Renal & Urinary NCLEX

A client who is performing peritoneal dialysis at home calls the clinic and reports that the outflow from the dialysis catheter seems to be decreasing in amount. The nurse appropriately asks which question first?

"Have you experienced any constipation recently?"

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."

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 void, save the specimen, and note the start time

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?

Aluminum intoxication

A client with benign prostatic hypertrophy (BPH) undergoes a transurethral resection of the prostate (TURP) and is receiving continuous bladder irrigations postoperatively. Which are the signs/symptoms of transurethral resection (TUR) syndrome?

Bradycardia and confusion

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?

Changing the drainage bag to a leg collection bag

A client has epididymitis as a complication of a urinary tract infection (UTI). The nurse is giving the client instructions to prevent recurrence. The nurse determines that the client needs further teaching if the client states the intention to do which action?

Continue to take antibiotics until all symptoms are gone

A male client has a tentative diagnosis of urethritis. The nurse collects data from the client knowing that which are signs/symptoms of this disorder?

Dysuria and penile discharge

A male client has a tentative diagnosis of urethritis. The nurse should assess the client for which manifestation of the disorder?

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?

Elevated serum creatinine level; Decreased red blood cell (RBC) count; Elevated blood urea nitrogen (BUN) level

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

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?

Gives specific cytological information about the lesion

Which condition places the client at risk for developing acute postrenal failure?

Hydronephrosis

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

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?

Increase intake of legumes in the diet

Which observations by the nurse caring for clients in a hospital medical-surgical unit should be immediately reported to the primary health care provider?

New confused mental state and pulse rate of 106 beats per minute in a 72-year-old client; A volume of 105 mL of urine over 4 hours in the collection bag of a 1-day postoperative client

A client with acute glomerulonephritis is admitted to the nursing unit. The nurse should plan to do which action immediately upon admission?

Remove the water pitcher from the bedside

A male client is diagnosed with urethritis caused by chlamydial infection. The unlicensed assistive personnel (UAP) assigned to the client asks the nurse what measures are necessary to prevent a contraction of the infection during care. Which instruction should the nurse give the UAP?

Standard precautions are sufficient because the infection is transmitted sexually

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?

Urinary retention

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 reviewing the history and physical examination on a client diagnosed with polycystic kidney disease. Which data should the nurse expect to see?

hematuria; flank pain; history of UTIs

Which actions are included in the nursing care of the client undergoing peritoneal dialysis?

monitor vital signs including temperature; weigh the client before and after dialysis; check color and volume of dialysate solution; maintain aseptic technique when assessing the peritoneal catheter

A client contacts the primary health care provider's office to report she is not feeling well, has burning with urination, and suspects she may have a urinary tract infection. The nurse instructs the client to collect a urine specimen for testing. Which urinalysis findings indicate the presence of a urinary tract infection?

nitrates, present; white blood cells, 10; leukocyte esterase, present

A client who underwent kidney transplant 6 months earlier is seen in the clinic for a routine monthly appointment. The nurse reviews how the client has been doing and observes for signs/symptoms of acute rejection. Which signs/symptoms suggest acute rejection of the transplanted kidney?

oliguria; elevation of blood pressure over baseline; abdominal tenderness on the side of the kidney transplant; elevation of serum blood urea nitrogen (BUN) and creatinine

A hemodialysis client with a left arm fistula is at risk for arterial steal syndrome. The nurse monitors this client for which signs/symptoms of this disorder?

pallor, diminished pulse, and pain in the left hand