Urinary/Reproductive

A nurse plans to teach the signs of rejection to a client who just had a transplanted kidney. What sign of rejection should the nurse include? 1. Weight loss 2. Subnormal temperature 3. Elevated blood pressure 4. Increased urinary output

3. Elevated blood pressure

The nurse assesses a male client with a preliminary diagnosis of cancer of the urinary bladder. The nurse recalls that which sign or symptom is a common early sign of cancer of the urinary system: 1. Dysuria 2. Retention 3. Hesitancy 4. Hematuria

4. Hematuria

During discharge teaching, a client with an ileal conduit asks how frequently the urine pouch should be emptied. The best reply by the nurse is: 1. "To prevent leakage and pulling of the pouch from the skin, it should be emptied every few hours." 2. "To prevent skin irritation, it should be emptied every hour if any urine has collected in the bag." 3. "To reduce the risk of infection, the system should be opened as little as possible; two times a day is adequate." 4. "To reduce the cost of drainage pouches, it should be emptied once the system is switched to a bedside collection bag."

1. "To prevent leakage and pulling of the pouch from the skin, it should be emptied every few hours."

A client with end-stage renal disease is hospitalized. For what signs and symptoms of complications should the nurse monitor the client? (Select all that apply.) 1. Anemia 2. Dyspnea 3. Jaundice 4. Anasarca 5. Hyperexcitability

1. Anemia 2. Dyspnea 4. Anasarca **Anemia is due to decreased production of erythropoietin by the kidneys, which causes decreased erythropoiesis by bone marrow. Dyspnea is a result of fluid overload, which is associated with chronic kidney failure. Diffuse, profound interstitial edema caused by altered capillary permeability and decreased cellular perfusion (anasarca) is associated with end-stage renal disease.

Despite receiving 2900 mL intake for two days, the client's urine output has progressively diminished. The nurse identifies that the urinary output is less than 40 mL/hr over the past three hours. What action should the nurse take? 1. Assess breath sounds and obtain vital signs 2. Decrease the intravenous (IV) flow rate and increase oral fluids 3. Insert an indwelling catheter to facilitate emptying of the bladder 4. Check for dependent edema by assessing the lower extremities

1. Assess breath sounds and obtain vital signs

A nurse is caring for a client with end-stage renal disease who has a mature arteriovenous (AV) fistula. What nursing care should be included in the client's plan of care? (Select all that apply.) 1. Auscultate for a bruit. 2. Palpate the site to identify a thrill. 3. Irrigate with saline to maintain patency. 4. Avoid drawing blood from the affected extremity. 5 . Keep the fistula clamped until ready to perform dialysis.

1. Auscultate for a bruit. 2. Palpate the site to identify a thrill. 4. Avoid drawing blood from the affected extremity.

A nurse instructs a client with a history of frequent urinary tract infections to drink cranberry juice to: 1. Decrease the urinary pH 2. Exert a bactericidal effect 3. Improve glomerular filtration 4. Relieve the symptoms of dysuria

1. Decrease the urinary pH

A client with acute renal failure moves into the diuretic phase after one week of therapy. For which signs during this phase should the nurse assess the client? (Select all that apply.) 1. Dehydration 2. Hypovolemia 3. Hyperkalemia 4. Metabolic acidosis 5. Skin rash

1. Dehydration 2. Hypovolemia

Trimethoprim-sulfamethoxazole (Septra) is prescribed for a client with cystitis. When teaching about the medication, the nurse instructs the client to: 1. Drink 8 to 10 glasses of water daily 2. Drink two glasses of orange juice daily 3. Take the medication with meals 4. Take the medication until symptoms subside

1. Drink 8 to 10 glasses of water daily

Which action should be included in the plan of care for a client who has had pelvic surgery? 1. Encouraging the client to ambulate in the hallway. 2. Elevating the client's legs by raising the bed's knee support. 3. Assisting the client to dangle the legs over the side of the bed. 4. Maintaining the client on bed rest until the bandages are removed.

1. Encouraging the client to ambulate in the hallway.

The most essential nursing intervention for a client with a nephrostomy tube is to: 1. Ensure free drainage of urine 2. Milk the tube every two hours 3. Instill 2 mL of normal saline every eight hours 4. Keep an accurate record of intake and output

1. Ensure free drainage of urine

A client has a kidney transplant. The nurse should monitor for which signs associated with rejection of the transplant? (Select all that apply.) 1. Fever 2. Oliguria 3. Jaundice 4. Moon face 5. Weight gain

1. Fever 2. Oliguria 5. Weight gain

A client is admitted to a medical unit with the diagnosis of acute kidney failure. The nurse reviews the client's laboratory data, performs a physical assessment, and obtains the client's vital signs. What should the nurse conclude the client is most likely experiencing? 1. Hyperkalemia 2. Hyponatremia 3. Hypouricemia 4. Hypercalcemia

1. Hyperkalemia

A client is diagnosed as having kidney failure. During the oliguric phase the nurse should assess the client for: 1. Hyperkalemia 2. Hypocalcemia 3. Hypernatremia 4. Hypoproteinemia

1. Hyperkalemia

A nurse is caring for a client who is admitted with ureteral colic and hematuria. The client also has stage 1 hypertension and is overweight. Which assessment finding should the nurse be most concerned about at this time? 1. Pain 2. Weight 3. Hematuria 4. Blood pressure of 120/64

1. Pain

The nurse is providing dietary teaching to a 40-year-old client who is receiving hemodialysis. The nurse should encourage the client to include what in the client's dietary plan? 1. Rice 2. Potatoes 3. Canned salmon 4. Barbecued beef

1. Rice **Foods high in carbohydrates and low in protein, sodium, and potassium are encouraged for these clients.

After a nephrectomy a client arrives in the post-anesthesia care unit in the supine position. Which action should be employed by the nurse to assess the client for signs of hemorrhage? 1. Turn the client to observe the dressings. 2. Press the client's nail beds to assess capillary refill. 3. Observe the client for hemoptysis when suctioning. 4. Monitor the client's blood pressure for a rapid increase.

1. Turn the client to observe the dressings.

A nurse is evaluating a client's response to fluid replacement therapy. Which clinical finding indicates adequate tissue perfusion to vital organs? 1. Urinary output of 30 mL in an hour 2. Central venous pressure reading of 2 mm Hg 3. Baseline pulse rate of 120 that decreases to 110 beats/min within a 15-minute period 4. Baseline blood pressure of 50/30 that increases to 70/40 mm Hg within a 30-minute period

1. Urinary output of 30 mL in an hour **A urinary output rate of 30 mL/hour is considered adequate for perfusion of the kidneys, heart, and brain.

A nurse is caring for a client with an indwelling urinary catheter. What is the most important action for the nurse to implement when irrigating the bladder? 1. Use sterile equipment. 2. Instill the fluid under high pressure. 3. Warm the solution to body temperature. 4. Aspirate immediately to ensure return flow.

1. Use sterile equipment.

A client has a permanent colostomy. During the first 24 hours, there is no drainage from the colostomy. The nurse concludes that this is a result of the: 1. Edema after the surgery 2. Absence of intestinal peristalsis 3. Decrease in fluid intake before surgery 4. Effective functioning of the nasogastric tube

2. Absence of intestinal peristalsis

A nurse concludes that the anemia that accompanies chronic kidney disease should be treated because it contributes to: 1. Uremic frost 2. Chronic fatigue 3. Tubular necrosis 4. Dependent edema

2. Chronic fatigue

The nurse is providing postoperative care eight hours after a client had a total cystectomy and the formation of an ileal conduit. What assessment finding should be reported immediately? 1. Edematous stoma 2. Dusky-colored stoma 3. Absence of bowel sounds 4. Pink-tinged urinary drainage

2. Dusky-colored stoma

A client with a history of chronic kidney disease is hospitalized. The nurse assesses the client for signs of related kidney insufficiency, which include: 1. Facial flushing 2. Edema and pruritus 3. Dribbling after voiding 4. Diminished force and caliber of stream

2. Edema and pruritus

The nurse reviews a client's medication history, which includes a cholinergic medication. The client states, "I take that for some kind of urinary problem." The nurse recalls that cholinergic medications are prescribed primarily for what type of urinary condition? 1. Kidney stones 2. Flaccid bladder 3. Spastic bladder 4. Urinary tract infections

2. Flaccid bladder

A client who had a transurethral resection of the prostate is transferred to the post-anesthesia care unit with an IV and a urinary retention catheter. For which major complication is it most important for the nurse to assess during the immediate postoperative period? 1. Sepsis 2. Hemorrhage 3. Leakage around the catheter 4. Urinary retention with overflow

2. Hemorrhage

An acute, life-threatening complication for which a nurse should assess a client in the early postoperative period after a radical nephrectomy is: 1. Sepsis 2. Hemorrhage 3. Renal failure 4. Paralytic ileus

2. Hemorrhage

A nurse is caring for a client who is being treated with continuous ambulatory peritoneal dialysis (CAPD) for chronic glomerulonephritis. What dietary need should the nurse discuss with the client? 1. Low-calorie foods 2. High-quality protein 3. Increased fluid intake 4. Foods rich in potassium

2. High-quality protein

A nurse is caring for a client who is scheduled for cystoscopy. What should the nurse include in the client's postprocedure teaching plan? 1. Remain flat in bed for the first 24 hours 2. Increase fluid intake for three to four days postoperatively 3. Notify the nurse if there is any drainage on the dressing 4. Bear down when attempting to void during the first six hours

2. Increase fluid intake for three to four days postoperatively

The nurse is caring for a client with acute renal failure. The most serious complication for this client is: 1. Anemia 2. Infection 3. Weight loss 4. Platelet dysfunction

2. Infection **Infection is responsible for one third of the traumatic or surgically induced deaths of clients with acute renal failure, as well as for medically induced acute renal failure.

A nurse is assessing a client who is scheduled for a liver biopsy. What assessment finding needs to be reported immediately because it warrants a postponement of the liver biopsy? 1. Mental confusion 2. International normalized ratio (INR) of 4.0 3. Presence of an infectious disease 4. Foods high in vitamin K eaten before the biopsy

2. International normalized ratio (INR) of 4.0

A nurse is caring for a client with chronic kidney failure. Which clinical findings should the nurse expect when assessing this client? (Select all that apply.) 1. Polyuria 2. Lethargy 3. Hypotension 4. Muscle twitching 5. Respiratory acidosis

2. Lethargy 4. Muscle twitching

A nurse is caring for a client with a diagnosis of renal calculi secondary to hyperparathyroidism. Which type of diet should the nurse explore with the client when providing discharge information? 1. Low purine 2. Low calcium 3. High phosphorus 4. High alkaline ash

2. Low calcium

A client's urine specific gravity is being measured. For what condition should the nurse conduct a focused assessment when a client's specific gravity is increased? 1. Fluid overload 2. Low-grade fever 3. Diabetes insipidus 4. Chronic kidney disease

2. Low-grade fever

A client is diagnosed with calcium oxalate renal calculi. Which nutrients should the nurse teach the client to avoid? (Select all that apply.) 1. Milk 2. Nuts 3. Liver 4. Spinach 5. Rhubarb

2. Nuts 4. Spinach 5. Rhubarb

A nurse is caring for an older bedridden male client who is incontinent of urine. What nursing intervention is the most satisfactory initial approach to managing urinary incontinence? 1. Restricting fluid intake 2. Offering the urinal regularly 3. Applying incontinence pants 4. Inserting an indwelling urinary catheter

2. Offering the urinal regularly

When a client returns from the postanesthesia care unit after a kidney transplant, the nurse should plan to measure the client's urinary output every: 1. 15 minutes 2. One hour 3. Two hours 4. Three hours

2. One hour

A client is admitted to the hospital with a diagnosis of chronic kidney disease. Which responses should the nurse expect the client to exhibit? (Select all that apply.) 1. Polyuria 2. Paresthesias 3. Hypertension 4. Metabolic alkalosis 5. Widening pulse pressure

2. Paresthesias 3. Hypertension

A nurse is caring for a client who has a radium implant for cancer of the cervix. What is the priority nursing intervention? 1. Store urine in lead-lined containers. 2. Restrict visitors to a 10-minute stay. 3. Wear a lead-lined apron when giving care. 4. Avoid giving injections in the gluteal muscle.

2. Restrict visitors to a 10-minute stay.

A sexually active client presents with a sore throat and a generalized rash. The client states that a chancre that had been present healed approximately three months ago. The physical assessment and the serologic test findings indicate a diagnosis of syphilis. The nurse recognizes that the client is experiencing what stage of syphilis? 1. Primary 2. Secondary 3. Latent 4. Tertiary

2. Secondary

A nurse is caring for a client who had a kidney transplant. Which test is most important for determining whether a client's newly transplanted kidney is working effectively? 1 Renal scan 2. Serum creatinine 3. 24-hour urine output 4. White blood cell (WBC) count

2. Serum creatinine

A client who has been on hemodialysis for several weeks asks the nurse what substances are being removed by the dialysis. The nurse informs the client that one of the substances passing through the membrane is: 1. Blood 2. Sodium 3. Glucose 4. Bacteria

2. Sodium

When assessing a client during peritoneal dialysis, a nurse observes that drainage of the dialysate from the peritoneal cavity has ceased before the required volume has returned. What should the nurse instruct the client to do? 1. Drink a glass of water 2. Turn from side to side 3. Deep breathe and cough 4. Rotate the catheter periodically

2. Turn from side to side **Turning from side to side will change the position of the catheter, thereby freeing the drainage holes of the tubing, which may be obstructed.

The laboratory values of a client with renal calculi reveal a serum calcium within expected limits and an elevated serum purine. The nurse concludes that the stone probably is composed of: 1. Cystine 2. Uric acid 3. Calcium oxalate 4. Magnesium ammonium phosphate

2. Uric acid

The nurse determines that which genitourinary factor contributes to urinary incontinence in older adults? 1. Sensory deprivation 2. Urinary tract infection 3. Frequent use of diuretics 4. Inaccessibility of a bathroom

2. Urinary tract infection

An older adult client is demonstrating mild confusion after surgical repair of a hernia. What should the nurse do to provide for this client's safety? 1. Use a nightlight in the client's room. 2. Secure a prescription for a soft vest restraint. 3. Activate the position-sensitive bed alarm. 4. Raise the four side rails on the client's bed.

3. Activate the position-sensitive bed alarm.

For which clinical indicator should a nurse monitor a client with end-stage renal disease? 1. Polyuria 2. Jaundice 3. Azotemia 4. Hypotension

3. Azotemia **Azotemia is an increase in nitrogenous waste (particularly urea) in the blood, which is common with end-stage renal disease.

A client admitted to the hospital in the oliguric phase of acute renal failure estimates that the urine output for the last 12 hours was less than 240 mL. The nurse reviews the plan of care and notes a prescription for 900 mL of water to be given orally over the next 24 hours. The nurse concludes that this amount of fluid was prescribed to: 1. Equal the expected urinary output for the next 24 hours 2. Prevent the development of hypostatic pneumonia and fever 3. Compensate for both insensible and expected output over the next 24 hours 4. Prevent hyperkalemia, which can lead to life-threatening cardiac dysrhythmias

3. Compensate for both insensible and expected output over the next 24 hours **Insensible losses are 400 to 500 mL in 24 hours; the measured output is about 400 mL in 24 hours based on the available history.

A nurse obtains a health history from a client with the diagnosis of renal calculi. The nurse concludes that the factor that most likely contributed to the calculi development is the client's: 1. High cholesterol diet 2. Excessive exercise program 3. Excess ingestion of antacids 4. Frequent consumption of alcohol

3. Excess ingestion of antacids

A client with uremic syndrome has the potential to develop many complications. Which complication should the nurse anticipate? 1. Hypotension 2. Hypokalemia 3. Flapping hand tremors 4. Elevated hematocrit values

3. Flapping hand tremors

A client with acute glomerulonephritis reports feeling thirsty. What should the nurse offer the client? 1. Ginger ale 2. Milkshake 3. Hard candy 4. Chicken broth

3. Hard candy

A nurse is caring for a client receiving hemodialysis for chronic kidney disease. The nurse should monitor the client for what complication? 1. Peritonitis 2. Renal calculi 3. Hepatitis B 4. Bladder infection

3. Hepatitis B **Hepatitis type B is transmitted by blood or blood products. The hemodialysis and routine transfusions needed for a client in end-stage renal failure constitute a high risk for exposure.

A client experiences difficulty in voiding after an indwelling urinary catheter is removed. The nurse determines that this difficulty most likely is related to: 1. Fluid imbalance 2. Sedentary lifestyle 3. Interruption in previous voiding habits 4. Nervous tension following the procedure

3. Interruption in previous voiding habits

A nurse is monitoring a client with renal failure for signs of fluid excess. Which finding does the nurse identify as inconsistent with fluid excess? 1. Increased weight 2. Distended neck veins 3. Orthostatic hypotension 4. Abnormal breath sounds

3. Orthostatic hypotension **Hypertension, not hypotension, is an indicator of fluid volume excess.

A nurse teaches a client with chronic renal failure that salt substitutes cannot be used in the diet because: 1. A person's body tends to retain fluid when a salt substitute is included in the diet. 2. Limiting salt substitutes in the diet prevents a buildup of waste products in the blood. 3. Salt substitutes contain potassium, which must be limited to prevent abnormal heartbeats. 4. A substance in the salt substitute interferes with the transfer of fluid across capillary membranes, resulting in anasarca.

3. Salt substitutes contain potassium, which must be limited to prevent abnormal heartbeats.

A client comes to the emergency department because of minimal urinary output despite drinking adequate fluid. The client's blood pressure is 190/94. For what additional clinical manifestation associated with this data, should the nurse assess the client? 1. Thirst 2. Urinary retention 3. Weight gain 4. Urinary hesitancy

3. Weight gain

What does the nurse determine is the most likely cause of renal calculi in clients with paraplegia? 1. High fluid intake 2. Increased intake of calcium 3. Inadequate kidney function 4. Accelerated bone demineralization

4. Accelerated bone demineralization

A client with acute kidney failure becomes confused and irritable. Which does the nurse determine is the most likely cause of this behavior? 1. Hyperkalemia 2. Hypernatremia 3. A limited fluid intake 4. An increased blood urea nitrogen level

4. An increased blood urea nitrogen level

During the postoperative period after surgery for a kidney transplant, the client's creatinine level is 3.1 mg/dL. What should the nurse do first in response to this laboratory result? 1. Notify the health care provider. 2. Check the intravenous (IV) infusion. 3. Obtain current blood test results. 4. Assess for decreased urine output.

4. Assess for decreased urine output.

A client just had a suprapubic prostatectomy. Which action should the nurse implement to prevent a secondary bladder infection? 1. Observe for signs of uremia 2. Attach the catheter to suction 3. Clamp off the connecting tube 4. Change the dressings frequently

4. Change the dressings frequently **After a suprapubic prostatectomy, leakage of urine generally is identified around the suprapubic tube; this creates an environment in which bacteria can flourish if the dressing is not changed frequently.

Which nursing action can best prevent infection from a urinary retention catheter? 1. Cleansing the perineum 2. Encouraging adequate fluids 3. Irrigating the catheter once daily 4. Cleansing around the meatus routinely

4. Cleansing around the meatus routinely

Which clinical manifestation should a nurse expect a client with diabetes insipidus to exhibit? 1. Increased blood glucose 2. Decreased serum sodium 3. Increased specific gravity 4. Decreased urine osmolarity

4. Decreased urine osmolarity

After a successful kidney transplant for a client with end-stage kidney disease, the nurse anticipates that laboratory studies will demonstrate: 1. Increased specific gravity 2. Correction of hypotension 3. Elevated serum potassium 4. Decreasing serum creatinine

4. Decreasing serum creatinine

A nurse assesses a newly admitted client with renal colic to determine the signs and symptoms that are present. The nurse assesses the client for which primary subjective symptom? 1. Uremia 2. Nausea 3. Voiding at night 4. Flank discomfort

4. Flank discomfort

A nurse is caring for a client with a diagnosis of chronic kidney failure who has just been told by the health care provider that hemodialysis is necessary. Which clinical manifestation indicates the need for hemodialysis? 1. Ascites 2. Acidosis 3. Hypertension 4. Hyperkalemia

4. Hyperkalemia **Protein breakdown liberates cellular potassium ions, leading to hyperkalemia, which can cause a cardiac dysrhythmia and standstill.

A nurse is developing a discharge plan for a client who was hospitalized with severe cirrhosis of the liver. The plan should include the: 1. Need for a high protein diet 2. Use of a sedative for relaxation 3. Need to increase fluids 4. Importance of reporting personality changes to the health care provider

4. Importance of reporting personality changes to the health care provider

The nurse providing postoperative care for a client who had kidney surgery reviews the client's urinalysis results. The nurse concludes that the presence of what substance in the urine needs to be reported to the health care provider? 1. Sodium 2. Potassium 3. Urea nitrogen 4. Large proteins

4. Large proteins

A male client reports dysuria, nocturia, and difficulty starting the urinary stream. A cystoscopy and biopsy of the prostate gland have been scheduled. After the procedure the client reports an inability to void. The nurse should: 1. Limit oral fluids until the client voids 2. Assure the client that this is expected 3. Insert a urinary retention catheter 4. Palpate above the pubic symphysis

4. Palpate above the pubic symphysis

The nurse should ask the client with secondary syphilis about sexual contacts during the past: 1. 21 days 2. 30 days 3. Three months 4. Six months

4. Six months **The client is in the secondary stage, which begins from six weeks to six months after primary contact; therefore, a six-month history is needed to ensure that all possible contacts are located.

What should a nurse do when caring for a client with continuous bladder irrigation? 1. Measure the output hourly. 2. Monitor the specific gravity of the urine. 3. Irrigate the catheter with saline three times daily. 4. Subtract the amount of irrigant instilled from the output.

4. Subtract the amount of irrigant instilled from the output.

A client is scheduled for an intravenous pyelogram (IVP). The nurse explains that on the day before the IVP the client must: 1. Avoid fats and proteins 2. Drink a large amount of fluids 3. Omit dinner and limit beverages 4. Take a laxative before going to bed

4. Take a laxative before going to bed **Laxatives remove feces and flatus, providing better visualization.

A client is receiving furosemide (Lasix) to relieve edema. The nurse should monitor the client for which responses? (Select all that apply.) 1 . Weight loss 2 . Negative nitrogen balance 3. Increased urine specific gravity 4. Excessive loss of potassium ions 5 . Pronounced retention of sodium ions

1 . Weight loss 4. Excessive loss of potassium ions

Which statement regarding treatment with interferon indicates that the client understands the nurse's teaching? 1. "I will drink two to three quarts of fluid a day." 2. "Any reconstituted solution must be discarded in one week." 3. "I can continue driving my car as long as I have the stamina." 4. "While taking this medicine I should be able to continue my usual activity."

1. "I will drink two to three quarts of fluid a day."

A client who has had a transurethral prostatectomy (TURP) experiences dribbling after the indwelling catheter is removed. To address this problem, an appropriate nursing response is: 1. "Increase your fluid intake and urinate at regular intervals." 2. "I know you're worried, but it will go away in a few days." 3. "Limit your fluid intake and urinate when you first feel the urge." 4. "The catheter will have to be reinserted until your bladder regains its tone."

1. "Increase your fluid intake and urinate at regular intervals."

A client is admitted to the hospital for acute gastritis and ascites secondary to alcoholism and cirrhosis. It is most important for the nurse to assess this client for: 1. Blood in the stool 2. Food intolerances 3. Complaints of nausea 4. Hourly urinary output

1. Blood in the stool

A client is scheduled for a transurethral resection of the prostate. What should the nurse tell the client to expect after surgery? 1. "Urinary control may be permanently lost to some degree." 2. "An indwelling urinary catheter is required for at least a day." 3. "Your ability to perform sexually will be impaired permanently." 4. "Burning on urination will last while the cystotomy tube is in place."

2. "An indwelling urinary catheter is required for at least a day."

A client with tuberculosis is started on a chemotherapy protocol that includes rifampin (RIF). The nurse evaluates that the teaching about rifampin is effective when the client states: 1. "I need to drink a lot of fluid while I take this medication." 2. "I can expect my urine to turn orange from this medication." 3. "I should have my hearing tested while I take this medication." 4. "I might get a skin rash because it is an expected side effect of this medication."

2. "I can expect my urine to turn orange from this medication."

A client with an ileal conduit is being prepared for discharge. As part of the discharge teaching, the nurse instructs the client to: 1. Abstain from beer and alcohol consumption 2. Maintain fluid intake of at least 2 L daily 3. Notify the health care provider if the stoma size decreases 4. Avoid getting soap and water on the peristomal skin

2. Maintain fluid intake of at least 2 L daily

A client is admitted to the hospital with urinary retention, and an indwelling urinary catheter is prescribed by the health care provider. What should the nurse do to help prevent the client from developing a urinary tract infection? 1. Assess urine specific gravity 2. Maintain the prescribed hydration 3. Collect a weekly urine specimen 4. Empty the drainage bag frequently

2. Maintain the prescribed hydration

When receiving hemodialysis, the complication of the removal of too much sodium may occur. For which clinical findings associated with hyponatremia should the nurse assess the client? (Select all that apply.) 1. Chvostek sign 2. Muscle cramps 3. Extreme fatigue 4. Cardiac dysrhythmias 5. Increased temperature

2. Muscle cramps 3. Extreme fatigue

A client who had a suprapubic prostatectomy returns from the post-anesthesia care unit and accidentally pulls out the urethral catheter. What should the nurse do first? 1. Reinsert a new catheter. 2. Notify the health care provider. 3. Check for bleeding by irrigating the suprapubic tube. 4. Take no immediate action if the suprapubic tube is draining.

2. Notify the health care provider.

When performing a peritoneal dialysis procedure, the nurse should: 1. Place the client in a side-lying position 2. Warm dialysate solution slightly before instillation 3. Infuse the dialysate solution slowly over several hours 4. Withhold the routine medications until after the procedure

2. Warm dialysate solution slightly before instillation

A client is to have hemodialysis. What must the nurse do before this treatment? 1. Obtain a urine specimen to evaluate kidney function. 2. Weigh the client to establish a baseline for later comparison. 3. Administer medications that are scheduled to be given within the next hour. 4. Explain that the peritoneum serves as a semipermeable membrane to remove wastes.

2. Weigh the client to establish a baseline for later comparison.

A nurse is caring for a client with end-stage renal disease. Which clinical indicators of end-stage renal disease should the nurse expect? (Select all that apply.) 1. Polyuria 2. Jaundice 3 .Azotemia 4. Hypertension 5. Polycythemia

3 .Azotemia 4. Hypertension

A nurse is preparing to discharge a client who had a transurethral prostatectomy for benign prostatic hyperplasia. The nurse evaluates that the client understands the discharge teaching when the client states: 1. "I will drink 6-8 cups of fluid daily and no fluids near bedtime." 2. "Now I don't have to go back to my health care provider's office." 3. "I will use stool softeners regularly for the next one to two months." 4. "I plan to go home and have sexual intercourse with my spouse."

3. "I will use stool softeners regularly for the next one to two months."

The nurse is providing care to a client who is being treated for bacterial cystitis. Before discharge, it is most important for the client to: 1. Understand the need to drink 4 L of water per day, an essential measure to prevent dehydration 2. Be able to identify dietary restrictions and plan menus 3. Achieve relief of symptoms and to maintain kidney function 4. Recognize signs of bleeding, a complication associated with this type of procedure

3. Achieve relief of symptoms and to maintain kidney function

A nurse is caring for a client with complications associated with peritoneal dialysis. For which signs and symptoms should the nurse monitor the client? (Select all that apply.) 1 . Pruritus 2. Oliguria 3. Tachycardia 4. Cloudy outflow 5. Abdominal pain

3. Tachycardia 4. Cloudy outflow 5. Abdominal pain

A client who is to begin continuous ambulatory peritoneal dialysis (CAPD) asks the nurse what this treatment entails. What information should the nurse include in the explanation? 1. Peritoneal dialysis is done in an ambulatory care clinic. 2. Hemodialysis and peritoneal dialysis are provided continuously. 3. The peritoneal membrane allows passage of toxins into the dialysate. 4. A quarter of a liter of dialysate is maintained inter- and intraperitoneally.

3. The peritoneal membrane allows passage of toxins into the dialysate.

A client who has repeated episodes of cystitis is scheduled for a cystoscopy to determine the possibility of urinary tract abnormalities. The client asks the nurse to describe the procedure. The nurse's most appropriate response is, "This procedure is: 1. A computerized scan that outlines the bladder and surrounding tissue." 2. An x-ray film of the abdomen, kidneys, ureters, and 3. The visualization of the inside of the bladder with an instrument connected to a source of light." 4. The visualization of the urinary tract through ureteral catheterization and the use of radiopaque material."

3. The visualization of the inside of the bladder with an instrument connected to a source of light."

A nurse is caring for a client with acute kidney failure who is receiving a protein-restricted diet. The client asks why this diet is necessary. What information should the nurse include in a response to the client's questions? 1. A high-protein intake ensures an adequate daily supply of amino acids to compensate for losses. 2. Essential and nonessential amino acids are necessary in the diet to supply materials for tissue protein synthesis. 3. This supplies only essential amino acids, reducing the amount of metabolic waste products, thus decreasing stress on the kidneys. 4. Urea nitrogen cannot be used to synthesize amino acids in the body, so the nitrogen for amino acid synthesis must come from the dietary protein.

3. This supplies only essential amino acids, reducing the amount of metabolic waste products, thus decreasing stress on the kidneys.

A nurse is planning to administer a prescribed intravenous solution that contains potassium chloride. What assessment should be brought to the health care provider's attention before administration of the intravenous (IV) line? 1. Uncharacteristic irritability 2. Poor tissue turgor with tenting 3. Urinary output of 200 mL during the previous 8 hours 4. Oral fluid intake of 300 mL during the previous 12 hours

3. Urinary output of 200 mL during the previous 8 hours

A nurse is caring for a client after surgical creation of a conduit diversion. What is the major disadvantage of a conduit diversion that the nurse should consider when caring for this client? 1. Peristalsis is greatly decreased. 2. Stool continuously oozes from it. 3. Urine continuously drains from it. 4. Absorption of nutrients is diminished.

3. Urine continuously drains from it.

The nurse provides education to a client about the side effects of furosemide (Lasix). Which client statements indicate that the teaching is understood? (Select all that apply.) 1. "I must not eat citrus fruits." 2 . "I should wear dark glasses." 3 . "I should avoid lying flat in bed." 4. "I should change my position slowly." 5. "I must eat a food that contains potassium every day."

4. "I should change my position slowly." 5. "I must eat a food that contains potassium every day."

A 40-year-old client scheduled for a hemi-colectomy because of ulcerative colitis asks if having a hemi-colectomy means wearing a pouch and having bowel movements in an abnormal way. Which is the best response by the nurse? 1. "Yes, hemi-colectomy is the same as a colostomy." 2. "Yes, but it will be temporary until the colitis is cured." 3. "No, that is necessary when a tumor is blocking the rectum." 4. "No, only part of the colon is removed and the rest reattached."

4. "No, only part of the colon is removed and the rest reattached."

A client with chronic kidney disease is admitted to the hospital with severe infection and anemia. The client is depressed and irritable. The client's spouse asks the nurse about the anticipated plan of care. What is an appropriate nursing response? 1. "The staff will provide total care because the infection causes severe fatigue." 2. "Mood elevators will be prescribed to improve depression and irritability." 3. "Iron will be prescribed for the anemia and the stools will be dark." 4. "The intake of meat, eggs, and cheese will be restricted so the kidneys can clear the body of waste products."

4. "The intake of meat, eggs, and cheese will be restricted so the kidneys can clear the body of waste products."

Before a transurethral resection of the prostate (TURP), a client asks about what to expect postoperatively. The most appropriate response by the nurse is: 1. "You will have an abdominal incision and a dressing." 2. "Your urine will be pink and free of clots." 3. "There will be an incision between your scrotum and rectum." 4. "There will be an indwelling urinary catheter and a continuous bladder irrigation in place."

4. "There will be an indwelling urinary catheter and a continuous bladder irrigation in place."

A lithotripsy to break up renal calculi is unsuccessful, and a nephrolithotomy is performed. Which postoperative clinical indicator should the nurse report to the health care provider? 1. Passage of pink-tinged urine 2. Pink drainage on the dressing 3. Intake of 1750 mL in 24 hours 4. Urine output of 20 to 30 mL/hr

4. Urine output of 20 to 30 mL/hr **Output should be at least 30 mL/hr or more; a decreased output may indicate obstruction or impaired kidney function.