years 3. Intermittent catheterization 6 months ago 4. Kidney stone removal 1 year ago
2
The nurse is caring for a client who has just returned to the surgical unit after a transurethral resection of the prostate (TURP). Which assessment finding will require the most immediate action? 1. Blood pressure reading of 153/88 mm Hg 2. Catheter that is draining deep red blood 3. Client not wearing antiembolism hose 4. Client report of abdominal cramping
2
The nurse is reviewing the lab values for a patient with risk for urinary problems. Which finding is of most concern to the nurse? 1. Blood urea nitrogen (BUN) of 10 mg/mL (3.6 mmol/L) 2. Presence of glucose and protein in urine 3. Serum creatinine of 0.6 mg/mL (53 mcmol/L) 4. Urinary pH of 8
2
A client who has just returned to the surgical unit after a transurethral resection of the prostate (TURP) reports acute bladder spasms. In which order will the nurse perform these prescribed actions? 1 Administer acetaminophen/oxycodone 325 mg/5 mg 2 Irrigate the retention catheter with 30 to 50 mL of sterile normal saline. 3 Infuse 500 mL of 5% dextrose in lactated Ringer's solution over 2 hours. 4 Offer the client oral fluids to at least 2500 to 3000 mL/day.
2134
The RN is teaching a patient how to perform intermittent self-catheterization for a long-term problem with incomplete bladder emptying. Which are important points for teaching this technique? Select all that apply. 1. Always use sterile techniques. 2. Proper hand washing and cleaning of the catheter reduce the risk for infection. 3. A small lumen and good lubrication of the catheter prevent urethral trauma. 4. A regular schedule for bladder emptying prevents distention and mucosal trauma. 5. The social work department can help you with the purchase of sterile supplies. 6. If you are uncomfortable with this procedure, a home health nurse can do it.
234
0. The nurse is observing the UAP providing direct care to a client with an indwelling catheter. Which data warrant immediate intervention by the nurse? 1. The UAP secures the tubing to the client's leg with tape. 2. The UAP provides catheter care with the client's bath. 3. The UAP puts the collection bag on the client's bed. 4. The UAP cares for the catheter after washing the hands.
3
4. Which intervention should the nurse implement first for the client who has had an incontinent episode? 1. Palpate the client's bladder to assess for urinary retention. 2. Obtain a bedside commode for the client. 3. Assist the client with changing the wet clothes. 4. Request the UAP to change the client's linens.
3
40. The nurse is examining a 15-year-old female who is complaining of pain, frequency, and urgency when urinating. After asking the parent to leave the room, which question should the nurse ask the client? 1. "When was your last menstrual cycle?" 2. "Have you noticed any change in the color of the urine?" 3. "Are you sexually active?" 4. "What have you taken for the pain?"
3
45. The nurse is discharging a client with a healthcare facility acquired urinary tract infection. Which information should the nurse include in the discharge teaching? 1. Limit fluid intake so the urinary tract can heal. 2. Collect a routine urine specimen for culture. 3. Take all the antibiotics as prescribed. 4. Tell the client to void every five (5) to six (6) hours.
3
46. The nurse is preparing a plan of care for the client diagnosed with acute glomerulonephritis. Which statement is an appropriate long-term goal? 1. The client will have a blood pressure within normal limits. 2. The client will show no protein in the urine. 3. The client will maintain normal renal function. 4. The client will have clear lung sounds.
3
47. The elderly client is diagnosed with chronic glomerulonephritis. Which laboratory value indicates to the nurse the condition has become worse? 1. The blood urea nitrogen is 15 mg/dL. 2. The creatinine level is 1.2 mg/dL. 3. The glomerular filtration rate is 40 mL/min. 4. The 24-hour creatinine clearance is 100 mL/min.
3
57. The client who is postoperative TURP asks the nurse, "When will I know if I will be able to have sex after my TURP?" Which response is most appropriate by the nurse? 1. "You seem anxious about your surgery." 2. "Tell me about your fears of impotency." 3. "Potency can return in six (6) to eight (8) weeks." 4. "Did you ask your doctor about your concern?"
3
61. The laboratory data reveal a calcium phosphate renal stone for a client diagnosed with renal calculi. Which discharge teaching intervention should the nurse implement? 1. Encourage the client to eat a low-purine diet and limit foods such as organ meats. 2. Explain the importance of not drinking water two (2) hours before bedtime. 3. Discuss the importance of limiting vitamin D-enriched foods. 4. Prepare the client for extracorporeal shock wave lithotripsy (ESWL).
3
67. The client diagnosed with renal calculi is scheduled for lithotripsy. Which postprocedure nursing task is the most appropriate to delegate to the UAP? 1. Monitor the amount, color, and consistency of urine output. 2. Teach the client about care of the indwelling Foley catheter. 3. Assist the client to the car when being discharged home. 4. Take the client's postprocedural vital signs.
3
7. Which nursing intervention is most important before attempting to catheterize a client? 1. Determine the client's history of catheter use. 2. Evaluate the level of anxiety of the client. 3. Verify the client is not allergic to latex. 4. Assess the client's sensation level and ability to void.
3
70. The client with a history of renal calculi calls the clinic and reports having burning on urination, chills, and an elevated temperature. Which instruction should the nurse discuss with the client? 1. Increase water intake for the next 24 hours. 2. Take two (2) Tylenol to help decrease the temperature. 3. Come to the clinic and provide a urinalysis specimen. 4. Use a sterile 4 Å~ 4 gauze to strain the client's urine.
3
72. The client is diagnosed with a uric acid stone. Which foods should the client eliminate from the diet to help prevent reoccurrence? 1. Beer and colas. 2. Asparagus and cabbage. 3. Venison and sardines. 4. Cheese and eggs.
3
A client has had a needle biopsy of the prostate gland using the transrectal approach. Which statement is most important to include in the client teaching plan? 1. "The health care provider (HCP) will call you about the test results." 2. "Serious infections may occur as a complication of this test." 3. "You will need to call the HCP if you develop a fever or chills." 4. "It is normal to have a small amount of rectal bleeding after the test."
3
The RN is supervising a new graduate nurse who is orientating to the unit. The new nurse asks why the patient with uncomplicated cystitis is being discharged with a prescription for ciprofloxacin 250 mg twice a day for only 3 days. What is the RN's best response? 1. "We should check with the health care provider because the patient should take this drug for 10 to 14 days." 2. "A 3-day course of ciprofloxacin is not the appropriate treatment for a patient with uncomplicated cystitis." 3. "Research has shown that a 3-day course of ciprofloxacin is effective for uncomplicated cystitis and there is increased patient adherence to the plan of care." 4. "Longer courses of antibiotic therapy are required for hospitalized patients to prevent nosocomial infections."
3
The RN is supervising a nurse orientating to the acute care unit who is discharging a patient admitted with kidney stones and who underwent lithotripsy. Which statement by the orienting nurse to the patient requires that the supervising RN intervene? 1. "You should finish all of your antibiotics to make sure that you don't get a urinary tract infection (UTI)." 2. "Remember to drink at least 3 L of fluids every day to prevent another stone from forming." 3. "Report any signs of bruising to your health care provider (HCP) immediately because this indicates bleeding." 4. "You can return to work in 2 days to 6 weeks, depending on what your HCP prescribes."
3
The nurse is assessing a long-term-care client with a history of benign prostatic hyperplasia. Which information will require the most immediate action? 1. The client states that he always has trouble starting his urinary stream. 2. The chart shows an elevated level of prostate-specific antigen. 3. The bladder is palpable above the symphysis pubis, and the client is restless. 4. The client says he has not voided since having a glass of juice 4 hours ago.
3
The nurse is caring for a patient with chronic kidney disease after hemodialysis. Which patient care action should the nurse delegate to the experienced unlicensed assistive personnel (UAP)? 1. Assess the patient's access site for a thrill and bruit. 2. Monitor for signs and symptoms of postdialysis bleeding. 3. Check the patient's postdialysis blood pressure and weight. 4. Instruct the patient to report signs of dialysis disequilibrium syndrome immediately.
3
The nurse is caring for a patient with risk for incomplete bladder emptying. Which noninvasive finding best supports this problem? 1. Patient is able to void additional 100 mL after nurse massages over the bladder. 2. Patient voids additional 350 mL with insertion of an intermittent catheter. 3. Patient has postvoid residual of 275 mL documented by bedside bladder scanner. 4. Patient has constant dribbling between voidings.
3
The nurse is creating a care plan for older adult patients with incontinence. For which patient will a bladder-training program be an appropriate intervention? 1. Patient with functional incontinence caused by mental status changes 2. Patient with stress incontinence due to weakened bladder neck support 3. Patient with urge incontinence and abnormal detrusor muscle contractions 4. Patient with transient incontinence related to loss of cognitive function
3
Which laboratory result is of most concern to the nurse for an adult patient with cystitis? 1. Serum white blood cell (WBC) count of 9000/mm3 (9 x 109/L) 2. Urinalysis results showing 1 or 2 WBCs present 3. Urine bacteria count of 100,000 colonies per milliliter 4. Serum hematocrit of 36%
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37. The client from a long-term care facility is admitted to the medical unit with a fever, hot flushed skin, and clumps of white sediment in the indwelling catheter. Which intervention should the nurse implement first? 1. Start an IV with a 20-gauge catheter. 2. Initiate antibiotic therapy IVPB. 3. Collect a urine specimen for culture. 4. Change the indwelling catheter.
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43. The female client in an outpatient clinic is being sent home with a diagnosis of urinary tract infection (UTI). Which instruction should the nurse teach to prevent a recurrence of a UTI? 1. Clean the perineum from back to front after a bowel movement. 2. Take warm tub baths instead of hot showers daily. 3. Void immediately preceding sexual intercourse. 4. Avoid coffee, tea, colas, and alcoholic beverages.
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5. The elderly client recovering from a prostatectomy has been experiencing stress incontinence. Which independent nursing intervention should the nurse discuss with the client? 1. Establish a set voiding frequency of every two (2) hours while awake. 2. Encourage a family member to assist the client to the bathroom to void. 3. Apply a transurethral electrical stimulator to relieve symptoms of urinary urgency. 4. Discuss the use of a "bladder drill," including a timed voiding schedule.
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51. Which data support to the nurse the client's diagnosis of acute bacterial prostatitis? 1. Terminal dribbling. 2. Urinary frequency. 3. Stress incontinence. 4. Sudden fever and chills.
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53. Which nursing diagnosis is priority for the client who has undergone a TURP? 1. Potential for sexual dysfunction. 2. Potential for an altered body image. 3. Potential for chronic infection. 4. Potential for hemorrhage.
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56. The client with a TURP who has a continuous irrigation catheter complains of the need to urinate. Which intervention should the nurse implement first? 1. Call the surgeon to inform the HCP of the client's complaint. 2. Administer the client a narcotic medication for pain. 3. Explain to the client this sensation happens frequently. 4. Assess the continuous irrigation catheter for patency.
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63. The client with possible renal calculi is scheduled for a renal ultrasound. Which intervention should the nurse implement for this procedure? 1. Ask if the client is allergic to shellfish or iodine. 2. Keep the client NPO eight (8) hours prior to the ultrasound. 3. Ensure the client has a signed informed consent form. 4. Explain the test is noninvasive and there is no discomfort.
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66. The client is diagnosed with an acute episode of ureteral calculi. Which client problem is priority when caring for this client? 1. Fluid volume loss. 2. Knowledge deficit. 3. Impaired urinary elimination. 4. Alteration in comfort.
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71. The client had surgery to remove a kidney stone. Which laboratory assessment data warrant immediate intervention by the nurse? 1. A serum potassium level of 3.8 mEq/L. 2. A urinalysis shows microscopic hematuria. 3. A creatinine level of 0.8 mg/100 mL. 4. A white blood cell count of 14,000/mm3.
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94. The client diagnosed with a urinary tract infection has a blood pressure of 83/56 mm Hg and a pulse of 122 bpm. Which should the nurse implement first? 1. Notify the health-care provider (HCP). 2. Hang the IVPB antibiotic at the prescribed rate. 3. Check the laboratory work to determine if the urine culture has been completed. 4. Increase the normal saline IV fluids from keep open to 150 mL/hour on the IV pump.
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A 28-year-old married female patient with cystitis requires instruction about how to prevent future urinary tract infections (UTIs). The supervising RN has assigned this teaching to a newly graduated nurse. Which statement by the new graduate requires that the supervising RN intervene? 1. "You should always drink 2 to 3 L of fluid every day." 2. "Empty your bladder regularly even if you do not feel the urge to urinate." 3. "Drinking cranberry juice daily will decrease the number of bacteria in your bladder." 4. "It's okay to soak in the tub with bubble bath because it will keep you clean."
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A client with benign prostatic hyperplasia has a new prescription for tamsulosin. Which statement about tamsulosin is most important to include when teaching this client? 1. "This medication will improve your symptoms by shrinking the prostate." 2. "The force of your urinary stream will probably increase." 3. "Your blood pressure might decrease as a result of taking this medication." 4. "You should avoid sitting up or standing up too quickly."
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A patient is being admitted to rule out interstitial cystitis. What should the nurse's plan of care for this patient include specific to this diagnosis? 1. Take daily urine samples for urinalysis. 2. Maintain accurate intake and output records. 3. Obtain an admission urine sample to determine electrolyte levels. 4. Teach the patient about the cystoscopy procedure.
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The day after a radical prostatectomy, a client has blood clots in the urinary catheter and reports bladder spasms. The client says that his right calf is sore and that he feels short of breath. Which action will the nurse take first? 1. Irrigate the catheter with 50 mL of sterile saline. 2. Administer oxybutynin 5 mg orally. 3. Apply warm packs to the right calf. 4. Measure oxygen saturation using pulse oximetry.
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The nurse has delegated collection of a urinalysis specimen to an experienced unlicensed assistive personnel (UAP). For which action must the nurse intervene? 1. The UAP provides the patient with a specimen cup. 2. The UAP reminds the patient of the need for the specimen. 3. The UAP assists the patient to the bathroom. 4. The UAP allows the specimen to sit for more than 1 hour.
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The nurse is providing care for a patient with reflex urinary incontinence. Which action could be appropriately assigned to a new LPN/LVN? 1. Teaching the patient bladder emptying by the Credé method 2. Demonstrating how to perform intermittent self-catheterization 3. Discussing when to report the side effects of bethanechol chloride to the health care provider (HCP) 4. Reinforcing the importance of proper hand washing to prevent infection
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The nurse is providing nursing care for a 24-year-old female patient admitted to the acute care unit with a diagnosis of cystitis. Which intervention should the nurse delegate to the unlicensed assistive personnel (UAP)? 1. Teaching the patient how to secure a clean-catch urine sample 2. Assessing the patient's urine for color, odor, and sediment 3. Reviewing the nursing care plan and add nursing interventions 4. Providing the patient with a clean-catch urine sample container
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The nurse obtains the following assessment data about a client who has had a transurethral resection of the prostate (TURP) and has continuous bladder irrigation. Which finding indicates the most immediate need for nursing intervention? 1. The client states that he feels a continuous urge to void. 2. The catheter drainage is light pink with occasional clots. 3. The catheter is taped to the client's thigh. 4. The client reports painful bladder spasms.
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