renal and urinary
The nurse is assisting in planning a diet for a client with acute kidney injury (AKI). The nurse plans to restrict which dietary component from this client's diet? Vitamines Carbohydrates Potassium Fats
Potassium
Bethanechol chloride is prescribed for a client with urinary retention. Which disorder should be a contraindication to the administration of this medication? Neurogenic atony Urinary stricture Gastroesophageal reflux Gastric atony
Urinary stricture
A client with a history of prostatic hypertrophy has purchased the over-the-counter medication, diphenhydramine, to treat symptoms of a runny nose. The nurse explains to the client that this medication combined with prostatic hypertrophy could cause exacerbation of which symptom? Excessive sweating Urinary retention Lowered heart rate Excessive drooling
urinary retention
The nurse has reinforced instructions to the client with a cystocele about Kegel exercises. The nurse determines that the client has not fully understood the directions if the client makes which statement? "Stop and start the stream of urine several times during a voiding." "Tighten perineal muscles for up to 10 seconds several times a day." "Tighten perineal muscles for up to 5 minutes three or four times a day." "Begin voiding and then stop the stream, holding residual urine for an hour."
"Begin voiding and then stop the stream, holding residual urine for an hour."
Which is an appropriate question to ask to determine the specific type of incontinence? "Have you needed to empty your bladder more frequently than usual?" "Have you been experiencing any urgency accompanied by dribbling or leaking urine?" "Do you have any difficulty in starting your stream of urine?" "Do you feel pain when you urinate?"
"Have you been experiencing any urgency accompanied by dribbling or leaking urine?"
After a renal biopsy, the client complains of pain at the biopsy site that radiates to the front of the abdomen. Which would this indicate? Infection Renal colic Bleeding Normal, expected pain
Bleeding
A sulfonamide is prescribed for a client with a urinary tract infection. During review of the client's record, the nurse notes that the client is taking warfarin sodium daily. Which prescription should the nurse anticipate for this client? A decrease in the usual dose of the sulfonamide A decrease in the warfarin sodium dosage An increase in the warfarin sodium dosage Discontinuation of warfarin sodium
A decrease in the warfarin sodium dosage
Phenazopyridine hydrochloride is prescribed for a client for symptomatic relief of pain resulting from a lower urinary tract infection. Which should the nurse reinforce to the client? Discontinue the medication if a headache occurs. Take the medication at bedtime. Take the medication before meals. A reddish-orange discoloration of the urine may occur
A reddish-orange discoloration of the urine may occur
A client with chronic kidney disease has been on dialysis for 3 years. The client is receiving the usual combination of medications for the disease, including aluminum hydroxide as a phosphate-binding agent. The client now has mental cloudiness, dementia, and complaints of bone pain. Which does this data indicate? Phosphate overdose Advancing uremia Aluminum intoxication Folic acid deficiency
Aluminum intoxication
A client is admitted to the surgical nursing unit following transurethral resection of the prostate (TURP) for benign prostatic hypertrophy. The client has a bladder irrigation infusing, and output is light cherry colored. The blood pressure is 134/82 mm Hg, the pulse is 84 beats per minute, and the client is afebrile with a respiratory rate of 18 breaths per minute. The licensed practical nurse (LPN) assisting in caring for the client collects assessment data 1 hour after admission to the nursing unit. The LPN notifies the registered nurse (RN) if which is noted on data collection? Red urine Urinary output of 200 mL greater than intake Pain related to bladder spasms Blood pressure of 102/50 mm Hg, pulse 110 beats per minute
Blood pressure of 102/50 mm Hg, pulse 110 beats per minute
A client receiving nitrofurantoin calls the primary health care provider's office complaining of side effects related to the medication. Which side effect indicates the need to stop treatment with this medication? Nausea Anorexia Chest pain Diarrhea
CHEST pain
The nurse must ambulate a client who has a nephrostomy tube attached to a drainage bag. The nurse plans to do this most safely by performing which action? Tying the drainage bag to the client's waist while ambulating Changing the drainage bag to a leg collection bag Hanging the drainage bag from a walker while ambulating Asking the client to hold the drainage bag lower than the level of the bladder
Changing the drainage bag to a leg collection bag
The nurse is collecting data from a client who has had benign prostatic hyperplasia (BPH) in the past. To determine whether the client is currently experiencing exacerbation of BPH, the nurse should ask the client about the presence of which early symptom? Urinary retention Urge incontinence Nocturia Decreased force in the stream of urine
Decreased force in the stream of urine
The nurse is reviewing the medical record of a client with a diagnosis of pyelonephritis. Which disorder noted on the client's record should the nurse identify as a risk factor for this diagnosis? Orthostatic hypotension Coronary artery disease Hypoglycemia Diabetes mellitus
Diabetes mellitus
The nurse is caring for a client with epididymitis. The nurse anticipates noting which group of findings on data collection? Fever, nausea and vomiting, and painful scrotal edema Diarrhea, groin pain, and scrotal edema Nausea, vomiting, and scrotal edema with widespread ecchymosis Fever, diarrhea, groin pain, and ecchymosis
Fever, nausea and vomiting, and painful scrotal edema
The nurse is reviewing the history and physical examination on a client diagnosed with polycystic kidney disease. Which data should the nurse expect to see? Select all that apply. Palpable abdominal mass Client age 20 years old Flank or lumbar pain History of urinary tract infections Hematuria
Flank or lumbar pain History of urinary tract infections Hematuria Palpable abdominal mass
The nurse suspects the client has a urinary tract infection (UTI). Which signs/symptoms suggest a UTI? Select all that apply. Flank pain Polydipsia Cloudy urine Hematuria Dysuria Frequency
Flank pain Cloudy urine Hematuria Dysuria Frequency
A client with chronic kidney disease is receiving epoetin alfa. Which laboratory result would indicate a therapeutic effect of the medication? Blood urea nitrogen level of 15 mg/dL (5.25 mmol/L) Hematocrit of 33% (0.33) White blood cell count of 6000 mm3 (6.0 × 109/L) Platelet count of 400,000 mm3 (400 × 109/L)
Hematocrit of 33% (0.33)
A client has undergone a transurethral resection of the prostate (TURP) a few hours ago to treat symptoms of benign prostatic hypertrophy. The nurse notes bright red blood and clots in the urinary catheter drainage bag. Which response should be the nurse's initial action? Remove the indwelling catheter and encourage increased oral fluids. Contact the client's surgeon to report the bleeding. Remove a small amount of fluid from the retention bulb. Increase the flow rate of the continuous bladder irrigation.
Increase the flow rate of the continuous bladder irrigation.
Which actions are included in the nursing care of the client undergoing peritoneal dialysis? Select all that apply. Weigh the client before and after dialysis. Maintain aseptic technique when accessing the peritoneal catheter. Instruct the client to remain supine until the dialysate is drained. Check color and volume of dialysate solution. Monitor vital signs including temperature.
Maintain aseptic technique when accessing the peritoneal catheter. Check color and volume of dialysate solution. monitor vitals weight before and after
The nurse is caring for a client undergoing peritoneal dialysis. The nurse checks the client and notes that the drainage from the outflow catheter is cloudy. The nurse notifies the registered nurse and plans to take which action? Add antibiotics to the next several dialysis bags Stop the peritoneal dialysis. Obtain a culture and sensitivity of the drainage. Institute hemodialysis temporarily.
Obtain a culture and sensitivity of the drainage.
The client with chronic kidney disease who is scheduled for hemodialysis this morning is due to receive a daily dose of enalapril. When should the nurse plan to administer this medication? The day after dialysis Just before dialysis On return from dialysis During dialysis
On return from dialysis
A client is scheduled for intravenous pyelography (IVP). Which priority nursing action should the nurse take? Determine if there is a history of allergies. Administer an oral preparation of radiopaque dye Administer a sedative. Restrict fluids
determine if there is a history of allergies
The nurse is instructing a client with diabetes mellitus about peritoneal dialysis. The nurse tells the client that it is important to maintain the prescribed dwell time for the dialysis because of the risk of which complication? Hyperglycemia Disequilibrium syndrome Peritonitis Hyperphosphatemia
hypergylcemia
The nurse is providing dietary instructions to a client with renal calculi, and the laboratory analysis has revealed that the calculus is composed of uric acid. The nurse tells the client that it would be helpful to make which dietary changes? Include organ meat type foods in the diet. Increase intake of cranberries and citrus fruits. Increase intake of seafood in the diet. Increase intake of legumes in the diet.
legumes
A client with end-stage kidney disease (ESKD) undergoes a surgical procedure to create an arteriovenous fistula for hemodialysis in the upper extremity. The nurse should take which actions when the client returns from surgery? Select all that apply. Monitor for circulation above the fistula site. Monitor bleeding and swelling at the site. Measure the blood pressure in the arm every hour. Check for audible bruit and palpable thrill at the fistula site. Monitor pain and administer analgesics.
monitor for pain monitor for bleeding Check for audible bruit and palpable thrill at the fistula site.
The nurse is assigned to care for a client who has just returned to the nursing unit after having hemodialysis for the first time. The nurse monitors the client carefully for which signs and symptoms of disequilibrium syndrome?
vomiting and headaches
The nurse is assigned to care for a client who has returned to the nursing unit following a left nephrectomy. The nurse places the highest priority on monitoring which data? Tolerance for sips of clear liquids Oxygen saturation levels Hourly urine output Ability to turn side to side
...hr urine output
The nurse is monitoring an older client suspected of having a urinary tract infection (UTI) for signs of infection. Which sign/symptom is likely to present first? Urgency Fever Frequency Confusion
Confusion
The nurse has a prescription to collect a 24-hour urine specimen from a client. The unlicensed assistive personnel (UAP) has been instructed on the collection technique. Which action by the UAP demonstrates the UAP needs further teaching? Asks the client to save a sample voided at the end of the collection time Discards a urine specimen collected at the start time Asks the client to void, save the specimen, and note the start time Places the specimen on ice
Asks the client to void, save the specimen, and note the start time
The nurse is caring for the client with epididymitis. Which treatment modalities should be implemented? Select all that apply. Heating pad Bed rest Scrotal elevation Sitz bath Antibiotics
Bed rest Scrotal elevation Sitz bath Antibiotics
A female client has a prescription for a clean-catch urine culture. After providing a sterile specimen cup to the client, the nurse should give which instruction so that the specimen is collected properly? Cleanse the labia using cleansing towels, position the container, and begin to void. Cleanse the labia using cleansing towels, begin to void into toilet, and then collect the specimen. Void into the container saving the full amount of urine Wipe the labia front to back with toilet paper and void into the sterile specimen container.
Cleanse the labia using cleansing towels, begin to void into toilet, and then collect the specimen.
The client who has a cold is seen in the emergency department with an inability to void. Because the client has a history of benign prostatic hyperplasia, the nurse determines that the client should be questioned about the use of which class of medications? Antitussives Decongestants Diuretics Antibiotics
Decongestants
The nurse is caring for a client who has been diagnosed as having a kidney mass. The client asks the nurse the reason for a renal biopsy when other tests such as computed tomography (CT) and ultrasound are available. In formulating a response, the nurse incorporates the knowledge that a renal biopsy serves which purpose? Helps differentiate between a solid mass and a fluid-filled cyst Determines if the mass is growing rapidly or slowly Gives specific cytological information about the lesion Provides an outline of the renal vascular system
Gives specific cytological information about the lesion
The nurse is caring for a client who had a renal biopsy. Which interventions should the nurse include in the plan of care for the client after this procedure? Select all that apply. Testing serial urine samples with dipsticks for occult blood Ambulating the client in the room and hall for short distances Monitoring vital signs and the puncture site frequently Restricting fluids during the first 24 hours Administering pain medication as prescribed
Monitoring vital signs and the puncture site frequently Testing serial urine samples with dipsticks for occult blood Administering pain medication as prescribed
The nurse is assessing the patency of an arteriovenous fistula in the left arm of a client who is receiving hemodialysis for the treatment of chronic kidney disease. Which finding indicates that the fistula is patent? Presence of a radial pulse in the left wrist Absence of a bruit on auscultation of the fistula Palpation of a thrill over the fistula Capillary refill less than 3 seconds in the nail beds of the left hand
Palpation of a thrill over the fistula
A client who had a prostatectomy has learned perineal exercises to gain control of the urinary sphincter. The nurse determines that the client needs further teaching if the client states that he will perform which action as part of these exercises? Contract the abdominal, gluteal, and perineal muscles. Tighten the muscles as if trying to prevent urination Perform the Valsalva maneuver. Tighten the rectal sphincter while relaxing abdominal muscles.
Perform the Valsalva maneuver.
The nurse monitoring a client receiving peritoneal dialysis notes that the client's outflow is less than the inflow. The nurse should take which actions? Select all that apply. Place the client in good body alignment. Reposition the client to his or her side. Increase the flow rate of the peritoneal dialysis solution. Contact the nephrologist. Check the level of the drainage bag. Check the peritoneal dialysis system for kinks.
Place the client in good body alignment. Reposition the client to his or her side. Check the level of the drainage bag. chk for kinks
Bethanechol is prescribed for the client with urinary retention, and an injectable form of bethanechol is available for use as prescribed. The nurse informs the client of the primary health care provider's prescription, knowing that the medication will be administered by which injectable route? Intravenously Subcutaneously Intramuscularly Intradermally
Subcutaneously
The nurse is reinforcing instructions to a client about the types of fluids that assist in prevention and treatment of urinary tract infections (UTIs). The nurse instructs the client to consume which fluids? Select all that apply. Apple juice Prune juice Milk Soda Cranberry juice
apple, prune, and cranberry
A client arrives at the ambulatory care clinic with low abdominal pain. A routine urine specimen reveals hematuria. The client does not have a fever. The nurse should next ask the client about a history of which condition? Pyelonephritis Glomerulonephritis Blow or trauma to the bladder or abdomen Renal cancer in the client's family
blow or trauma to the kidney
A client is seen in the health care clinic and acute pyelonephritis (kidney infection) is suspected. The nurse reviews the client's record and should expect to note which associated signs and symptoms documented? Select all that apply. Low-grade fever Nausea and vomiting General weakness Pale, dilute urine Chills Flank pain on the unaffected side
chills nausea and vomiting general weakness
A client is admitted to the emergency department following a fall from a horse. The primary health care provider (PHCP) prescribes the insertion of an indwelling urinary catheter. The nurse notes blood at the urinary meatus while preparing for the procedure. Which action should the nurse take? Use a smaller catheter. Use extra povidone-iodine solution in cleansing the meatus. Notify the primary health care provider. Administer pain medication before inserting the catheter.
notify MD
The nurse provides home care instructions to a client undergoing hemodialysis with regard to care of an arteriovenous (AV) fistula. Which statement by the client indicates an understanding of the instructions? "I am glad that the laboratory will be able to draw my blood from the fistula." "I should wear a shirt with tight arms to provide some compression on the fistula." "I should check the fistula every day by feeling it for a vibration." "I should check my blood pressure in the arm where I have my fistula every week."
"I should check the fistula every day by feeling it for a vibration."
The nurse is admitting a client to the nursing unit who has returned from the postanesthesia care unit following prostatectomy. The client has a three-way Foley catheter with continuous bladder irrigation. The nurse should maintain the flow rate of the continuous bladder infusion to maintain which urine output characteristic? Yellow with small clots Colorless Red Pale yellow or slightly pink
pale yellow or slightly pink
The nurse is caring for a hospitalized client following cystoscopy. Which discharge instructions are given to the client? Select all that apply. Take sitz baths for voiding discomfort. Expect pink-tinged urine for 1 week. Report severe pain to health care provider. Use antispasmodics for pain. Restrict oral fluids for 1 to 2 days
take sitz bath for discomfort Report severe pain to health care provider. Use antispasmodics for pain.
A male client has a tentative diagnosis of urethritis. The nurse should assess the client for which manifestation of the disorder? Hematuria and urgency Hematuria and pyuria Dysuria and proteinuria Dysuria and penile discharge
Dysuria and penile discharge
The nurse is reviewing the client's record and notes that the primary health care provider (PHCP) has documented that the client has a renal disorder. Which laboratory results would indicate a decrease in renal function? Select all that apply. Elevated blood urea nitrogen (BUN) level Decreased white blood cell (WBC) count Elevated serum creatinine level Decreased red blood cell (RBC) count Elevated thrombocyte cell count
Elevated blood urea nitrogen (BUN) level Elevated serum creatinine level Decreased red blood cell (RBC) count
A client with acute pyelonephritis is scheduled for a voiding cystourethrogram. After the nurse provides information about this procedure, the client states, "I can't urinate in front of other people. I have a 'bashful' kidney." What is the nurse's best response? "You will be screened and given as much privacy as possible." "If you cannot urinate in front of others, the test will be cancelled." "The people there are all medical professionals." "Everyone feels that way."
"You will be screened and given as much privacy as possible."
The nurse is caring for a hospitalized client following cystoscopy. Which discharge instructions are given to the client? Select all that apply. Take sitz baths for voiding discomfort. Expect pink-tinged urine for 1 week. Report severe pain to health care provider. Use antispasmodics for pain. Restrict oral fluids for 1 to 2 days.
Take sitz baths for voiding discomfort. Report severe pain to health care provider. Use antispasmodics for pain.