Acute Nursing Care: Renal/GU Prep Questions

A client has renal colic due to renal lithiasis. What is the nurse's first priority in managing care for this client? a. Do not allow the client to ingest fluids b. Encourage the client to drink at least 500mL of water c. Request the central supply department to send supplies for straining urine d. Administer an opioid analgesic as prescribed

Administer an opioid analgesic as prescribed

Which hospitalized client is at the highest risk for catheter-associated urinary tract infection (CAUTI)? a. Client with diabetes mellitus b. Client who had one course of antibiotic therapy c. Client with a family history of UTIs d. A client with a urinary calculus

Client with diabetes mellitus

A client has nephropathy. The health care provider (HCP) prescribes a 24-hour urine collection for creatinine clearance. Which action is necessary to ensure proper collection of the specimen? a. Collect the urine in a preservative-free container and keep it on ice b. Inform the client to discard the last voided specimen at the conclusion of the urine collection c. Obtain a self-report of the client's weight before beginning the collection of urine d. Request a prescription of insertion of an indwelling urinary catheter

Collect the urine in a preservative-free container and keep it on ice

A client with acute renal failure asks the nurse, " Will my kidneys ever function normally again?" What should the nurse tell the client? You will: a. Continue to improve over a period of weeks b. Likely need dialysis c. Improve when you have a kidney transplant d. Have more kidney damage in several years

Continue to improve over a period of weeks

Which abnormal blood value would not be improved by dialysis treatment? a. Elevated serum creatinine levels b. Hyperkalemia c. Decreased hemoglobin concentration d. Hypernatremia

Decrease hemoglobin concentration

A high-carbonate, low-protein diet is prescribed for the client with acute renal failure. What should the nurse tell the client to expect when following this diet? a. Act as a diuretic b. Reduce demands on the liver c. Help maintain urine acidity d. Prevent the development of ketosis

Prevent the development of ketosis

A client is scheduled to undergo weekly intravesical chemotherapy for bladder cancer for 8 weeks. Which statement indicates that the client understands how to manage the urine as a biohazard? a. "I'll void into a bedpan and then empty the urine into the toilet." b. "I can disinfect the urine and toilet with bleach for 6 hours following a treatment." c. "It's important to clean the bathroom daily with disinfectant wipes." d. "I should use a separate bathroom from the rest of the family for thee next 8 weeks."

"I can disinfect the urine and toilet with bleach for 6 hours following a treatment."

Which symptom indicates that a client has developed a complication after a cystoscopy? a. Dizziness b. Chills c. Pink-tinged urine d. Bladder spasms

Chills

A nurse is assessing a client with a urinary tract infection who takes an antihypertensive drug. The nurse reviews the client's urinalysis result. What should the nurse do next? pH 6.8, RBCs = 3 per high power field, color = yellow, specific gravity = 1.030 a. Encourage the client to increase fluid intake b. Withhold the next dose of antihypertensive medication c. Restrict the client's sodium intake d. Encourage the client to eat at least half of a banana per day

Encourage the client to increase fluid intake

The client newly diagnosed with chronic kidney disease recently has begun hemodialysis. Knowing that the client is at risk for disequilibrium syndrome, the nurse should assess the client during dialysis for which associated manifestations? a. Hypertension, tachycardia, and fever b. Hypotension, bradycardia, and hypothermia c. Restlessness, irritability, and generalized weakness d. Headache, deteriorating level of consciousness, and twitching

Headache, deteriorating level of consciousness, and twitching

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 for which complication? a. Infection b. Hyperglycemia c. Hypophosphatemia d. Disequilibrium syndrome

Hyperglycemia

The nurse is instructing the client with chronic renal failure to maintain adequate nutritional intake. Which diet would be most appropriate? a. High-carbonate, high-protein b. High-calcium, high-potassium, high-protein c. Low-protein, low-sodium, low-potassium d, Low-protein, high-potassium

Low-protein, low-sodium, low-potassium

Which should be included in the client's plan of care during dialysis therapy? a. Limit the client's blood pressure b. Monitor the client's blood pressure c. Pad the side rails of the bed d. Keep thee client on nothing-by-mouth (NPO)

Monitor the client's blood pressure

A client is to relieve peritoneal dialysis. What should the nurse do to prepare the client for the procedure? a. Assess the dialysis access for a bruit and thrill b. Insert an indwelling urinary catheter and drain all the urine from the bladder c. Ask the client to turn toward the left side d. Warm the dialysis solution in the warmer

Warm the dialysis solution in the warmer

An older adult is admitted with new-onset confusion, headache, poor skin turgor, bounding pulse, and urinary incontinence and has been drinking copious amounts of water. Upon reviewing the lab results, the nurse discovers a sodium level of 122 mEq/L. A report to the health care provider (HCP) should include what recommendations? (Select all that apply). a. Fluid restriction b. Vital signs at least every 2 hours c. Bed alarm d. Foley catheter e. 2-g sodium diet

a, b, c, d

The nurse explains to the client the importance of drinking large quantities of fluid to prevent cystitis. How much fluid should the nurse tell the client to drink? a. Twice as much fluid as usual b. At least 1,000 mL more than usual c. As much water or juice as possible d. At least 3,000 mL of fluids daily

At least 3,000 mL of fluids daily

A client with end-stage chronic renal failure is admitted to the hospital with a serum potassium level of 7 mEq/L. In what order to priority from first to last does the nurse perform the prescriptions. a. Administer regular insulin and dextrose b. Start an IV access site c. Obtain serum potassium level d. Attach the client to a cardiac monitor

b, d, a, c

A client developed cardiogenic shock after a severe myocardial infarction and has now developed acute renal failure. What should the nurse tell the family? "Because of the cardiogenic shock. there is: a. A decrease in the blood flow through the kidneys." b. An obstruction of urine flow from the kidneys." c. A clot that formed in the kidneys." d. Structural damage to the kidneys."

A decrease in the blood flow through the kidneys

The client with acute renal failure asks the nurse for a snack. Because the client's potassium level is elevated, which snack is most appropriate? a. A gelatin dessert b. Yogurt c. An orange d. Peanuts

A gelatin dessert

Aluminum hydroxide gel is prescribed for the client with chronic renal failure to take at home. What is the expected outcome of this drug? a. Relieving the pain of gastric hyperacidity b. Preventing stress ulcers c. Binding phosphate in the intestine d. Reversing metabolic acidosis

Binding phosphate in the intestine

A client with acute renal failure has a serum potassium level of 6.5 mEq/L. The nurse should monitor the client for which potential complication? a. Cardiac arrest b. Pulmonary edema c. Circulatory collapse d. Hemorrhage

Cardiac arrest

A client with end-stage renal failure has an internal arteriovenous fistula in the left arm for vascular access during hemodialysis. What should the nurse instruct the client to do? a. Remind health care providers to draw blood from the veins on the left side b. Avoid sleeping on the left side c. Wear a wristband on the right arm d. Assess fingers on the left arm for warmth e. Obtain blood pressures from the left arm

a, b, e

A client had a percutaneous nephrolithotomy to remove a kidney stone. The client is being discharged with drainage tubes from the kidney. What should the nurse instruct the client to do after the procedure? (Select all that apply). a. Avoid heavy lifting for 2-4 weeks b. Return to work after 1 month c. Report fever or chills to the health care provider (HCP) d. Go to the emergency department for bleeding from the drainage tubes e. Strain all urine and report presence of stones

a, c, d

A nurse is planning care for a client who underwent a percutaneous needle biopsy of the kidney. What should the nurse plan to do immediately after the biopsy? (Select all that apply). a. Assess the biopsy site b. Take vital signs every hour c. Assess urine for hematuria d. Place the client in a prone position e. Assess the client for chest pain

a, c, d

Which of the responsibilities related to the care of a client with a Foley catheter are appropriate for the nurse to delegate to the unlicensed assistive personnel (UAP)? (Select all that apply). a. Flush the catheter to ensure patency b. Empty drainage bag, and record output at specific times c. Perform bladder irrigation as prescribed d. Provide Foley catheter and perineal care each shift e. Ensure the drainage bag is below the level of the bladder at all times

b, d, e