Urology Pharmacology and Adult Care
The nurse is admitting a client with chronic kidney disease (CKD) to the nursing unit. The nurse monitors the client for which frequent cardiovascular sign that occurs in CKD?
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The nurse is assigned to care for a client who has returned to the nursing unit following a left nephrectomy. The nurse places the highest priority on monitoring which data?
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The nurse is assisting in planning a teaching session with a client diagnosed with urethritis caused by infection with Chlamydia. The nurse should plan to include which point in the teaching session?
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The nurse is reviewing the medical record of a client with a diagnosis of pyelonephritis. Which disorder noted on the client's record should the nurse identify as a risk factor for this diagnosis?
diabetes mellitus
A client hospitalized with urolithiasis has a sudden significant decrease in urine output. The nurse should perform which action?
notify the RN
The nurse is collecting data from a client with epididymitis. The nurse should expect to note which signs and symptoms of this problem?
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Oxybutynin chloride is prescribed for a client with neurogenic bladder. Which sign would indicate a possible toxic effect related to this medication?
restlessness
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 has reinforced instructions to the client with a cystocele about Kegel exercises. The nurse determines that the client has not fully understood the directions if the client makes which statement?
"Begin voiding and then stop the stream, holding residual urine for an hour."
Which is an appropriate question to ask to determine the specific type of incontinence?
"Have you been experiencing any urgency accompanied by dribbling or leaking urine?"
The nurse provides home care instructions to a client undergoing hemodialysis with regard to care of an arteriovenous (AV) fistula. Which statement by the client indicates an understanding of the instructions?
"I should check the fistula every day by feeling it for a vibration."
A client diagnosed with chronic kidney disease is being treated at home with continuous ambulatory peritoneal dialysis. The client notes that there is a decrease in the catheter outflow following the prescribed 6-hour dwell time and calls the nurse to report this occurrence. The nurse should reinforce instructing the client to take which action?
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A client who had a prostatectomy has learned perineal exercises to gain control of the urinary sphincter. The nurse determines that the client needs further teaching if the client states that he will perform which action as part of these exercises?
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A client with acute kidney injury secondary to heart failure develops fluid volume excess. Which signs and symptoms should the nurse expect to see? Select all that apply.
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The nurse is reviewing the laboratory results and physical examination of a client with acute glomerulonephritis. Which data should the nurse see? Select all that apply.
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Which statements indicate an understanding of the necessary dietary modifications of a client diagnosed with chronic kidney disease? Select all that apply.
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A client with acute kidney injury (AKI) has been treated with sodium polystyrene sulfonate by mouth. The nurse evaluates this therapy as effective if which value is noted on follow-up laboratory testing?
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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?
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A client with chlamydial infection has received instructions on self-care and prevention of further infection. The nurse determines that the client needs further teaching if the client states which?
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The use of peritoneal dialysis for the treatment of chronic kidney disease would be contraindicated for which clients?
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Phenazopyridine hydrochloride is prescribed for a client for symptomatic relief of pain resulting from a lower urinary tract infection. Which should the nurse reinforce to the client?
A reddish-orange discoloration of the urine may occur.
An alkaline-ash diet is prescribed for a client with renal calculi. Which diet menu does the nurse advise the client to select?
A spinach salad, milk, and a banana
Following kidney transplantation, cyclosporine is prescribed for a client. Which laboratory result would indicate an adverse effect from the use of this medication?
BUN 25 Cyclosporine is an immunosuppressant. Nephrotoxicity can occur from the use of cyclosporine. Nephrotoxicity is evaluated by monitoring for elevated blood urea nitrogen and serum creatinine levels. The normal blood urea nitrogen level is 10 to 20 mg/dL (3.6 to 7.1 mmol/L). The normal creatinine level for a male is 0.6 to 1.2 mg/dL (53 to 106 mcmol/L) and for a female 0.5 to 1.1 mg/dL (44 to 97 mcmol/L). Cyclosporine can lower complete blood cell count levels. A normal hemoglobin is Male: 14 to 18 g/dL (140 to 180 mmol/L); Female: 12 to 16 g/dL (120 to 160 mmol/L). Anormal hemoglobin is not an adverse effect. Cyclosporine does affect the glucose level. The normal fasting glucose is 70 to 110 mg/dL (4 to 6 mmol/L).
Bethanechol is prescribed for the client with urinary retention, and an injectable form of bethanechol is available for use as prescribed. The nurse informs the client of the primary health care provider's prescription, knowing that the medication will be administered by which injectable route?
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A client newly diagnosed with chronic kidney disease will be receiving peritoneal dialysis. During the infusion of the dialysate, the client complains of abdominal pain. Which action by the nurse is appropriate?
Explain that the pain will subside after the first few exchanges.
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
A client has undergone a transurethral resection of the prostate (TURP) a few hours ago to treat symptoms of benign prostatic hypertrophy. The nurse notes bright red blood and clots in the urinary catheter drainage bag. Which response should be the nurse's initial action?
Increase the flow rate of the continuous bladder irrigation.
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 sulfonamide is prescribed for a client with a urinary tract infection. During review of the client's record, the nurse notes that the client is taking warfarin sodium daily. Which prescription should the nurse anticipate for this client?
a decrease in the warfarin sodium dosage Sulfonamides can potentiate the effects of warfarin sodium, phenytoin, and orally administered hypoglycemics such as tolbutamide. When an oral anticoagulant is combined with a sulfonamide, a decrease in the anticoagulant dosage may be needed.
The nurse is caring for a client who had a renal biopsy. Which interventions should the nurse include in the plan of care for the client after this procedure? Select all that apply.
administering pain medication as prescribed monitoring vital signs and puncture site frequently testing serial urine samples with dipsticks for occult blood
In reviewing the admission assessment data and primary health care provider's prescriptions for a client with peptic ulcer disease, the nurse notes that the client has a history of renal disease. Based on this data, the nurse determines that which antacid should be prescribed for this client?
aluminum hydroxide
The nurse is caring for a client with epididymitis. which treatment modalities should be implemented? select all that apply.
bed rest sitz bath antibiotics scrotal elevation
After a renal biopsy, the client complains of pain at the biopsy site that radiates to the front of the abdomen. Which would this indicate?
bleeding
The nurse who is administering bethanechol chloride is monitoring for acute toxicity associated with the medication. The nurse should check the client for which sign of toxicity?
bradycardia
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 monitoring a client receiving peritoneal dialysis notes that the client's outflow is less than the inflow. The nurse should take which actions? Select all that apply.
check the level of the drainage bag reposition the client on their side place client in good body alignment check the system for kinks
The nurse is assisting a client with cystitis to select foods that are appropriate for an acid-ash diet. The nurse encourages the client to eat which food?
cheese
A client receiving nitrofurantoin calls the primary health care provider's office complaining of side effects related to the medication. Which side effect indicates the need to stop treatment with this medication?
chest pain
A client is seen in the health care clinic and acute pyelonephritis is suspected. The nurse reviews the client's record and should expect to note which associated signs and symptoms documented? Select all that apply.
chills general weakness nausea and vomiting
the nurse is collecting data from a client who had benign prostatic hyperplasia (BPH) in the past. To determine whether the client is currently experiencing exacerbation of BPH, the nurse should ask the client about the presence of which early symptom?
decreased force in the stream of urine
The nurse is reinforcing discharge instructions to a client receiving sulfadiazine. Which should be included in the list of instructions?
maintain high fluid intake
The nurse is reinforcing discharge instructions to a client receiving sulfisoxazole. Which should be included in the plan of care for instructions?
maintain high fluid intake
Which actions are included in the nursing care of the client undergoing peritoneal dialysis? Select all that apply.
monitor vitals including temp weigh the client before and after dialysis check color and volume of dialysate solution maintain aseptic technique when assessing the catheter
A client is admitted to the emergency department following a fall from a horse. The primary health care provider (PHCP) prescribes the insertion of an indwelling urinary catheter. The nurse notes blood at the urinary meatus while preparing for the procedure. Which action should the nurse take?
notify the health care provider
The nurse is reinforcing dietary instructions to a client diagnosed with acute glomerulonephritis. The nurse determines that the client understands the information presented if the client states the intention to do which action?
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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?
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The nurse notes that a client's urinalysis report contains a notation of positive red blood cells (RBCs). The nurse interprets that this finding is unrelated to which information in the client's medical record?
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A client has been diagnosed with pyelonephritis. The nurse interprets that which health problem has placed the client at risk for this disorder?
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A client's kidneys are retaining larger than normal amounts of sodium. The nurse is reviewing the most recent laboratory data. The nurse should expect which laboratory value to be abnormal since the client is retaining sodium?
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Bethanechol chloride is prescribed for a client. When should the nurse tell the client to take the medication?
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The nurse is assessing a client with suspected acute kidney injury. Which finding would support a diagnosis of acute intrarenal failure?
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The nurse is talking with a client who has an arteriovenous fistula in the left arm. What statement by the client indicates a need for further teaching?
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The client with diabetes mellitus receiving peritoneal dialysis asks the nurse why it is important to leave the dialysate infused only for a specific amount of time. The nurse responds that not adhering to the dwell time can increase the risk of the client experiencing which complication?
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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?
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The nurse is reinforcing instructions to a client with renal calculi about how to change the urine pH to be more acidic. The nurse determines that the client needs further teaching if the client states which type of drink is acceptable?
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A client arrives at the ambulatory care clinic with low abdominal pain. A routine urine specimen reveals hematuria. The client does not have a fever. The nurse should next ask the client about a history of which condition?
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A client has received instructions on self-management of peritoneal dialysis. The nurse determines that the client needs further teaching if the client makes which statement?
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A client who has a cold is seen in the emergency department with an inability to void. Because the client has a history of benign prostatic hyperplasia (BPH), the nurse questions the client about use of which medication?
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The nurse is urging a client to cough and deep breathe after a nephrectomy. The client tells the nurse, "That's easy for you to say! You don't have to do this." The nurse interprets that the client's statement is likely a result of which contributing factor?
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A client who suffered a crush injury to the leg has a highly positive urine myoglobin level. The nurse plans to monitor this particular client carefully for signs of which complication?
Acute Tubular Necrosis
The nurse prepares to administer sodium polystyrene sulfonate to a client with chronic kidney disease for which laboratory abnormality?
Potassium level of 7.2 mEq/L
The client who has a cold is seen in the emergency department with an inability to void. Because the client has a history of benign prostatic hyperplasia, the nurse determines that the client should be questioned about the use of which class of medications?
decongestants Episodes of urinary retention can be triggered by certain medications such as decongestants, anticholinergics, and antidepressants. Diuretics, antibiotics, and antitussives generally do not trigger urinary retention. Retention also can be precipitated by other factors such as alcoholic beverages, infection, bed rest, and becoming chilled.
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? Select all that apply.
elevated serum creatinine decreased RBC elevated BUN
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 had any constipation recently
A client with chronic kidney disease is receiving epoetin alfa. Which laboratory result would indicate a therapeutic effect of the medication?
hct 32%
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
Bethanechol chloride is prescribed for a client with urinary retention. Which disorder should be a contraindication to the administration of this medication?
urinary strictures
A male client has a history of urinary tract infections due to urinary retention. Which intervention should the nurse implement to decrease the risk of infection?
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A urinary analgesic is prescribed for a client with a urinary tract infection. When should the nurse tell the client that it is best to take the medication?
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Aluminum hydroxide is prescribed for the client with chronic kidney disease (CKD). When should the nurse instruct the client to take this medication?
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Propantheline bromide is prescribed for a client with bladder spasms. Which disorder, noted in the client's record, alerts the nurse to question the prescription for this medication?
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The nurse is assisting in planning a diet for a client with acute kidney injury (AKI). The nurse plans to restrict which dietary component from this client's diet?
Potassium
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 is scheduled for intravenous pyelography (IVP). Which priority nursing action should the nurse take?
determine history of allergies
A client has been prescribed allopurinol. The nurse reinforces which information concerning the administration of the medication?
drink at least 8 glasses of water every day
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
A client with chronic kidney disease is receiving epoetin alfa. Which laboratory result would indicate a therapeutic effect of the medication?
hematocrit 33%
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? Select all that apply.
hematuria flank or lumbar pain history of UTI
Which condition places the client at risk for developing acute postrenal failure?
hydronephrosis
The nurse is admitting a client to the nursing unit who has returned from the postanesthesia care unit following prostatectomy. The client has a three-way Foley catheter with continuous bladder irrigation. The nurse should maintain the flow rate of the continuous bladder infusion to maintain which urine output characteristic?
pale yellow or slightly pink
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 of the left hand.
The nurse is assessing the patency of an arteriovenous fistula in the left arm of a client who is receiving hemodialysis for the treatment of chronic kidney disease. Which finding indicates that the fistula is patent?
palpation of a thrill over the fistula
The nurse is reinforcing instructions to a client about the types of fluids that assist in prevention and treatment of urinary tract infections (UTIs). The nurse instructs the client to consume which fluids? Select all that apply.
prune juice apple juice cranberry juice
The use of peritoneal dialysis for the treatment of chronic kidney disease would be contraindicated for which client?
severe emphysema
A client is diagnosed with polycystic kidney disease, and the nurse provides information to the client about the treatment plan. The nurse determines that the client needs further teaching if the client states that which component is part of the treatment plan?
sodium restriction
The nurse is caring for a hospitalized client following cystoscopy. Which discharge instructions are given to the client? Select all that apply.
use antispasmodic for pain take sitz baths for voiding discomfort report sever pain to the health care provider
The nurse is caring for a client diagnosed with Parkinson's disease who is prescribed benztropine mesylate daily. The nurse reinforces instructions to both the client and the spouse regarding the side effects of this medication and the need to report which side effect if it occurs?
inability to urinate
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
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
A client with diabetes mellitus is receiving peritoneal dialysis. The nurse should ensure maintenance of the dwell time for the dialysis at the prescribed time because of risk for which complication?
hyperglycemia
The nurse is caring for a client undergoing peritoneal dialysis. The nurse checks the client and notes that the drainage from the outflow catheter is cloudy. The nurse notifies the registered nurse and plans to take which action?
obtain C/S of the drainage
The client with chronic kidney disease who is scheduled for hemodialysis this morning is due to receive a daily dose of enalapril. When should the nurse plan to administer this medication?
on the return from dialysis
Trimethoprim-sulfamethoxazole is prescribed for a client. The nurse should instruct the client to report which symptom if it developed during the course of this medication therapy?
sore throat Clients taking trimethoprim-sulfamethoxazole should be informed about early signs of blood disorders that can occur from this medication. These include sore throat, fever, and pallor, and the client should be instructed to notify the PHCP if these symptoms occur. The other options do not require PHCP notification.
The nurse is reinforcing dietary instructions to a client who is currently prescribed probenecid. Which food should the nurse encourage the client to continue to eat?
spinach
A client with prostatitis resulting from kidney infection has received instructions on management of the condition at home and prevention of recurrence. Which statement indicates that the client understood the instructions?
use warm sitz baths and analgesics to increase comfort
The nurse is monitoring an older client suspected of having a urinary tract infection (UTI) for signs of infection. Which sign/symptom is likely to present first?
confusion
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 the symptoms are gone. Do increase fluids, limit force of stream during voiding, and use condoms to eliminate risk associated with chlamydia and gonorrhea.
The nurse is caring for a client with kidney failure. The serum phosphate level is reported as 7 mg/dL. Which medication should the nurse plan to administer as prescribed to the client?
aluminum hydroxide gel
A long-term care nurse notes that an older client who is normally alert has become progressively confused and irritable. What diagnostic tests should the nurse anticipate the health care provider to prescribe? Select all that apply.
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