Final
The client with polycystic kidney disease asks the nurse, "Will my kidneys ever function normally again?" The best response by the nurse is: "As the disease progresses, you will most likely require renal replacement therapy." "Dietary changes can reverse the damage that has occurred in your kidneys." "Draining of the cysts and antibiotic therapy will cure your disease." "Genetic testing will determine the best treatment for your condition."
"As the disease progresses, you will most likely require renal replacement therapy." There is no cure for polycystic kidney disease. Medical management includes therapies to control blood pressure, urinary tract infections, and pain. Renal replacement therapy is indicated as the kidneys fail.
The nurse is giving discharge instructions to the client following a bladder ultrasound. Which statement by the client indicates the client understands the instructions? "I can resume my usual activities without restriction." "I should increase my fluid intake for the rest of the day." "If I have difficulty urinating, I should contact my physician." "It is normal for my urine to be blood-tinged."
"I can resume my usual activities without restriction."
A nurse is teaching an older adult client about good bowel habits. Which statement by the client indicates to the nurse that additional teaching is required? "I should eat a fiber-rich diet with raw, leafy vegetables, unpeeled fruit, and whole grain bread." "I need to use laxatives regularly to prevent constipation." "I need to drink 2 to 3 liters of fluids every day." "I should exercise four times per week."
"I need to use laxatives regularly to prevent constipation."
The nurse instructs a client on care at home after a laparoscopic cholecystectomy. Which client statement indicates that teaching has been effective? "I can drive after 2 weeks." "I can take a shower in a week." "I should remain on bed rest for several days." "I should wash the site with mild soap and water."
"I should wash the site with mild soap and water."
The nurse instructs a client with acute gastritis on lifestyle modifications. Which client statement indicates that additional teaching is required? "I will avoid alcoholic beverages." "I will reduce the amount of smoking." "I will switch to decaffeinated coffee." "I will increase my intake of fresh fruit."
"I will reduce the amount of smoking."
After undergoing a total cystectomy and urinary diversion, a client has a Kock pouch (continent internal reservoir) in place. Which statement by the client indicates a need for further teaching? "I'll have to wear an external collection pouch for the rest of my life." "I should eat foods from all the food groups." "I'll need to drink at least eight glasses of water a day." "I'll have to catheterize my pouch every 2 hours."
"I'll have to wear an external collection pouch for the rest of my life."
A client who has been treated for chronic renal failure (CRF) is ready for discharge. The nurse should reinforce which dietary instruction? "Be sure to eat meat at every meal." "Eat plenty of bananas." "Increase your carbohydrate intake." "Drink plenty of fluids, and use a salt substitute."
"Increase your carbohydrate intake." A client with CRF requires extra carbohydrates to prevent protein catabolism. In a client with CRF, unrestricted intake of sodium, protein, potassium, and fluid may lead to a dangerous accumulation of electrolytes and protein metabolic products, such as amino acids and ammonia. Therefore, the client must limit intake of sodium; meat, which is high in protein; bananas, which are high in potassium; and fluid, because the failing kidneys can't secrete adequate urine. Salt substitutes are high in potassium and should be avoided.
A patient has been diagnosed with acute gastritis and asks the nurse what could have caused it. What is the best response by the nurse? (Select all that apply.) "It can be caused by ingestion of strong acids." "You may have ingested some irritating foods." "Is it possible that you are overusing aspirin." "It is a hereditary disease." "It is probably your nerves."
"It can be caused by ingestion of strong acids." "You may have ingested some irritating foods." "Is it possible that you are overusing aspirin."
A nurse is caring for a patient with a Salem sump gastric tube attached to low intermittent suction for decompression. The patient asks, "What's this blue part of the tube for?" Which response by the nurse would be most appropriate? "It is a vent that prevents backflow of the secretions." "It acts as a siphon, pulling secretions into the clear tubing." "It helps regulate the pressure on the suction machine." "It works as a marker to make sure that the tube stays in place."
"It is a vent that prevents backflow of the secretions."
A client with liver and renal failure has severe ascites. On initial shift rounds, his primary nurse finds his indwelling urinary catheter collection bag too full to store more urine. The nurse empties more than 2,000 ml from the collection bag. One hour later, she finds the collection bag full again. The nurse notifies the physician, who suspects that a bladder rupture is allowing the drainage of peritoneal fluid. The physician orders a urinalysis to be obtained immediately. The presence of which substance is considered abnormal? Creatinine Urobilinogen Chloride Albumin
Albumin
Which hormone causes the kidneys to reabsorb sodium? Antidiuretic hormone Aldosterone Growth hormone Prostaglandins
Aldosterone Aldosterone is a hormone synthesized and released by the adrenal cortex. Antidiuretic hormone is secreted by the posterior pituitary gland. Growth hormone and prostaglandins do not cause the kidneys to reabsorb sodium.
A client is admitted with a new onset of pyloric obstruction. What client symptoms should the nurse anticipate? Select all that apply. Anorexia Nausea and vomiting Diarrhea Weight loss Epigastric fullness
Anorexia Nausea and vomiting Epigastric fullness
The nurse is employed in a urologist's office. Which classification of medication is anticipated for clients having difficulty with urinary incontinence? Anticholinergic Diuretics Anticonvulsant Cholinergic
Anticholinergic
The patient has been diagnosed with urge incontinence. What classification of medication does the nurse expect the patient will be placed on to help alleviate the symptoms? Antispasmodic agents Urinary analgesics Antibiotics Anticholinergic agents
Anticholinergic agents
A client with gastric cancer is scheduled to undergo a Billroth II procedure. The client's spouse asks how much of the client's stomach will be removed. What would be the most accurate response from the nurse? Approximately 25% Approximately 50% Approximately 75% The amount will depend on the client's weight.
Approximately 75%
While caring for a patient who has had radical neck surgery, the nurse notices an abnormal amount of serosanguineous secretions in the wound suction unit during the first postoperative day. What does the nurse know is an expected amount of drainage in the wound unit? Between 40 and 80 mL Approximately 80 to 120 mL Between 120 and 160 mL Greater than 160 mL
Approximately 80 to 120 mL
A client in the emergency department reports that a piece of meat became stuck in the throat while eating. The nurse notes the client is anxious with respirations at 30 breaths/min, frequent swallowing, and little saliva in the mouth. An esophagogastroscopy with removal of foreign body is scheduled for today. What would be the first activity performed by the nurse? Assess lung sounds bilaterally. Administer prescribed morphine intravenously. Obtain consent for the esophagogastroscopy. Suction the oral cavity of the client
Assess lung sounds bilaterally. All these activities are things the nurse may do for a client with a foreign body in the esophagus. This client is at risk for esophageal perforation, and thus pneumothorax. By auscultating lung sounds the nurse will be able to assess if a pneumothorax is present. The client has little saliva in the oral cavity and does not need to be suctioned. A client may also report pain with a foreign body. However, ABCs (airway, breathing, circulation) take priority. The consent for the esophagogastroscopy may be obtained after the nurse has completed the client assessment.
A 61-year-old woman presented to a scheduled appointment with her nurse practitioner, stating, "I'm having a lot of trouble with constipation over the past few months." What action should the nurse first take in response to this patient's health complaint? Assess the woman's family history of constipation and bowel obstruction. Assess the woman's typical bowel patterns and her expectations for bowel function. Advise the woman to increase her fluid intake, activity level, and fiber intake. Arrange for a barium enema or colonoscopy to assess the woman's lower bowel.
Assess the woman's typical bowel patterns and her expectations for bowel function.
The nurse is caring for a patient with cirrhosis of the liver and observes that the patient is having hand-flapping tremors. What does the nurse document this finding as? Constructional apraxia Fetor hepaticus Ataxia Asterixis
Asterixis Asterixis, an involuntary flapping of the hands, may be seen in stage II encephalopathy (Fig. 49-13).
A client had a central line inserted for parenteral nutrition and is awaiting transport to the radiology department for catheter placement verification. The client reports feeling anxious and has a respiratory rate of 28 breaths/minute. What is the next action of the nurse? Auscultate lung sounds Position client flat in bed Apply nasal cannula oxygen Consult with the healthcare provider
Auscultate lung sounds
A nonresponsive client has a nasogastric tube to low intermittent suction due to gastrointestinal bleeding. It is most important for the nurse to Apply water-based lubricant to the nares daily. Auscultate lung sounds every 4 hours. Inspect the nose daily for skin irritation. Change the nasal tape every 2 to 3 days.
Auscultate lung sounds every 4 hours.
Health teaching for a patient with GERD is directed toward decreasing lower esophageal sphincter pressure and irritation. The nurse instructs the patient to do which of the following? Select all that apply. Drink three, 8 oz. glasses of regular milk daily to coat the esophagus. Avoid beer, especially in the evening. Eat 1 hour before bedtime so there will be food in the stomach overnight to absorb excess acid. Elevate the head of the bed on 6- to 8-inch blocks. Elevate the upper body on pillows.
Avoid beer, especially in the evening. Elevate the head of the bed on 6- to 8-inch blocks. Elevate the upper body on pillows.
A 69-year-old man is postoperative day 2 following a transurethral prostatic resection (TUPR). The patient had his urinary catheter removed at 06:00 this morning but has not voided in the 5 hours since the removal, despite the fact that he has been drinking large amounts of fluids. What nursing assessment will most accurately determine whether the patient is retaining urine? Bladder palpation Bladder ultrasound Inspection of the patient's pubic region An audit of the patient's recent intake and output
Bladder ultrasound
After teaching a group of students about malignant bladder tumors, the instructor determines that the teaching was successful when the students identify which of the following clients as having the greatest risk for developing a malignant bladder tumor? Client with a history of untreated gonorrhea Client with a history of bladder inflammation Client with a history of cigarette smoking Client with a history of a sexually transmitted disease
Client with a history of cigarette smoking
The nurse caring for a client is providing instructions for an upcoming renal angiography. Which nursing action, explained in the preoperative instructions, is essential in the postprocedure period? Encourage voiding following the procedure. Assess renal blood work. Assess cognitive status. Complete a pulse assessment of the legs and feet.
Complete a pulse assessment of the legs and feet.
The nurse has been closely monitoring the blood work of a patient who recently experienced nephrotoxic effects from an over-the-counter medication. In the course of providing care, the nurse has been teaching the patient about the various roles that the kidney plays in the maintenance of homeostasis. Which of the following functions is performed by the kidneys? Control of protein synthesis Regulation of metabolism Control of acid-base balance Regulation of digestion
Control of acid-base balance
The nurse is providing preoperative care for a client with gastric cancer who is having a resection. What is the nursing management priority for this client? Discharge planning Correcting nutritional deficits Preventing deep vein thrombosis (DVT) Teaching about radiation treatment
Correcting nutritional deficits
A client is having a diagnostic workup for reports of frequent diarrhea, right lower abdominal pain, and weight loss. The nurse is reviewing the results of the barium study and notes the presence of "string sign." What does the nurse understand that this is significant of? Crohn's disease Ulcerative colitis Irritable bowel syndrome Diverticulitis
Crohn's disease
The nurse is preparing a client for a test that involves inserting a thick barium paste into the rectum with radiographs taken as the client expels the barium. What test will the nurse prepare the client for? Kidneys, ureters, bladder (KUB) Colonic transit studies Defecography Abdominal radiography
Defecography
The nurse is caring for a client receiving enteral nutrition with a standard polymeric formula. For which reason will the nurse question using this formula for the client? History of diverticulitis Diagnosed with malabsorption syndrome Treatment for internal hemorrhoids Polyps removed during a colonoscopy
Diagnosed with malabsorption syndrome
A patient is receiving nasogastric tube feedings. The intake and output record for the past 24 hours reveals an intake of 3100 mL and an output of 2400 mL. The nurse identifies which nursing diagnosis as most likely? Excess fluid volume Risk for imbalanced nutrition, more than body requirements Deficient fluid volume Impaired urinary elimination
Excess fluid volume
The nurse is caring for a client experiencing unintentional weight loss and occasional abdominal pain. Which additional symptoms will the nurse expect to assess if the client has a tumor In the small intestine? Select all that apply. Fatigue Nausea Jaundice Vomiting Weakness
Fatigue Nausea Vomiting Weakness
During a psychotic episode, a client with schizophrenia swallows a small wooden spoon. Which medication would the nurse in the emergency department be most likely to administer to facilitate removal of the foreign body? Glucagon Insulin Haloperidol Epinephrine
Glucagon Glucagon is administered before removing a foreign body because it relaxes the smooth muscle of the esophagus, thereby facilitating insertion of the endoscope. Haloperidol is an antipsychotic drug and is not indicated. Insulin and epinephrine would not assist with foreign body removal.
The nurse analyzes a urinalysis report. He is aware that the presence of this substance in the urine indicates a blood level that exceeds the kidney's reabsorption capacity. Select the substance. Sodium Bicarbonate Creatinine Glucose
Glucose Glucose is usually filtered at the level of the glomerulus. It does not normally appear in the urine. Renal glycosuria occurs if the glucose in the blood exceeds the amount that is able to be reabsorbed. The other substances are normally excreted in the urine.
A client is being cared for after a nephrectomy. Because of the incisional pain and restricted positioning, the client frequently suffers from breathing difficulty. Which measures should the nurse include in the care plan to relieve this distress? Select all that apply. Help the client to breathe deeply and cough every 2 hours. Provide firm support for the incision when the client coughs. Have client walk around the room as much as possible. Administer antibiotic therapy as prescribed.
Help the client to breathe deeply and cough every 2 hours. Provide firm support for the incision when the client coughs.
The nurse is assessing a client with an ulcer for signs and symptoms of hemorrhage. The nurse interprets which condition as a sign/symptom of possible hemorrhage? Hematemesis Bradycardia Hypertension Polyuria
Hematemesis
The nurse cares for a client after extensive abdominal surgery. The client develops an infection that is treated with IV gentamicin. After 4 days of treatment, the client develops oliguria, and laboratory results indicate azotemia. The client is diagnosed with acute tubular necrosis and transferred to the ICU. The client is hemodynamically stable. Which dialysis method would be most appropriate for the client? Hemodialysis Peritoneal dialysis Continuous arteriovenous hemofiltration (CAVH) Continuous venovenous hemofiltration (CVVH)
Hemodialysis
The nurse is caring for a client who has just returned from the PACU after surgery for peptic ulcer disease. For what potential complications does the nurse know to monitor? Select all that apply. Hemorrhage Inability to clear secretions Perforation Penetration Pyloric obstruction Cachexia
Hemorrhage Perforation Penetration Pyloric obstruction
A patient is diagnosed with detrusor sphincter dyssynergia. The nurse understands that the patient would most likely experience which of the following voiding problems? Frequency Urgency Hesitancy Nocturia
Hesitancy
Based on the pathophysiologic changes that occur as renal failure progresses, the nurse identifies the following indicators associated with the disease. Select all that apply. Hyperkalemia Metabolic alkalosis Anemia Hyperalbuminemia Hypocalcemia
Hyperkalemia Anemia Hypocalcemia
A medical patient has been admitted to the intensive care unit after developing acute renal failure (ARF). The intensive care nurse should anticipate performing interventions to resolve which of the following health problems? Fluid volume deficit and hypotension Hyperkalemia and acidosis Disseminated intravascular coagulation (DIC) Hemolytic anemia and hyperbilirubinemia
Hyperkalemia and acidosis
The nurse is caring for a patient in acute renal failure. The nurse should expect hypertonic glucose, insulin infusions, and sodium bicarbonate to be used to treat: Hypernatremia. Hypokalemia. Hyperkalemia. Hypercalcemia.
Hyperkalemia.
A client is diagnosed with polycystic kidney disease. Which symptom would the nurse most likely assess? Hypertension Flank pain Fever Periorbital edema
Hypertension
The nurse is caring for a client diagnosed with bladder cancer and requiring a cystectomy. The nurse overhears the physician instructing the client on the presence of a stoma with temporary pouch. In gathering information for the client, which urinary diversion would the nurse select? Ileal conduit Kock Pouch Ureterosigmoidostomy Indiana Pouch
Ileal conduit
Which type of voiding dysfunction is seen in clients diagnosed with Parkinson disease? Incontinence Urinary retention Urgency Incomplete bladder emptying
Incontinence
A client has end-stage renal failure. Which of the following should the nurse include when teaching the client about nutrition to limit the effects of azotemia? Increase fat intake and limit carbohydrates. Eliminate fat intake and increase protein intake. Increase carbohydrates and limit protein intake. Increase protein, carbohydrates, and fat intake.
Increase carbohydrates and limit protein intake. Calories are supplied by carbohydrates and fat to prevent wasting. Protein is restricted because the breakdown products of dietary and tissue protein (urea, uric acid, and organic acids) accumulate quickly in the blood.
The nurse advises the patient with chronic pyelonephritis that he should: Limit his fluid intake to 1.5 L/day to minimize bladder fullness, which could cause backward pressure on the kidneys. Decrease his sodium intake to prevent fluid retention. Increase fluids to 3 to 4 L/24 hours to dilute the urine. Decrease his intake of calcium rich foods to prevent kidney stones.
Increase fluids to 3 to 4 L/24 hours to dilute the urine.
What is a characteristic of the intrarenal category of acute renal failure? Decreased creatinine Increased BUN High specific gravity Decreased urine sodium
Increased BUN
A client reports urinary frequency, urgency, and dysuria. Which of the following would the nurse most likely suspect? Obstruction of the lower urinary tract Acute renal failure Infection Nephrotic syndrome
Infection
A urology nurse is caring for a male patient admitted to the unit with bladder distention from prostatic hypertrophy. The health care provider orders placement of an indwelling urinary catheter. The nurse and urologist are both unsuccessful in catheterizing this patient due to the prostatic obstruction. What approach does the nurse anticipate the health care provider using to drain the patient's bladder? Insertion of a suprapubic catheter Scheduling the patient immediately for surgery to relieve the bladder obstruction Application of warm compresses to the perineum to assist with relaxation, which will result in the patient voiding on his own Medication administration to relax the bladder muscles and attempting catheterization in 6 hours
Insertion of a suprapubic catheter
A nurse cares for a client with a disorder of the endocrine function of the pancreas. Which hormones or enzymes may be impacted by this disorder? Select all that apply. Insulin Glucagon Somatostatin Lipase Amylase
Insulin Glucagon Somatostatin
A patient visited a nurse practitioner because he had diarrhea for 2 weeks. He described his stool as large and greasy. The nurse knows that this description is consistent with a diagnosis of: A small bowel disorder. Intestinal malabsorption. Inflammatory colitis. A disorder of the large bowel.
Intestinal malabsorption.
A client with acute renal failure progresses through four phases. Which describes the onset phase? It is accompanied by reduced blood flow to the nephrons. Fluid volume excess develops, which leads to edema, hypertension, and cardiopulmonary complications. The excretion of wastes and electrolytes continues to be impaired despite increased water content of the urine. Normal glomerular filtration and tubular function are restored.
It is accompanied by reduced blood flow to the nephrons.
The nurse is comparing Crohn's disease (regional enteritis) with ulcerative colitis. Which of the following describes Crohn's disease? Fistulas are rare Diarrhea is more severe Bleeding is common and severe Its course is prolonged and variable
Its course is prolonged and variable
The patient is concerned about leakage of gastric contents out of the gastric sump tube the nurse has just inserted. What would the nurse do to prevent reflux gastric contents from coming through the blue vent of a gastric sump tube? Prime the tubing with 20 mL of normal saline. Keep the vent lumen above the patient's stomach level. Maintain the patient in a high Fowler's position. Have the patient pin the tube to the thigh.
Keep the vent lumen above the patient's stomach level.
The nurse is caring for a patient in the oliguric phase of acute kidney injury (AKI). What does the nurse know would be the daily urine output? 1.5 L 1.0 L Less than 400 mL Less than 50 mL
Less than 400 mL
The health care provider orders the insertion of a single lumen nasogastric tube. When gathering the equipment for the insertion, what will the nurse select? Salem sump tube Miller-Abbott tube Sengstaken-Blakemore tube Levin tube
Levin tube
For a client in the oliguric phase of acute renal failure (ARF), which nursing intervention is the most important? Encouraging coughing and deep breathing Promoting carbohydrate intake Limiting fluid intake Providing pain-relief measures
Limiting fluid intake
A 66-year-old African-American client has recently visited a physician to confirm a diagnosis of gastric cancer. The client has a history of tobacco use and was diagnosed 10 years ago with pernicious anemia. He and his family are shocked about the possibility of cancer because he was asymptomatic prior to recent complaints of pain and multiple gastrointestinal symptoms. On the basis of knowledge of disease progression, the nurse assumes that organs adjacent to the stomach are also affected. Which of the following organs may be affected? Choose all that apply. Liver Pancreas Bladder Duodenum Lungs
Liver Pancreas Duodenum
Which of the following are functions of saliva? Select all that apply. Lubrication Protection against harmful bacteria Digestion Elimination Metabolism
Lubrication Protection against harmful bacteria Digestion
A client is scheduled for a renal angiography. Which of the following would be appropriate before the test? Monitor the client for signs of electrolyte and water imbalance. Monitor the client for an allergy to iodine contrast material. Assess the client's mental changes. Evaluate the client for periorbital edema.
Monitor the client for an allergy to iodine contrast material.
Which is a true statement regarding gastric cancer? Most clients are asymptomatic during the early stage of the disease. Women have a higher incidence of gastric cancer. The prognosis for gastric cancer is good. Most cases are discovered before metastasis.
Most clients are asymptomatic during the early stage of the disease.
The nurse in the ED admits a client with suspected gastric outlet obstruction. The client's symptoms include nausea and vomiting. The nurse anticipates that the physician will issue which order? Pelvic x-ray Stool specimen Nasogastric tube insertion Oral contrast
Nasogastric tube insertion
The nurse is caring for a patient who underwent percutaneous lithotripsy earlier in the day. In this procedure, an ultrasonic probe inserted through a nephrostomy tube into the renal pelvis generates ultra-high-frequency sound waves to shatter renal calculi. What instruction should the nurse give the patient? Limit oral fluid intake for 1 to 2 weeks. Report the presence of fine, sandlike particles through the nephrostomy tube. Notify the health care provider about cloudy or foul-smelling urine. Report pink urine within 24 hours after the procedure.
Notify the health care provider about cloudy or foul-smelling urine.
A client undergoes total gastrectomy. Several hours after surgery, the nurse notes that the client's nasogastric (NG) tube has stopped draining. How should the nurse respond? Notify the health care provider. Reposition the tube. Irrigate the tube. Increase the suction level.
Notify the health care provider.
A client is receiving continuous tube feedings at 75 mL/h. When the nurse checked the residual volume 4 hours ago, it was 250 mL, and now the residual volume is 325 mL. What is the priority action by the nurse? Discard the residual volume. Stop the continuous feeding. Decrease the rate to 40 mL/h. Notify the healthcare provider.
Notify the healthcare provider.
The nurse working in the recovery room is caring for a client who had a radical neck dissection. The nurse notices that the client makes a coarse, high-pitched sound upon inspiration. Which intervention by the nurse is appropriate? Document the presence of stridor Administer a breathing treatment Notify the physician Lower the head of the bed
Notify the physician
During a home visit the nurse notes that a client recovering from peptic ulcer disease is experiencing cool clammy skin and has a heart rate of 96 beats a minute. Which action will the nurse take? Notify the primary health care provider. Provide a dose of a proton pump inhibitor. Encourage the client to drink a warm beverage. Discuss the types of foods the client has been eating.
Notify the primary health care provider.
Peptic ulcer disease occurs more frequently in people with which blood type? A B AB O
O
A client, aged 75, is diagnosed with a renal disease and administered nephrotoxic drugs in normal doses. The nurse is aware that it is important to observe the client closely for any changes in renal status. Which of the following measures may help a nurse determine a change in renal status? Observing the client's fluid intake. Checking for a thrill or a bruit daily. Observing the client's urinary output. Observing the skin color and nail beds.
Observing the client's urinary output.
A patient is postoperative day 3 following the successful transplantation of a kidney. The nurse is aware of the importance of assessing the patient for signs and symptoms of rejection. Consequently, the nurse is constantly monitoring the patient for: Decreased level of consciousness and pruritus Oliguria and edema Pain and hematuria Weight loss and lethargy
Oliguria and edema
Which medication classification represents a proton (gastric acid) pump inhibitor? Omeprazole Sucralfate Famotidine Metronidazole
Omeprazole
The nurse is caring for a client with intussusception of the bowel. What does the nurse understand occurs with this disorder? The bowel twists and turns itself and obstructs the intestinal lumen. One part of the intestine telescopes into another portion of the intestine. The bowel protrudes through a weakened area in the abdominal wall. A loop of intestine adheres to an area that is healing slowly after surgery.
One part of the intestine telescopes into another portion of the intestine.
An elderly patient comes into the emergency department complaining of an earache. The patient has an oral temperature of 100.2° F. Otoscopic assessment of the ear reveals a pearly gray tympanic membrane with no evidence of discharge or inflammation. Which action should the triage nurse take next? Palpate the patient's parotid glands to detect swelling and tenderness. Assess the temporomandibular joint for evidence of a malocclusion. Test the integrity of the 12th cranial nerve by asking the patient to protrude his tongue. Inspect the patient's gums for bleeding and hyperpigmentation.
Palpate the patient's parotid glands to detect swelling and tenderness.
A 37-year-old male patient presents at the emergency department complaining of nausea and vomiting and severe abdominal pain. While the nurse is assessing the patient, the patient's wife informs the nurse that the patient ingested 24 ounces of vodka last evening. The patient's abdomen is rigid, and there is bruising to the patient's flank. What is the patient exhibiting signs of? Pancreatitis with possible peritonitis Acute cholecystitis Obstruction of the bowel Acute appendicitis
Pancreatitis with possible peritonitis
A patient reports an inflamed salivary gland below the right ear. The nurse documents probable inflammation of which gland? Buccal Parotid Sublingual Submandibular
Parotid
The nurse is preparing to assess the donor site of a client who underwent a myocutaneous flap after a radical neck dissection. The nurse prepares to assess the most commonly used muscle for this surgery. Which muscle should the nurse assess? Pectoralis major Trapezius Biceps Sternomastoid
Pectoralis major
The nurse is providing an education program for the nursing assistants in a long-term care facility in order to decrease the number of UTIs in the female population. What interventions should the nurse introduce in the program? Select all that apply. For those patients who are incontinent, insert indwelling catheters. Perform hand hygiene prior to patient care. Assist the patients with frequent toileting. Provide careful perineal care. Encourage patients to wear briefs.
Perform hand hygiene prior to patient care. Assist the patients with frequent toileting. Provide careful perineal care.
If an indwelling catheter is necessary, which nursing intervention should be implemented to prevent infection? Use clean technique during insertion Use sterile technique to disconnect the catheter from the tubing to obtain urine specimens Place the catheter bag on the client's abdomen when moving the client Perform meticulous perineal care daily with soap and water
Perform meticulous perineal care daily with soap and water
A 26-year-old man experienced severe burns in an industrial accident and has been admitted to the burn unit of a tertiary care hospital. In the days since the accident, the care team has been pleased with the trajectory of the man's recovery, and they estimate that he will require parenteral nutrition for 2 to 3 months. Which of the following access devices is most likely appropriate for this patient's nutritional needs? Implanted port Tunneled central catheter Peripherally inserted central catheter (PICC) Nontunneled central catheter
Peripherally inserted central catheter (PICC)
A client with a diagnosis of acute appendicitis is awaiting surgical intervention. The nurse listens to bowel sounds and hears none and observes that the abdomen is rigid and board-like. What complication does the nurse determine may be occurring at this time? Constipation Paralytic ileus Peritonitis Accumulation of gas
Peritonitis
The following catheterization procedures are used to treat clients with urinary retention. Which procedure would the nurse identify as carrying the greatest risk to the client? Suprapubic cystostomy tube Permanent drainage with a urethral catheter Clean intermittent catheterization Credé voiding procedure
Permanent drainage with a urethral catheter
Which medication may be ordered to relieve discomfort associated with a urinary tract infection? Nitrofurantoin Phenazopyridine Ciprofloxacin Levofloxacin
Phenazopyridine Phenazopyridine is a urinary analgesic ordered to relieve discomfort associated with a UTI. Nitrofurantoin, ciprofloxacin, and levofloxacin are antibiotics.
A client is scheduled for a renal arteriogram. When the nurse checks the chart for allergies to shellfish or iodine, she finds no allergies recorded. The client is unable to provide the information. During the procedure, the nurse should be alert for which finding that may indicate an allergic reaction to the dye used during the arteriogram? Increased alertness Hypoventilation Pruritus Unusually smooth skin
Pruritus
The nurse is reviewing the results of a urinalysis on a client with acute pyelonephritis. Which of the following would the nurse most likely expect to find? High specific gravity Slightly acidic pH Absent proteinuria Pyuria
Pyuria The chief abnormality noted with the urinalysis is pyuria (combination of bacteria and leukocytes). Specific gravity would be low, pH would be slightly alkaline, and proteinuria would be minimal to mild.
Which liver function study is used to show the size of the liver and hepatic blood flow and obstruction? Magnetic resonance imaging Angiography Radioisotope liver scan Electroencephalography
Radioisotope liver scan
The nurse is reviewing a patient's laboratory results. What findings does the nurse assess that are consistent with acute glomerulonephritis? Select all that apply. Red blood cells in the urine Polyuria Proteinuria White blood cell casts in the urine Hemoglobin of 12.8 g/dL
Red blood cells in the urine Proteinuria
A nurse is caring for a client who had an ileal conduit 3 days earlier. The nurse examines the stoma site and determines that she should consult with the ostomy nurse. Which assessment finding indicates the need for further consultation? Beefy red stoma site Stoma site not sensitive to touch Red, sensitive skin around the stoma site Clear mucus mixed with yellow urine drained from the appliance bag
Red, sensitive skin around the stoma site
Sympathomimetics have which of the following effects on the body? Relaxation of bladder wall Decrease of heart rate Constriction of bronchioles Constriction of pupils
Relaxation of bladder wall Sympathomimetics mimic the sympathetic nervous system, causing increased heart rate and contractility, dilation of bronchioles and pupils, and bladder wall relaxation.
The nurse is caring for a client with chronic gastritis. Which interventions will the nurse add to this client's plan of care? Select all that apply. Remind to avoid alcohol intake. Review actions to reduce stress. Provide omeprazole as prescribed. Instruct to avoid foods that aggravate the condition. Suggest using over the counter ibuprofen for pain control.
Remind to avoid alcohol intake. Review actions to reduce stress. Provide omeprazole as prescribed. Instruct to avoid foods that aggravate the condition.
When a central venous catheter dressing becomes moist or loose, what should a nurse do first? Draw a circle around the moist spot and note the date and time. Notify the physician. Remove the catheter, check for catheter integrity, and send the tip for culture. Remove the dressing, clean the site, and apply a new dressing.
Remove the dressing, clean the site, and apply a new dressing.
A patient has been diagnosed with postrenal failure. The nurse reviews the patient's electronic health record and notes a possible cause. Which of the following is the possible cause? Acute pyelonephritis Osmotic dieresis. Dysrhythmias Renal calculi
Renal calculi Postrenal ARF is the result of an obstruction that develops anywhere from the collecting ducts of the kidney to the urethra. This results from ureteral blockage, such as from bilateral renal calculi or benign prostatic hypertrophy (BPH).
Common tests of renal function include which of the following? Select all that apply. Renal concentration test Creatinine clearance Serum creatinine Blood urea nitrogen (BUN) Arterial blood gas analysis
Renal concentration test Creatinine clearance Serum creatinine Blood urea nitrogen (BUN)
A client presents to the ED with acute abdominal pain, fever, nausea, and vomiting. During the client's examination, the lower left abdominal quadrant is palpated, causing the client to report pain in the RLQ. This positive sign is referred to as ________ and suggests the client may be experiencing ________. Rovsing's sign; acute appendicitis McBurney's sign; acute appendicitis Rovsing's sign; perforation McBurney's sign; perforation
Rovsing's sign; acute appendicitis
A client is being tested to determine the presence of an insulinoma. Which symptoms will the nurse expect to assess in this client? Select all that apply. Seizure activity Generalized weakness Mental confusion Blood glucose level of 46 mg/dl Blood pressure reading of 156/92 mm Hg
Seizure activity Generalized weakness Mental confusion Blood glucose level of 46 mg/dl
Which of the following would a nurse classify as a prerenal cause of acute renal failure? Polycystic disease Ureteral stricture Prostatic hypertrophy Septic shock
Septic shock Prerenal causes of acute renal failure include hypovolemic shock, cardiogenic shock secondary to congestive heart failure, septic shock, anaphylaxis, dehydration, renal artery thrombosis or stenosis, cardiac arrest, and lethal dysrhythmias. Ureteral stricture and prostatic hypertrophy would be classified as postrenal causes. Polycystic disease is classified as an intrarenal cause of acute renal failure.
The nurse notes that a client has inflammation of the salivary glands. The nurse documents which finding? Parotitis Sialadenitis Stomatitis Pyosis
Sialadenitis Sialadenitis is inflammation of the salivary glands. Parotitis is inflammation of the parotid glands. Stomatitis is inflammation of the oral mucosa. Pyosis is pus.
Which term is used to describe stone formation in a salivary gland, usually the submandibular gland? Sialolithiasis Parotitis Sialadenitis Stomatitis
Sialolithiasis
A client is preparing for discharge to home following a partial gastrectomy and vagotomy. Which is the best rationale for the client being taught to lie down for 30 minutes after each meal? Slows gastric emptying Provides much needed rest Allows for better absorption of vitamin B12 Removes tension on internal suture line
Slows gastric emptying
A patient is recovering in the PACU following gastric surgery. The nurse who is providing this patient's care is performing frequent assessments of the character and quantity of the patient's nasogastric (NG) drainage. What are the nurse's expected findings during these assessments? Copious quantities of straw-colored output Scant amounts of greenish-colored output Small amounts of blood-tinged output Moderate amounts of clear output
Small amounts of blood-tinged output
The nurse is completing a health history on a patient whose diagnosis is chronic gastritis. Which of the data below should the nurse consider most significantly related to the etiology of the patient's health problem? Consumes one or more protein drinks daily Takes over-the-counter antacids frequently Smokes two packs of cigarettes daily Reports a history of social drinking on a weekly basis
Smokes two packs of cigarettes daily
The nurse is caring for a client who has undergone a nephrectomy. Which assessment finding is most important in determining nursing care for the client? Urine output of 35 to 40 mL/hour Pain of 3 out of 10, 1 hour after analgesic administration SpO2 at 90% with fine crackles in the lung bases Blood tinged drainage in Jackson-Pratt drainage tube
SpO2 at 90% with fine crackles in the lung bases
A client is demonstrating symptoms of pancreatic cancer. Which diagnostic test will the nurse expect to be prescribed to prepare the client for surgery? Spiral computed tomography (CT) scan Endoscopic ultrasound Percutaneous transhepatic cholangiography Endoscopic retrograde cholangiopancreatogram
Spiral computed tomography (CT) scan
The nurse is reviewing the laboratory test results of a client with Crohn disease. Which of the following would the nurse most likely find? Decreased white blood cell count Increased albumin levels Stool cultures negative for microorganisms or parasite Decreased erythrocyte sedimentation rate
Stool cultures negative for microorganisms or parasite
A client with hepatitis who has not responded to medical treatment is scheduled for a liver transplant. Which of the following most likely would be ordered? Chenodiol Ursodiol Tacrolimus Interferon alfa-2b, recombinant
Tacrolimus In preparation for a liver transplant, a client receives immunosuppressants to reduce the risk for organ rejection. Tacrolimus or cyclosporine are two immunosuppressants that may be used. Chenodiol and ursodiol are agents used to dissolve gall stones. Recombinant interferon alfa-2b is used to treat chronic hepatitis B, C, and D to force the virus into remission.
The nursing educator is teaching a group of nurses about constipation and the elderly. What recommendation for this population should a nurse can make about treating chronic constipation? Take a mild laxative, such as magnesium citrate, when necessary. Take a stool softener, such as docusate sodium (Colace), daily. Administer a tap water enema weekly. Administer a phospho-soda (Fleet) enema when necessary.
Take a stool softener, such as docusate sodium (Colace), daily.
Hyperkalemia is a serious side effect of acute renal failure. Identify the electrocardiogram (ECG) tracing that is diagnostic for hyperkalemia. Tall, peaked T waves Shortened QRS complex Multiple spiked P waves Prolonged ST segment
Tall, peaked T waves
A community health nurse is well-aware that the incidence and prevalence of chronic renal failure (CRF) has increased significantly in recent years. In a recent strategic planning meeting, the nurse has proposed health promotion activities to address this problem. Which of the following health promotion campaigns addresses the most common cause of CRF? Promoting smoking cessation Teaching individuals with diabetes to manage their disease Encouraging adults to know their family history of CRF Screening for CRF among adults age 70 and older
Teaching individuals with diabetes to manage their disease
A healthcare provider prescribes a combination of drugs to treat reoccurring peptic ulcer disease, and the client asks the nurse the reason for all the medications. What teaching should the nurse review with the client? The antibiotics, prostaglandin E1 analogs, and bismuth salts will work together to suppress or eradicate H. pylori. The proton pump inhibitors, prostaglandin E1 analogs, and bismuth salts will suppress or eradicate H. pylori. The bismuth salts, antibiotics, and proton pump inhibitors will work together to suppress or eradicate H. pylori. The prostaglandin E1 analogs, antibiotics, and proton pump inhibitors will work together to suppress or eradicate H. pylori.
The bismuth salts, antibiotics, and proton pump inhibitors will work together to suppress or eradicate H. pylori. The recommended combination of bismuth salts, antibiotics, and proton pump inhibitors will suppress or eradicate H. pylori. Prostaglandin E1 analogs enhance mucosal resistance to injury; they do not suppress or eradicate H. pylori.
Ammonia, the major etiologic factor in the development of encephalopathy, inhibits neurotransmission. Increased levels of ammonia are damaging to the body. The largest source of ammonia is from: The digestion of dietary and blood proteins. Excessive diuresis and dehydration. Severe infections and high fevers. Excess potassium loss subsequent to prolonged use of diuretics.
The digestion of dietary and blood proteins.
Total parenteral nutrition (TPN) has been ordered for a male patient who has been experiencing a severe and protracted exacerbation of Crohn's disease. Before TPN can be initiated, the patient requires: A random blood glucose level of ≤160 mg/dL Angiography to determine the patency of his vascular system The insertion of a central venous access device A fluid challenge to assess his renal function
The insertion of a central venous access device
A patient is placed on hemodialysis for the first time. The patient complains of a headache with nausea and begins to vomit, and the nurse observes a decreased level of consciousness. What does the nurse determine has happened? The dialysis was performed too rapidly. The patient is having an allergic reaction to the dialysate. The patient is experiencing a cerebral fluid shift. Too much fluid was pulled off during dialysis.
The patient is experiencing a cerebral fluid shift. Dialysis disequilibrium results from cerebral fluid shifts. Signs and symptoms include headache, nausea and vomiting, restlessness, decreased level of consciousness, and seizures. It is rare and more likely to occur in AKI or when BUN levels are very high (exceeding 150 mg/dL).
A 44-year-old woman was diagnosed with an uncomplicated urinary tract infection (UTI) and completed her prescribed 3-day course of antibiotics 2 days ago. However, she states that she is experiencing the same signs and symptoms that initially prompted her to seek care. The nurse should anticipate that: The patient's signs and symptoms will likely resolve over the next 48 to 72 hours. The patient will likely require a course of IV antibiotics. The patient may require another short course of antibiotics followed by a longer-term regimen. The patient will need to continue taking the same antibiotic for the next 4 to 6 months.
The patient may require another short course of antibiotics followed by a longer-term regimen.
The nurse is planning the care of a male patient who has been admitted to the medical unit with an exacerbation of chronic pyelonephritis. Which of the following goals should the nurse prioritize in the planning of this patient's nursing care? The patient will consume 3 to 4 L of fluid each day. The patient will void every 3 hours. The patient will express an understanding of the pathophysiology of pyelonephritis. The patient will maintain his preadmission activities of daily living (ADLs).
The patient will consume 3 to 4 L of fluid each day.
A man with severe ulcerative colitis has been informed by his health care provider that he will require a colectomy and an ileostomy. The patient has been told by his health care provider that he is candidate for a continent ileal reservoir (Kock pouch). The patient's nurse recognizes which of the following advantages to the use of a Kock pouch as an alternative to the creation of an ileal stoma? The patient's abdominal wall will remain intact. The patient will soon be able to resume normal bowel function. The patient will have to make minimal dietary modifications. The patient will not have to wear an external collection bag.
The patient will not have to wear an external collection bag.
The nurse is assessing the client's ileal conduit stoma in the clinic. Which assessment finding would be of greatest concern to the nurse? The urine has an ammonia odor. Yellow urine is draining from the stoma. The skin surrounding the stoma is red. The stoma is dusky red.
The stoma is dusky red.
The nurse is checking placement of a nasogastric (NG) tube that has been in place for 2 days. The tube is draining green aspirate. What does this color of aspirate indicate? The tube is in the pleural space. The tube is the intestine. The tube is in the stomach. The tube is in the esophagus.
The tube is in the stomach. The patient's aspirate is from the gastric area when the nurse observes that the color of the aspirate is green. Clear, yellow, and bile-colored are associated with intestinal aspirate. Tan mucus is associated with tracheobronchial secretions, and pleural secretions are pale yellow.
A nurse practitioner treating a patient who is diagnosed with hepatitis A should provide health care information. Which of the following statements are correct for this disorder? Select all that apply. The incubation period for this virus is up to 4 months. There is a 70% chance that jaundice will occur. Transmission of the virus is possible with oral-anal contact during sex. Typically there is a spontaneous recovery. There is a 50% risk that cirrhosis will develop.
There is a 70% chance that jaundice will occur. Transmission of the virus is possible with oral-anal contact during sex. Typically there is a spontaneous recovery.
Which of the following is the procedure of choice for men with recurrent or complicated urinary tract infections (UTIs)? Transrectal ultrasonography IV urogram Computed tomography (CT) scan Magnetic resonance imaging (MRI)
Transrectal ultrasonography A transrectal ultrasonography is the procedure of choice for men with recurrent or complicated UTIs.
Which of the following diagnostic studies definitely confirms the presence of ascites? Ultrasound of liver and abdomen Abdominal x-ray Colonoscopy Computed tomography of abdomen
Ultrasound of liver and abdomen
A patient had an ileal conduit created and is being cared for by a postsurgical nurse. What is a complication the nurse would monitor this patient for in the immediate postoperative care period? Respiratory alkalosis Colon obstruction Ureteral obstruction Gangrene of the ilium
Ureteral obstruction
A patient is admitted to the hospital with a diagnosis of acute glomerulonephritis. What is the clinical sign that the nurse would document with this diagnosis? Blood urea nitrogen (BUN) of 16 mg/dL Serum creatinine of 0.4 mg/dL Urinary protein of 6 g/24h Elevated serum albumin level
Urinary protein of 6 g/24h
A group of students are reviewing information about disorders of the bladder and urethra. The students demonstrate understanding of the material when they identify which of the following as a voiding dysfunction? Cystitis Bladder stones Urinary retention Urethral stricture
Urinary retention Urinary retention and urinary incontinence are voiding dysfunctions, temporary or permanent alterations in the ability to urinate normally. Cystitis is an infectious disorder. Bladder stones and urethral stricture are obstructive disorders.
A client admitted with a gunshot wound to the abdomen is transferred to the intensive care unit after an exploratory laparotomy. IV fluid is being infused at 150 mL/hour. Which assessment finding suggests that the client is experiencing acute renal failure (ARF)? Blood urea nitrogen (BUN) level of 22 mg/dl Serum creatinine level of 1.2 mg/dl Temperature of 100.2° F (37.8° C) Urine output of 250 ml/24 hours
Urine output of 250 ml/24 hours ARF, characterized by abrupt loss of kidney function, commonly causes oliguria, which is characterized by a urine output of 250 ml/24 hours. A serum creatinine level of 1.2 mg/dl isn't diagnostic of ARF. A BUN level of 22 mg/dl or a temperature of 100.2° F (37.8° C) wouldn't result from this disorder.
Which of the following is the most effective strategy to prevent hepatitis B infection? Vaccine Barrier protection during intercourse Covering open sores Avoid sharing toothbrushes
Vaccine
x Cardiac complications, which may occur following resection of an esophageal tumor, are associated with irritation of which nerve at the time of surgery? Hypoglossal Vestibulocochlear Vagus Trigeminal
Vagus
Which medication is used to decrease portal pressure, halting bleeding of esophageal varices? Spironolactone Vasopressin Nitroglycerin Cimetidine
Vasopressin
A client with chronic pancreatitis is treated for uncontrolled pain. Which complication does the nurse recognize is most common in the client with chronic pancreatitis? Diarrhea Fatigue Weight loss Hypertension
Weight loss
The nurse is assigned to care for a patient in the oliguric phase of kidney failure. When does the nurse understand that oliguria is said to be present? When the urine output is less than 30 mL/h When the urine output is about 100 mL/h When the urine output is between 300 and 500 mL/h When the urine output is between 500 and 1,000 mL/h
When the urine output is less than 30 mL/h
A client is admitted to the emergency department with reports right lower quadrant pain. Blood specimens are drawn and sent to the laboratory. Which laboratory finding should be reported to the health care provider immediately? Hematocrit 42% White blood cell (WBC) count 22.8/mm3 Serum potassium 4.2 mEq/L Serum sodium 135 mEq/L
White blood cell (WBC) count 22.8/mm3
Because of difficulties with hemodialysis, peritoneal dialysis is initiated to treat a client's uremia. Which finding during this procedure signals a significant problem? Blood glucose level of 200 mg/dl White blood cell (WBC) count of 20,000/mm3 Potassium level of 3.5 mEq/L Hematocrit (HCT) of 35%
White blood cell (WBC) count of 20,000/mm3
A comatose patient is receiving oral care. What oral care regimen would be most effective in decreasing the patient's risk of tooth decay and plaque accumulation? Irrigating the mouth using a syringe filled with a bactericidal mouthwash Applying a water-soluble gel to the teeth and gums Wiping the teeth and gums with a gauze pad Gently stroking the teeth and gums with a lemon and glycerin swab
Wiping the teeth and gums with a gauze pad
A nurse is caring for a client admitted with acute pancreatitis. Which nursing action is most appropriate for a client with this diagnosis? Withholding all oral intake, as ordered, to decrease pancreatic secretions Administering meperidine, as ordered, to relieve severe pain Limiting I.V. fluids, as ordered, to decrease cardiac workload Keeping the client supine to increase comfort
Withholding all oral intake, as ordered, to decrease pancreatic secretions
Which of the following is the most common type of diverticulum? Zenker's diverticulum Mid-esophageal Epiphrenic Intramural
Zenker's diverticulum The most common type of diverticulum, which is found three times more frequently in men than women, is Zenker's diverticulum (also known as pharyngoesophageal pulsion diverticulum or a pharyngeal pouch).
The nurse cares for a client who underwent a kidney transplant. The nurse understands that rejection of a transplanted kidney within 24 hours after transplant is termed: acute rejection. hyperacute rejection. chronic rejection. simple rejection.
hyperacute rejection. After a kidney transplant, rejection and failure can occur within 24 hours (hyperacute), within 3 to 14 days (acute), or after many years. A hyperacute rejection is caused by an immediate antibody-mediated reaction that leads to generalized glomerular capillary thrombosis and necrosis. The term "simple" is not used in the categorization of types of rejection of kidney transplants.
A nurse is assessing a client and obtains the following findings: abdominal discomfort, mild diarrhea, blood pressure of 100/80 mm Hg, pulse rate of 88 beats/minute, respiratory rate of 20 breaths/minute, temperature 100° F (37.8° C). What diagnosis will the nurse suspect for this client? inflammatory bowel disease (IBD) colorectal cancer diverticulitis liver failure
inflammatory bowel disease (IBD)
A client with enteritis reports frequent diarrhea. What assessment should the nurse should anticipate? respiratory acidosis respiratory alkalosis metabolic acidosis metabolic alkalosis
metabolic acidosis Diarrhea causes a bicarbonate deficit. With loss of the relative alkalinity of the lower GI tract, the relative acidity of the upper GI tract predominates, leading to metabolic acidosis. Loss of acid, which occurs with severe vomiting, may lead to metabolic alkalosis. Diarrhea doesn't lead to respiratory acid-base imbalances, such as respiratory acidosis and respiratory alkalosis.
The nurse cares for a client who receives parenteral nutrition (PN). The nurse notes on the care plan that the catheter will need to be removed 6 weeks after insertion and that the client's venous access device is a peripherally inserted central catheter . nontunneled central catheter. tunneled central catheter. implanted port.
nontunneled central catheter.
A client is going to have a surgical procedure called a periurethral bulking to improve urinary control. Periurethral bulking is: placement of small amounts of collagen in urethral walls to aid the closing pressure. a procedure that increases storage capacity of the bladder. implantation of an artificial sphincter that can be inflated to prevent urine loss and deflated to allow urination. a procedure that increases support to the bladder by tightening the vaginal wall under the urethra.
placement of small amounts of collagen in urethral walls to aid the closing pressure.
Twenty-four hours after undergoing kidney transplantation, a client develops a hyperacute rejection. To correct this problem, the nurse should prepare the client for: removal of the transplanted kidney. high-dose IV cyclosporine (Sandimmune) therapy. bone marrow transplant. intra-abdominal instillation of methylprednisolone sodium succinate (Solu-Medrol).
removal of the transplanted kidney.
A client presents to the emergency department complaining of a dull, constant ache along the right costovertebral angle along with nausea and vomiting. The most likely cause of the client's symptoms is: renal calculi. an overdistended bladder. interstitial cystitis. acute prostatitis.
renal calculi. Renal calculi usually presents as a dull, constant ache at the costovertebral angle. The client may also present with nausea and vomiting, diaphoresis, and pallor. The client with an overdistended bladder and interstitial cystitis presents with dull, continuous pain at the suprapubic area that's intense with voiding. The client also complains of urinary urgency and straining to void. The client with acute prostatitis presents with a feeling of fullness in the perineum and vague back pain, along with frequency, urgency, and dysuria.
A client with viral hepatitis A is being treated in an acute care facility. Because the client requires enteric precautions, the nurse should: place the client in a private room. wear a mask when handling the client's bedpan. wash her hands after touching the client. wear a gown when providing personal care for the client.
wash her hands after touching the client.
A female client presents to the health clinic for a routine physical examination. The nurse observes that the client's urine is bright yellow. Which question is most appropriate for the nurse to ask the client? "Have you noticed any vaginal bleeding?" "Do you take phenytoin daily?" "Do you take multiple vitamin preparations?" "Have you had a recent urinary tract infection?"
"Do you take multiple vitamin preparations?"
A client with gastric ulcers caused by H. pylori is prescribed metronidazole. Which client statement indicates to the nurse that teaching about this medication was effective? "It might cause a metallic taste in my mouth." "I can take this medication with my blood thinner." "I can have an alcoholic drink in the evenings." "My appetite may increase while taking this medication."
"It might cause a metallic taste in my mouth." Metronidazole is a synthetic antibacterial and antiprotozoal agent that assists with eradicating H. pylori bacteria in the gastric mucosa when given with other antibiotics and proton pump inhibitors. This medication may cause a metallic taste in the mouth. It should not be taken with anticoagulants as it will increase the blood thinning effects of warfarin. Alcohol should be avoided while taking this medication. This medication may cause anorexia and not an increased appetite.
A patient with end-stage renal disease (ESRD) is scheduled for his first hemodialysis treatment. The patient asks the nurse what common complications may occur from the treatment. What would be the nurse's best reply? "High blood sugar levels and low protein levels may occur." "Bleeding and double vision may occur." "Confusion and diarrhea may occur." "Low blood pressure and cramping sometimes occur."
"Low blood pressure and cramping sometimes occur."
An obese male patient has sought advice from the nurse about the possible efficacy of medications in his efforts to lose weight. What should the nurse teach the patient about pharmacologic interventions for the treatment of obesity? "Medications are usually reserved for people who have had unsuccessful bariatric surgery." "Medications may be of some use, but they don't tend to resolve obesity on their own." "Medications are an excellent option for individuals who prefer not to exercise or reduce their food intake." "Medications have the potential to reduce hunger but they rarely result in weight loss."
"Medications may be of some use, but they don't tend to resolve obesity on their own."
Which statement by the client with end-stage renal disease indicates teaching by the nurse was effective? "There are few complications with renal replacement therapies." "A family member can help me perform hemodialysis in my home." "Ultrafiltration methods take much longer than hemodialysis." "A special access is created in my vein for peritoneal dialysis."
"Ultrafiltration methods take much longer than hemodialysis."
A client with newly diagnosed renal cancer is questioning why detection was delayed. Which is the best response by the nurse? "Squamous cell carcinomas do not present with detectable symptoms." "You should have sought treatment earlier." "Very few symptoms are associated with renal cancer." "Painless gross hematuria is the first symptom in renal cancer."
"Very few symptoms are associated with renal cancer."
A patient has acute kidney injury (AKI) with a negative nitrogen balance. How much weight does the nurse expect the patient to lose? 0.5 kg/day 1.0 kg/day 1.5 kg/day 2.0 kg/day
0.5 kg/day
Medical management of a patient with peritonitis includes fluid, electrolyte, and colloid replacement. The nurse knows to prepare the initial, most appropriate intravenous solution. Which of the following is the correct solution? 0.9% NS D5W D10W 0.45% of NS
0.9% NS
Semi-Fowler position is maintained for at least which timeframe following completion of an intermittent tube feeding? 30 minutes 1 hour 90 minutes 2 hours
1 hour
Accurate intake and output are an essential part of the nursing management for ARF. A part of fluid assessment is estimating insensible fluid loss. The nurse knows that a patient with a temperature of 100.6°F would have a maximum insensible fluid loss of __________ mL/day. 800 875 950 1,008
1,008
At the end of five peritoneal exchanges, a patient's fluid loss was 500 mL. How much is this loss equal to? 0.5 lb 1.0 lb 1.5 lb 2 lb
1.0 lb
Which value represents a normal BUN-to-creatinine ratio? 4:1 6:1 8:1 10:1
10:1
Approximately what percentage of blood passing through the glomeruli is filtered into the nephron? 10% 20% 30% 40%
20%
Which period of acute renal failure is accompanied by an increase in the serum concentration of substances usually excreted by the kidneys? Initiation Oliguria Diuresis Recovery
Oliguria
A client with morbid obesity and a history of severe sleep apnea and severe diabetes is being considered for bariatric surgery. When reviewing the client's medical record, the nurse would identify that which body mass index (BMI) would meet the criteria for such surgery? 30kg/m2 32 kg/m2 34 kg/m2 36 kg/m2
36 kg/m2
The nurse inserts a nasogastric tube into the right nares of a patient. When testing the tube aspirate for pH to confirm placement, what does the nurse anticipate the pH will be if placement is in the lungs? 1 2 4 6
6
Pharmacologic therapy frequently is used to dissolve small gallstones. It takes about how many months of medication with UDCA or CDCA for stones to dissolve? 1 to 2 3 to 5 6 to 12 13 to 18
6 to 12
A nurse is caring for a patient with impaired renal function. A creatinine clearance measurement has been ordered. The nurse is aware that the specimens needed for the calculation of the patient's creatinine clearance will include what? A fasting serum potassium level and a random urine sample A 24-hour urine specimen collection and a serum creatinine level midway through the urine collection process A blood, urea, nitrogen (BUN) level and a serum creatinine level on three consecutive mornings A sterile urine specimen and an electrolyte panel, including sodium, potassium, calcium, and phosphorus values
A 24-hour urine specimen collection and a serum creatinine level midway through the urine collection process
A patient has stage 3 chronic kidney failure. What would the nurse expect the patient's glomerular filtration rate (GFR) to be? A GFR of 90 mL/min/1.73 m2 A GFR of 30-59 mL/min/1.73 m2 A GFR of 120 mL/min/1.73 m2 A GFR of 85 mL/min/1.73 m2
A GFR of 30-59 mL/min/1.73 m2
A nurse is preparing a presentation for a local community group of older adults about colon cancer. What would the nurse include as the primary characteristic associated with this disorder? Abdominal distention Frank blood in the stool A change in bowel habits Abdominal pain
A change in bowel habits Although abdominal distention and blood in the stool (frank or occult) may be present, the chief characteristic of cancer of the colon is a change in bowel habits, such as alternating constipation and diarrhea. Abdominal pain is a late sign.
Which intervention would the nurse expect to implement following urologic endoscopy? Select all that apply. Assist with coughing and deep breathing. Teach leg and range-of-motion exercises. Administer an antispasmodic agent. Provide privacy to promote bladder emptying. Verify the client's understanding about procedure.
Administer an antispasmodic agent. Provide privacy to promote bladder emptying. The nurse would expect to administer an antispasmodic agent, such as flavoxate (Urispas), and provide privacy to promote bladder emptying. The nurse verifies the client's understanding prior to the procedure. Assisting with coughing and deep breathing and teaching leg exercises and range of motion are not specific interventions post-urologic endoscopy.
After assessing a client with peritonitis, how would the nurse most likely document the client's bowel sounds? Mild High-pitched Hyperactive Absent
Absent
A nurse is performing an assessment for a client who presents to the clinic with an erythemic, fissuring lip lesion with white hyperkeratosis. What does the nurse suspect that these findings are characteristic of? Actinic cheilitis Human papillomavirus lesion Frey syndrome Sialadenitis
Actinic cheilitis
The nurse is conducting a community education session on the prevention of oral cancers. The nurse includes which cancer as being a type of premalignant squamous cell skin cancer? Herpes simplex 1 Actinic cheilitis Chancre Erythroplakia
Actinic cheilitis
A client is diagnosed with a disorder that affects pancreatic digestive enzymes, and their typsin levels are elevated. The client has jaudice and verbalizes severe abdominal pain. The nurse most likely anticipates which condition? Choledochostomy Steatorrhea Acute pancreatitis Cholecysitis
Acute pancreatitis
What is the most common cause of small-bowel obstruction? Hernias Neoplasms Adhesions Volvulus
Adhesions
When preparing a client for a hemorrhoidectomy, the nurse should take which action? Administer an enema as ordered. Administer oral antibiotics as ordered. Administer topical antibiotics as ordered. Administer analgesics as ordered.
Administer an enema as ordered.
The nurse is preparing to administer orlistat to a client with obesity. Which safety warning(s) should the nurse consider when administering this medication to the client? Select all that apply. Administer with meals, stagger administration with other drugs. Provide a vitamin supplement with the medication. Monitor liver function. Avoid caffeine. Avoid use among clients with heart disease, hypertension, and hyperthyroidism.
Administer with meals, stagger administration with other drugs. Provide a vitamin supplement with the medication. Monitor liver function.
The nurse is reviewing the potassium level of a patient with kidney disease. The results of the test are 6.5 mEq/L, and the nurse observes peaked T waves on the ECG. What priority intervention does the nurse anticipate the physician will order to reduce the potassium level? Administration of an insulin drip Administration of a loop diuretic Administration of sodium bicarbonate Administration of sodium polystyrene sulfonate [Kayexalate])
Administration of sodium polystyrene sulfonate [Kayexalate])
A nurse is presenting an educational event to a local community group and is speaking about colorectal cancer. What would the nurse identify as a risk factor associated with colorectal cancer? Age greater than 50 History of bowel obstruction Family history of stomach cancer Low-fat, low-protein, low-fiber diet
Age greater than 50
A patient with portal hypertension has been admitted to the medical floor. What will the nurse assess for related to portal hypertension? Bowel obstruction Vitamin A deficiency Ascites Hepatic encephalopathy
Ascites Obstruction to blood flow through the damaged liver results in increased blood pressure (portal hypertension) throughout the portal venous system. This can result in varices and ascites in the abdominal cavity. Portal hypertension does not generally cause bowel obstruction. Vitamin A deficiency is not something the nurse assesses for. Hepatic encephalopathy is a complication of cirrhosis.
A patient has undergone a renal biopsy. After the test, while the patient is resting, the patient reports severe pain in the back, arms, and shoulders. Which intervention should be offered by the nurse? Assess the patient's back and shoulder areas for signs of internal bleeding. Distract the patient's attention from the pain. Provide analgesics to the patient. Enable the patient to sit up and ambulate.
Assess the patient's back and shoulder areas for signs of internal bleeding.
A client with achalasia recently underwent pneumatic dilation. The nurse intervenes after the procedure by Assessing lung sounds Providing fluids to drink Preparing for a barium swallow Administering the prescribed analgesic
Assessing lung sounds
The nurse is conducting discharge teaching for a client who was admitted with a kidney stone. The nurse includes which instruction as a measure to prevent additional kidney stones? Increase protein intake. Adhere to a low-calcium diet. Avoid drinking water before bedtime. Avoid drinking tea.
Avoid drinking tea. The nurse should teach the client to avoid tea and other oxalate-containing foods, such as spinach, strawberries, rhubarb, peanuts, and wheat bran. The client should restrict protein intake to 60 g/day and should drink two glasses of water at bedtime. Low-calcium diets are generally not recommended.
The nurse is evaluating a client's ulcer symptoms to differentiate ulcer as duodenal or gastric. Which symptom should the nurse at attribute to a duodenal ulcer? Vomiting Hemorrhage Awakening in pain Constipation
Awakening in pain
The nurse is assisting in the preoperative planning for stoma placement in a client scheduled for urinary diversion surgery. Where should the nurse plan for the stoma to be located? Over a bony prominence Away from skin folds At the belt line At the umbilicus
Away from skin folds
Which of the following is a term used to describe excessive nitrogenous waste in the blood, as seen in acute glomerulonephritis? Azotemia Proteinuria Hematuria Bacteremia
Azotemia
The nurse expects which of the following assessment findings in the client in the diuretic phase of acute renal failure? Dehydration Hyperkalemia Crackles Hypertension
Dehydration
A client diagnosed with bladder cancer wants to avoid surgery. For which intravesical treatment will the nurse prepare teaching for this client? Bacillus Calmette Guerin (BCG) Live Radiation therapy Periodic cystoscopy Infusion of a cytotoxic agent
Bacillus Calmette Guerin (BCG) Live
Which of the following is the most effective intravesical agent for recurrent bladder cancer? Bacillus Calmette-Guérin (BCG) Methotrexate Cisplatin Vinblastine
Bacillus Calmette-Guérin (BCG)
Which drug is considered a stimulant laxative? Magnesium hydroxide Bisacodyl Mineral oil Psyllium hydrophilic mucilloid
Bisacodyl
The nurse is assessing a client with advanced gastric cancer. The nurse anticipates that the assessment will reveal which finding? Abdominal pain below the umbilicus Weight gain Bloating after meals Increased appetite
Bloating after meals
Which clinical manifestation is not associated with hemorrhage? Tachycardia Bradycardia Tachypnea Hypotension
Bradycardia
A patient with IBD would be encouraged to increase fluids, use vitamins and iron supplements, and follow a diet designed to reduce inflammation. Select the meal choice that would be recommended for a low-residue diet. A peanut butter sandwich and fruit cup Broiled chicken with low-fiber pasta Salami on whole grain bread and V-8 juice A fruit salad with yogurt
Broiled chicken with low-fiber pasta
A client has been receiving radiation therapy to the lungs and now has erythema, edema, and pain of the mouth. What instruction will the nurse give to the client? Use a hard-bristled toothbrush. Rinse with an alcohol-based solution. Brush and floss daily. Continue with the usual diet.
Brush and floss daily. The description of erythema, edema, and pain of the mouth following radiation treatment describes stomatitis. Nursing considerations include prophylactic mouth care such as brushing and flossing daily. A soft-bristled toothbrush is recommended. The client is to avoid alcohol-based mouth rinses and hot or spicy foods that may be part of the client's usual diet.
Which part of the kidney contains the nephrons? Cortex Pelvis Medulla Glomerulus
C
Which of the following appears to be a significant factor in the development of gastric cancer? Diet Age Ethnicity Gender
Diet
A patient admitted with electrolyte imbalance has carpopedal spasm, ECG changes, and a positive Chvostek sign. What deficit does the nurse suspect the patient has? Magnesium Phosphorus Calcium Sodium
Calcium
A client requires hemodialysis. Which type of drug should be withheld before this procedure? Phosphate binders Insulin Antibiotics Cardiac glycosides
Cardiac glycosides
Which term describes a reddened, circumscribed lesion that ulcerates and becomes crusted and is a primary lesion of syphilis? Lichen planus Actinic cheilitis Chancre Leukoplakia
Chancre
When caring for a client with advanced cirrhosis and hepatic encephalopathy, which assessment finding should the nurse report immediately? Weight loss of 2 pounds in 3 days Change in the client's handwriting and/or cognitive performance Anorexia for more than 3 days Constipation for more than 2 days
Change in the client's handwriting and/or cognitive performance
Patient education regarding a fistulae or graft includes which of the following? Select all that apply. Check daily for thrill and bruit. Avoid compression of the site. No IV or blood pressure taken on extremity with dialysis access. No tight clothing. Cleanse site b.i.d.
Check daily for thrill and bruit. Avoid compression of the site. No IV or blood pressure taken on extremity with dialysis access. No tight clothing.
The nurse is assessing a patient admitted to the unit with kidney stones. What assessment parameters would be priorities for the nurse to address? Select all that apply. Dietary history Family history of renal stones Medication history Surgical history Vaccination history
Dietary history Family history of renal stones Medication history
A client informs the nurse of having abdominal pain that is relieved when having a bowel movement. The health care provider diagnosed the client with irritable bowel syndrome. What does the nurse recognize as characteristic of this disorder? Weight loss due to malabsorption Blood and mucus in the stool Chronic constipation with sporadic bouts of diarrhea Client is awakened from sleep due to abdominal pain.
Chronic constipation with sporadic bouts of diarrhea
A patient has been diagnosed with a UTI and is prescribed an antibiotic. What first-line fluoroquinolone antibacterial agent for UTIs has been found to be significantly effective? Bactrim Cipro Macrodantin Septra
Cipro
Diet modifications are part of nutritional therapy for the management of ARF. Select the high-potassium food that should be restricted. White rice Salad oils Citrus fruits Butter
Citrus fruits Dietary restrictions include foods and fluids containing potassium, such as bananas, citrus, tomatoes, melons, or those with phosphorus, which is found in dairy, beans, nuts legumes, and carbonated beverages. Caffeine is also restricted.
A patient is suspected to have diverticulosis without symptoms of diverticulitis. What diagnostic test does the nurse anticipate educating the patient about prior to scheduling? Colonoscopy Barium enema Flexible sigmoidoscopy CT scan
Colonoscopy
A pediatric nurse is providing care for a 7-year-old boy who has been diagnosed with glomerulonephritis. In addition to monitoring this child's blood work closely, what other assessment should prioritized in order to gauge the progression of his disease? Daily weights Assessment of skin turgor Chest auscultation Apical heart rate
Daily weights
The nurse is completing a routine urinalysis using a dipstick. The test reveals an increased specific gravity. The nurse should suspect which condition? Decreased fluid intake Increased fluid intake Glomerulonephritis Diabetes insipidus
Decreased fluid intake
A patient with chronic renal failure has frequent blood work ordered so that the care team can monitor the progression of his disease. The nurse has noted a consistent downward trend in the patient's levels of hemoglobin, hematocrit, and red blood cells (RBCs). The nurse understands that this is likely attributable to what pathophysiologic phenomenon? Inadequate metabolism of folic acid Increased hemolysis of red cells by the spleen Decreased synthesis and release of erythropoietin Aplastic anemia
Decreased synthesis and release of erythropoietin
A client has an elevated serum ammonia concentration and is exhibiting changes in mental status. The nurse should suspect which condition? Hepatic encephalopathy Portal hypertension Asterixis Cirrhosis
Hepatic encephalopathy
A client is being treated for diverticulosis. Which points should the nurse include in this client's teaching plan? Select all that apply. Do not suppress the urge to defecate. Drink at least 8 to 10 large glasses of fluid every day. Use bulk-forming laxatives Encourage an individualized exercise program Avoid high-fiber foods
Do not suppress the urge to defecate. Drink at least 8 to 10 large glasses of fluid every day. Use bulk-forming laxatives Encourage an individualized exercise program
Clients with Type O blood are at higher risk for which of the following GI disorders? Gastric cancer Duodenal ulcers Esophageal varices Diverticulitis
Duodenal ulcers
Compliance to a renal diet is a difficult lifestyle change for a patient on hemodialysis. The nurse should reinforce nutritional information. Which of the following teaching points should be included? Select all that apply. Limit protein to 1.6 g/kg/day. Eat foods such as milk, fish, and eggs. Restrict sodium to 2,000 to 3,000 mg daily. Increase potassium to prevent cardiac problems. Restrict fluid to daily urinary output plus 500 to 800 mL.
Eat foods such as milk, fish, and eggs. Restrict sodium to 2,000 to 3,000 mg daily. Restrict fluid to daily urinary output plus 500 to 800 mL.
Which of the following would be least appropriate to suggest to a client with a urinary diversion to control odor? Avoid foods such as buttermilk or yogurt. Eat plenty of cheese and eggs. Avoid pouches with carbon filters. Add a few drops of diluted white vinegar to the pouch.
Eat plenty of cheese and eggs.
A patient comes to the clinic complaining of pain in the epigastric region. The nurse suspects that the patient's pain is related to a peptic ulcer when the patient states the pain is relieved by what? Eating Drinking milk Suppressing emesis Having a bowel movement
Eating
A client underwent a continent ileostomy. Within which time frame should the client expect to empty the reservoir? At least once a day At least once every 2 days Three or four times daily Every 4 to 6 hours
Every 4 to 6 hours
The nurse is to discontinue a nasogastric tube that had been used for decompression. What is the first action the nurse should take? Remove the tape from the nose of the client. Withdraw the tube gently for 6 to 8 inches. Flush with 10 mL of water. Provide oral hygiene.
Flush with 10 mL of water. Before a nasogastric tube is removed, the nurse flushes the tube with 10 mL of water or normal saline to ensure that the tube is free of debris and away from the gastric tissue. The tape keeps the tube in the correct position while flushing is occurring and is then removed from the nose. The nurse then withdraws the tube gently for 6 to 8 inches until the tip reaches the esophagus, and then the remainder of the tube is withdrawn rapidly from the nostril. After the tube is removed, the nurse provides oral hygiene.
Which type of deficiency results in macrocytic anemia? Folic acid Vitamin C Vitamin A Vitamin K
Folic acid
The nurse is caring for a client with incontinence. Which criteria will the nurse instruct the client to track when logging self-care activities? Select all that apply. Frequency of voiding Episodes of incontinence Use of protective clothing Changes in bladder function Timing of pelvic floor muscle exercises
Frequency of voiding Episodes of incontinence Changes in bladder function Timing of pelvic floor muscle exercises
A nurse is assessing a client with acute renal failure. What medications should the nurse identify as a nephrotoxic drug? Select all that apply. Penicillin Gentamycin Tobramycin Neomycin Ceftriaxone
Gentamycin Tobramycin Neomycin The kidneys are sensitive to the metabolic byproducts from aminoglycosides such as gentamycin, tobramycin, and neomycin. Penicillin and ceftriaxone are not known to be nephrotoxic.
The nurse is caring for a client during the postoperative period following radical neck dissection. Which finding should be reported to the physician? High epigastric pain and/or discomfort Crackles that clear after coughing Serous drainage on the dressing Temperature of 99.0°F (37.2°C)
High epigastric pain and/or discomfort The nurse should report high epigastric pain and/or discomfort because this can be a sign of impending rupture. Crackles that clear after coughing, serous drainage on the dressing, and a temperature of 99.0°F are normal findings in the immediate postoperative period and do not need to be reported to the physician.
A patient diagnosed with IBS is advised to eat a diet that is: Sodium-restricted. High in fiber. Low in residue. Restricted to 1,200 calories/day.
High in fiber.
The nurse passes out medications while a client prepares for hemodialysis. The client is ordered to receive numerous medications including antihypertensives. What is the best action for the nurse to take? Administer the medications as ordered. Hold the medications until after dialysis. Check with the dialysis nurse about the medications. Ask if the client wants to take the medications.
Hold the medications until after dialysis.
A client with cancer has a neck dissection and laryngectomy. An intervention that the nurse will do is: Make a notation on the call light system that the client cannot speak. Teach the client exercises for the neck and shoulder area to perform 1 day after surgery. Provide oxygen without humidity through the tracheostomy tube. Encourage the client to position himself on his side.
Make a notation on the call light system that the client cannot speak.
Vomiting results in which of the following acid-base imbalances? Metabolic alkalosis Metabolic acidosis Respiratory acidosis Respiratory alkalosis
Metabolic alkalosis
Which of the following is considered a bulk-forming laxative? Metamucil Milk of Magnesia Mineral oil Dulcolax
Metamucil
The nurse is preparing to visit the home of a client recovering from gastritis. Which information will the nurse prepare to instruct this client? Select all that apply. Methods to remember to take medication as prescribed Time when all medications can be safely stopped Adhering with the prescribed medication regimen Findings that should be reported to the health care provider Identification of foods and substances that cause the condition
Methods to remember to take medication as prescribed Adhering with the prescribed medication regimen Findings that should be reported to the health care provider Identification of foods and substances that cause the condition
What is a hallmark of the diagnosis of nephrotic syndrome? Hyponatremia Proteinuria Hyperalbuminemia Hypokalemia
Proteinuria
A client with a disorder of the oral cavity cannot tolerate tooth brushing or flossing. Which strategy should the nurse use to assist the client? Urge the client to regularly rinse the mouth with tap water. Recommend that the client drink a small glass of alcohol at the end of the day to kill germs. Provide the client with an irrigating solution of baking soda and warm water. Regularly wipe the outside of the client's mouth to prevent germs from entering.
Provide the client with an irrigating solution of baking soda and warm water.
Which term refers to inflammation of the renal pelvis? Pyelonephritis Cystitis Urethritis Interstitial nephritis
Pyelonephritis
After undergoing a liver biopsy, a client should be placed in which position? Semi-Fowler's position Right lateral decubitus position Supine position Prone position
Right lateral decubitus position After a liver biopsy, the client is placed on the right side (right lateral decubitus position) to exert pressure on the liver and prevent bleeding. Semi-Fowler's position and the supine and prone positions wouldn't achieve this goal.
Which nursing diagnosis is appropriate for a client with renal calculi? Ineffective tissue perfusion (renal) Functional urinary incontinence Risk for infection Decreased cardiac output
Risk for infection
Which of the following is the most sensitive indicator of renal function? Serum creatinine Blood urea nitrogen (BUN) Creatinine clearance Potassium
Serum creatinine
Diagnostic testing of a patient with a history of chronic renal failure has been ordered. The care provider has ordered a test of the patient's creatinine clearance in an effort to gauge the progression of his disease. The nurse understands that this test reflects what aspect of the kidney structure and function? The volume of blood that the kidneys are able to filter in a given time The kidneys' ability to accommodate changes in blood pH The locations in the renal tubules where excretion and resorption are occurring The combined volume of the renal pelvises and the ureters
The volume of blood that the kidneys are able to filter in a given time A creatinine clearance test measures volume of blood cleared of endogenous creatinine in 1 minute, which provides an approximation of the glomerular filtration rate. It does not indicate the volume of the kidneys, accommodation of pH changes, or the functioning of specific locations within the kidneys
The nurse is caring for a patient with acute pancreatitis. The patient has an order for an anticholinergic medication. The nurse explains that the patient will be receiving that medication for what reason? To decrease metabolism To depress the central nervous system and increase the pain threshold To reduce gastric and pancreatic secretions To relieve nausea and vomiting
To reduce gastric and pancreatic secretions
A client with carcinoma of the head of the pancreas is scheduled for surgery. Which of the following should a nurse administer to the client before surgery? Potassium Vitamin K Vitamin B Oral bile acids
Vitamin K Clients with carcinoma of the head of the pancreas typically require vitamin K before surgery to correct a prothrombin deficiency. Potassium would be given only if the client's serum potassium levels were low. Oral bile acids are not prescribed for a client with carcinoma of the head of the pancreas; they are given to dissolve gallstones. Vitamin B has no implications in the surgery.
Which condition indicates an overdose of lactulose? Watery diarrhea Constipation Hypoactive bowel sounds Fecal impaction
Watery diarrhea
Which of the following assessment findings would be most important for indicating dumping syndrome in a postgastrectomy client? Abdominal distention, elevated temperature, weakness before eating Constipation, rectal bleeding following bowel movements Persistent loose stools, chills, hiccups after eating Weakness, diaphoresis, diarrhea 90 minutes after eating
Weakness, diaphoresis, diarrhea 90 minutes after eating
Which of the following is the most accurate indicator of fluid loss or gain? Urine output Caloric intake Body temperature Weight
Weight
A nursing assessment of a client with peritonitis reveals hypotension, tachycardia, and signs and symptoms of dehydration. What else would the nurse expect to find? tenderness and pain in the right upper abdominal quadrant jaundice and vomiting severe abdominal pain with direct palpation or rebound tenderness rectal bleeding and a change in bowel habits
severe abdominal pain with direct palpation or rebound tenderness
The nurse cares for a client diagnosed with chronic glomerulonephritis. The nurse will observe the client for the development of hypokalemia. anemia. metabolic alkalosis. hypophosphatemia.
anemia
In a diagnosis of a lower urinary tract infection, which structures could be affected? Select all that apply. bladder urethra ureter kidney
bladder urethra
The nurse is preparing a client for a nuclear scan of the kidneys. Following the procedure, the nurse instructs the client to drink liberal amounts of fluids. maintain bed rest for 2 hours. carefully handle urine because it is radioactive. notify the health care team if bloody urine is noted.
drink liberal amounts of fluids.
A nurse is caring for a client who underwent a subtotal gastrectomy. To manage dumping syndrome, the nurse should advise the client to: restrict fluid intake to 1 qt (1,000 ml)/day. drink liquids only with meals. don't drink liquids 2 hours before meals. drink liquids only between meals.
drink liquids only between meals.
Although the primary function of the urinary system is the transport of urine, the kidneys perform several functions. Which is NOT a function of the kidneys? excreting protein excreting nitrogen waste products regulating blood pressure stimulating RBC production
excreting protein Although the kidneys excrete excess water and nitrogen-based waste products of protein metabolism, persistent renal excretion of protein is not the function of kidneys, which are in the state of homeostasis. The kidneys assist in maintenance of acid-base and electrolyte balance; produce the enzyme renin, which helps regulate blood pressure; and produce the hormone erythropoietin.
What is the recommended dietary treatment for a client with chronic cholecystitis? low-fat diet high-fiber diet low-residue diet low-protein diet
low-fat diet
A client is admitted to the hospital with an exacerbation of chronic gastritis. When assessing the client's nutritional status, the nurse should expect to find what type of deficiency? vitamin A vitamin B6 vitamin B12 vitamin C
vitamin B12