Evolve - Med Surg - Renal & Repro
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?
"The intake of meat, eggs, and cheese will be restricted so the kidneys can clear the body of waste products."
An older adult client states, "I walk 2 miles a day for exercise, but now that the weather is hot, I am worried about becoming dehydrated." What should the nurse teach the client?
Fluids should be increased if the urine is getting darker
The nurse is caring for a client with a diagnosis of acute kidney failure associated with drug toxicity. When the client complains of thirst, the nurse should offer:
Hard candy
A client is admitted to the hospital with a ureteral calculus. The nurse expects what urinary clinical findings?
Hematuria with sharp pain when voiding
A client with a history of benign prostatic hypertrophy asks whether cranberry juice prevents bladder infections. The nurse replies that cranberry juice may be helpful because it:
Increases acidity of the urine
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?
Low calcium
A nurse is caring for a client who just had surgery to repair an inguinal hernia. To limit a common complication associated with this surgery, the nurse should:
Place a support under the scrotum
A nurse is caring for a client who has a radium implant for cancer of the cervix. What is the priority nursing intervention?
Restrict visitors to a 10-minute stay.
A nurse is providing postoperative care to a client who had a kidney transplant. What assessment is the best indicator of the functioning of the newly transplanted kidney?
Serum creatinine
A male client has discharge from his penis. Gonorrhea is suspected. To obtain a specimen for a culture, the nurse should:
Swab the drainage directly from the urethra to obtain a specimen
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:
Uric acid
A client is to have hemodialysis. What must the nurse do before this treatment?
Weigh the client to establish a baseline for later comparison
Which statement regarding treatment with interferon indicates that the client understands the nurse's teaching?
"I will drink two to three quarts of fluid a day"
When performing a peritoneal dialysis procedure, the nurse should:
Warm dialysate solution slightly before instillation
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?
High-quality protein
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?
Large proteins
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?
Flaccid bladder
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?
Low-grade fever
A nurse is counseling a woman who had recurrent urinary tract infections. What factor should the nurse explain is the reason why women are at a greater risk than men for contracting a urinary tract infection?
Proximity of the urethra to the anus
A nurse is providing preoperative teaching for a client who is scheduled for a transurethral resection of the prostate. What should the nurse include in the client's postoperative teaching plan?
Spasms of the bladder occur during the first 24 to 48 hours
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?
This supplies only essential amino acids, reducing the amount of metabolic waste products, thus decreasing stress on the kidneys.
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?
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?
Hyperkalemia
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:
Sodium
A nurse is caring for a client receiving hemodialysis for chronic kidney disease. The nurse should monitor the client for what complication?
Hepatitis B
The nurse reviews the medical records of four male clients and concludes that the client that is at highest risk of developing prostate cancer is the:
Black 55-year-old
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?
International normalized ratio (INR) of 4.0
A client with renal colic is scheduled for extracorporeal shock-wave lithotripsy. The night before the procedure, the client puts the call light on frequently and has many demands. Which would be an appropriate statement for the nurse to make?
"You are facing a new experience tomorrow; tell me what concerns you have."
What does the nurse determine is the most likely cause of renal calculi in clients with paraplegia?
Accelerated bone demineralization
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:
Blood in the stool
Which clinical manifestation should a nurse expect a client with diabetes insipidus to exhibit?
Decreased urine osmolarity
When admitting a client with benign prostatic hyperplasia, the most relevant assessment made by the nurse is:
Distention of the suprapubic area
A female client who has recurrent urinary tract infections (UTIs) is inquiring about the prevention of future UTIs. What information should the nurse include when teaching the client?
Drink 8 to 10 glasses of water each day, urinate immediately after sexual intercourse
A nurse teaches the signs of organ rejection to a client who had a kidney transplant. What should be included in the education?
Elevated blood pressure
A client who has been told she needs a hysterectomy for cervical cancer is upset about being unable to have a third child. What is the next nursing action?
Ensure that other treatment options for her will be explored
Before a client with syphilis can be treated, what should be determined?
Existence of allergies
After prostate surgery a client's indwelling catheter and continuous bladder irrigation (CBI) are to be removed. The nurse evaluates that the teaching is understood when the client states, "After the catheter is removed I probably will:
Experience some burning on urination."
A client with uremic syndrome has the potential to develop many complications. Which complication should the nurse anticipate?
Flapping hand tremors
The nurse should ask the client with secondary syphilis about sexual contacts during the past:
Six months
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?
Urinary output of 200 mL during the previous 8 hours
