Renal and Urinary

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A nurse is teaching a client who has chronic kidney disease (CKD). Which of the following instructions should the nurse include? -Limit fluid intake. -Limit caloric intake. -Eat a diet high in phosphorus. -Eat a diet high in protein.

Limit fluid intake.

A nurse is providing dietary teaching to a client who has chronic renal failure. Which of the following food choices by the client indicates an understanding of the teaching? -Canned soup -Grilled fish -Pastrami -Peanut butter

Grilled Fish

A nurse is assessing a client who is receiving hemodialysis for the first time. Which of the following finding indicates that the client is developing dialysis disequilibrium syndrome (DDS)? -Elevated BUN -Bradycardia -Headache -Terperature 39.2 C. (102.5 F)

Headache

A nurse is caring for a client who has chronic glomerulonephritis with oliguria. For which of the following electrolyte imbalances should the nurse monitor? -Hypercalcemia -Hyperkalemia -Hypomagnesemia -Hypophosphatemia

Hyperkalemia

A nurse is reviewing the laboratory findings of a client who has chronic kidney disease. The client reports significant persistent nausea and muscle weakness. Which of the following findings should the nurse expect? -Hypernatremia -Hypomagnesemia -Hypercalcemia -Hyperkalemia

Hyperkalemia

A nurse is teaching a client who is preoperative for a renal biopsy. Which of the following statement should the nurse make? -"You will be NPO for 8 hours following the procedure." -"An Allergy to shellfish is a contraindication to this procedure." -"You will need to be on bed rest following the procedure." -"A creatinine clearance is needed prior to the procedure"

"You will need to be on bed rest following the procedure."

A nurse is assessing a client who has urolithiasis and reports pain in his thigh. This finding indicates the stone is in which of the following structures? -Ureter -Bladder -Renal Pelvis -Renal tubules

Ureter

A nurse is assessing a client who is receiving continuous ambulatory peritoneal dialysis. Which of the following findings should the nurse report to the provider? -WBC 6,000/mm -Potassium 3.0 -Clear, pale yellow drainage -Report of abdominal fullness

Potassium 3.0 mEq/L

A nurse is teaching a newly licensed nurse about caring for a client who has a new left arteriovenous fistula. Which of the following statements should the nurse make? -"Check the fistula site daily for a vibration." -"Instruct the client to restrict movement of his left arm." -"Avoid taking blood pressure on the client's left arm." -"Instruct the client to sleep on his left side."

"Avoid taking blood pressure on clients left arm."

A nurse is teaching a client who is preoperative for a cystoscopy. Which of the following statements should the nurse make? -"You will need to keep the sutures clean after this procedure." -"You will be placed on your left side for this procedure." -"Expect to be on bed rest for 24 hours after this procedure." -"Expect to have pink-tinged urine after this procedure."

"Expect to have pink-tinged urine after this procedure."

A female client who has recurrent cystitis asks the nurse about preventing future episodes. For which of the following client statements should the nurse provide further teaching? -"I drink at least 2 L. of fluid per day." -"I prefer taking tub baths to showering." -"I urinate before and after sexual relations." -"I wipe from front to back after urinating."

"I prefer taking a tub baths to showering"

A nurse is providing teaching to a client who is preoperative prior to a transurethral resection of the prostate (TURP). Which of the following statement indicates an understanding of the information? -"I will not need to have a urinary catheter following this procedure." -"I will expect my urine to be cloudy after having this procedure." -"At least I won't have leakage of urine after having this procedure." -"I will feel the urge to urinate following this procedure."

"I will feel the urge to urinate following this procedure"

A nurse is teaching a client who has a spinal cord injury to perform intermittent urinary self-catheterization at home after discharge. Which of the following statements indicates that the client understands the procedure? -"I'll drink less water so I don't have to catheterize myself too often." -"I must use sterile technique for each of the catheterizations." -"I should stop the catheterization when I have removed 150 mL of urine." -"I will preform intermittent self-catheterization every 2-3 hrs"

"I will preform intermittent self-catheterization every 2-3 hr."

A nurse is teaching a female client who has pyelonephritis about the disorder. Which of the following pieces of information should the nurse include to help the client prevent a recurrence? -"Douche after vaginal intercourse. -"Wipe from front to back after defecation." -"Avoid foods that are high in phosphate." -Add yogurt to your diet regularly.

"Wipe from front to back after defecation."

A nurse is teaching a client about the prostate-specific antigen (PSA) test. Which of the following statements should the nurse make? -"Your should fast for 8 hours after the PSA test." -"Annual PSA screening should begin at age 40" -"Expected PSA values will decrease as you get older" -"You should not ejaculate for 24 hours prior to the PSA test."

"You should not ejaculate for 24 hours prior to the PSA test."

A nurse is preparing an inservice program about the stages of acute kidney injury (AKI). Which of the following pieces of information should the nurse include about prerenal azotemia? -Prerenal azotemia begins prior to the onset of symptoms. -Interference with renal perfusion causes prerenal azotemia. -Prerenal azotemia is irreversible, even in the early stages -Infection and tumors cause prerenal azotemia.

-Interference with renal perfusion causes prerenal azotemia.

A nurse is caring for a client who has manifestations of acute tubular necrosis (ATN) following a kidney transplantation. Which of the following interventions should the nurse anticipate for this client? (Select all that apply.) A. Hemodialysis B. Biopsy C. Immunosuppression D. Balloon angioplasty E. Surgical repair

A. Hemodialysis B. Biopsy C.Immunosuppression

A nurse is providing teaching to a client who has gout and urolithiasis. The client asks how to prevent future uric acid stones. Which of the following suggestions should the nurse provide? (Select all that apply) A. Take allopurinol as prescribed -B. Exercise several times a week -C. Limit intake of foods high in purine -D. Decrease daily fluid intake -E. Avoid citrus juices

A. Take allopurinol as prescribed B. Exercise several times a week C. Limit intake of foods high in purine

A nurse is teaching a client about urinary tract infections (UTI 's). which of the following manifestations should the nurse include? -Weight gain -back pain -vaginal discharge -Muscle Cramps

Back Pain

A nurse is assessing a client who is 1 week postoperative following a living donor kidney transplant. Which of the following findings should indicate to the nurse that the client is experiencing acute kidney rejection? -Blood pressure 160/90 -Creatinine 0.8 mg/dL -Sodium 137 mg/dL -Urinary output 100 mL/hr

Blood pressure 160/90

A nurse is assessing a client who is 4 hr postoperative following a transurethral resection of the prostate and has an indwelling urinary catheter in place. Which of the following findings should the nurse expect? -Blood-tinged urine in the drainage bag -Catheter tubing coiled at the client's side -Client report of severe bladder spasms -Urinary output of 30mL/hr

Blood tinged urine in the drainage bag

A nurse is providing dietary teaching to a client who has late-stage chronic kidney disease (CKD). Which of the following nutrients should the nurse instruct the client to increase in her diet? -Calcium -Phosphorous -Potassium -Sodium

Calcium

A nurse is providing teaching to a young adult client who has a history of calcium oxalate renal calculi. Which of the following instructions should the nurse include? -Drink fruit punch of juice with every meal. -Consume 1000 mg of dietary calcium daily -Take 1 g of a vitamin C supplement daily. -Increase your daily bran intake

Consume 1,000 mg of dietary calcium daily

A nurse is caring for a client who is receiving peritoneal dialysis. The nurse notes that the client's dialysate output is less than the input, and his abdomen is distended. which of the following actions should the nurse take? -Insert an indwelling urinary catheter -administer pain medication to the client. -Change the client's position. -place the drainage bag above the client's abdomen

Change the clients position.

A nurse is caring for a client who is in the oliguric-anuric stage of acute kidney injury. The client reports diarrhea, a dull headache, palpitations, and muscle tingling and weakness. Which of the following actions should the nurse take first. -Administer an analgesic to the client. -Check the client's electrolyte values -Measure the client's weight. -Restrict the client's protein intake

Check the client's electrolyte values.

A nurse is caring for a client who had a nephrostomy tube inserted 8 hours ago. Which of the following actions should the nurse include in the client's plan of care? -Flush the nephrostomy tube every 4 hours with sterile water. -Clamp the nephrostomy tube intermittently to establish continence. -Check the skin at the nephrostomy site for irritation from urine leakage -Monitor for and report any blood-tinged drainage to the provider immediately.

Check the skin at the nephrostomy site for irritation from urine leakage

A nurse is assessing a client who is receiving peritoneal dialysis. Which of the following finding should the nurse report to the provider immediately? -Difficulty draining the effluent -Redness at the access site -Fluid flowing from the catheter site -Cloudy effluent

Cloudy Effluent

A nurse is assessing a client who is postoperative following a transurethral resection of the prostate (TURP). After the nurse discontinues the client's urinary catheter, which of the following findings should the nurse report to the provider? -Pink-tinged urine -Report of burning upon urination -stress incontinence -Decreased urine output

Decreased Urine Output (Indicates obstruction)

A nurse is conducting a dietary teaching with a client who has a history of renal calculi. Which of the following instructions should the nurse include in the teaching? -Consume foods containing vitamin C -Drink 3.8 L (4 qt) of water throughout the day -Suggest almonds as a snack -Limit sodium intake to 3 g per day

Drink 3.8 L (4 qt of water throughout the day

A nurse is monitoring a client who is undergoing extracorporeal shockwave lithotripsy (ESWL). The nurse should identify that which of the following findings is the priority? -Dysrhythmias -Pink-tinged urine -Bruising on the flank area -Stone fragments in the urine

Dysrhythmias

A nurse is assessing a client who was brought to the emergency department following a motor vehicle crash. The nurse should recognize that which of the following findings is a manifestation of bladder trauma. -stress incontinence -Hematuria -Pyuria -Fever

Hematuria

A nurse is assessing a client who was brought to the emergency department following a motor-vehicle crash. Which of the following findings is a manifestation of bladder trauma? -Stress incontinence -Hematuria -Pyuria -Fever

Hematuria

A nurse is reviewing the laboratory report of a client who has chronic kidney disease (CKD). The nurse finds the following laboratory test results: potassium 6.8 mEq/L, Calcium 7.4 mg/dL, hemoglobin 10.2 g/dL, and phosphate 4.8 mg/dL. Which finding is the priority for the nurse to report to the provider? -hypocalcemia -Hyperkalemia -Anemia -Hypoalbuminemia

Hyperkalemia

A nurse is providing teaching to a client who has a history of urinary tract infections (UTI 's). which of the following statements should indicate to the nurse the need for additional teaching? -"I will empty my bladder every 4 hours." -"I will drink 2 liters of fluids per day." -"I will use a vaginal douche daily." -"I will wear cotton underwear."

I will use a vaginal douche daily.

A nurse is assessing a client who is postoperative following a transurethral resection of the prostate (TURP) and has continuous bladder irrigation. The nurse notes no drainage in the client's urinary drainage bag over 1 hr. Which of the following actions should the nurse take? -Instruct the client to attempt to void around the indwelling urinary catheter -Increase the rate of irrigation of fluid instillation -Irrigate the indwelling urinary catheter with a syringe -Prepare to administer a diuretic

Irrigate the indwelling urinary catheter with a syringe.

A nurse is assessing a client who has acute kidney injury (AKI). According to the RIFLE classification system, which of the following findings indicates that the client has end-state kidney disease? -<0.5 mL/kg of urine output for 12 hr -No urine output for 12 hr -No urine output without renal replacement therapy for 4 to 12 weeks -No urine output without renal replacement therapy for more than 3 months

No urine output without renal replacement therapy for more than 3 months

A nurse is planning care for a client who had a stroke. The client has hemiplegia and occasional urinary incontinence. Which of the following actions should the nurse include in the client's plan of care? -Offer the client a bedpan every 2 hr -Limit the client's daily fluid intake until he is no longer incontinent -Request a prescription for an indwelling urinary catheter from the client's provider -Ambulate the client to the bathroom every 30 min

Offer the client a bedpan every 2 hr

A nurse is caring for a client who is receiving peritoneal dialysis. The nurse should monitor the client for which of the following adverse effects? -Diarrhea -Increased serum albumin -Hypoglycemia -Peritonitis

Peritonitis

A nurse is teaching a newly licensed nurse about collecting a 24-hour urine specimen for creatinine clearance. Which of the following instructions should the nurse include? -Include the first voided specimen at the start of the collection period. -Discard the last voided specimen at the end of the collection period. -Place signs in the bathroom as a reminder about the test in progress. -Instruct the client to increase exercise during the 24-hr period.

Place signs in the bathroom as a reminder about the test in progress.

A nurse is checking the laboratory values of a client who has chronic kidney disease. The nurse should expect elevations in which of the following values? -Potassium and magnesium -Calcium and bicarbonate -Hemoglobin and hematocrit -Arterial pH and PaCO2

Potassium and Magnesium

A nurse is teaching a client with chronic kidney disease about predialysis dietary recommendations. The nurse should recommend restricting the intake of which of the following nutrients.

Protein

A nurse is caring for a client who has a diagnosis of renal calculi and reports severe flank pain. Which of the following is the priority nursing action? -Relieve the client's Pain -Encourage the client to increase fluid intake. -Monitor the client's I&O -Strain the client's Urine

Relieve the clients pain

A nurse is caring for a client who is receiving intermittent peritoneal dialysis. The nurse observes that the peritoneal fluid is not adequately draining. Which of the following actions should the nurse take? -Turn the client from side to side. -Elevate the height of the dialysate bag -Lower the head of the client's bed -Advance the catheter approximately 2.5 cm (1 in) further

Turn the client from side to side.

A nurse is caring for a client who has just returned from the surgical suite following a right nephrectomy. Which of the following indicates that the client is meeting a successful short-term goal following this procedure? -The client requests pain medications upon arrival from surgery. -A chest X-ray shows consolidation in the right lower lobe. -Urinary output is 35 to 50 mL/hr consistently -The client has slight abdominal distention.

Urinary output is 35-50 mL/hr consistently

A nurse is caring for a client who has continuous bladder irrigation following a transurethral resection of the prostate (TURP). Which of the following findings should the nurse report to the provider? -Output equal to the instilled irrigant -Client report of bladder spasms -Viscous urinary output with clots -Client report of a strong urge to urinate

Viscous urinary output with clots

A nurse is preparing a client who is schduled for an intravenous pyelogram (IVP). Which of the following findings should the nurse report to the provider? -Allergy to egg products -Vomiting and diarrhea for the last 6 hr -Serum potassium of 3.6 mEq/L -Serum Creatinine of 1.2 mg/dL

Vomiting and diarrhea for the last 6 hr.

A nurse is teaching a client who has acute pyelonephritis. Which of the following instructions should the nurse include in the teaching? -"you should complete the entire cycle of antibiotic therapy" -"You should maintain complete bed rest until manifestations decrease." -"You should drink 1000 milliliters of fluid per day" -"You should use NSAIDS for pain"

You should complete the entire cycle of antibiotic therapy


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