Renal, Genitourinary, Reproductive

When a client returns from the operating room after undergoing a left nephrectomy, a nurse must make sure that urine is draining through the client's indwelling urinary catheter. This assessment is important for this client because it:

assesses functions of the remaining kidney

A child with a Wilms tumor has had surgery to remove a kidney and has received chemotherapy. The nurse should include which instructions at discharge?

avoid contact sports

A client is receiving furosemide, 40 mg by mouth twice per day. In the plan of care, the nurse should emphasize teaching the client about the importance of consuming:

bananas and oranges

A child is brought to the health care provider's office for treatment of a rash. Many petechiae are seen over the entire body. The nurse would suspect which condition?

bleeding disorder

A nurse is examining the following laboratory values in the chart of a client with chronic renal failure. Which value indicates that hemodialysis is an effective treatment for this client?

blood urea nitrogen (BUN)

The clinic nurse is reviewing the laboratory results of a client diagnosed with acute renal failure. What two values reflect the kidney's ability to excrete waste?

blood urea nitrogen (BUN) and creatinine

A client with chronic renal failure has a serum potassium level of 6.8 mEq/L. What should the nurse assess first?

cardiac rhythm

Two nurses are discussing which types of blood can be safely administered to a client with type AB negative blood. Which blood types can safely be administered to this client? Select all that apply.

A negative B negative

A pregnant client being seen in the clinic reports increasing leg cramps. Which response by the nurse is most appropriate?

"Sometimes gently stretching the legs helps relieve leg cramps."

A client reports urinary frequency and burning. The health care provider diagnoses cystitis and prescribes sulfamethoxazole-trimoxazole. Which instruction should the nurse give the client?

"Take the medication with 6 to 8 oz (180 to 240 mL) of water."

The nurse is preparing to teach a prenatal class about fetal circulation. Which statements should be included in the teaching plan? Select all that apply.

"The ductus arteriosus allows blood to bypass the fetal lungs.", "One vein carries oxygenated blood from the placenta to the fetus.", "Two arteries carry deoxygenated blood and waste products away from the fetus to the placenta."

A client comes to the emergency department complaining of sudden onset of sharp, severe pain in the lumbar region, which radiates around the side and toward the bladder. The client also reports nausea and vomiting and appears pale, diaphoretic, and anxious. The physician tentatively diagnoses renal calculi and orders flat-plate abdominal X-rays. Renal calculi can form anywhere in the urinary tract. The nursing instructor asks the student where is the common formation site? How should the student reply?

"The most common renal calculi formation site is the kidney."

When assisting in discharge planning for a child with Duchenne muscular dystrophy, what should the nurse be sure to include regarding the diet?

low calorie, high protein, and high fiber

A nurse is planning discharge teaching for a client on a loop diuretic. Which information would the nurse include about the therapeutic action of loop diuretics?

They block sodium reabsorption in the ascending loop and dilate renal vessels.

A client is injected with radiographic contrast medium and immediately shows signs of dyspnea, flushing, and pruritus. Which intervention should take priority?

make sure the airway is patent

The nurse is caring for a group of clients. Which activities by the nurse is the best example of the nurse as an interdisciplinary team member?

recommending a physical therapy consult because of altered mobility

After collecting a urine specimen, which action by the nurse is most appropriate?

take the specimen to the lab immediately

The nurse is caring for a school-age child with swelling and tenderness of the left tibia hospitalized for treatment of acute osteomyelitis. The primary health care provider prescribes antibiotic therapy and immobilization of the affected limb in a splint. Which nursing goal is most appropriate?

the child will change positions with minimal discomfort

Which statement describes primary prevention of sexually transmitted infections (STIs) by avoiding exposure?

the least expensive and most effective approach

A client with suspected renal insufficiency is scheduled for a comprehensive diagnostic workup. The nurse develops a teaching plan to explain the diagnostic tests. Which portion of the kidney does the nurse plan to include as the "working" or functional unit?

the nephron

The nurse inadvertently gives a client a double dose of a prescribed medication. After discovering the error, whom should the nurse notify?

the prescriber

A 6-year-old child's indwelling urinary catheter was removed at 6 a.m. At noon, the child still has not voided, appears uncomfortable, and the nurse palpates slight bladder distention. Which action should the nurse take first?

turn on the water faucet and provide privacy

Which finding would lead the nurse to suspect that a client has developed hypovolemic shock caused by postpartum hemorrhage?

urine output less than 25 ml/hour

The nurse is reviewing the report of a client's routine urinalysis. Which value should the nurse consider abnormal?

urine pH of 3.0

The nurse educator is preparing an in-service on antidiuretics. Which of the following functions of antidiuretic hormone (ADH) would the nurse include in the presentation?

water absorption and urine concentration

The nurse receives a client into the medical unit immediately after a liver biopsy. Which finding indicates to the nurse that the client is experiencing a post-procedure complication?

weak, rapid pulse

Which purposes of placental functioning should the nurse include in a prenatal class? Select all that apply.

It is the way the baby gets food and oxygen, It provides an exchange of nutrients and waste products

A client requires behavioral therapies to decrease or eliminate urinary incontinence. Which procedures would the nurse expect to include when assisting with the development of the teaching plan? Select all that apply.

Kegel exercises prompted voiding biofeedback

Which question should the nurse ask the parents of a child suspected of having glomerulonephritis?

"Has the child had a sore throat or a throat infection in the last few weeks?"

A female client with a history of four urinary tract infections (UTIs) in the past 3 months comes to the urology clinic reporting of burning and urinary urgency and frequency. A health care provider makes the diagnosis of UTI. Which instructions should the nurse give the client to help prevent recurring infections? Select all that apply.

"Avoid using irritating substances such as bubble bath and scented toilet paper." "Clean the perineal area from front to back."

The nurse is reviewing a treatment plan with the parents of a newborn with hypospadias. Which statement by the parents indicates their understanding of the plan?

"Circumcision has been delayed to save tissue for surgical repair."

The nurse receives a call from a client concerned about eliminating browncolored urine after taking nitrofurantoin for a urinary tract infection. The nurse should make which appropriate response?

"Continue taking the medication; the brown urine occurs and is not harmful."

A couple comes to the family planning clinic and asks about sterilization procedures. Which question by the nurse should determine whether this method of family planning would be most appropriate?

"Do you plan to have any other children?"

The nurse is gathering data from a female client that states she has had difficulty conceiving. Which statement made by the client would the nurse find most significant related to the difficulty getting pregnant?

"I had gonorrhea that went untreated for about 3 months."

A nurse is providing prenatal instructions to a female client newly diagnosed with human immunodeficiency virus (HIV). Which statement from the client would indicate to the nurse that further teaching is necessary?

"I look forward to the bonding I'll experience when I breastfeed my baby."

Which statement made by a client with a chlamydial infection indicates understanding of the potential complications?

"I need to treat this infection so it doesn't spread into my pelvis because I want to have children some day."

A nurse is obtaining data from a client with a urinary tract infection (UTI). Which statement should the nurse expect the client to make?

"I need to urinate frequently." "It burns when I urinate." "I need to urinate urgently."

The nurse reviews the record of a child who is suspected to have glomerulonephritis. Which statement by the child's parent should the nurse expect that is associated with this diagnosis?

"I noticed his urine was the color of cola lately."

When reinforcing education about fluid intake with the parents of a child with a urinary tract infection (UTI), which statement by a parent would indicate the need for further education?

"I should offer my child carbonated beverages about every 2 hours."

A client with nephritis is taking the diuretic furosemide as prescribed. To avoid potassium depletion, the nurse reinforces education on prevention techniques. Which client statement indicates an accurate understanding of this education?

"I'll eat such foods as apricots, dates, and citrus fruits."

The nurse provided discharge instructions to the parents of a 2-year-old child who had an orchiopexy to correct cryptorchidism. Which statement by the parents indicates the need for further instruction?

"I'll let him decide when to return to his play activities."

A client undergoes extracorporeal shock wave lithotripsy. Before discharge, the nurse should provide which instruction?

"Increase your fluid intake to 2 to 3 L per day."

The nursing instructor asks the student to describe fetal circulation, specifically the ductus venosus. Which statement by the student indicates an understanding of the ductus venosus?

"It connects the umbilical vein to the inferior vena cava."

The nurse is conducting a prenatal class on the female reproductive system. When a client in the class asks why the fertilized ovum stays in the fallopian tube for 3 days, what is the nurse's best response?

"It promotes the fertilized ovum's normal implantation in the top portion of the uterus."

A nurse is caring for an older adult client who was admitted with a hip fracture. The client is occasionally confused and has incidents of urinary incontinence. The nurse overhears the unlicensed assistive personnel state, "I am tired of changing that client's bed linen because she can't hold her urine. The client is with it mentally most of the time." Which response by the nurse is most appropriate?

"Let's go to a private area so that we can talk more about your frustration."

The nurse is reinforcing education about antihypertensive therapy with the parents of a child with glomerulonephritis. Which statement made by the parent indicates that further teaching is required?

"My child will need to take antihypertensive drugs for the rest of his life."

The nurse is reinforcing education with an adolescent diagnosed with chlamydia. Which statement by the adolescent indicates a correct understanding of the teaching?

"My sexual partners will also need to be treated."

A 55-year-old male client confides in the nurse that he is concerned about his sexual function. What is the nurse's best response?

"Please share with me more about your concerns."

A client diagnosed with cardiomyopathy saw a posting on the Internet describing research about a new herbal treatment for the disorder. When the client asks about this research, which response is most appropriate?

"Research found on the Internet should be verified with a health care provider."

The parents of a child with a history of seizures who has been taking phenytoin ask the nurse why it's difficult to maintain therapeutic plasma levels of this medication. Which statement by the nurse would be most accurate?

"Small increments in dosage lead to sharp increases in plasma drug levels."

The nurse is preparing a client who has been newly diagnosed with asthma for discharge. As part of his discharge orders, the client is prescribed albuterol via nebulizer every 8 hours for 3 days, followed by one dose daily thereafter. Which instruction should the nurse include when teaching the client about nebulizer use?

"You should take your pulse before and after treatment; if your pulse rate increases by more than 30 beats/minute you should notify your physician."

A female client is diagnosed with condylomata acuminata (genital warts). What information is appropriate for the nurse to give provide to this client?

"You will need regular Papanicolaou (Pap) test for follow up of this condition."

The nurse should make which statement to a pregnant client found to have a gynecoid pelvis?

"Your type of pelvis is the most favorable for labor and birth."

A health care provider prescribes I.V. normal saline solution to be infused at a rate of 150 mL/hour for a client. How many liter(s) of solution will the client receive during an 8-hour shift? Record your answer using one decimal place.

1.2

The label of a drug package reads "hydralazine, 20 mg/ml." How many milliliters would the nurse give a client for a 25-mg dose?

1.25

A client with severe pain is prescribed hydromorphone 10 mg by mouth every 4 hours as needed for pain. The client rates pain as eight on a one-to-ten scale, so the nurse prepares to administer a dose. The oral liquid contained in the unit's opioid stock contains 5 mg/5 mL. How many milliliters of solution should the nurse give to the client? Record your answer using a whole number.

10

The nurse is preparing to administer penicillin VK 0.5 g to a child with glomerulonephritis. The nurse has available an oral solution of penicillin VK 250 mg/5 mL. How many milliliters should the nurse administer with each dose? Record your answer using a whole number.

10

The nurse is caring for a child with a urinary tract infection. The health care provider has ordered cephalexin 125 mg by mouth every 8 hours. Cephalexin is available 250 mg per 5 mL. How many milliliters should the nurse administer per dose? Record your answer using one decimal place.

2.5

The health care provider's order reads 2 g of cephalexin PO daily in equally divided doses of 500 mg each. How many times per day should the nurse administer this medication? Record your answer using a whole number.

4

When explaining to the parents the optimal time for repair of hypospadias, the nurse should indicate which as the age of choice?

6 to 18 months

A nurse is completing an intake and output record for a client who is receiving continuous bladder irrigation after transurethral resection of the prostate (TURP). How many milliliters of urine should the nurse record as output for his or her shift if the client received 1,800 mL of normal saline irrigating solution and the output in the urine drainage bag is 2,400 mL? Record your answer as a whole number.

600

A client with chronic kidney disease being hemodialyzed suddenly becomes short of breath and complains of chest pain. The client is tachycardic, pale, and anxious, and the nurse suspects air embolism. What are the priority nursing actions? Select all that apply.

Administer oxygen to the client. Notify the primary health care provider (PHCP) and Rapid Response Team. Stop dialysis, and turn the client on the left side with head lower than feet.

A client with chronic kidney disease being hemodialyzed suddenly becomes short of breath and complains of chest pain. The client is tachycardic, pale, and anxious, and the nurse suspects air embolism. What are the priority nursing actions? Select all that apply.

Administer oxygen to the client., Notify the primary health care provider (PHCP) and Rapid Response Team., Stop dialysis, and turn the client on the left side with head lower than feet.

A client is scheduled to receive levothyroxine at 0900. When the nurse is finally able to administer the medication at 0930, the client is eating breakfast. The nurse knows that levothyroxine should be administered on an empty stomach. Which action by the nurse is best?

Administer the medication 30 mins after eating.

A client with chronic renal failure must restrict her fluid intake to 500 ml daily. Despite having reached the limit, the client is insisting that she have more fluid. Which intervention by a nurse is appropriate?

Allow her to have a hard piece of candy.

The nursing instructor asks a nursing student to explain the characteristics of the amniotic fluid. The student responds correctly by explaining which as characteristics of amniotic fluid? Select all that apply.

Allows for fetal movement, Surrounds, cushions, and protects the fetus, Maintains the body temperature of the fetus, Can be used to measure fetal kidney function

A nurse is working with a nursing assistant, who is given the task of calculating three clients' intake and output at the end of the shift. When the nurse reviews the nursing assistant's work, she discovers inaccuracies in the nursing assistant's results. What should the nurse do?

Ask the nursing assistant to show her how she determined the results.

The nurse collects a urine specimen preoperatively from a child with epispadias who is scheduled for surgical repair. When analyzing the results of the urinalysis, which should the nurse most likely expect to note?

Bacteriuria

A client is admitted to the hospital with a diagnosis of benign prostatic hyperplasia, and a transurethral resection of the prostate is performed. Four hours after surgery, the nurse takes the client's vital signs and empties the urinary drainage bag. Which assessment finding indicates the need to notify the primary health care provider (PHCP)?

Blood pressure, 100/50 mm Hg; pulse, 130 beats per minute

A client is admitted to the hospital with a diagnosis of benign prostatic hyperplasia, and a transurethral resection of the prostate is performed. Four hours after surgery, the nurse takes the client's vital signs and empties the urinary drainage bag. Which assessment finding indicates the need to notify the primary health care provider (PHCP)?

Blood pressure, 100/50 mm Hg; pulse, 130 beats per minute

Following kidney transplantation, cyclosporine is prescribed for a client. Which laboratory result would indicate an adverse effect from the use of this medication?

Blood urea nitrogen level of 25 mg/dL (8.8 mmol/L)

The nurse, who is administering bethanechol chloride, is monitoring for cholinergic overdose associated with the medication. The nurse should check the client for which sign of overdose?

Bradycardia

A client requires hemodialysis. Which of the following drugs should be withheld before this procedure?

Cardiac glycosides

A client had a transurethral prostatectomy for benign prostatic hyperplasia (BPH). He is currently being treated with continuous bladder irrigation and is reporting an increase in severity of bladder spasms. What should the nurse do first for this client?

Check for the presence of clots, and make sure the catheter is draining properly.

The nurse monitoring a client receiving peritoneal dialysis notes that the client's outflow is less than the inflow. Which actions should the nurse take? Select all that apply.

Check the level of the drainage bag, Reposition the client to her or his side., Place the client in good body alignment, Check the peritoneal dialysis system for kinks

The nurse monitoring a client receiving peritoneal dialysis notes that the client's outflow is less than the inflow. Which actions should the nurse take? Select all that apply.

Check the level of the drainage bag. Reposition the client to her or his side. Place the client in good body alignment Check the peritoneal dialysis system for kinks

A client with head trauma develops a urine output of 300 ml/hour, dry skin, and dry mucous membranes. Which nursing intervention is most appropriate to perform immediately?

Check urine specific gravity

After being treated with heparin for a pulmonary embolism, a client is prescribed warfarin using a sliding scale. Which action should the nurse take before administering this drug?

Closely monitor prothrombin time (PT) and international normalized ratio (INR) results to determine the dose of warfarin to administer.

A nurse is planning care for a client after a tracheotomy. One of the client's goals is to overcome verbal communication impairment. Which nursing intervention should the nurse include when assisting with development of the care plan?

Encourage the client to communicate by allowing time to write words.

A child is to receive phenytoin, 5 mg/kg by mouth each day. When teaching the parents about the medication regimen, the nurse should use which approach?

Conduct brief education sessions, provide written materials during each visit, and repeat information as appropriate.

When preparing to give a client a prescribed drug, the nurse realizes that the drug is one the nurse has never administered before. No drug references on the nursing unit contain information about the drug in question. What is the nurse's best action?

Contact a pharmacist to obtain information about the drug

The nurse is caring for an infant with a diagnosis of bladder exstrophy. To protect the exposed bladder tissue, the nurse should plan which intervention?

Cover the bladder with a nonadhering plastic wrap.

A 3½-year-old Vietnamese child with a fever, decreased urine output, wheezing, and coughing is brought to the emergency department. On data collection, the nurse discovers red, round, weltlike lesions on the child's upper back and chest. The nurse would interpret these lesions to be caused by which of the following?

Cultural practice

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, the nurse determines that the client should be questioned about the use of which medication?

Decongestants

The nurse is collecting data from a client. Which symptom described by the client is characteristic of an early symptom of benign prostatic hyperplasia?

Decreased force in the stream of urine

The nurse is collecting data from a client. Which symptom described by the client is characteristic of an early symptom of benign prostatic hyperplasia?

Decreased force in the stream of urine

A nurse is teaching a client regarding his or her medication schedule. What is the best nursing intervention to improve this client's compliance with the prescribed medication schedule?

Devise the simplest medication schedule possible.

A client admitted with bacterial pneumonia is prescribed cefuroxime axetil 550 mg I.V. every 4 hours. While assessing the client, the nurse notices that cefazolin 500 mg I.V. is infusing. Which action by the nurse is most appropriate?

Discontinuing the medication and notifying the physician of the error

The nurse is providing discharge instructions to a client receiving trimethoprim-sulfamethoxazole. Which instruction should be included in the list?

Drink 8 to 10 glasses of water per day

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 male client has a tentative diagnosis of urethritis. The nurse should assess the client for which manifestation of the disorder?

Dysuria and penile discharge

The nurse is reviewing a client's record and notes that the primary health care provider has documented that the client has chronic kidney disease. On review of the laboratory results, the nurse most likely would expect to note which finding?

Elevated creatinine level

The nurse is reviewing a client's record and notes that the primary health care provider has documented that the client has chronic kidney disease. On review of the laboratory results, the nurse most likely would expect to note which finding?

Elevated creatinine level

A client is admitted into a medical unit confused and agitated. Which nursing measure should the nurse implement first to keep the client safe?

Encourage family, friends, or a sitter to stay with the client.

The nurse is assessing the patency of a client's left arm arteriovenous fistula prior to initiating hemodialysis. Which finding indicates that the fistula is patent?

Palpation of a thrill over the fistula.

The nurse is assigned to care for a suicidal client. Initially, before assuming care for clients, which is the nurse's highest care priority?

Exploring the nurse's own feelings about suicide

The nurse is reviewing the laboratory results for a client receiving tacrolimus. Which laboratory result would indicate to the nurse that the client is experiencing an adverse effect of the medication?

Fasting blood glucose of 200 mg/dL (11.1 mmol/L)

The nurse is assessing a client with epididymitis. The nurse anticipates which findings on physical examination?

Fever, nausea, vomiting, and painful scrotal edema

The nurse is reviewing a client's fluid intake and output record. If the client is in homeostasis, the nurse expects the fluid intake and urine output should relate in which way?

Fluid intake should be approximately equal to the urine output.

The nurse is reinforcing education with the parents of a child with a recurrent urinary tract infection (UTI). Which statement should the nurse include?

Follow-up urine cultures are necessary to detect recurrent infections and antibiotic effectiveness.

The nurse performing an admission assessment on a 2-year-old child who has been diagnosed with nephrotic syndrome notes that which most common characteristic is associated with this syndrome?

Generalized edema

A client is admitted for treatment of glomerulonephritis. During the initial assessment, the nurse documents which finding (one of the classic signs of acute glomerulonephritis found in sudden onset)?

Generalized edema, especially of the face and periorbital area

The nurse is planning a group teaching session on the topic of urinary tract infection (UTI) prevention. Which points would the nurse want to include? Select all that apply.

Gently wash the perineal area before sexual intercourse. Notify the health care provider if urinary urgency, burning, frequency, or difficulty occurs.

A client with chronic obstructive lung disease tells the nurse that he feels short of breath. The client's respiratory rate is 36 breaths/minute, and the nurse auscultates diffuse wheezes. His arterial oxygen saturation is 84%. The nurse calls the assigned respiratory therapist to administer a prescribed nebulizer treatment. The therapist says, "I have several more percussions to do on the unit where I am now. As soon as I'm done, I'll come assess the client." The nurse's most appropriate action is to:

Give the neabulizer treatment herself

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

The client newly diagnosed with chronic kidney disease recently has begun hemodialysis. Knowing that the client is at risk for disequilibrium syndrome, the nurse should assess the client during dialysis for which associated manifestations?

Headache, deteriorating level of consciousness, and twitching

The client newly diagnosed with chronic kidney disease recently has begun hemodialysis. Knowing that the client is at risk for disequilibrium syndrome, the nurse should assess the client during dialysis for which associated manifestations?

Headache, deteriorating level of consciousness, and twitching

A client with chronic kidney disease is receiving epoetin alfa. Which laboratory result would indicate a therapeutic effect of the medication?

Hematocrit of 33% (0.33)

The nurse discusses plans for future treatment options with a client with symptomatic polycystic kidney disease. Which treatment should be included in this discussion? Select all that apply.

Hemodialysis Kidney transplant Bilateral nephrectomy

The nurse discusses plans for future treatment options with a client with symptomatic polycystic kidney disease. Which treatment should be included in this discussion? Select all that apply.

Hemodialysis, Kidney transplant, Bilateral nephrectomy

Following a pulmonary embolism, a client is placed on I.V. heparin. The client asks the nurse about the purpose of the heparin. Which statement by the nurse is correct?

Heparin will slow the development of any blood clots.

The nurse is caring for a 21 kg child with a urinary tract infection. The health care provider has ordered amoxicillin 750 mg by mouth every 8 hours. The recommended pediatric dosage is 40 to 90 mg/kg/day in two to three divided doses. Which action should the nurse take?

Hold the medication and notify the health care provider that the dose exceeds the recommended range.

The nurse is administering medications to a client when the client indicates that the name of the medication does not sound familiar. What should the nurse do?

Hold the medication and verify that the client should receive the medication.

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

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

Which statement indicates a client with bulimia nervosa is making progress in interrupting the binge-purge cycle?

I called my friend the last 2 times I got upset.

A nurse is reinforcing education to a client diagnosed with renal calculi. Which statement made by the client suggests further instruction is indicated?

I don't need to limit my intake of tea or cola.

The nurse is gathering data from a client who states, "I do not know what is wrong, but my urine has a very strong odor." The client's urinalysis, vital signs, and physical assessment findings are within normal ranges. Which finding, given by the client, may suggest to the nurse the reason for the client's strong urine odor?

I eat asparagus 3 to 4 times a week

A client reports pain during intercourse. Which statement by the client would be most important for the nurse to report to the health care provider?

I had a HPV infection at age 32.

After a nurse reinforces discharge education to the parents of a child with hypospadias, which statement by the parent indicates that additional education is needed?

I should bathe my child in the tub daily

The nurse is reinforcing education for a client who will be discharged from the hospital with an indwelling catheter. Which statement made by the client demonstrates an understanding of the education about prevention of infection?

I will take a shower instead of a tub bath.

A nurse reinforces teaching comfort measures to a client with genital herpes. Which statement by the client indicates the teaching has been effective?

I will wear loose cotton underwear.

A client is to be discharged on daily medication delivered by a transdermal disk. Which statement, given to the nurse by the client, indicates the need for further medication teaching?

I'll place the disk on the same spot each time.

Which statement by a man scheduled for a vasectomy indicates he needs further education about the procedure?

If I decide I want a child, I'll just get a reversal.

A week after kidney transplantation, a client develops a temperature of 101° F (38.3° C), the blood pressure is elevated, and there is tenderness over the transplanted kidney. The serum creatinine is rising and urine output is decreased. The x-ray indicates that the transplanted kidney is enlarged. Based on these assessment findings, the nurse anticipates which treatment?

Increased immunosuppression therapy

A week after kidney transplantation, a client develops a temperature of 101°F (38.3° C), the blood pressure is elevated, and there is tenderness over the transplanted kidney. The serum creatinine is rising and urine output is decreased. The x-ray indicates that the transplanted kidney is enlarged. Based on these assessment findings, the nurse anticipates which treatment?

Increased immunosuppression therapy

A client with a urinary tract infection is receiving ciprofloxacin by the intravenous (IV) route. The nurse appropriately administers the medication by performing which action?

Infusing slowly over 60 minutes

A client with severe back pain and hematuria is found to have hydronephrosis due to urolithiasis. The nurse anticipates which treatment will be done to relieve the obstruction? Select all that apply.

Insertion of a nephrostomy tube Placement of a ureteral stent with ureteroscopy

A client with severe back pain and hematuria is found to have hydronephrosis due to urolithiasis. The nurse anticipates which treatment will be done to relieve the obstruction? Select all that apply.

Insertion of a nephrostomy tube Placement of a ureteral stent with ureteroscopy

A client had gastric bypass surgery, is on nothing-by-mouth (NPO) status, and is in pain. The nurse gives morphine 4 mg as ordered. In 20 minutes, the client reports feeling nauseous. What would the nurse suspect as the most likely cause?

Morphine, which was given for pain, has a tendency to cause nausea.

A 7-year-old child is seen in a clinic, and the pediatrician documents a diagnosis of nighttime (nocturnal) enuresis. The nurse should provide which information to the parents?

Nighttime (nocturnal) enuresis is usually outgrown without therapeutic intervention.

A client recovering from a stroke has right-sided hemiplegia and telegraphic speech and often seems frustrated and agitated, especially when trying to communicate. However, the chart indicates that the client's auditory and reading comprehension are intact. The nurse suspects that the client has:

Nonfluent asphasia

Trimethoprim-sulfamethoxazole is prescribed for a client. The nurse should instruct the client to report which symptom if it develops during the course of this medication therapy?

Sore throat

A client is admitted to the emergency department following a fall from a horse, and the primary health care provider (PHCP) prescribes insertion of a urinary catheter. While preparing for the procedure, the nurse notes blood at the urinary meatus. The nurse should take which action?

Notify the PHCP before performing the catheterization.

A client is admitted to the emergency department following a fall from a horse, and the primary health care provider (PHCP) prescribes insertion of a urinary catheter. While preparing for the procedure, the nurse notes blood at the urinary meatus. The nurse should take which action?

Notify the PHCP before performing the catheterization.

A client is receiving a blood transfusion. If this client experiences an acute hemolytic reaction, which nursing interventions are most important?

Notify the health care provider, immediately stop the transfusion, infuse normal saline solution, and notify the blood bank.

The nurse is performing an assessment on a client who is at 38 weeks' gestation and notes that the fetal heart rate (FHR) is 174 beats per minute. On the basis of this finding, what is the priority nursing action?

Notify the obstetrician (OB).

A nurse is providing postprocedure care for a client who underwent percutaneous lithotripsy. Which instruction should the nurse give to the client?

Notify the primary care provider about cloudy or foul-smelling urine

A client with chronic kidney disease returns to the nursing unit following a hemodialysis treatment. On assessment, the nurse notes that the client's temperature is 38.5° C (101.2° F). Which nursing action is most appropriate?

Notify the primary health care provider

The nurse is performing an assessment on a client who has returned from the dialysis unit following hemodialysis. The client is complaining of headache and nausea and is extremely restless. Which is the priority nursing action?

Notify the primary health care provider (PHCP).

The nurse is performing an assessment on a client who has returned from the dialysis unit following hemodialysis. The client is complaining of headache and nausea and is extremely restless. Which is the priority nursing action?

Notify the primary health care provider (PHCP).

A client with chronic kidney disease returns to the nursing unit following a hemodialysis treatment. On assessment, the nurse notes that the client's temperature is 38.5° C (101.2° F). Which nursing action is most appropriate?

Notify the primary health care provider.

A client is scheduled for surgery at 8 a.m. While completing the preoperative checklist, the nurse sees that the surgical consent form hasn't been signed. It's time to administer the preoperative analgesic. Which nursing action takes the highest priority in this situation?

Notifying the surgeon that the consent form hasn't been signed

A client is prescribed digoxin 0.125 mg by mouth stat. The pharmacy dispenses digoxin 0.25 mg. The nurse promptly administers the medication and then realizes the incorrect dose has been administered. How should the nurse proceed?

Obtain vital signs, and immediately notify the primary health care provider and charge nurse of the error.

For a client who's moving into the active phase of labor, the nurse should include which of the following as the priority of care?

Offer support by reviewing the short-pant form of breathing.

A client is diagnosed with otitis externa. Which finding should the nurse anticipate during data collection?

Pain that occurs when the pinna of the ear is pulled.

The nurse is performing an assessment on a child admitted to the hospital with a probable diagnosis of nephrotic syndrome. Which assessment findings should the nurse expect to observe? Select all that apply.

Pallor, Edema, Anorexia, Proteinuria

A hemodialysis client with a left arm fistula is at risk for arterial steal syndrome. The nurse should assess for which manifestations of this complication?

Pallor, diminished pulse, and pain in the left hand

The nurse is assessing the patency of a client's left arm arteriovenous fistula prior to initiating hemodialysis. Which finding indicates that the fistula is patent?

Palpation of a thrill over the fistula.

A 3-year-old child is admitted with pneumonia and exhibits a productive cough and difficulty breathing. The parents inform the nurse of a poor appetite and inactivity. Which interventions would be included in the care plan to improve airway clearance? Select all that apply

Perform chest physiotherapy as ordered. Encourage coughing and deep breathing. Perform postural drainage. Maintain humidification with a cool mist humidifier.

The nurse is inserting an indwelling catheter into a female client before a surgical procedure. There is difficulty with the insertion and the nurse inserts the catheter into the vagina. Which action by the nurse should be performed next?

Perform the procedure again using a new catheter and kit.

A client with acute kidney injury has a serum potassium level of 7.0 mEq/L (7.0 mmol/L). The nurse should plan which actions as a priority? Select all that apply.

Place the client on a cardiac monitor., Notify the primary health care provider (PHCP)., Review the client's medications to determine whether any contain or retain potassium.

A nurse is reinforcing education for a client with a long leg cast on how to use crutches properly while descending a staircase. What step should the nurse inform the client to do first?

Place the crutches on the first stair below you.

Which steps should the nurse follow to insert a straight urinary catheter?

Prepare the client and the equipment, create a sterile field, put on gloves, clean the urinary meatus, and insert the catheter until urine flows.

A 4-year-old child is scheduled for a nephrectomy to remove a Wilms tumor. Which intervention should the nurse be sure is included in the plan of care?

Reinforce preoperative teaching to the child and parents.

A nurse is providing care to a child on the pediatric unit. While visiting the child, two family members begin arguing in a child's room and start to hit each other. The child becomes visibly upset and begins to cry. Which action would the nurse implement as the priority?

Remove the child from the room.

When checking a client's medication profile, the nurse notes that the client is receiving a drug that is contraindicated in clients with glaucoma. The nurse knows that this client has a history of glaucoma and has been receiving the medication for the past 3 days. What should the nurse do first?

Report the information to the physician to ensure client safety.

Oxybutynin chloride is prescribed for a client with urge incontinence. Which sign would indicate a possible toxic effect related to this medication?

Restlessness

A nurse is working on the oncology unit when a chemotherapy drug spills on the floor. What should the nurse do next?

Restrict access to the area of the spill.

The nurse is planning care for a child with hemolytic-uremic syndrome who has been anuric and will be receiving peritoneal dialysis treatment. The nurse should plan to implement which measure?

Restrict fluids as prescribed

A nurse must administer an antiseptic douche to a client scheduled for a vaginal hysterectomy. Place the steps in the correct order.

Separate the labia. Clean the vaginal orifice. Insert the douche nozzle 2 in (5 cm). Administer 100°F (37.7°C) solution 2 in (5 cm) above the client's hip level.

A client is to receive several oral medications. Which nursing instruction or action is appropriate in this situation?

Stating the name and action or use of each medication before administering it

The nurse is caring for a client on an oncology unit who is refusing further chemotherapy treatment after the rationale for the treatment has been clearly explained. What is the nurse's best action?

Support the client's decision and hold all treatments.

The nurse is reinforcing education about surgery with the parents of a child with Wilms tumor. Which statement by the nurse best explains the role of surgery for Wilms tumor?

Surgery is usually performed within 24 to 48 hours of admission.

Parents ask the nurse about the prognosis of their child diagnosed with Wilms tumor. The nurse should base the response on which factor?

Survival rates for Wilms tumor are the highest among childhood cancers.

Tacrolimus is prescribed for a client who underwent a kidney transplant. Which instruction should the nurse include when teaching the client about this medication?

Take the oral medication every 12 hours at the same times every day.

A client was recently enrolled in a clinical trial for lung cancer. The client's health insurance provider asks the nurse caring for the client about the client's status, treatment regimen, and possible adverse effects of the medication she is taking. How can the nurse best respond?

Tell the provider that a Certificate of Confidentiality was issued; therefore, no information can be released.

A client complains of fever, perineal pain, and urinary urgency, frequency, and dysuria. To assess whether the client's problem is related to bacterial prostatitis, the nurse reviews the results of the prostate examination for which characteristic of this disorder?

Tender, indurated prostate gland that is warm to the touch

A client complains of fever, perineal pain, and urinary urgency, frequency, and dysuria. To assess whether the client's problem is related to bacterial prostatitis, the nurse reviews the results of the prostate examination for which characteristic of this disorder?

Tender, indurated prostate gland that is warm to the touch

A pregnant client tells the clinic nurse that she wants to know the sex of her baby as soon as it can be determined. The nurse informs the client that she should be able to find out the sex at 16 weeks' gestation because of which factor?

The appearance of the fetal external genitalia

Nitrofurantoin is prescribed for a client with a urinary tract infection. The client contacts the nurse and reports a cough, chills, fever, and difficulty breathing. The nurse should make which interpretation about the client's complaints?

The client is experiencing a pulmonary reaction requiring cessation of the medication.

After having a transurethral resection of the prostate (TURP), a client returns to the unit with a three-way indwelling urinary catheter and continuous closed bladder irrigation. Which finding suggests that the client's catheter is occluded?

The client reports bladder spasms and the urge to void.

A client has been hospitalized with a diagnosis of conversion disorder blindness. Which statement best explains this manifestation?

The client's anxiety has been relieved through physical symptoms.

An LPN is assigned to care for eight clients. Two unlicensed assistive personnel are assigned to work with this nurse. The LPN integrates understanding of which statement when delegating client care assignments to the unlicensed assistive personnel?

The nurse is responsible for supervising the two unlicensed assistive personnel.

A client with bladder cancer had the bladder removed and an ileal conduit created for urine diversion. While changing this client's pouch, the nurse observes that the area around the stoma is red, weeping, and painful. What should the nurse conclude?

The pouch faceplate does not fit the stoma.

A client arrives at the emergency department with complaints of low abdominal pain and hematuria. The client is afebrile. The nurse next assesses the client to determine a history of which condition?

Trauma to the bladder or abdomen

A client arrives at the emergency department with complaints of low abdominal pain and hematuria. The client is afebrile. The nurse next assesses the client to determine a history of which condition?

Trauma to the bladder or abdomen

The nurse suspects that a client with a temperature of 103.6° F (39.8° C) and an elevated white blood cell count is in the initial stage of sepsis. The nurse reviews the client's chart and expects to find which disorder, which is the most common cause of sepsis in hospitalized clients?

UTI

Bethanechol chloride is prescribed for a client with urinary retention. Which disorder would be a contraindication to the administration of this medication?

Urinary strictures

Phenazopyridine is prescribed for a client with a urinary tract infection. The nurse evaluates that the medication is effective based on which observation?

Urination is not painful

A client admitted with a gunshot wound to the abdomen is transferred to the intensive care unit after an exploratory laparotomy. Which data collection finding suggests that the client is experiencing acute renal failure (ARF)?

Urine output of 400 ml/24 hours

A nurse is preparing a client for hysterosalpingography. Which education would the nurse reinforce for this client? Select all that apply.

You will need to wear a perineal pad after the procedure. You will be in the knee-chest position during the procedure.

The nurse is preparing to administer an intramuscular (I.M.) injection to a 6-month-old infant. Which appropriate site would the nurse inject the infant?

Vastus lateralis muscle

A nurse reviews a client's medical record and notes that a physician ordered an indwelling urinary catheter due to client's urine retention. Which action should the nurse perform first?

Verify the clients identity

A client is admitted for treatment of chronic renal failure (CRF). The nurse reviews the client's chart to monitor which electrolyte imbalance?

Water and sodium retention

A client is being admitted to the facility and the spouse asks the nurse why they must sign a statement confirming the client is informed of rights to communicate wishes about life support and resuscitation. Which statement(s) by the nurse are congruent with Health Insurance Portability and Accountability Act regulations? Select all that apply.

We make sure our clients know they have the right to specify advance directives and appoint someone to speak for them." "We want to be sure that the client is able to make an informed decision about the care they choose to receive." "It is important for your spouse as a consumer of health care to be able to have specific rights regarding health care and to have their wishes respected."

A 10-month-old infant with bacterial meningitis was just started on antibiotic therapy. Which nursing action is especially important in this situation?

Wear a mask while providing care.

A nurse is caring for a client diagnosed with cystitis. What information should the nurse include? Select all that apply

Wear cotton underpants. Encourage intake of cranberry juice.

A client with an indwelling urinary catheter is suspected of having a urinary tract infection. Which technique should the nurse use to collect a urine specimen for culture and sensitivity?

Wipe the self-sealing aspiration port with antiseptic solution, and aspirate urine with a sterile needle.

The nurse is preparing to administer a dose of chlorpropamide to a client with type 2 diabetes. Before administering the drug, the nurse checks the client's allergies and notices that the client is wearing an allergy alert bracelet that indicates an allergy to sulfa drugs. Which action should the nurse take?

Withhold the drug and notify the health care provider.

A nurse is caring for a client with renal failure who is reporting nausea. Which factor best explains how nausea is related to renal failure?

accumulation of metabolic wastes

The nurse is reviewing the laboratory values of a client's urinalysis. He or she correctly identifies a urine sample with a pH of 5.2 as being which type of solution?

acidic

An adult who has never had mumps reports that he was just notified that a child of a family with whom he stayed recently has been diagnosed with mumps. Which treatment should the man receive?

administration of gamma globin

The nurse is caring for a child who has had a nephrectomy after diagnosis of a Wilms tumor. The nurse has determined the child's pain and is preparing to administer an oral opiate. Which method is the best choice for administering the medication?

an oral syringe

A client has not voided for 10 hours following an inguinal hernia repair. Which factor may place a surgical client at risk for urine retention?

anticholinergic medication before surgery

A client is undergoing peritoneal dialysis. The dialysate dwell time is completed, and the clamp is opened to allow the dialysate to drain. The nurse notes that drainage has stopped and that only 500 mL has drained; the amount of dialysate instilled was 1,500 mL. Which intervention should be done first?

check the catheter for kinks or obstructions

A client in the short-procedure unit is recovering from renal angiography in which a femoral puncture site was used. When providing postprocedure care, the nurse should:

check the client's pedal pulses frequently

The nurse is caring for a group of clients on the acute care unit. Which client should the nurse most closely monitor for the development of acute kidney failure?

client with diabetes who has a heart catheterization

In which group is it most important for the client to understand the importance of an annual Papanicolaou (Pap) test?

clients infected with the human papillomavirus (HPV)

The nurse is preparing medications for a client. Which prescription should the nurse question?

clopidogrel for a client who is being prepared for a major surgery

A 25-year-old client comes to the emergency department with her clothes torn. She has visible cuts, bruises, and profuse vaginal bleeding. A nurse suspects that this client has been raped. What should the nurse do?

collect forensic evidence

A client with an indwelling catheter asked the nurse to remove the catheter. Which first intervention is best when removing an indwelling catheter?

deflate the balloon before removing the catheter

The nurse-client relationship progresses through phases. At which time should the nurse introduce information about the end of the nurse-client relationship?

during the orientation phase

A male client has acute upper GI bleeding. Which diagnostic test would the nurse first prepare the client for first to evaluate his acute upper GI bleeding?

endoscopy

A client with chronic renal failure who receives hemodialysis three times weekly has a hemoglobin (Hb) level of 7 g/dl. The most therapeutic pharmacologic intervention would be to administer:

epoetin alfa

The red blood cell (RBC) production in a client with chronic renal failure (CRF) has decreased. The nurse should monitor this client for:

fatigue and weakness

The nurse is collecting data on a male client diagnosed with gonorrhea. Which symptom likely prompted the client to seek medical attention?

foul smelling discharge from the penis

A client comes to the outpatient department complaining of vaginal discharge, dysuria, and genital irritation. Suspecting a sexually transmitted disease (STD), the physician orders diagnostic tests of the vaginal discharge. If diagnosed, which STD will the staff report to the public health department?

gonorrhea

A health care provider tells a client to return 1 week after treatment to have a repeat culture done to verify the cure. This order would be appropriate for a woman with which condition?

gonorrhea

Which information must be included in a medication order?

healthcare provider's signature

A nurse is administering morning medications to a client on warfarin. Upon reviewing the laboratory results, the nurse notes a prothrombin time (PT) of 27.3. What should the nurse do?

hold the medication and notify the healthcare provider

A client with benign prostatic hyperplasia (BPH) does not respond to medical treatment and is admitted to the facility for surgical intervention, transurethral resection of the prostate (TURP). In the postoperative period, the nurse reviews the laboratory values for which potential electrolyte imbalance?

hyponatremia

Immediately after giving an injection, a nurse is inadvertently stuck with the needle. When is the best time to test the nurse for human immunodeficiency virus (HIV) antibodies?

immediately, and then again in 3 months

The nurse is gathering data from a child with acute poststreptococcal glomerulonephritis (APSGN) for signs of improvement. Which early finding by the nurse would indicate that improvement is occurring?

increased urine output

The nurse is caring for a client with acute pyelonephritis. Which nursing intervention is most important?

increasing fluid intake to 3L/day

A client has an IV line in place for 3 days and begins to report discomfort at the insertion site. Based on the client's progress notes shown, which condition has most likely occurred?

infiltration

A client is admitted to the behavioral health facility for an attempted suicide. The nurse overhears a nursing assistant say to a family member, "There is no way to help someone who wants to kill themself." What is the best action by the nurse?

inform the nursing assistant that suicidal clients may have mixed feelings; the attempt may be a plea for help

The clinic nurse is working with clients with chronic renal disease secondary to diabetes. Which are symptoms of chronic renal disease? Select all that apply.

nausea/vomiting shortness of breath fatigue/weakness

The LVN/LPN suspects narcotic diversion when a particular nurse volunteers to administer medication to clients when they call for pain medication and the clients continue to report pain. What should the nurse do?

notify the nursing supervisor

Which finding indicates that oxycodone given to a client with breast cancer that has metastasized to the bone is exerting the desired effect?

pain is 0-2 on 10 point scale

Following a fall from a horse during rodeo practice, an 18-year-old client is seen in the emergency department. He has a large, dirty laceration on his leg. The wound is vigorously cleaned, closed, and dressed. In the past, the client has received the full immunization regimen for tetanus toxoid. The nurse asks the client about his tetanus immunization history, and he says, "I had my last shot when I was 11 years old." The nurse should:

plan on administering a dose of tetanus vaccine

A child has arrived in the emergency department. The nurse documents the following findings in the client's chart knowing that they are consistent with which disease process?

pneumonia

A nurse is working in a managed-care environment. On which criteria would the nurse focus?

quality care and cost containment

A client in a nursing home is receiving continuous nasogastric (NG) feedings. At the start of the shift, a nurse finds the client turned on the side with the bed flat. The feeding is running with a volumetric pump at 75 mL/hour, as prescribed. The formula container is filled with 150 mL of fluid. Based on this information, which action should the nurse take?

raise the head of the bed (HOB) at least 30 degrees

The nurse is planning to administer a sodium polystyrene sulfonate enema to a client with a potassium level of 5.9 mEq/L. Correct administration and the effects of this enema would include having the client:

retain the enema for 30 minutes to allow for sodium exchange; afterward, the client should have diarrhea.

A client is prescribed alfuzosin for benign prostatic hyperplasia. What teaching should the nurse reinforce to the client?

rise slowly from the supine position

A client with renal failure is undergoing continuous ambulatory peritoneal dialysis. Which nursing diagnosis is most appropriate for this client?

risk for infection

A client is prescribed diazepam to treat severe skeletal muscle spasms. During this therapy, the nurse monitors the client closely for adverse reactions. Which adverse reaction is most likely to occur?

sedation

The client is scheduled for extracorporeal shock wave lithotripsy (ESWL). The nurse should reinforce that the stones will be what?

shattered

A client is reporting severe flank, abdominal pain and is diagnosed with urolithiasis. Which intervention should the nurse instruct the client to perform?

strain all urine

When gathering data on a preschool child, which observation indicates that a child has a potential Wilms tumor?

swelling within the abdomen

An older adult client is admitted to the hospital with a diagnosis of pneumonia. The nurse learns that the client lives alone and has not been eating or drinking. Which finding should the nurse expect to see in this client?

tachycardia

The nurse is caring for a 20 kg child being treated for acute glomerulonephritis (AGN). Which of the following data collected by the nurse indicates improvement in the child's condition? Select all that apply.

weight loss of 1 kg demonstrates no periorbital, facial, or body edema

The nurse is caring for a client with chronic renal failure. Which nursing action should be included when assisting with development of the plan of care?

weight the client daily before breakfast

The nurse is attempting to gather data from a client with obsessive-compulsive disorder during a visit to the clinic. Which statement should the nurse use?

where would you like to begin?