Ch 65 NCLEX

One of the nurse's roles is talking to adult clients about urinary and sexual hygiene. Which words does the nurse use when referring to the client's reproductive body areas?

Words that the client uses

Which percussion technique does the nurse use to assess a client who reports flank pain?

Place one hand with the palm down flat over the flank area and use the other fisted hand to thump the hand on the flank.

The RN is caring for a client who has just had a kidney biopsy. Which action does the nurse perform first?

Position the client supine.

A client is in the emergency department for an inability to void and for bladder distention. What is most important for the nurse to provide to the client?

Privacy

A client had a computed tomography (CT) scan with contrast dye 8 hours ago. Which nursing intervention is the priority for this client?

Promoting fluid intake

A client has returned from a captopril renal scan. Which teaching does the nurse provide when the client returns to the unit?

"Arise slowly and call for assistance when ambulating."

Which instruction does the nurse give a client who needs a clean-catch urine specimen?

"Do not touch the inside of the container."

An older adult woman who reports a change in bladder function says, "I feel like a child who sometimes pees her pants." What is the nurse's best response?

"Have you tried using the toilet at least every couple of hours?"

The nurse is teaching a client how to provide a clean-catch urine specimen. Which statement by the client indicates that teaching was effective?

"I'll start to urinate in the toilet, stop, and then urinate into the cup."

When obtaining a health history from a 22-year-old female client who has new onset urinary incontinence, which findings or factors does the nurse consider significant? (Select all that apply.) a. Chemical exposure in the workplace b. A burning sensation occurring on urination c. Urinating 10 times daily although fluid intake remains unchanged d. A recent change in the client's oral contraceptive prescription e. A new inability to hold urine (urgency) f. A "stinky" odor from the urine

A burning sensation occurring on urination Urinating 10 times daily although fluid intake remains unchanged A new inability to hold urine (urgency) A "stinky" odor from the urine

A client with these assessment data is preparing to undergo a computed tomography (CT) scan with contrast:Physical AssessmentDiagnostic FindingsMedicationsFlank painBUN 54 mg/dL (19.3 mmol/L)CaptoprilDysuriaCreatinine 2.4 mg/dL (212 umol/L)MetforminBilateral knee painCalcium 8.5 mg/dL (2.13 mmol/L)AcetylcysteineWhich medication does the nurse plan to administer before the procedure?

Acetylcysteine (Mucomyst)

Which client being managed for dehydration does the nurse consider at greatest risk for possible reduced kidney function?

An 80-year-old man who has benign prostatic hyperplasia

Which laboratory test is the best indicator of kidney function?

Creatinine

Which technique does the nurse use to obtain a sterile urine specimen from a client with a Foley catheter?

Clamp the tubing, attach a syringe to the specimen, and withdraw at least 5 mL of urine.

For which clients scheduled for a computed tomography (CT) scan with contrast does the nurse communicate safety concerns to the health care provider (HCP)?

Client with an allergy to shrimp Client with a history of asthma Client with a blood urea nitrogen of 62 mg/dL (22.1 mmol/L) and a creatinine of 2.0 mg/dL (177 umol/L) Client who took metformin (Glucophage) 4 hours ago

The nurse has these client assignments. Which client does the nurse encourage to consume 2 to 3 liters of fluid each day?

Client with hyperparathyroidism

The charge nurse is making client assignments for the day shift. Which client is best to assign to an LPN/LVN?

Client with polycystic kidney disease who is having a kidney ultrasound

Which age-related change can cause nocturia?

Decreased ability to concentrate urine

When planning an assessment of the urethra, what does the nurse do first?

Don gloves.

When performing bladder scanning to detect residual urine in a female client, the nurse must first assess which factor?

History of hysterectomy

The nurse is reviewing the medical record for a client with polycystic kidney disease who is scheduled for computed tomographic angiography with contrast:History and Physical AssessmentMedicationsDiagnostic FindingsPolycystic kidney diseaseDiabetesHysterectomyAbdomen distendedNegative edemaGlyburideMetforminSynthroidBUN 26 mg/dL (9.2 mmol/L)Creatinine 1.0 mg/dL (77 umol/L)HbA1c 6.9%Glucose 132 mg/dL (7.3 mmol/L)Which intervention is essential for the nurse to perform?

Hold the metformin 24 hours before and on the day of the procedure.

Which urinary assessment information for a client indicates the potential need for increased fluids?

Increased blood urea nitrogen

When a client with diabetes returns to the medical unit after a computed tomography (CT) scan with contrast dye, all of these interventions are prescribed. Which intervention does the nurse implement first?

Infuse 0.45% normal saline at 125 mL/hr.

When caring for a client with uremia, the nurse assesses for which symptom?

Nausea and vomiting

A client is scheduled for a cystoscopy later this morning. The consent form is not signed, and the client has not had any preoperative medication. The nurse notes that the health care provider (HCP) visited the client the day before. What action does the nurse take?

Notifies the department and the HCP

The nurse visualizes blood clots in a client's urinary catheter after a cystoscopy. What nursing intervention does the nurse perform first?

Notify the health care provider (HCP).

Which assessment finding alarms the nurse immediately after a client returns from the operating room for cystoscopy performed under conscious sedation?

Temperature of 100.8°F (38.2°C)

Which symptom(s) in a client during the first 12 hours after a kidney biopsy indicates to the nurse a possible complication from the procedure?

The heart rate is 118, blood pressure is 108/50, and peripheral pulses are thready.

The nurse is admitting a client who has type 2 diabetes (T2D) and is scheduled for surgery. Which laboratory findings from this client's admission panel does the nurse report as indicating possible abnormal kidney function? (Select all that apply.) a. Presence of ammonia in the urine b. Urine microalbumin 240 mcg/24 hour (0.240 g/24 hour) c. Urine specific gravity of 1.028 d. Blood urea nitrogen of 38 mg/dL (13.5 mmol/L) e. Serum creatinine 2.2 mg/dL (294.3 mcmol/L) f. Blood osmolarity 290 mOsm/kg (290 mmol/kg)

Urine microalbumin 240 mcg/24 hr Blood urea nitrogen of 38 mg/dL Serum creatinine 2.2 mg/dL