CC Exam 4 Practice Questions

1,4,5

Which manifestations may indicate a client has systemic lupus erythematosus (SLE)? Select all that apply. 1. Pericarditis 2. Esophagitis 3. Fibrotic skin 4. Discoid lesions 5. Pleural effusions

2,4

Which medications prescribed to a client after a kidney transplant surgery may require the client to visit a dentist? Select all that apply. 1. Sirolimus 2. Everolimus 3. Prednisone 4. Cyclosporine 5. Prednisolone

1,2,5

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

3

A client is admitted to the hospital in the oliguric phase of acute kidney injury. The nurse estimates that the urine output for the last 12 hours is about 200 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. What does the nurse conclude about the amount of fluid prescribed? 1. It equals the expected urinary output for the next 24 hours. 2. It will prevent the development of pneumonia and a high fever. 3. It will compensate for both insensible and expected output over the next 24 hours. 4. It will reduce hyperkalemia, which can lead to life-threatening cardiac dysrhythmias.

2,3,4

A client is recovering from a kidney transplant. Which medications should the nurse expect to be prescribed for this client's maintenance therapy? Select all that apply. 1. Basiliximab 2. Azathioprine 3. Prednisone 4. Cyclosporine Antithymocyte globulin-equine

2,3

A client with acute kidney injury moves into the diuretic phase after 1 week of therapy. For which clinical indicators during this phase should the nurse assess the client? Select all that apply. 1. Skin rash 2. Dehydration 3. Hypovolemia 4. Hyperkalemia 5. Metabolic acidosis

1

A nurse is caring for a client who recently had a kidney transplant. Which priority assessment finding requires follow up by the nurse? 1. Fever 2. Hematuria 3. Moon facies 4. Yellow sclera

2

A client with acute kidney injury is to receive peritoneal dialysis and asks why the procedure is necessary. Which is the nurse's best response? 1. "It prevents the development of serious heart problems." 2. "It helps perform some of the work usually done by the kidneys." 3. "It will keep your kidneys from getting worse and may 'restart' your kidneys to perform better than before." 4. "It speeds recovery because the kidneys are not responding to regulating hormones."

2

A client with acute kidney injury states, "Why am I twitching and my fingers and toes tingling?" Which process should the nurse consider when formulating a response to this client? 1. Acidosis 2. Calcium depletion 3. Potassium retention 4. Sodium chloride depletion

3

A nurse is caring for a client after surgical creation of a conduit diversion (ileal conduit). Which information will the nurse consider when planning care 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

A nurse is caring for a client who is scheduled for cystoscopy. What should the nurse include in the client's postcystoscopy teaching plan? 1. "Remain flat in bed for the first 24 hours." 2. "Notify the nurse if there is any drainage on the dressing." 3. "Increase fluid intake for 3 to 4 days after the procedure." 4. "Bear down when attempting to void during the first 6 hours."

1,3,5

A nurse is caring for a client with acute kidney injury. Which findings should the nurse anticipate when reviewing the laboratory report of the client's blood level of calcium, potassium, and creatinine? Select all that apply. 1. Calcium: 7.6 mg/dL (1.9 mmol/L) 2. Calcium: 10.5 mg/dL (2.6 mmol/L) 3. Potassium 6.0 mEq/L (6.0 mmol/L) 4. Potassium 3.5 mEq/L (3.5 mmol/L) 5. Creatinine: 3.2 mg/dL (194 mcmol/L) 6. Creatinine: 1.1 mg/dL (90 mcmol/L

1

During discharge teaching, a client with an ileal conduit asks how frequently the urine pouch should be emptied. Which reply by the nurse is best? 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

The nurse is caring for a client 4 days after the client had a cystectomy and formation of an ileal conduit. After observing mucous threads in the client's urine, what should the nurse do? 1. Recognize that this is an expected response. 2 Obtain a specimen for culture and sensitivity. 3. Report this to the primary healthcare provider immediately. 4. Increase the client's fluid intake for the next 12 hours.

1

The nurse is providing education to a client with systemic lupus erythematosus. Which education will the nurse consider as high priority? 1. Instructing about ways to protect the skin 2. Helping the client to identify coping strategies 3. Teaching methods to monitor body temperature 4. Teaching about the effects of the disease on lifestyle

1

A 3-year-old child is hospitalized with nephrotic syndrome. The child has oliguria and generalized edema. What factor does the nurse identify that will have the greatest effect on the child's adjustment to hospitalization? 1. Lack of parental visits 2. Inability to select a variety of foods 3. Response of peers to the edematous appearance 4. Willingness to participate in cooperative play activities

3

A 4-year-old child is being treated for nephrotic syndrome. What assessment finding indicates that the child's condition is improving? 1. The child gains weight. 2. Urine output decreases. 3. Urine specific gravity decreases. 4. The child's hemoglobin and hematocrit increase.

4

A client is diagnosed with bladder cancer, and a cystectomy and creation of an ileal conduit are scheduled. What should the nurse plan to do preoperatively? 1. Limit fluid intake for 24 hours. 2. Teach range-of-motion and Kegel exercises. 3. Explain the procedure for irrigating the ileal conduit. 4. Administer cleansing enemas and laxatives as prescribed.

3

A nurse is caring for a client with acute kidney injury who is receiving a protein-restricted diet. The client asks why this diet is necessary. Which 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.

1,3

A nurse is interviewing a client who was diagnosed with systemic lupus erythematosus (SLE). Which common responses to this disease can the nurse expect the client to exhibit? Select all that apply. 1. Butterfly facial rash 2. Firm skin fixed to tissue 3. Inflammation of the joints 4. Muscle mass degeneration 5. Inflammation of small arteries

4

After surgery to create an ileal conduit, a client is admitted to the postanesthesia care unit. Which clinical finding during the first hour of the postoperative period should the nurse report to the primary healthcare provider? 1. Edematous stoma 2. Episodes of vomiting 3. Diminished bowel sounds 4. Absence of urinary output

3

A client with advanced cancer of the bladder is scheduled for a cystectomy and ileal conduit. What intervention does the nurse anticipate the healthcare provider will prescribe to prepare the client for surgery? 1. Intravesicular chemotherapy 2. Instillation of a urinary antiseptic 3. Administration of an antibiotic 4. Placement of an indwelling catheter

1

A client with an ileal conduit is being prepared for discharge. As part of the discharge teaching, which instruction should the nurse include? 1. "Maintain fluid intake of at least 2 L daily." 2. "Abstain from beer and alcohol consumption." 3. "Avoid getting soap and water on the peristomal skin." 4. "Notify the primary healthcare provider if the stoma size decreases."

1

A client with end-stage kidney disease says to the nurse, "I heard that it is inevitable that I will need a kidney transplant. If so, which one of my kidneys will be removed?" Which is the best response by the nurse? 1. "Neither of your kidneys will be removed unless they are infected." 2. "The kidney that is the most diseased is removed and replaced with a new one." 3. "It is up to the primary healthcare provider as to which kidney is replaced with a new one." 4. "Your right kidney will be removed, because it has a longer renal vein, making transplantation easier."

2,4

A healthcare team is caring for a client who underwent kidney transplantation. Which task is most suitable to be delegated to a licensed practical nurse (LPN) to provide effective client care? Select all that apply. 1. Emptying urinary drainage bag 2. Recording vital signs 3. Assessing of urine output 4. Placing the urinary catheter 5. Administering intravenous fluids

2

A nurse is caring for a client who had a kidney transplant. Which test is most important for the nurse to monitor to determine 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

3

A nurse is notified that the latest potassium level for a client in acute kidney injury is 6.2 mEq (6.2 mmol/L). Which action should the nurse take first? 1. Alert the cardiac arrest team. 2. Call the laboratory to repeat the test. 3. Take vital signs and notify the primary healthcare provider. 4. Obtain an electrocardiogram (ECG) strip and obtain an antiarrhythmic medication.

3

A nurse teaches the signs of organ rejection to a client who had a kidney transplant. What should the nurse include in the education? 1. Weight loss 2. Subnormal temperature 3. Elevated blood pressure 4. Increased urinary output

1

A student nurse is teaching a client about preventive measures for Lyme disease. Which instruction given by the student nurse indicates a need for correction? 1. "Wear dark colored dresses." 2. "Wear closed shoes or boots." 3. "Tuck your shirt into your pants." 4. "Bathe immediately after being in an infested area."

2

The nurse is providing postoperative care 8 hours after a client had a total cystectomy and the formation of an ileal conduit. Which assessment finding should be reported immediately? 1. Edematous stoma 2. Dusky-colored stoma 3. Absence of bowel sounds 4. Pink-tinged urinary drainage

2

The nurse is providing postoperative care to a kidney transplant recipient. What is the nurse's first priority during this period? 1. Teaching signs of rejection to the client 2. Maintaining fluid and electrolyte balance 3. Providing emotional support to the recipient 4. Advising the client to have frequent blood testing

2

The nurse is teaching self-management techniques to a client newly diagnosed with polycystic kidney disease. Which statement of the client indicates a need for further teaching? 1. "I should monitor my bowel movements." 2. "I should weigh myself once a week." 3. "I should record my blood pressure daily." 4. "I should notify my healthcare provider if I have fever."

3

Which roommate should the nurse manager assign to a 4-year-old boy who has been admitted to the pediatric unit with nephrotic syndrome? 1. 3-year-old boy with impetigo 2. 2-year-old boy with pneumonia 3. 5-year-old girl with thalassemia 4. 4-year-old girl with conjunctivitis