Urinary and Renal System
c. Report the patient's symptoms to the health care provider.
After the insertion of an arteriovenous graft (AVG) in the right forearm, a 54-year-old patient complains of pain and coldness of the right fingers. Which action should the nurse take? a. Teach the patient about normal AVG function. b. Remind the patient to take a daily low- dose aspirin tablet. c. Report the patient's symptoms to the health care provider. d. Elevate the patient's arm on pillows to above the heart level.
b. Strike a flat hand covering the costovertebral angle (CVA).
How will the nurse assess for flank tenderness in a 30-year-old female 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.
a. bowel sounds.
Sodium polystyrene sulfonate (Kayexalate) is ordered for a patient with hyperkalemia. Before administering the medication, the nurse should assess the a. bowel sounds. b. blood glucose. c. blood urea nitrogen (BUN). d. level of consciousness (LOC).
b. Urine output
The nurse is titrating the IV fluid infusion rate immediately after a patient has had kidney transplantation. Which parameter will be most important for the nurse to consider? a. Heart rate b. Urine output c. Creatinine clearance d. Blood urea nitrogen (BUN) level
a. ibuprofen (Motrin)
Which medication taken at home by a 47-year-old 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)
c. Poached eggs, whole-wheat toast, and apple juice
Which menu choice by the patient who is receiving hemodialysis indicates that the nurse's teaching has been successful? a. Split-pea soup, English muffin, and nonfat milk b. Oatmeal with cream, half a banana, and herbal tea c. Poached eggs, whole-wheat toast, and apple juice d. Cheese sandwich, tomato soup, and cranberry juice
a. 60 mL/min
What glomerular filtration rate (GFR) would the nurse estimate for a 30- year-old patient with a creatinine clearance result of 60 mL/min? a. 60 mL/min b. 90 mL/min c. 120 mL/min d. 180 mL/min
C) Insertion of a suprapubic catheter
A 20-year-old male patient has been brought to the emergency department (ED) by ambulance with a gunshot wound that has resulted in urethral trauma. In light of this patient's injuries, the ED nurse should anticipate what intervention? A) Insertion of a urinary catheter B) Cystoscopy C) Insertion of a suprapubic catheter D) Lithotripsy
d. bladder cancer.
A 32-year-old patient who is employed as a hairdresser and has a 15 pack- year history of cigarette smoking is scheduled for an annual physical examination. The nurse will plan to teach the patient about the increased risk for a. renal failure. b. kidney stones. c. pyelonephritis. d. bladder cancer.
c. WBC 20 to 26/hpf
Which information from a patient's urinalysis requires that the nurse notify the health care provider? a. pH 6.2 b. Trace protein c. WBC 20 to 26/hpf d. Specific gravity 1.021
c. Large container for urine
A hospitalized patient with possible renal insufficiency after coronary artery bypass surgery is scheduled for a creatinine clearance test. Which equipment will the nurse need to obtain? a. Urinary catheter b. Cleaning towelettes c. Large container for urine d. Sterile urine specimen cup
c. Knee and hip joint pain
Which assessment finding may indicate that a patient is experiencing adverse effects to a corticosteroid prescribed after kidney transplantation? a. Postural hypotension b. Recurrent tachycardia c. Knee and hip joint pain d. Increased serum creatinine
b. Serum potassium level 6.5 mEq/L
A 25-year-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 2.1 mg/dL b. Serum potassium level 6.5 mEq/L c. White blood cell count 11,500/μL d. Blood urea nitrogen (BUN) 56 mg/dL
A) Pain on urination C) Urinary frequency D) Urgency
A 30-year-old woman has presented for care, stating, "I'm pretty sure that I've got a UTI, so I think I'll need some antibiotics." In the presence of a UTI, the nurse would expect the woman to have which of the following signs and symptoms? Select all that apply. A) Pain on urination B) Excessively dilute urine C) Urinary frequency D) Urgency E) Copper-colored urine
c. Glomerular filtration rate (GFR)
A 37-year-old female patient is hospitalized with acute kidney injury (AKI). Which information will be most useful to the nurse in evaluating improvement in kidney function? a. Urine volume b. Creatinine level c. Glomerular filtration rate (GFR) d. Blood urea nitrogen (BUN) level
b. There is a nontender axillary lump.
A 38-year-old patient who had a kidney transplant 8 years ago is receiving the immunosuppressants tacrolimus (Prograf), cyclosporine (Sandimmune), and prednisone (Deltasone). Which assessment data will be of most concern to the nurse? a. The blood glucose is 144 mg/dL. b. There is a nontender axillary lump. c. The patient's skin is thin and fragile. d. The patient's blood pressure is 150/92.
b. Place the patient on a cardiac monitor.
A 42-year-old patient admitted with acute kidney injury due to dehydration has oliguria, anemia, and hyperkalemia. Which prescribed actions 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).
A) Stress incontinence
A 42-year-old woman comes to the clinic complaining of intermittent urinary incontinence when she sneezes. The clinic nurse is aware that this patient is experiencing what type of incontinence? A) Stress incontinence B) Reflex incontinence C) Overflow incontinence D) Functional incontinence
C) The patient may require another short course of antibiotics followed by a longer-term regimen.
A 44-year-old woman was diagnosed with an uncomplicated urinary tract infection (UTI) and completed her prescribed 3-day course of antibiotics 2 days ago. However, she states that she is experiencing the same signs and symptoms that initially prompted her to seek care. The nurse should anticipate that: A) The patient's signs and symptoms will likely resolve over the next 48 to 72 hours. B) The patient will likely require a course of IV antibiotics. C) The patient may require another short course of antibiotics followed by a longer-term regimen. D) The patient will need to continue taking the same antibiotic for the next 4 to 6 months.
b. Ibuprofen (Advil) 400 mg PO PRN for pain
A 48-year-old patient with stage 2 chronic kidney disease (CKD) is scheduled for an intravenous pyelogram (IVP). Which order for the patient will the nurse question? a. NPO for 6 hours before procedure b. Ibuprofen (Advil) 400 mg PO PRN for pain c. Dulcolax suppository 4 hours before procedure d. Normal saline 500 mL IV infused before procedure
D) Body image disturbance related to the presence of an ileostomy
A 49-year-old male patient has just had an ileostomy created as part of the treatment plan for bladder cancer. The nurse has begun the patient's discharge planning process and is creating an appropriate plan of care. When planning this patient's care, what psychosocial nursing diagnosis should the nurse most likely prioritize? A) Dysfunctional grieving related to the presence of an ileostomy B) Ineffective family coping related to the presence of an ileostomy C) Anxiety related to the presence of an ileostomy D) Body image disturbance related to the presence of an ileostomy
B) Pain
A 49-year-old man has been brought to the emergency department by his wife, who states that her husband is experiencing a repeat episode of kidneys stones. When planning interventions for this patient's immediate care, what problem is likely to be the priority? A) Decreased cardiac output B) Pain C) Fluid and electrolyte imbalance D) Decreased level of consciousness (LOC)
B) Knowledge deficit about the surgical procedure and postoperative care
A 52-year-old patient is scheduled to undergo ileal conduit surgery and has several appropriate questions for the nurse. What would be the most relevant nursing diagnosis for this patient? A) Self-care deficit related to the surgical procedure and creation of an ileal conduit B) Knowledge deficit about the surgical procedure and postoperative care C) Fear and anxiety related to the surgical procedure D) Risk of infection related to the surgical procedure
c. Hemoglobin level 13 g/dL
A 55-year-old patient with end-stage kidney disease (ESKD) is scheduled to receive a prescribed dose of epoetin alfa (Procrit). Which information should the nurse report to the health care provider before giving the medication? a. Creatinine 1.6 mg/dL b. Oxygen saturation 89% c. Hemoglobin level 13 g/dL d. Blood pressure 98/56 mm Hg
A) Fecal contamination from the patient's perineum
A 60-year-old woman has begun a course of oral antibiotics for the treatment of a urinary tract infection (UTI). The patient's nurse should recognize that the causative microorganisms most likely originated from: A) Fecal contamination from the patient's perineum B) Colonization of the patient's urethra from bloodborne pathogens C) Proliferation of normal microbiotic flora D) Ingested microorganisms
b. Urine output over an 8-hour period is 2500 mL.
A 62-year-old female patient has been hospitalized for 8 days with acute kidney injury (AKI) caused by dehydration. Which information will be most important for the nurse to report to the health care provider? a. The creatinine level is 3.0 mg/dL. b. Urine output over an 8-hour period is 2500 mL. c. The blood urea nitrogen (BUN) level is 67 mg/dL. d. The glomerular filtration rate is <30 mL/ min/1.73m2.
C) The patient's bladder overfills, leading to overflow incontinence without the patient's knowledge.
A 62-year-old male patient was diagnosed with type 2 diabetes 5 years ago but has not implemented measures to closely monitor or control his blood sugar levels. As a result, he has begun to experience some of the sequelae of diabetes, including flaccid bladder. In cases of flaccid bladder, what pathophysiological process takes place? A) An incompetent sphincter results in a constant dribbling of urine. B) Because of a neurological lesion, the patient has no control over when the bladder empties. C) The patient's bladder overfills, leading to overflow incontinence without the patient's knowledge. D) Due to a lesion, the patient experiences inappropriate urges to void that are unrelated to the quantity of urine in the bladder.
c. More protein is allowed because urea and creatinine are removed by dialysis.
A 64-year-old male 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. Unlimited fluids are allowed because retained fluid is removed during dialysis. c. More protein is allowed because urea and creatinine are removed by dialysis. d. Dietary potassium is not restricted because the level is normalized by dialysis.
A) Making lifestyle changes that will result in weight loss
A 67-year-old woman whose medical history includes obesity, type 2 diabetes, and hypertension has admitted to her care provider that she has often been incontinent of urine over the past several months. In an effort to control her problem, she has been using absorbent pads but is motivated to find a solution to her overactive bladder. What goal should the patient and the nurse emphasize to restore the patient's urinary continence? A) Making lifestyle changes that will result in weight loss B) Changing the woman's diet to reduce her sodium intake C) Increasing the frequency of glucometer checks and improving her glycemic control D) Monitoring the patient's blood pressure more closely
B) Bladder ultrasound
A 69-year-old man is postoperative day 2 following a transurethral prostatic resection (TUPR). The patient had his urinary catheter removed at 06:00 this morning but has not voided in the 5 hours since the removal, despite the fact that he has been drinking large amounts of fluids. What nursing assessment will most accurately determine whether the patient is retaining urine? A) Bladder palpation B) Bladder ultrasound C) Inspection of the patient's pubic region D) An audit of the patient's recent intake and output
a. Insert urethral catheter.
A 72-year-old patient with a history of benign prostatic hyperplasia (BPH) is admitted with acute urinary retention and elevated blood urea nitrogen (BUN) and creatinine levels. Which prescribed therapy should the nurse implement first? a. Insert urethral catheter. b. Obtain renal ultrasound. c. Draw a complete blood count. d. Infuse normal saline at 50 mL/hour.
b. "Tell me more about what you are thinking regarding dialysis."
A 74-year-old who is progressing to stage 5 chronic kidney disease asks the nurse, "Do you think I should go on dialysis? Which initial response by the nurse is best? a. "It depends on which type of dialysis you are considering." b. "Tell me more about what you are thinking regarding dialysis." c. "You are the only one who can make the decision about dialysis." d. "Many people your age use dialysis and have a good quality of life."
b. Leave a light on in the bathroom during the night.
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.
a. Ask about the usual urinary pattern and any measures used for bladder control.
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.
b. teach the patient to clean the urethral area, void a small amount into the toilet, and then void into a sterile specimen cup.
A female patient with a suspected urinary tract infection (UTI) is to provide a clean-catch urine specimen for culture and sensitivity testing. To obtain the specimen, the nurse will a. have the patient empty the bladder completely, then obtain the next urine specimen that the patient is able to void. b. teach 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. The patient's peritoneal effluent appears cloudy.
A female patient with chronic kidney disease (CKD) is receiving peritoneal dialysis with 2 L inflows. Which information should the nurse report immediately to the health care provider? a. The patient has an outflow volume of 1800 mL. b. The patient's peritoneal effluent appears cloudy. c. The patient has abdominal pain during the inflow phase. d. The patient's abdomen appears bloated after the inflow.
B) The use of indwelling urinary catheters
A gerontological nurse is aware of the high incidence and prevalence of urinary tract infections (UTIs) among older adults. Consequently, the nurse is implementing plans of care that attempt to reduce this risk. Which of the following actions present the greatest risk of UTIs for older adults? A) The use of antibiotics for respiratory infections B) The use of indwelling urinary catheters C) Restricting older adults' mobility and levels of activity D) Restricting fluid in older adults with congestive heart failure (CHF) or renal disease
c. The LPN/LVN administers the iron supplement and phosphate binder with lunch.
A licensed practical/vocational nurse (LPN/LVN) is caring for a patient with stage 2 chronic kidney disease. Which observation by the RN requires an intervention? a. The LPN/LVN administers the erythropoietin subcutaneously. b. The LPN/LVN assists the patient to ambulate out in the hallway. c. The LPN/LVN administers the iron supplement and phosphate binder with lunch. d. The LPN/LVN carries a tray containing low-protein foods into the patient's room.
c. Ask the patient about current medications.
A male patient in the clinic provides a urine sample that is red-orange in color. Which action should the nurse take first? a. Notify the patient's health care provider. b. Teach correct midstream urine collection. c. Ask the patient about current medications. d. Question the patient about urinary tract infection (UTI) risk factors.
c. serum creatinine.
A patient with diabetes who has bacterial pneumonia is being treated with IV gentamicin (Garamycin) 60 mg IV BID. The nurse will monitor for adverse effects of the medication by evaluating the patient's a. blood glucose. b. urine osmolality. c. serum creatinine. d. serum potassium.
B) "If you smoke cigarettes, quitting will greatly reduce your risk of bladder cancer."
A nurse is presenting at a community health promotion fair that is focused on disease prevention and screening. A middle-aged participant has brought up an article that she recently read about bladder cancer and has asked the nurse about prevention measures. How should the nurse respond to this woman's inquiry? A) "The majority of people who develop bladder cancer have a family history of the disease, so genetics play a large part." B) "If you smoke cigarettes, quitting will greatly reduce your risk of bladder cancer." C) "People who tend not to drink enough fluids put themselves at an increased risk of bladder cancer." D) "An unhealthy diet is the most significant risk factor for the development of bladder cancer."
B) Ensure that the collection bag is always below the height of the patient's bladder.
A nurse is providing care for a patient who has had an indwelling urinary catheter in place for the past several days. To reduce this patient's risk of developing a catheter-related infection, the nurse should: A) Swab the length of the tubing with chlorhexidine once per day. B) Ensure that the collection bag is always below the height of the patient's bladder. C) Empty the collection bag whenever the contents are ≥250 mL of urine. D) Clamp the collection tubing for 2 hours each day unless medically contraindicated.
d. infuse a bolus of normal saline.
A patient complains of leg cramps during hemodialysis. The nurse should first a. massage the patient's legs. b. reposition the patient supine. c. give acetaminophen (Tylenol). d. infuse a bolus of normal saline.
b. The patient lists allergies to shellfish and penicillin.
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.
C) Ureteral obstruction
A patient had an ileal conduit created and is being cared for by a postsurgical nurse. What is a complication the nurse would monitor this patient for in the immediate postoperative care period? A) Respiratory alkalosis B) Colon obstruction C) Ureteral obstruction D) Gangrene of the ilium
b. Check blood pressure before starting dialysis.
A patient has arrived for a scheduled hemodialysis session. Which nursing action is most appropriate for the registered nurse (RN) to delegate to a dialysis technician? a. Teach the patient about fluid restrictions. b. Check blood pressure before starting dialysis. c. Assess for causes of an increase in predialysis weight. d. Determine the ultrafiltration rate for the hemodialysis.
a. Fleet enema
A patient has elevated blood urea nitrogen (BUN) and serum creatinine levels. Which bowel preparation order would the nurse question for this patient who is scheduled for a renal arteriogram? a. Fleet enema b. Tap-water enema c. Senna/docusate (Senokot-S) d. Bisacodyl (Dulcolax) tablets
c. "Your doctor will insert a lighted tube into the bladder through your urethra, inspect the bladder, and instill a dye that will outline your bladder on x-ray."
A patient passing bloody urine is scheduled for a cystoscopy with cystogram. Which description of the procedure by the nurse is accurate? a. "Your doctor will place a catheter into an artery in your groin and inject a dye that will visualize the blood supply to the kidneys." b. "Your doctor will insert a lighted tube into the bladder, and little catheters will be inserted through the tube into your kidney." c. "Your doctor will insert a lighted tube into the bladder through your urethra, inspect the bladder, and instill a dye that will outline your bladder on x-ray." d. "Your doctor will inject a radioactive solution into a vein in your arm and the distribution of the isotope in your kidneys and bladder will be checked."
c. Cardiac rhythm
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
a. A fistula is much less likely to clot.
A patient will need vascular access for hemodialysis. Which statement by the nurse accurately describes an advantage of a fistula over a graft? a. A fistula is much less likely to clot. b. A fistula increases patient mobility. c. A fistula can accommodate larger needles. d. A fistula can be used sooner after surgery.
c. Check the medical record for most recent potassium level.
A patient with acute kidney injury (AKI) has longer QRS intervals on the electrocardiogram (ECG) than were noted on the previous shift. Which action should the nurse take first? a. Notify the patient's health care provider. b. Document the QRS interval measurement. c. Check the medical record for most recent potassium level. d. Check the chart for the patient's current creatinine level.
A) Insertion of a suprapubic catheter
A urology nurse is caring for a male patient admitted to the unit with bladder distention from prostatic hypertrophy. The health care provider orders placement of an indwelling urinary catheter. The nurse and urologist are both unsuccessful in catheterizing this patient due to the prostatic obstruction. What approach does the nurse anticipate the health care provider using to drain the patient's bladder? A) Insertion of a suprapubic catheter B) Scheduling the patient immediately for surgery to relieve the bladder obstruction C) Application of warm compresses to the perineum to assist with relaxation, which will result in the patient voiding on his own D) Medication administration to relax the bladder muscles and attempting catheterization in 6 hours
d. Patient who has just returned from having hemodialysis and has a heart rate of 124/ min
After receiving change-of-shift report, which patient should the nurse assess first? a. Patient who is scheduled for the drain phase of a peritoneal dialysis exchange b. Patient with stage 4 chronic kidney disease who has an elevated phosphate level c. Patient with stage 5 chronic kidney disease who has a potassium level of 3.4 mEq/L d. Patient who has just returned from having hemodialysis and has a heart rate of 124/ min
c. serum phosphate.
Before administration of calcium carbonate (Caltrate) to a patient with chronic kidney disease (CKD), the nurse should check laboratory results for a. potassium level. b. total cholesterol. c. serum phosphate. d. serum creatinine.
b. potassium.
Before administration of captopril (Capoten) 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.
C) The majority of the patient's genitourinary system
Cystoscopy, computed tomography, and a biopsy have culminated in a diagnosis of invasive bladder cancer for a 61-year-old female patient. Consequently, the woman is preparing to undergo a radical cystectomy. The nurse on the urological-gynecological unit of the hospital is aware that this procedure will involve the removal of: A) The patient's urethra and bladder B) The patient's fallopian tubes and uterus C) The majority of the patient's genitourinary system D) The patient's kidneys, ureters, and bladder
c. The respiratory rate is 38 breaths/minute.
Which assessment of a 62-year-old patient who has just had an intravenous pyelogram (IVP) requires immediate action by the nurse? a. The heart rate is 58 beats/minute. b. The patient complains of a dry mouth. c. The respiratory rate is 38 breaths/minute. d. The urine output is 400 mL after 2 hours.
b. Check patient's blood pressure (BP).
During routine hemodialysis, the 68-year-old patient complains of nausea and dizziness. Which action should the nurse take first? a. Slow down the rate of dialysis. b. Check patient's blood pressure (BP). c. Review the hematocrit (Hct) level. d. Give prescribed PRN antiemetic drugs.
b. Document the information on the assessment form.
The nurse completing a physical assessment for a newly admitted male patient is unable to feel either kidney on palpation. Which action should the nurse take next? a. Obtain a urine specimen to check for hematuria. b. Document the information on the assessment form. c. Ask the patient about any history of recent sore throat. d. Ask the health care provider about scheduling a renal ultrasound.
B) Teach the patient to perform pelvic floor muscle exercises
The clinic nurse is preparing a plan of care for a patient complaining of stress incontinence. The plan of care incorporates behavioral therapy as an approach to the management of stress incontinence. What role will the nurse have in implementing the behavioral therapy approach? A) Provide medication teaching related to pseudoephedrine sulfate B) Teach the patient to perform pelvic floor muscle exercises C) Prepare the patient for an anterior vaginal repair procedure D) Provide information on the semipermanent procedure of periurethral bulking
C) Drink liberal amounts of fluids.
The clinic nurse is teaching a young woman about preventing recurrent urinary tract infections. What information should the nurse include? A) Bathe daily. B) Avoid voiding immediately after sexual intercourse. C) Drink liberal amounts of fluids. D) Void every 6 to 8 hours.
b. identify renal artery bruits.
The nurse assessing the urinary system of a 45-year-old female would use auscultation to a. determine kidney position. b. identify renal artery bruits. c. check for ureteral peristalsis. d. assess for bladder distention.
b. understands to expect blood-tinged urine.
The nurse caring for a patient after cystoscopy plans that the patient 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) Avoid further interventions at this time, as this is an acceptable finding.
The nurse has implemented a bladder retraining program with a 65-year-old woman after the removal of her indwelling urinary catheter. The nurse places the patient on a timed voiding schedule and performs an ultrasonic bladder scan after each void. The nurse notes that the patient has 50 mL of urine remaining in her bladder after voiding. What would be the nurse's best response to this finding? A) Perform a straight catheterization on this patient. B) Avoid further interventions at this time, as this is an acceptable finding. C) Place an indwelling urinary catheter. D) Press on the patient's bladder in an attempt to encourage complete emptying.
b. Magnesium hydroxide
The nurse in the dialysis clinic is reviewing the home medications of a patient with chronic kidney disease (CKD). Which medication reported by the patient indicates that patient teaching is required? a. Multivitamin with iron b. Magnesium hydroxide c. Acetaminophen (Tylenol) d. Calcium phosphate (PhosLo)
b. The patient's central venous pressure (CVP) is decreased.
The nurse is assessing a patient 4 hours after a kidney transplant. Which information is most important to communicate to the health care provider? a. The urine output is 900 to 1100 mL/hr. b. The patient's central venous pressure (CVP) is decreased. c. The patient has a level 7 (0 to 10 point scale) incisional pain. d. The blood urea nitrogen (BUN) and creatinine levels are elevated.
A) Dietary history B) Family history of renal stones C) Medication history
The nurse is assessing a patient admitted to the unit with kidney stones. What assessment parameters would be priorities for the nurse to address? Select all that apply. A) Dietary history B) Family history of renal stones C) Medication history D) Surgical history E) Vaccination history
a. Monitor the urine output after the procedure.
The nurse is caring for a 68-year-old hospitalized patient with a decreased glomerular filtration rate who is scheduled for an intravenous pyelogram (IVP). Which action will be included in the plan of care? a. Monitor the urine output after the procedure. b. Assist with monitored anesthesia care (MAC). c. Give oral contrast solution before the procedure. d. Insert a large size urinary catheter before the IVP.
C) Notify the health care provider about cloudy or foul-smelling urine.
The nurse is caring for a patient who underwent percutaneous lithotripsy earlier in the day. In this procedure, an ultrasonic probe inserted through a nephrostomy tube into the renal pelvis generates ultra-high-frequency sound waves to shatter renal calculi. What instruction should the nurse give the patient? A) Limit oral fluid intake for 1 to 2 weeks. B) Report the presence of fine, sandlike particles through the nephrostomy tube. C) Notify the health care provider about cloudy or foul-smelling urine. D) Report pink urine within 24 hours after the procedure.
D) Urinary tract infection (UTI)
The nurse is caring for an 84-year-old female patient who was brought to the emergency room by her daughter, who related that her mother has had very recent mental status changes and periods of incontinence. What condition should the nurse first suspect? A) Urinary retention B) Urinary stasis C) Urinary calculi D) Urinary tract infection (UTI)
b. maintaining cardiac output.
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 collaborative treatment goal in the plan will be a. augmenting fluid volume. b. maintaining cardiac output. c. diluting nephrotoxic substances. d. preventing systemic hypertension.
A) The patient will consume 3 to 4 L of fluid each day.
The nurse is planning the care of a male patient who has been admitted to the medical unit with an exacerbation of chronic pyelonephritis. Which of the following goals should the nurse prioritize in the planning of this patient's nursing care? A) The patient will consume 3 to 4 L of fluid each day. B) The patient will void every 3 hours. C) The patient will express an understanding of the pathophysiology of pyelonephritis. D) The patient will maintain his preadmission activities of daily living (ADLs).
d. "Do you have pain when you urinate?"
To assess whether there is any improvement in a patient's dysuria, which question will the nurse ask? 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?"
b. rapid, deep respirations.
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. bounding peripheral pulses. d. hot, flushed face and neck.
c. inquire about which medications the patient is currently taking.
When a patient's urine dipstick test indicates a small amount of protein, the nurse's next action should be to a. send a urine specimen to the laboratory to test for ketones. b. obtain a clean-catch urine for culture and sensitivity testing. c. inquire about which medications the patient is currently taking. d. ask the patient about any family history of chronic renal failure.
a. Auscultate for a bruit at the fistula site.
When caring for a patient with a left arm arteriovenous fistula, which action will the nurse include in the plan of care to maintain the patency of the fistula? a. Auscultate for a bruit at the fistula site. b. Assess the quality of the left radial pulse. c. Compare blood pressures in the left and right arms. d. Irrigate the fistula site with saline every 8 to 12 hours.
d. Patient who will have catheterization to check for residual urine after voiding
When working in the urology/nephrology clinic, which patient could the nurse delegate to an experienced licensed practical/vocational nurse (LPN/LVN)? a. Patient who is scheduled for a renal biopsy after a recent kidney transplant b. Patient who will need monitoring for several hours after a renal arteriogram c. Patient who requires teaching about possible post-cystoscopy complications d. Patient who will have catheterization to check for residual urine after voiding
c. The patient cleans the catheter while taking a bath each day.
Which action by a 70-year-old patient who is using peritoneal dialysis (PD) indicates that the nurse should provide more teaching about PD? a. The patient leaves the catheter exit site without a dressing. b. The patient plans 30 to 60 minutes for a dialysate exchange. c. The patient cleans the catheter while taking a bath each day. d. The patient slows the inflow rate when experiencing abdominal pain.
b. The patient has metastatic lung cancer.
Which information in a patient's history indicates to the nurse that the patient is not an appropriate candidate for kidney transplantation? a. The patient has type 1 diabetes. b. The patient has metastatic lung cancer. c. The patient has a history of chronic hepatitis C infection. d. The patient is infected with the human immunodeficiency virus.
a. Avoid commercial salt substitutes. c. Take phosphate-binders with each meal. d. Choose high-protein foods for most meals.
Which information will be included when the nurse is teaching self- management to a patient who is receiving peritoneal dialysis (select all that apply)? a. Avoid commercial salt substitutes. b. Drink 1500 to 2000 mL of fluids daily. c. Take phosphate-binders with each meal. d. Choose high-protein foods for most meals. e. Have several servings of dairy products daily.
b. Phosphate level
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. Restrict physical activity to bed rest.
Which intervention will be included in the plan of care for a male patient with acute kidney injury (AKI) who has a temporary vascular access catheter in the left femoral vein? a. Start continuous pulse oximetry. b. Restrict physical activity to bed rest. c. Restrict the patient's oral protein intake. d. Discontinue the urethral retention catheter.
d. Apply a pressure dressing and keep the patient on the affected side for 30 minutes.
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 for 30 minutes.
c. "I will measure my urinary output each day to help calculate the amount I can drink."
Which statement by a 62-year-old patient with stage 5 chronic kidney disease (CKD) indicates that the nurse's teaching about management of CKD has been effective? a. "I need to get most of my protein from low-fat dairy products." b. "I will increase my intake of fruits and vegetables to 5 per day." c. "I will measure my urinary output each day to help calculate the amount I can drink." d. "I need to take erythropoietin to boost my immune system and help prevent infection."
d. "My temperature is 101."
Which statement by a patient who had a cystoscopy the previous day should be reported immediately to the health care provider? a. "My urine looks pink." b. "My IV site is bruised." c. "My sleep was restless." d. "My temperature is 101."
A) The patient does not have to wear an external collection bag.
n consultation with her care team, a woman with a diagnosis of cancer has had a continent urinary diversion (Indiana pouch) created. The patient is discussing the advantages and disadvantages of this procedure with her nurse. The nurse should be aware of which of the following advantages of an Indiana pouch? A) The patient does not have to wear an external collection bag. B) The procedure can be performed on an outpatient basis. C) The procedure allows for the spontaneous resumption of normal genitourinary function. D) The patient does not require medical follow-up after the procedure.
