NSG 333 Review D
A patient is admitted to the emergency department with possible renal trauma after an automobile accident. Which prescribed intervention will the nurse implement first? A) Check blood pressure and heart rate B) Administer morphine sulfate 4 mg IV C) Transport to radiology for an intravenous pyelogram D) Insert a urethral catheter and obtain a urine specimen.
A
A female patient being admitted with pneumonia has a history of neurogenic bladder as a result of a spinal cord injury. Which action will the nurse plan to take first? A) Ask about the usual urinary pattern and any measures used for bladder control B) Assist the patient to the toilet at scheduled times to help ensure bladder emptying C) Check the patient for urinary incontinence every 2 hours to maintain skin integrity D) Use intermittent catheterization on a regular schedule to avoid the risk of infection.
A
A 55-year-old woman admitted for shoulder surgery asks the nurse for a perineal pad, saying that laughing or coughing causes leakage of urine. Which intervention is appropriate to include in the care plan for the patient A) Teach the patient how to perform Kegel exercises B) Demonstrate how to perform Credé's maneuver C) Place commode at the patient's bedside D) Assist the patient to the bathroom q3hr
A
After change-of-shift report, which patient should the nurse assess first? A) Patient with a urethral stricture who has not voided for 12 hours B) Patient who has cloudy urine after orthotopic bladder reconstruction C) Patient with polycystic kidney disease whose blood pressure is 186/98 mm Hg D) Patient who voided bright red urine immediately after returning from lithography
A
Sodium polystyrene sulfonate (Kayexalate) is ordered for a patient with hyperkalemia. Before administering the medication A) bowel sounds B) blood glucose C) blood urea nitrogen (BUN) D) level of consciousness (LOC).
A
Which medication taken by a patient with decreased renal function will be of most concern to the nurse? A) Ibuprofen (Motrin) B) Warfarin (Coumadin) C) Folic acid (vitamin B9) D) Penicillin (Bicillin LA)
A
Which nursing action is of highest priority for a patient with renal calculi who is being admitted to the hospital with gross hematuria and severe colicky left flank pain? A) Administer prescribed analgesics. B) Monitor temperature every 4 hours C) Encourage increased oral fluid intake D) Give antiemetics as needed for nausea.
A
A nurse is caring for a client who reports recurrent flank pain, nausea, and vomiting for 24 hr. Which of the following actions is the nurse's priority? A) Monitor I&O B) Administer pain med C) Strain urine D) Administer an antiemetic
B
A patient admitted with acute kidney injury due to dehydration has oliguria, anemia, and hyperkalemia. Which prescribed action should the nurse take first? A) Insert a urinary retention catheter B) Place the patient on a cardiac monitor C) Administer epoetin alfa (Epogen, Procrit) D) Give sodium polystyrene sulfonate (Kayexalate).
B
A patient gives the nurse health information before a scheduled intravenous pyelogram (IVP). Which item has the most immediate implications for the patient's care? A) The patient has not had food or drink for 8 hours B) The patient lists allergies to shellfish and penicillin C) The patient complains of costovertebral angle (CVA) tenderness D) The patient used a bisacodyl (Dulcolax) tablet the previous night.
B
A patient who has had progressive chronic kidney disease (CKD) for several years has just begun regular hemodialysis. Which information about diet will the nurse include in patient teaching? A) Increased calories are needed because glucose is lost during hemodialysis B) More protein is allowed because urea and creatinine are removed by dialysis C Dietary potassium is not restricted because the level is normalized by dialysis D) Unlimited fluids are allowed because retained fluid is removed during dialysis.
B
Before administration of captopril to a patient with stage 2 chronic kidney disease (CKD), the nurse will check the patient's A) Glucose B) Potassium C) Creatinine D) Phosphate.
B
To prevent recurrence of uric acid kidney stones, the nurse teaches the patient to avoid eating: A) Milk and cheese B) Sardines and liver C) Spinach and chocolate D) Legumes and dried fruit.
B
A nurse is caring for a client who has end-stage renal disease (ESRD). Which of the following are expected findings? (select all that apply) A) Hypotension B) Confusion C) Bradypnea D) Puritis E) Restless leg syndrome
B, D, E
The home health nurse teaches a patient with a neurogenic bladder how to use intermittent catheterization for bladder emptying. Which patient statement indicates that the teaching has been effective? A) "I will buy seven new catheters weekly and use a new one every day." B) "I will use a sterile catheter and gloves for each time I self-catheterize." C) "I will clean the catheter carefully before and after each catheterization." D) "I will take prophylactic antibiotics to prevent any urinary tract infections."
C
To determine possible causes, the nurse will ask a patient admitted with acute glomerulonephritis about A) Recent bladder infection B) History of kidney stones C) Recent sore throat and fever D) History of high blood pressure.
C
Which information about a patient with Goodpasture syndrome requires the most rapid action by the nurse? A) Blood urea nitrogen level is 70 mg/dL B) Urine output over the last 2 hours is 30 mL C) Audible crackles bilaterally over the posterior chest to the midscapular level D) Elevated level of antiglomerular basement membrane (anti-GBM) antibodies.
C
A client is admitted with acute kidney injury (AKI) and a urine output of 2000 mL/day. What is the major concern of the nurse regarding this clients care? A) Mental health status B) Edema and pain C) Cardiac and respiratory status D) Electrolyte and fluid balance
D
A nurse is planning care for a client who has acute glomerulonephritis related to a streptococcal infection. Which of the following interventions is appropriate to include in the plan of care? A) Monitor urine output B) Encourage a high protein diet C) Obtain weekly weight D) Administer prescribed antibiotics
D
A young adult employed as a hairdresser and has a 15 pack-year history of cigarette smoking arrives for an annual physical examination. Which area of increased risk should the nurse plan to teach the patient? A) Renal failure. B) Kidney stones. C) Pyelonephritis D) Bladder cancer.
D
The nurse is caring for four clients with chronic kidney disease. Which client should the nurse assess first upon initial rounding? A) Client with halitosis and stomatitis B) Woman with BP of 150/90 C) Man with skin itching from head to toe D) Client with Kussmaul respirations
D
A 68-yr-old patient admitted to the hospital with dehydration is confused and insentient of urine. Which nursing action should be included in the plan of care? A) Assist the patient to the bathroom every 2 hours during the day B) Restrict fluids between meals and after the evening meal C) Insert an indwelling catheter until the symptoms have resolved D) Apply absorbed adult incontinence diapers and pads over the bed linens
A
A 58-yr-old male patient who is diagnosed with nephrotic syndrome has ascites and 4+ leg edema. Which patient problem is present based on these findings? A) Activity intolerance B) Excess fluid volume C) Poor perfusion D) Inadequate nutrition
B
Following rectal surgery, a patient voids about 50 mL of urine every 30 to 60 minutes for the first 4 hours. Which nursing action is most appropriate? A) Monitor the patient's intake and output over night. B) Have the patient drink small amounts of fluid frequently. C) Use an ultrasound scanner to check the postvoiding residual volume. D) Reassure the patient that this is normal after rectal surgery because of anesthesia.
C
A patient has been diagnosed with urinary tract calculi that are high in uric acid. Which foods will the nurse teach the patient to avoid (select all that apply)? A) Chicken B) Cabbage C) Chocolate D) Milk E) Liver F) Spinach
A, E
A 25-yr-old male patient has been admitted with a severe crushing injury after an industrial accident. Which laboratory result will be most important to report to the health care provider? A) Serum creatinine level of 2.1 mg/dL B) Serum potassium level of 6.5 mEq/L C) White blood cell count of 11,500/μL D) Blood urea nitrogen (BUN) of 56 mg/dL
B
A 42-yr-old patient admitted with acute kidney injury due to dehydration has oliguria, anemia, and hyperkalemia. Which prescribed action should the nurse take first? A) Insert a urinary retention catheter B) Place the patient on a cardiac monitor C) Administer epoetin alfa (Epogen, Procrit) D) Give sodium polystyrene sulfonate (Kayexalate).
B
A 48-yr-old male patient who weighs 242 lb (110 kg) undergoes a nephrectomy for massive kidney trauma from a motor vehicle crash. Which postoperative assessment finding is most important to communicate to the surgeon? A) Blood pressure is 102/58 B) Urine output is 20 mL/hr for 2 hours C) Incisional pain level is reported as 9/10 D) Crackles are heard at bilateral lung bases.
B
A 79-year-old man has been admitted with benign prostatic hyperplasia. What is most appropriate to include in the nursing plan of care? A) Limit fluid intake to no more than 1000 mL/day B) Leave a light on in the bathroom during the night. C) Ask the patient to use a urinal so that urine can be measured D) Pad the patient's bed to accommodate overflow incontinence.
B
A adult patient is admitted to the hospital with new-onset nephrotic syndrome. Which assessment data will the nurse expect? A) Poor skin turgor B) Recent weight gain C) Elevated urine ketones D) Decreased blood pressure
B
A female patient with a suspected urinary tract infection (UTI) is to provide a clean-catch urine specimen for culture and sensitivity testing. What should the nurse do to obtain the specimen? A) Have the patient empty the bladder completely, then obtain the next urine specimen that the patient is able to void B) Tell the patient to clean the urethral area, void a small amount into the toilet, and then void into a sterile specimen cup C) Insert a short sterile "mini" catheter attached to a collecting container into the urethra and bladder to obtain the specimen D) Clean the area around the meatus with a povidone-iodine (Betadine) swab, and then have the patient void into a sterile container.
B
How will the nurse assess for flank tenderness in a patient with suspected pyelonephritis? A) Palpate along both sides of the lumbar vertebral column B) Strike a flat hand covering the costovertebral angle (CVA) C) Push fingers upward into the two lowest intercostal spaces D) Percuss between the iliac crest and ribs along the midaxillary line.
B
Nursing staff on a hospital unit are reviewing rates of health care-associated infections (HAI)of the urinary tract. Which nursing action will be most helpful in decreasing the risk for urinary HAI in patients admitted to the hospital? A) Testing urine with a dipstick daily for nitrites B) Avoiding unnecessary urinary catheterizations C) Encouraging adequate oral fluid and nutritional intake D) Providing perineal hygiene to patients daily and as needed
B
The nurse is planning care for a patient with severe heart failure who has developed elevated blood urea nitrogen (BUN) and creatinine levels. The primary treatment goal in the plan will be A) Augmenting fluid volume B) Maintaining cardiac output C) Diluting nephrotoxic substances D) Preventing systemic hypertension.
B
When a patient with acute kidney injury (AKI) has an arterial blood pH of 7.30, the nurse will expect an assessment finding of A) Persistent skin tenting B) Rapid, deep respirations C) Hot, flushed face and neck D) Bounding peripheral pulses.
B
When caring for a patient after cystoscopy, what should the nurse include in the plan of care? A) Learns to request narcotics for pain B) Understands to expect blood-tinged urine C) Restricts activity to bed rest for a 4 to 6 hours D) Remains NPO for 8 hours to prevent vomiting.
B
Which assessment finding for a patient who has just been admitted with acute pyelonephritis is most important for the nurse to report to the health care provider? A) Complaint of flank pain B) Blood pressure 90/48 mm Hg C) Cloudy and foul-smelling urine D) Temperature 100.1° F (57.8° C)
B
Which information will the nurse monitor in order to determine the effectiveness of prescribed calcium carbonate (Caltrate) for a patient with chronic kidney disease (CKD)? A) Blood pressure B) Phosphate level C) Neurologic status D)Creatinine clearance
B
A 28-yr-old male patient is diagnosed with polycystic kidney disease. Which information should the nurse include in teaching during the first teaching session? A) Complications of renal transplantation B) Methods for treating severe chronic pain C) Options to consider for genetic counseling D) Differences between hemodialysis and peritoneal dialysis
C
A nurse is caring for a client who has continuous bladder irrigation following a transurethral resection of the prostate. Upon detecting an output obstruction, which of the following actions should the nurse take first? A) Increase the client's oral fluid intake B) Request an increased IV fluid rate C) Irrigate the catheter D) Monitor the Urine output hourly
C
A patient who had a kidney transplant eight years ago is receiving the immunosuppressants tacrolimus (Prograf), cyclosporine (Sandimmune), and prednisone .Which assessment data will be of MOST concern to the nurse? A) Skin is thin and fragile B) Blood pressure is 150/92 C) A nontender axillary lump D) Blood glucose is 144 mg/dL.
C
A patient who has acute glomerulonephritis is hospitalized with hyperkalemia. Which information will the nurse monitor to evaluate the effectiveness of the prescribed calcium gluconate IV? A) Urine volume B) Calcium level C) Cardiac rhythm D) Neurologic status
C
A patient with diabetes who has bacterial pneumonia is being treated with IV gentamicin. What should the nurse monitor for adverse effects of the medication? A) Blood glucose B) Urine osmolality C) Serum creatinine D) Serum potassium.
C
Which assessment data reported by a patient is consistent with a lower urinary tract infection(UTI)? A) Low urine output B) Bilateral flank pain C) Nausea and vomiting D) Burning on urination
D
Which assessment finding is most important to report to the health care provider regarding a patient who has had left-sided extracorporeal shock wave lithotripsy? A) Blood in urine B) Left flank bruising C) Left flank discomfort D) Decreased urine output
D
Which finding by the nurse will be most helpful in determining whether a 67-yr-old patient with benign prostatic hyperplasia has an upper urinary tract infection (UTI)? A) Bladder distention B) Foul-smelling urine C) Suprapubic discomfort D) Costovertebral tenderness
D
Which nursing action is essential for a patient immediately after a renal biopsy? A) Check blood glucose to assess for hyperglycemia or hypoglycemia. B) Insert a urinary catheter and test urine for gross or microscopic hematuria C) Monitor the blood urea nitrogen (BUN) and creatinine to assess renal function. D) Apply a pressure dressing and keep the patient on the affected side
D
Which question will the nurse ask to asses patient's dysuria? A) "Do you have to urinate at night?" B) "Do you have blood in your urine?" C) "Do you have to urinate frequently?" D) "Do you have pain when you urinate?"
D
