NUR 213 Test 1
What are the causes of pre-renal acute kidney injury?
- blood loss, dehydration - diabetes, shock, decreased cardiac output
How is Hepatitis C transmitted?
- blood to blood - IV needle sharers - needle-sticks in hospitals
What is an appropriate nursing action for a patient with hyperkalemia?
- cardiac monitoring - contact the provider - review medication history to find reason for holding onto potassium - switch patient to a potassium sparring diuretic (lasix)
Dietary restrictions when it comes to taking cyclosporine:
- do not take with grapefruit juice
A 59-year-old patient with a history of alcohol abuse spanning 15 years has been diagnosed with cirrhosis. The patient will be undergoing abdominal paracentesis today. Which assessment finding alerts the nurse that the paracentesis has been successful? A.Decrease in post-procedure weight B.No residual obtained during procedure C.Substantial decrease in blood pressure D.Immediate sensation of a need to urinate
A
A nurse assesses a client with nephrotic syndrome. For which clinical manifestations should the nurse assess? (Select all that apply.) a. Proteinuria b. Hypoalbuminemia c. Dehydration d. Lipiduria e. Dysuria f. Costovertebral angle (CVA) tenderness
A, B, D
What findings would require immediate action to prevent acute kidney injury in a patient with volume loss?
- Volume loss - Lack of perfusion - (hypotension & oliguria)
How and when should tacrolimus (prevents rejection of an organ) be given?
- at the same time everyday
Which generation might have Hepatitis C?
- baby boomers because they were receiving blood transfusions before we were testing for blood types
A client is taking furosemide (Lasix) 40 mg/day for management of chronic kidney disease (CKD). To detect the positive effect of the medication, what action of the nurse is best? a. Obtain daily weights of the client. b. Auscultate heart and breath sounds. c. Palpate the clients abdomen. d. Assess the clients diet history.
A
A male client comes into the emergency department with a serum creatinine of 2.2 mg/dL and a blood urea nitrogen (BUN) of 24 mL/dL. What question should the nurse ask first when taking this clients history? a. Have you been taking any aspirin, ibuprofen, or naproxen recently? b. Do you have anyone in your family with renal failure? c. Have you had a diet that is low in protein recently? d. Has a relative had a kidney transplant lately?
A
A male client with chronic kidney disease (CKD) is refusing to take his medication and has missed two hemodialysis appointments. What is the best initial action for the nurse? a. Discuss what the treatment regimen means to him. b. Refer the client to a mental health nurse practitioner. c. Reschedule the appointments to another date and time. d. Discuss the option of peritoneal dialysis.
A
A marathon runner comes into the clinic and states I have not urinated very much in the last few days. The nurse notes a heart rate of 110 beats/min and a blood pressure of 86/58 mm Hg. Which action by the nurse is the priority? a. Give the client a bottle of water immediately. b. Start an intravenous line for fluids. c. Teach the client to drink 2 to 3 liters of water daily. d. Perform an electrocardiogram.
A
A nurse assesses a client who is recovering from a paracentesis 1 hour ago. Which assessment finding requires action by the nurse? a. Urine output via indwelling urinary catheter is 20 mL/hr b. Blood pressure increases from 110/58 to 120/62 mm Hg c. Respiratory rate decreases from 18 to 14 breaths/min d. A decrease in the clients weight by 6 kg
A
A nurse assesses clients at a community health fair. Which client is at greatest risk for the development of hepatitis B? a. A 20-year-old college student who has had several sexual partners b. A 46-year-old woman who takes acetaminophen daily for headaches c. A 63-year-old businessman who travels frequently across the country d. An 82-year-old woman who recently ate raw shellfish for dinner
A
A nurse cares for a client who is prescribed lactulose (Heptalac). The client states, I do not want to take this medication because it causes diarrhea. How should the nurse respond? a. Diarrhea is expected; thats how your body gets rid of ammonia. b. You may take Kaopectate liquid daily for loose stools. c. Do not take any more of the medication until your stools firm up. d. We will need to send a stool specimen to the laboratory.
A
The nurse is teaching a client with chronic kidney disease (CKD) about the sodium restriction needed in the diet to prevent edema and hypertension. Which statement by the client indicates more teaching is needed? a. I am thrilled that I can continue to eat fast food. b. I will cut out bacon with my eggs every morning. c. My cooking style will change by not adding salt. d. I will probably lose weight by cutting out potato chips.
A
Which does the nurse recognize as the primary reason for a higher incidence of liver cancer in the United States? A.Incidence of hepatitis C B.Incidence of HIV infection C.Incidence of illicit drug use Incidence of hepatitis A
A
A client is undergoing hemodialysis. The clients blood pressure at the beginning of the procedure was 136/88 mm Hg, and now it is 110/54 mm Hg. What actions should the nurse perform to maintain blood pressure? (Select all that apply.) a. Adjust the rate of extracorporeal blood flow. b. Place the client in the Trendelenburg position. c. Stop the hemodialysis treatment. d. Administer a 250-mL bolus of normal saline. e. Contact the health care provider for orders.
A, B, D
A client is unsure of the decision to undergo peritoneal dialysis (PD) and wishes to discuss the advantages of this treatment with the nurse. Which statements by the nurse are accurate regarding PD? (Select all that apply.) a. You will not need vascular access to perform PD. b. There is less restriction of protein and fluids. c. You will have no risk for infection with PD. d. You have flexible scheduling for the exchanges. e. It takes less time than hemodialysis treatments.
A, B, D
The nurse is caring for a child with acute renal failure. What laboratory findings should the nurse expect to find? (Select all that apply.) a. Hyponatremia b. Hyperkalemia c. Metabolic alkalosis d. Elevated blood urea nitrogen level e. Decreased plasma creatinine level
A, B, D
An infection control nurse develops a plan to decrease the number of health care professionals who contract viral hepatitis at work. Which ideas should the nurse include in this plan? (Select all that apply.) a. Policies related to consistent use of Standard Precautions b. Hepatitis vaccination mandate for workers in high-risk areas c. Implementation of a needleless system for intravenous therapy d. Number of sharps used in client care reduced where possible e. Postexposure prophylaxis provided in a timely manner
A, C, D, E
What are signs and symptoms of a possible kidney transplant rejection in a child? (Select all that apply.) a. Fever b. Hypotension c. Diminished urinary output d. Decreased serum creatinine e. Swelling and tenderness of graft area
A, C, E
A week after a kidney transplant, the client develops a temperature of 101F, the blood pressure is elevated, and the kidney is tender. An x-ray reveals the transplanted kidney is enlarged. Based on these findings. the nurse should suspect which complication?
Acute Rejection
A client is admitted with acute kidney injury (AKI) and a urine output of 2000 mL/day. What is the major concern of the nurse regarding this clients care? a. Edema and pain b. Electrolyte and fluid imbalance c. Cardiac and respiratory status d. Mental health status
B
A client is recovering from a kidney transplant. The clients urine output was 1500 mL over the last 12-hour period since transplantation. What is the priority assessment by the nurse? a. Checking skin turgor b. Taking blood pressure c. Assessing lung sounds d. Weighing the client
B
A nurse cares for a client who has cirrhosis of the liver. Which action should the nurse take to decrease the presence of ascites? a. Monitor intake and output. b. Provide a low-sodium diet. c. Increase oral fluid intake. d. Weigh the client daily.
B
A nurse cares for a client with hepatic portal-systemic encephalopathy (PSE). The client is thin and cachectic in appearance, and the family expresses distress that the client is receiving little dietary protein. How should the nurse respond? a. A low-protein diet will help the liver rest and will restore liver function. b. Less protein in the diet will help prevent confusion associated with liver failure. c. Increasing dietary protein will help the client gain weight and muscle mass. d. Low dietary protein is needed to prevent fluid from leaking into the abdomen.
B
A nurse cares for a client with hepatitis C. The clients brother states, I do not want to contract this infection, so I will not go into his hospital room. How should the nurse respond? a. If you wear a gown and gloves, you will not get this virus. b. Viral hepatitis is not spread through casual contact. c. This virus is only transmitted through a fecal specimen. d. I can give you an update on your brothers status from here.
B
A nurse obtains a clients health history at a community health clinic. Which statement alerts the nurse to provide health teaching to this client? a. I drink two glasses of red wine each week. b. I take a lot of Tylenol for my arthritis pain. c. I have a cousin who died of liver cancer. d. I got a hepatitis vaccine before traveling.
B
After teaching a client who has been diagnosed with hepatitis A, the nurse assesses the clients understanding. Which statement by the client indicates a correct understanding of the teaching? a. Some medications have been known to cause hepatitis A. b. I may have been exposed when we ate shrimp last weekend. c. I was infected with hepatitis A through a recent blood transfusion. d. My infection with Epstein-Barr virus can co-infect me with hepatitis A.
B
After teaching a client with early polycystic kidney disease (PKD) about nutritional therapy, the nurse assesses the clients understanding. Which statement made by the client indicates a correct understanding of the teaching? a. I will take a laxative every night before going to bed. b. I must increase my intake of dietary fiber and fluids. c. I shall only use salt when I am cooking my own food. d. Ill eat white bread to minimize gastrointestinal gas.
B
The patient's assessment reveals yellowish coloration of skin and sclerae. Which laboratory values does the nurse anticipate? A.Increased urine bilirubin, decreased direct bilirubin B.Increased direct bilirubin, increased indirect bilirubin C.Decreased direct bilirubin, increased indirect bilirubin D.Increased direct bilirubin, decreased indirect bilirubin
B
What immunization is recommended for all newborns? a. Hepatitis A vaccine b. Hepatitis B vaccine c. Hepatitis C vaccine d. Hepatitis A, B, and C vaccines
B
What is the priority nursing intervention in the management of a patient with decompensated cirrhosis? A.Limiting protein intake B.Managing nausea and vomiting C.Monitoring fluid intake and output D.Elevating the head of bed >30 degrees
B
What therapeutic intervention provides the best chance of survival for a child with cirrhosis? a. Nutritional support b. Liver transplantation c. Blood component therapy d. Treatment with corticosteroids
B
Parents of a child who will need hemodialysis ask the nurse, "What are the advantages of a fistula over a graft or external access device for hemodialysis?" What response should the nurse give? (Select all that apply.) a. It is ready to be used immediately. b. There are fewer complications with a fistula. c. There is less restriction of activity with a fistula. d. It produces dilation and thickening of the superficial vessels. e. The fistula does not require a needle insertion at each dialysis.
B, C, D
The nurse is preparing to admit a 7-year-old child with hepatitis B. What clinical features of hepatitis B should the nurse recognize? (Select all that apply.) a. The onset is rapid. b. Rash is common. c. Jaundice is present d. No carrier state exists. e. The mode of transmission is principally by the parenteral route.
B, C, E
A nurse assesses a client who has liver disease. Which laboratory findings should the nurse recognize as potentially causing complications of this disorder? (Select all that apply.) a. Elevated aspartate transaminase b. Elevated international normalized ratio (INR) c. Decreased serum globulin levels d. Decreased serum alkaline phosphatase e. Elevated serum ammonia f. Elevated prothrombin time (PT)
B, E, F
After teaching a client who has plans to travel to a non-industrialized country, the nurse assesses the clients understanding regarding the prevention of viral hepatitis. Which statement made by the client indicates a need for additional teaching? a. I should drink bottled water during my travels. b. I will not eat off anothers plate or share utensils. c. I should eat plenty of fresh fruits and vegetables. d. I will wash my hands frequently and thoroughly.
C
The charge nurse is orienting a float nurse to an assigned client with an arteriovenous (AV) fistula for hemodialysis in her left arm. Which action by the float nurse would be considered unsafe? a. Palpating the access site for a bruit or thrill b. Using the right arm for a blood pressure reading c. Administering intravenous fluids through the AV fistula d. Checking distal pulses in the left arm
C
The nurse is caring for four clients with chronic kidney disease. Which client should the nurse assess first upon initial rounding? a. Woman with a blood pressure of 158/90 mm Hg b. Client with Kussmaul respirations c. Man with skin itching from head to toe d. Client with halitosis and stomatitis
C
The nurse is taking the vital signs of a client after hemodialysis. Blood pressure is 110/58 mm Hg, pulse 66 beats/min, and temperature is 99.8 F (37.6 C). What is the most appropriate action by the nurse? a. Administer fluid to increase blood pressure. b. Check the white blood cell count. c. Monitor the clients temperature. d. Connect the client to an electrocardiographic (ECG) monitor.
C
The patient tells the nurse that once he is discharged to home, he has no intention to stop drinking alcohol. What is the appropriate nursing response? A."Why do you continue to drink?" B."It's your choice to drink or not to drink." C."Does it frighten you to consider quitting?" D."If you continue to drink, you are going to die."
C
A nurse is caring for a client who is scheduled for a dose of cefazolin and vitamins at this time. Hemodialysis for this client is also scheduled in 60 minutes. Which action by the nurse is best? a. Administer cefazolin since the level of the antibiotic must be maintained. b. Hold the vitamins but administer the cefazolin. c. Hold the cefazolin but administer the vitamins. d. Hold all medications since both cefazolin and vitamins are dialyzable.
D
An acute care facility values job satisfaction among its registered nurses by implementing a shared governance model. Which element is a fundamental characteristic of this model? a. Administration has an open-door policy b. Established dispute resolution process c. Implementation of mandatory reporting d. Nurses have an active role in patient care decision making
D
What should the RN do when asked to accept a patient assignment that he or she may feel unqualified to manage? a. Accept the assignment as appropriate if assigned by a legitimate power. b. Be primarily concerned with the number of patients being assigned. c. Ask how other nurses have handled the assignment in the past. d. Determine whether he or she is familiar with the types of patients being assigned.
D
What workplace factor has been found to contribute to the nursing shortage? a. Movement of nurses into acute care settings b. The use of unlicensed assistive personnel to replace RNs c. A severe lack of males who have chosen nursing as a career d. An aging nursing workforce
D
Which assessment finding requires immediate nursing intervention in a patient with severe ascites? A.Confusion B.Temperature 38.2º C C.Tachycardia, rate 110 beats/min D.Shallow respirations, rate 32 breaths/min
D
Which situation would be considered a workforce advocacy issue that is reportable to the state nurses association or the Center for American Nurses if it is not resolved at the local level? a. Nurses prefer to wear navy blue scrubs, but the institution requires burgundy scrubs, which interferes with autonomy. b. The cafeteria often serves fried vegetables rather than healthier baked vegetables, causing the potential for hyperlipidemia. c. The hospital pharmacy does not fill employee prescriptions upon receiving them; instead, they fill employee prescriptions after all inpatient prescriptions have been filled. d. The key needed to change the sharps container is locked in the supervisor's office all day on weekends, preventing changing of the container when needed and places nurses at risk for needlesticks.
D
The nurse is providing dietary instructions to a client who has been prescribed cyclosporine. Which food item should the nurse instruct the client to exclude from the diet?
Grapefruit Juice
Who is at greatest risk of contracting Hep B?
Healthcare workers and drug users
Tacrolimus is ordered for a client. Which disorder, if noted in the record, would indicate that the medication should be given with caution?
Hepatitis
A client with chronic renal failure has completed a hemodialysis treatment. The nurse will measure which parameters to determine hemodynamic stability and the effectiveness of fluid extraction?
Vital Signs & Weight
A patient with severe chronic liver dysfunction comes to the clinic with bleeding of the gums and blood in the stool. What vitamin deficiency does the nurse suspect the patient may be experiencing?
Vitamin K
A client has an elevated serum ammonia concentration and is exhibiting changes in mental status. The nurse should suspect which condition?
hepatic encephalopathy
Because peritoneal dialysis uses glucose, what do we need to monitor for?
hyperglycemia
What is paracentesis?
removal of fluid from the abdominal cavity
What dietary instructions should the nurse give to parents of a child in the oliguria phase of acute glomerulonephritis with edema and hypertension? (Select all that apply.) a. High fat b. Low protein c. Encouragement of fluids d. Moderate sodium restriction e. Limit foods high in potassium
D, E
What would the nurse do initially for a patient with the nursing diagnosis of fluid overload?
- daily weights - strict I/O's - VS - restrict fluids - teach about low sodium diet
What other lab abnormalities will you find in a patient with liver disease?
- decreased protein and albumin due to the low protein diet - high bilirubin levels (jaundice) - elevated ALT & AST - elevated PT & INR puts patient at risk for bleeding
A client with chronic renal failure is admitted with a heart rate of 122 beats/minute, a respiratory rate of 32 breaths/minute, a blood pressure of 190/110 mm Hg, jugular vein distention, and bibasilar crackles. Which nursing diagnosis takes highest priority for this client?
- excess fluid volume (fluid overload)
Patient with liver cancer is at greatest risk for what?
- high cirrhosis level
Kidney failure patients are at risk for which electrolyte imbalances?
- hyperkalemia
What are signs of dehydration?
- hypotension - bradycardia - oliguria
Which lab values can Tacrolimus increase?
- kidney function levels (ACR & GFR)
What is some care to be done after an organ transplant?
- monitor for rejection (fever, pain at incision site, liver levels get worse) - infection control - immunosuppressants
Other interventions a nurse can do for a patient receiving lasix?
- monitor potassium & electrolyte levels - I/O's
You have a patient with CKD on fluid restriction. Which assessment finding would indicate a stable fluid balance?
- stable weights
What are complications of a paracentesis?
- sudden drop in blood pressure, or they may even code
What is the purpose of a safe work environment?
- to provide safe patient care and protect the care of our nurses - improves nurse job satisfaction and promotes positive patient outcomes
A nurse teaches a client with hepatitis C who is prescribed ribavirin (Copegus). Which statement should the nurse include in this clients discharge education? a. Use a pill organizer to ensure you take this medication as prescribed. b. Transient muscle aching is a common side effect of this medication. c. Follow up with your provider in 1 week to test your blood for toxicity. d. Take your radial pulse for 1 minute prior to taking this medication.
A
A nurse cares for a client who has elevated levels of antidiuretic hormone (ADH). Which disorder should the nurse identify as a trigger for the release of this hormone? a. Pneumonia b. Dehydration c. Renal failure d. Edema
B
The nurse is preparing to admit a 5-year-old child with hepatitis A. What clinical features of hepatitis A should the nurse recognize? (Select all that apply.) a. The onset is rapid. b. Fever occurs early. c. There is usually a pruritic rash. d. Nausea and vomiting are common. e. The mode of transmission is primarily by the parenteral route.
A, B, D
A nurse is caring for a postoperative 70-kg client who had major blood loss during surgery. Which findings by the nurse should prompt immediate action to prevent acute kidney injury? (Select all that apply.) a. Urine output of 100 mL in 4 hours b. Urine output of 500 mL in 12 hours c. Large amount of sediment in the urine d. Amber, odorless urine e. Blood pressure of 90/60 mm Hg
A, C, E
A nurse cares for a client who is scheduled for a paracentesis. Which intervention should the nurse delegate to an unlicensed assistive personnel (UAP)? a. Have the client sign the informed consent form. b. Assist the client to void before the procedure. c. Help the client lie flat in bed on the right side. d. Get the client into a chair after the procedure.
B
How is Hep B contracted?
Blood & Bodily fluids
A telehealth nurse speaks with a client who is recovering from a liver transplant 2 weeks ago. The client states, I am experiencing right flank pain and have a temperature of 101 F. How should the nurse respond? a. The anti-rejection drugs you are taking make you susceptible to infection. b. You should go to the hospital immediately to have your new liver checked out. c. You should take an additional dose of cyclosporine today. d. Take acetaminophen (Tylenol) every 4 hours until you feel better.
B
After teaching a client with nephrotic syndrome and a normal glomerular filtration, the nurse assesses the clients understanding. Which statement made by the client indicates a correct understanding of the nutritional therapy for this condition? a. I must decrease my intake of fat. b. I will increase my intake of protein. c. A decreased intake of carbohydrates will be required. d. An increased intake of vitamin C is necessary.
B
An RN suspects that an employer hires nursing students at a higher rate of pay and allows them to perform certain procedures that require the skills of an RN. The nursing students enjoy the autonomy and extra pay. Before the RN participates in whistle-blowing, he or she should: A.file a formal complaint to The Joint Commission to initiate an investigation and receive protection from retaliation by the employer. B.collect adequate documentation and, if possible, consult with the state nurses association before reporting to the state agency responsible for regulation of the employer. C.remember that protection from retaliation by the employer is provided until unethical or illegal actions are reported in writing. D.confront the individual suspected of wrongdoing and request that he or she stop the behavior.
B
Hospitals surveyed nurses who terminated their employment to determine why they chose to leave. What is one of the most common reasons nurses are leaving hospital practice? a. Decreased pay for alternative shifts b. Nurse/patient ratio prevents safe care. c. Facilities are choosing an all-RN staff, which decreases opportunities for advancement. d. Agency and foreign nurses are favored by administration over full-time nursing staff.
B
The nurse is assessing a client with a diagnosis of pre-renal acute kidney injury (AKI). Which condition would the nurse expect to find in the clients recent history? a. Pyelonephritis b. Myocardial infarction c. Bladder cancer d. Kidney stones
B
The nurse is discussing home care with a mother whose 6-year-old child has hepatitis A. What information should the nurse include? a. Advise bed rest until 1 week after the icteric phase. b. Teach infection control measures to family members. c. Inform the mother that the child cannot return to school until 3 weeks after onset of jaundice. d. Reassure the mother that hepatitis A cannot be transmitted to other family members.
B
The nurse is teaching the main principles of hemodialysis to a client with chronic kidney disease. Which statement by the client indicates a need for further teaching by the nurse? a. My sodium level changes by movement from the blood into the dialysate. b. Dialysis works by movement of wastes from lower to higher concentration. c. Extra fluid can be pulled from the blood by osmosis. d. The dialysate is similar to blood but without any toxins.
B
What dietary instructions should the nurse give to parents of a child undergoing chronic hemodialysis? (Select all that apply.) a. High protein b. Fluid restriction c. High phosphorus d. Sodium restriction e. Potassium restriction
B, D, E
A client is placed on fluid restrictions because of chronic kidney disease (CKD). Which assessment finding would alert the nurse that the clients fluid balance is stable at this time? a. Decreased calcium levels b. Increased phosphorus levels c. No adventitious sounds in the lungs d. Increased edema in the legs
C
A nurse assesses a client with renal insufficiency and a low red blood cell count. The client asks, Is my anemia related to the renal insufficiency? How should the nurse respond? a. Red blood cells produce erythropoietin, which increases blood flow to the kidneys. b. Your anemia and renal insufficiency are related to inadequate vitamin D and a loss of bone density. c. Erythropoietin is usually released from the kidneys and stimulates red blood cell production in the bone marrow. d. Kidney insufficiency inhibits active transportation of red blood cells throughout the blood.
C
A nurse assesses clients on the medical-surgical unit. Which client is at greatest risk for the development of carcinoma of the liver? a. A 22-year-old with a history of blunt liver trauma b. A 48-year-old with a history of diabetes mellitus c. A 66-year-old who has a history of cirrhosis d. An 82-year-old who has chronic malnutrition
C
A nurse reviews these laboratory values of a client who returned from kidney transplantation 12 hours ago: Sodium 136 mEq/L Potassium 5 mEq/L Blood urea nitrogen (BUN) 44 mg/dL Serum creatinine 2.5 mg/dL What initial intervention would the nurse anticipate? a. Start hemodialysis immediately. b. Discuss the need for peritoneal dialysis. c. Increase the dose of immunosuppression. d. Return the client to surgery for exploration.
C
A nurse teaches a client who is recovering from a urography. Which instruction should the nurse include in this clients discharge teaching? a. Avoid direct contact with your urine for 24 hours until the radioisotope clears. b. You may have some dribbling of urine for several weeks after this procedure. c. Be sure to drink at least 3 liters of fluids today to help eliminate the dye faster. d. Your skin may become slightly yellow from the dye used in this procedure.
C
What condition is the most common cause of acute renal failure in children? a. Pyelonephritis b. Tubular destruction c. Severe dehydration d. Upper tract obstruction
C
What diet is most appropriate for the child with chronic renal failure (CRF)? a. Low in protein b. Low in vitamin D c. Low in phosphorus d. Supplemented with vitamins A, E, and K
C
What statement is an advantage of peritoneal dialysis compared with hemodialysis? a. Protein loss is less extensive. b. Dietary limitations are not necessary. c. It is easy to learn and safe to perform. d. It is needed less frequently than hemodialysis.
C
What was an original purpose of the Social Security Act of 1935? a. Increase research that focused on minority groups b. Provide medical care for chemically impaired persons c. Ensure health care for older adults through a national insurance system d. Decrease the public's financial burden by limiting services offered by local health departments
C
A client asks the nurse, "Can you explain the amendment to the Social Security Act called Title XVIII to me?" The nurse demonstrates an understanding of this legislation when providing what response? a. It led to many hospital closings, along with a decrease in acute care hospital-based nursing care. b. It provided medical insurance to those younger adults or children who were not eligible for private insurance because of catastrophic illnesses such as cancer. c. It provided preventive care for women, infants, and children. d. It ensured that individuals with end-stage renal disease had health care insurance.
D
A client has just had a central line catheter placed that is specific for hemodialysis. What is the most appropriate action by the nurse? a. Use the catheter for the next laboratory blood draw. b. Monitor the central venous pressure through this line. c. Access the line for the next intravenous medication. d. Place a heparin or heparin/saline dwell after hemodialysis.
D
A client is assessed by the nurse after a hemodialysis session. The nurse notes bleeding from the clients nose and around the intravenous catheter. What action by the nurse is the priority? a. Hold pressure over the clients nose for 10 minutes. b. Take the clients pulse, blood pressure, and temperature. c. Assess for a bruit or thrill over the arteriovenous fistula. d. Prepare protamine sulfate for administration.
D
A client with chronic kidney disease states, I feel chained to the hemodialysis machine. What is the nurses best response to the clients statement? a. That feeling will gradually go away as you get used to the treatment. b. You probably need to see a psychiatrist to see if you are depressed. c. Do you need help from social services to discuss financial aid? d. Tell me more about your feelings regarding hemodialysis treatment.
D
A nurse assesses a client who is recovering from a radical nephrectomy for renal cell carcinoma. The nurse notes that the clients blood pressure has decreased from 134/90 to 100/56 mm Hg and urine output is 20 mL for this past hour. Which action should the nurse take? a. Position the client to lay on the surgical incision. b. Measure the specific gravity of the clients urine. c. Administer intravenous pain medications. d. Assess the rate and quality of the clients pulse.
D
