Urology Saunders

Which statements indicate an understanding of the necessary dietary modifications of a client diagnosed with chronic kidney disease? Select all that apply.

"I should avoid eggs, and a bagel is preferable." "I should consume approximately 40 g of protein daily."

A urinary analgesic is prescribed for a client with a urinary tract infection. When would the nurse tell the client that it is best to take the medication?

1

The nurse suspects the client has a urinary tract infection (UTI). Which signs/symptoms suggest a UTI? Select all that apply.

1,2,3,4,6

The nurse is caring for a hospitalized client following cystoscopy. Which discharge instructions are given to the client? Select all that apply.

1,4,5

A client with acute kidney injury secondary to heart failure develops fluid volume excess. Which signs and symptoms would the nurse expect to see? Select all that apply.

2,3,4,6

A client, who had experienced significant blood loss in an automobile crash, was admitted to the hospital 2 days earlier. The nurse observes the client for which signs/symptoms that indicate acute kidney injury (AKI)? Select all that apply.

2,4,5

The nurse is reviewing data on a client with sepsis and acute kidney injury with related azotemia and oliguria. Which are the primary features of azotemia and oliguria? Select all that apply.

3,4,5

The nurse is admitting a client to the nursing unit who has returned from the postanesthesia care unit following prostatectomy. The client has a three-way Foley catheter with continuous bladder irrigation. The nurse would maintain the flow rate of the continuous bladder infusion to maintain which urine output characteristic?

4

A client with benign prostatic hyperplasia is being administered finasteride. Which information would be included in the plan of care?

A pregnant caregiver should not be exposed to the crushed tablets of finasteride.

A client is scheduled for intravenous pyelography (IVP). Which priority nursing action would the nurse take?

Determine if there is a history of allergies.

Which factors contribute to the problem of stress incontinence? Select all that apply.

Obesity Sneezing

A hemodialysis client with a left arm fistula is at risk for arterial steal syndrome. The nurse monitors this client for which signs/symptoms of this disorder?

Pallor, diminished pulse, and pain in the left hand

A client who had a prostatectomy has learned perineal exercises to gain control of the urinary sphincter. The nurse determines that the client needs further teaching if the client states that he will perform which action as part of these exercises?

Perform the Valsalva maneuver

The nurse prepares to administer sodium polystyrene sulfonate to a client with chronic kidney disease for which laboratory abnormality?

Potassium level of 7.2 mEq/L

The nurse is reinforcing instructions to a client about the types of fluids that assist in prevention and treatment of urinary tract infections (UTIs). The nurse instructs the client to consume which fluids? Select all that apply.

Prune juice Apple juice Cranberry juice

A client with acute glomerulonephritis is admitted to the nursing unit. The nurse would plan to do which action immediately upon admission?

Remove the water pitcher from the bedside

The nurse is caring for a 58-year-old client with chronic kidney disease who is receiving peritoneal dialysis. Which finding is considered most important by the nurse, requiring primary health care provider notification? Refer to chart.

WBC 15,000 mm3

A client with diabetes mellitus is receiving peritoneal dialysis. The nurse would ensure maintenance of the dwell time for the dialysis at the prescribed time because of risk for which complication?

hyperglycemia

The nurse is admitting a client with chronic kidney disease (CKD) to the nursing unit. The nurse monitors the client for which frequent cardiovascular sign that occurs in CKD?

hypertension

A client is seen in the clinic for complaints of thirst, frequent urination, and headaches. Following diagnostic studies, diabetes insipidus is diagnosed. Desmopressin acetate is prescribed for the client. What would the nurse explain to the client as the purpose of the medication?

increase water reabsorption

The nurse is reinforcing dietary instructions to a client diagnosed with acute glomerulonephritis. The nurse determines that the client understands the information presented if the client states the intention to do which action?

limit protein intake

Which condition places the client at risk for developing acute postrenal failure?

hydronephrosis

A client is diagnosed with polycystic kidney disease, and the nurse provides information to the client about the treatment plan. The nurse determines that the client needs further teaching if the client states that which component is part of the treatment plan?

sodium restriction

A client with a history of prostatic hypertrophy has purchased the over-the-counter medication, diphenhydramine, to treat symptoms of a runny nose. The nurse explains to the client that this medication combined with prostatic hypertrophy could cause exacerbation of which symptom?

urinary retention

Aluminum hydroxide is prescribed for the client with chronic kidney disease (CKD). When would the nurse instruct the client to take this medication?

with meals

A client with chronic kidney disease is receiving ferrous sulfate. The nurse would monitor the client for which common side effect associated with this medication?

Constipation

The nurse is reviewing the history and physical examination on a client diagnosed with polycystic kidney disease. Which data would the nurse expect to see? Select all that apply.

1,2,5

A client with end-stage kidney disease (ESKD) begins peritoneal dialysis. The nurse observes for which signs/symptoms indicating peritonitis? Select all that apply.

1,3,4,5

The nurse is discharging a postoperative female client who had a urinary tract infection (UTI) after surgery. Which essential issues about UTIs would the nurse reinforce in the discharge instructions? Select all that apply.

1,3,4,5

Which actions are included in the nursing care of the client undergoing peritoneal dialysis? Select all that apply.

1,2,3,5

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

Dysuria and penile discharge

An alkaline-ash diet is prescribed for a client with renal calculi. Which diet menu does the nurse advise the client to select?

A spinach salad, milk, and a banana

The nurse has reinforced instructions to the client with a cystocele about Kegel exercises. The nurse determines that the client has not fully understood the directions if the client makes which statement?

"Begin voiding and then stop the stream, holding residual urine for an hour."

Which is an appropriate question to ask to determine the specific type of incontinence?

"Have you been experiencing any urgency accompanied by dribbling or leaking urine?"

The nurse provides home care instructions to a client undergoing hemodialysis with regard to care of an arteriovenous (AV) fistula. Which statement by the client indicates an understanding of the instructions?

"I should check the fistula every day by feeling it for a vibration."

The nurse is caring for a client with epididymitis. The nurse anticipates noting which group of findings on data collection?

Fever, nausea and vomiting, and painful scrotal edema

The nurse caring for a client taking tamsulosin determines that which finding indicates the need for follow-up?

Pulse rate of 120 beats per minute

After a renal biopsy, the client complains of pain at the biopsy site that radiates to the front of the abdomen. Which would this indicate?

bleeding

The nurse is speaking with a client who underwent a minimally invasive procedure treatment for recurrent urolithiasis. Which instructions are appropriate to reinforce in the teaching plan? Select all that apply.

1,4,5

The nurse is assessing a client with suspected acute kidney injury. Which finding would support a diagnosis of acute intrarenal failure?

2

A client with end-stage kidney disease (ESKD) undergoes a surgical procedure to create an arteriovenous fistula for hemodialysis in the upper extremity. The nurse would take which actions when the client returns from surgery? Select all that apply.

1,2,5

A client tells the nurse she completed an educational program to manage her stress incontinence but is now discouraged. Which information from the client indicates the need for further teaching? Select all that apply.

1,3,5

The nurse is reviewing the client's record and notes that the primary health care provider (PHCP) has documented that the client has a renal disorder. Which laboratory results would indicate a decrease in renal function? Select all that apply.

1,3,5

A client is seen in the health care clinic, and acute pyelonephritis is suspected. The nurse reviews the client's record and would expect to note which associated signs and symptoms documented? Select all that apply.

1,4,5

The nurse is caring for a hemodialysis client who has been receiving treatment for several years and is not a candidate for kidney transplant. The nurse knows that the majority of deaths of hemodialysis clients are related to which causes? Select all that apply.

1,4,5

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

2,3,4,5

The nurse is talking with a client who has an arteriovenous fistula in the left arm. What statement by the client indicates a need for further teaching?

"I sleep on my left side with my arm tucked under my pillow."

A client has received instructions on self-management of peritoneal dialysis. The nurse determines that the client needs further teaching if the client makes which statement?

"I will use a strong adhesive tape to anchor the catheter dressing."

The nurse is assessing a client's arteriovenous fistula being used for hemodialysis. Which findings would prompt the nurse to notify the primary health care provider immediately? Select all that apply.

1,2,4

A client in renal failure is receiving epoetin alfa. The nurse would monitor the client for which adverse effect of this medication?

4

The nurse caring for a client with chronic kidney disease on a medical-surgical unit that requires hemodialysis but is not tolerating it. What other treatment consideration could be used that would be effective for this client?

4

The nurse is caring for a client who had a renal biopsy. Which interventions would the nurse include in the plan of care for the client after this procedure? Select all that apply.

2,3,4

The nurse is reviewing the laboratory results and physical examination of a client with acute glomerulonephritis. Which data would the nurse see? Select all that apply.

2,3,5

A client who has calcium phosphate kidney stones tells the nurse, "Tell me what I can do so that I never have this pain again." Which instructions would the nurse plan to include in the reinforcement of dietary instructions? Select all that apply.

2,4,5

The nurse is caring for a client who received a recent kidney transplant. Besides actual rejection of the transplant, which are some of the most important complications this client is at risk for? Select all that apply.

2,4,5,6

The nurse is caring for a client with kidney failure. The serum phosphate level is reported as 7 mg/dL. Which medication would the nurse plan to administer as prescribed to the client?

4

The nurse is collecting data from a client who has had benign prostatic hyperplasia (BPH) in the past. To determine whether the client is currently experiencing exacerbation of BPH, the nurse would ask the client about the presence of which early symptom?

4

The client has a three-way closed continuous bladder irrigation system. Which information would be included in the documentation for this client? Select all that apply.

1,2,3,4,5

A client with benign prostatic hypertrophy (BPH) undergoes a transurethral resection of the prostate (TURP) and is receiving continuous bladder irrigations postoperatively. Which are the signs/symptoms of transurethral resection (TUR) syndrome?

Bradycardia and confusion

A client is admitted to the emergency department following a fall from a horse. The primary health care provider (PHCP) prescribes the insertion of an indwelling urinary catheter. The nurse notes blood at the urinary meatus while preparing for the procedure. Which action would the nurse take?

2

The nurse is assisting a client who is new to a low-potassium diet to select food items from the menu. Which food item is lowest in potassium and would be recommended to the client on this dietary restriction?

2

The nurse is reviewing the medical record of a client with a diagnosis of pyelonephritis. Which disorder noted on the client's record would the nurse identify as a risk factor for this diagnosis?

2

A client is to be monitored for residual urine every 8 hours. Which are appropriate nursing actions for the nurse to complete this task? Select all that apply.

2,3

The nurse is told by an older woman that she has begun to be incontinent of urine at night and now drinks no fluids after 6.00 pm. Which is the nurse's best response?

3. "Incontinence at any age should be evaluated by your primary health care provider."

A client has undergone a transurethral resection of the prostate (TURP) a few hours ago to treat symptoms of benign prostatic hypertrophy. The nurse notes bright red blood and clots in the urinary catheter drainage bag. Which response would be the nurse's initial action?

3

A client who is performing peritoneal dialysis at home calls the clinic and reports that the outflow from the dialysis catheter seems to be decreasing in amount. The nurse appropriately asks which question first?

3

Which is the most appropriate catheter for a male client with severe urinary retention, a history of urinary tract infections, and a stage 4 pressure injury on the coccyx? Refer to chart.

3

A client, on the waiting list for a renal transplant, receives a hemodialysis treatment. Which findings indicate to the nurse that the hemodialysis treatment has been effective? Select all that apply.

3,4,5

Which observations by the nurse caring for clients in a hospital medical-surgical unit would be immediately reported to the primary health care provider? Select all that apply.

3,5

The nurse is preparing a subcutaneous dose of bethanechol chloride prescribed for a client with urinary retention. Before giving the dose, the nurse checks to see that which medication is available on the emergency cart?

3. atropine sulfate

A male client is diagnosed with urethritis caused by chlamydial infection. The assistive personnel (AP) assigned to the client asks the nurse what measures are necessary to prevent a contraction of the infection during care. Which instruction would the nurse give the AP?

4

A female client has a prescription for a clean-catch urine culture. After providing a sterile specimen cup to the client, the nurse would give which instruction so that the specimen is collected properly?

Cleanse the labia using cleansing towels, begin to void into toilet, and then collect the specimen.

A client with chronic kidney disease has been on dialysis for 3 years. The client is receiving the usual combination of medications for the disease, including aluminum hydroxide as a phosphate-binding agent. The client now has mental cloudiness, dementia, and complaints of bone pain. Which does this data indicate?

Aluminum intoxication

A client is admitted to the surgical nursing unit following transurethral resection of the prostate (TURP) for benign prostatic hypertrophy. The client has a bladder irrigation infusing, and output is light cherry colored. The blood pressure is 134/82 mm Hg, the pulse is 84 beats per minute, and the client is afebrile with a respiratory rate of 18 breaths per minute. The licensed practical nurse (LPN) assisting in caring for the client collects assessment data 1 hour after admission to the nursing unit. The LPN notifies the registered nurse (RN) if which is noted on data collection?

Blood pressure of 102/50 mm Hg, pulse 110 beats per minute

The nurse must ambulate a client who has a nephrostomy tube attached to a drainage bag. The nurse plans to do this most safely by performing which action?

Changing the drainage bag to a leg collection bag

The nurse is assisting a client with cystitis to select foods that are appropriate for an acid-ash diet. The nurse encourages the client to eat which food?

Cheese

A client has epididymitis as a complication of a urinary tract infection (UTI). The nurse is giving the client instructions to prevent recurrence. The nurse determines that the client needs further teaching if the client states the intention to do which action?

Continue to take antibiotics until all symptoms are gone

A client with new-onset renal failure is having a first hemodialysis treatment. The nurse is especially careful to monitor the client for which signs/symptoms after the dialysis treatment?

Headache, decreasing level of consciousness, and seizures

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 is providing dietary instructions to a client with renal calculi, and the laboratory analysis has revealed that the calculus is composed of uric acid. The nurse tells the client that it would be helpful to make which dietary changes?

Increase intake of legumes in the diet.

A client hospitalized with urolithiasis has a sudden significant decrease in urine output. The nurse would perform which action?

Notify the registered nurse.

The nurse is caring for a client undergoing peritoneal dialysis. The nurse checks the client and notes that the drainage from the outflow catheter is cloudy. The nurse notifies the registered nurse and plans to take which action?

Obtain a culture and sensitivity of the drainage

A client with prostatitis resulting from kidney infection has received instructions on management of the condition at home and prevention of recurrence. Which statement indicates that the client understood the instructions?

Use warm sitz baths and analgesics to increase comfort

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 reinforcing instructions to a client with renal calculi about how to change the urine pH to be more acidic. The nurse determines that the client needs further teaching if the client states which type of drink is acceptable?

orange juice

The nurse is caring for a client with epididymitis. Which treatment modalities would be implemented? Select all that apply.

1,2,3,5

A client who underwent kidney transplant 6 months earlier is seen in the clinic for a routine monthly appointment. The nurse reviews how the client has been doing and observes for signs/symptoms of acute rejection. Which signs/symptoms suggest acute rejection of the transplanted kidney? Select all that apply.

1,4,5,6

A client contacts the primary health care provider's office to report she is not feeling well, has burning with urination, and suspects she may have a urinary tract infection. The nurse instructs the client to collect a urine specimen for testing. Which urinalysis findings indicate the presence of a urinary tract infection? Select all that apply.

1,4,6

The client is prescribed trimethoprim-sulfamethoxazole for a recurrent urinary tract infection (UTI). The nurse would reinforce which most appropriate instructions to the client regarding this medication?

4

The nurse has a prescription to collect a 24-hour urine specimen from a client. The assistive personnel (AP) has been instructed on the collection technique. Which action by the AP demonstrates the AP needs further teaching?

Asks the client to void, save the specimen, and note the start time

A client arrives at the ambulatory care clinic with low abdominal pain. A routine urine specimen reveals hematuria. The client does not have a fever. The nurse would next ask the client about a history of which condition?

Blow or trauma to the bladder or abdomen

A client's kidneys are retaining larger than normal amounts of sodium. The nurse is reviewing the most recent laboratory data. The nurse would expect which laboratory value to be abnormal since the client is retaining sodium?

Chloride 112 mEq/L

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 (BPH), the nurse questions the client about use of which medication?

Decongestants

The 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 would be questioned about the use of which class of medications?

Decongestants

A client has an arteriovenous (AV) shunt in place for hemodialysis. The nurse would take which priority precaution knowing that bleeding is a potential complication?

Ensure that small clamps are attached to the AV shunt dressing

A client with a neurological impairment experiences urinary incontinence. Which nursing action would help the client adapt to this alteration?

Establishing a toileting schedule

A client with chronic kidney disease who is scheduled for hemodialysis this morning is due to receive a daily dose of enalapril. When would the nurse plan to administer this medication?

On return from dialysis

The nurse is urging a client to cough and deep breathe after a nephrectomy. The client tells the nurse, "That's easy for you to say! You don't have to do this." The nurse interprets that the client's statement is likely a result of which contributing factor?

Pain that is intensified because the location of the incision is near the diaphragm

The nurse is assessing the patency of an arteriovenous fistula in the left arm of a client who is receiving hemodialysis for the treatment of chronic kidney disease. Which finding indicates that the fistula is patent?

Palpation of a thrill over the fistula

The nurse is assisting in planning a diet for a client with acute kidney injury (AKI). The nurse plans to restrict which dietary component from this client's diet?

Potassium

A client with acute kidney injury (AKI) has been treated with sodium polystyrene sulfonate by mouth. The nurse evaluates this therapy as effective if which value is noted on follow-up laboratory testing?

Potassium, 4.9 mEq/L

The use of peritoneal dialysis for the treatment of chronic kidney disease would be contraindicated for which client?

The client with chronic obstructive pulmonary disease (COPD)

The use of peritoneal dialysis for the treatment of chronic kidney disease would be contraindicated for which client?

The client with severe emphysema

The nurse is assigned to care for a client who has just returned to the nursing unit after having hemodialysis for the first time. The nurse monitors the client carefully for which signs and symptoms of disequilibrium syndrome?

Vomiting and headaches

A client with acute pyelonephritis is scheduled for a voiding cystourethrogram. After the nurse provides information about this procedure, the client states, "I can't urinate in front of other people. I have a 'bashful' kidney." What is the nurse's best response?

You will be screened and given as much privacy as possible

Nalidixic acid is prescribed for a client diagnosed with a urinary tract infection. Reviewing the client's record, the nurse notes that the client is prescribed warfarin on a daily basis. Which prescription would the nurse anticipate because the client is taking this oral anticoagulant?

A reduction in the anticoagulation dosage

A client has just undergone renal biopsy. In planning care for this client, the nurse would avoid which intervention?

Ambulate in the room and hall for short distances.

A client newly diagnosed with chronic kidney disease will be receiving peritoneal dialysis. During the infusion of the dialysate, the client complains of abdominal pain. Which action by the nurse is appropriate?

Explain that the pain will subside after the first few exchanges

The nurse is caring for a client who has been diagnosed as having a kidney mass. The client asks the nurse the reason for a renal biopsy when other tests such as computed tomography (CT) and ultrasound are available. In formulating a response, the nurse incorporates the knowledge that a renal biopsy serves which purpose?

Gives specific cytological information about the lesion

A client who suffered a crush injury to the leg has a highly positive urine myoglobin level. The nurse plans to monitor this particular client carefully for signs of which complication?

acute tubular necrosis

The nurse is monitoring an older client suspected of having a urinary tract infection (UTI) for signs of infection. Which sign/symptom is likely to present first?

confusion

A client has been diagnosed with pyelonephritis. The nurse interprets that which health problem has placed the client at risk for this disorder?

diabetes mellitus

The nurse notes that a client's urinalysis report contains a notation of positive red blood cells (RBCs). The nurse interprets that this finding is unrelated to which information in the client's medical record?

diabetes mellitus

Propantheline bromide is prescribed for a client with bladder spasms. Which disorder, noted in the client's record, alerts the nurse to question the prescription for this medication?

glaucoma

The client with diabetes mellitus receiving peritoneal dialysis asks the nurse why it is important to leave the dialysate infused only for a specific amount of time. The nurse responds that not adhering to the dwell time can increase the risk of the client experiencing which complication?

hyperglycemia

After having a transurethral resection of the prostate (TURP), a client has a continuous bladder irrigation (CBI) postoperatively. The nurse notes that fluid is entering the bladder, but none appears to be draining. Select the appropriate nursing interventions. Select all that apply.

- Check the bladder for distention - Review intake and output record - Check to ensure drainage tubing is not kinked - Ask the client about bladder spasms and discomfort.

A long-term care nurse notes that an older client who is normally alert has become progressively confused and irritable. What diagnostic tests would the nurse anticipate the primary health care provider to prescribe? Select all that apply.

1,6

A client diagnosed with chronic kidney disease is being treated at home with continuous ambulatory peritoneal dialysis. The client notes that there is a decrease in the catheter outflow following the prescribed 6-hour dwell time and calls the nurse to report this occurrence. The nurse would reinforce instructing the client to take which action?

1

A male client has a history of urinary tract infections due to urinary retention. Which intervention would the nurse implement to decrease the risk of infection?

1

The nurse is assigned to care for a client who has returned to the nursing unit following a left nephrectomy. The nurse places the highest priority on monitoring which data?

1

A client has been diagnosed with functional incontinence. Which interventions are most appropriate to care for this type of incontinence? Select all that apply.

-Schedule toileting every 2 hours. -Modify clothing for easy removal. -Assess environment for obstacles. -Set up schedule of cues such as mealtimes, awakening, and bedtime.