Nursing 201 week 5 questions
A 22-year-old male reports burning and difficulty with urination. What priority question will the nurse ask to assess for the cause of dysuria? A. "Are you sexually active?" B. "Do you have low back pain?" C. "How long have you had these symptoms?" D. "Have you had a fever in the past 24 hours?"
A
A client has returned from a captopril renal scan. Which teaching does the nurse provide when the client returns to the unit? A. "Arise slowly and call for assistance when ambulating." B. "I must measure your intake and output." C. "We must save your urine because it is radioactive." D. "I must attach you to this cardiac monitor."
A
A client who is admitted with urolithiasis reports "spasms of intense flank pain, nausea, and severe dizziness." Which intervention does the nurse implement first? A. Administer morphine sulfate 4 mg IV. B. Begin an infusion of metoclopramide (Reglan) 10 mg IV. C. Obtain a urine specimen for urinalysis. D. Start an infusion of 0.9% normal saline at 100 mL/hr.
A
A client who was previously diagnosed with a urinary tract infection (UTI) and started on antibiotics returns to the clinic 3 days later with the same symptoms. When asked about the previous UTI and medication regimen, the client states, "I only took the first dose because after that, I felt better." How does the nurse respond? A. "Not completing your medication can lead to return of your infection." B. "That means your treatment will be prolonged with this new infection." C. "This means you will now have to take two drugs instead of one." D. "What you did was okay; however, let's get you started on something else."
A
A client with chronic kidney disease asks the nurse about the relationship between the disease and high blood pressure. What is the nurse's best response? A. "Because the kidneys cannot get rid of fluid, blood pressure goes up." B. "The damaged kidneys no longer release a hormone that prevents high blood pressure." C. "The waste products in the blood interfere with other mechanisms that control blood pressure." D. "This is a compensatory mechanism that increases blood flow through the kidneys in an effort to get rid of some of the waste products."
A
A client with these assessment data is preparing to undergo a computed tomography (CT) scan with contrast: Physical Assessment Diagnostic Findings Medications Flank pain BUN 54 mg/dL (19.3 mmol/L) Captopril Dysuria Creatinine 2.4 mg/dL (212 umol/L)Metformin Bilateral knee pain Calcium 8.5 mg/dL (2.13 mmol/L)Acetylcysteine Which medication does the nurse plan to administer before the procedure? A. Acetylcysteine (Mucomyst) B. Metformin (Glucophage) C. Captopril (Capoten) D. Acetaminophen (Tylenol)
A
A client, who is a mother of two, has autosomal dominant polycystic kidney disease (ADPKD). Which statement by the client indicates a need for further education about her disease? A. "By maintaining a low-salt diet in our house, I can prevent ADPKD in my children." B. "Even though my children don't have symptoms at the same age I did, they can still have ADPKD." C. "If my children have the ADPKD gene, they will have cysts by the age of 30." D. "My children have a 50% chance of inheriting the ADPKD gene that causes the disease."
A
A patient with end-stage kidney disease (ESKD) has this serum laboratory analysis K+ 5.9 mEq/L Na+ 152 mEq/L Creatinine 6.2 mg/dL BUN 60 mg/dL What is the priority nursing intervention? A. Assess heart rate and rhythm. B. Implement seizure precautions. C. Assess the patient's respiratory status. D. Evaluate the patient's acid-base balance.
A
An older adult woman who reports a change in bladder function says, "I feel like a child who sometimes pees her pants." What is the nurse's best response? A. "Have you tried using the toilet at least every couple of hours?" B. "How does that make you feel?" C. "We can fix that." D. "That happens when we get older."
A
The nurse educates a group of women who have had frequent urinary tract infections (UTIs) about how to avoid recurrences. Which client statement shows a correct understanding of what the nurse has taught? A. "I need to be drinking at least 1.5 to 2.5 liters of fluids every day." B. "It is a good idea for me to reduce germs by taking a tub bath daily." C. "Trying to get to the bathroom to urinate every 6 hours is important for me." D. "Urinating 1000 mL on a daily basis is a good amount for me."
A
The nurse is caring for a client who has just returned to the surgical unit after a radical nephrectomy. Which assessment information alarms the nurse? A. Blood pressure is 98/56 mm Hg; heart rate is 118 beats/min. B. Urine output over the past hour was 80 mL. C. Pain is at a level 4 (on a 0-to-10 scale). D. Dressing has a 1-cm area of bleeding.
A
The nurse is caring for four patients. Which patient does the nurse assess to be at greatest risk of developing a kidney stone? A. Caucasian male who is obese B. African-American female with family history of kidney stones C. Female with history of frequent urinary tract infections D. Hispanic/Latina female who eats animal protein at every meal
A
The nurse is questioning a female client with a urinary tract infection (UTI) about her antibiotic drug regimen. Which statement by the client indicates a need for further instruction? A. "I take my medication only when I have symptoms." B. "I always wipe front to back." C. "I don't use bubble baths and other scented bath products." D. "I try to drink 3 liters of fluid a day."
A
The school nurse is counseling a teenage student about how to prevent kidney trauma. Which statement by the student indicates a need for further teaching? A. "I can't play any type of contact sports because my brother had kidney cancer." B. "I avoid riding motorcycles." C. "I always wear pads when playing football." D. "I always wear a seat belt in the car."
A
When caring for a client 24 hours after a nephrectomy, the nurse notes that the client's abdomen is distended. Which action does the nurse perform next? A. Check vital signs. B. Notify the surgeon. C. Continue to monitor. D. Insert a nasogastric (NG) tube.
A
When caring for a client with nephrotic syndrome, which intervention would be included in the plan of care? A. Administering angiotensin-converting enzyme (ACE) inhibitors to decrease protein loss B. Administering heparin to prevent deep vein thrombosis (DVT) C. Providing antibiotics to decrease infection D. Providing transfusion of clotting factors
A
When caring for a client with polycystic kidney disease, which goal is most important? A. Preventing progression of the disease B. Performing genetic testing C. Assessing for related causes D. Consulting with the dialysis unit
A
When taking the health history of a client with acute glomerulonephritis (GN), the nurse questions the client about which related cause of the problem? A. Recent respiratory infection B. Hypertension C. Unexplained weight loss D. Neoplastic disease
A
Which age-related change can cause nocturia? A. Decreased ability to concentrate urine B. Decreased production of antidiuretic hormone C. Increased production of erythropoietin D. Increased secretion of aldosterone
A
Which condition may predispose a client to chronic pyelonephritis? A. Spinal cord injury B. Cardiomyopathy C. Hepatic failure D. Glomerulonephritis
A
Which urinary assessment information for a client indicates the potential need for increased fluids? A. Increased blood urea nitrogen B. Increased creatinine C. Pale-colored urine D. Decreased sodium
A
A client with a urinary tract infection is prescribed trimethoprim/sulfamethoxazole (Bactrim). What information does the nurse provide to this client about taking this drug? Select all that apply. A. "Be certain to wear sunscreen and protective clothing." B. "Drink at least 3 liters of fluids every day." C. "Take this drug with 8 ounces (236 ml) of water." D. "Try to urinate frequently to keep your bladder empty." E. "You will need to take all of this drug to get the benefits."
A, B, C, E
When assessing a client with acute pyelonephritis, which findings does the nurse anticipate will be present? Select all that apply. A. Suprapubic pain B. Vomiting C. Chills D. Dysuria E. Oliguria
A, B, C,D
What information will the nurse provide to a client who is scheduled for extracorporeal shock wave lithotripsy? Select all that apply. A. "Your urine will be strained after the procedure." B. "Be sure to finish all of your antibiotics." C. "Immediately call the primary health care provider if you notice bruising." D. "Remember to drink at least 3 liters of fluid a day to promote urine flow." E. "You will need to change the incisional dressing once a day."
A, B, D
Which clients with long-term urinary problems does the nurse refer to community resources and support groups? Select all that apply. A. A 32-year-old with a cystectomy B. A 44-year-old with a Kock pouch C. A 48-year-old with urinary calculi D. A 78-year-old with urinary incontinence E. An 80-year-old with dementia
A, B, D
For which clients scheduled for a computed tomography (CT) scan with contrast does the nurse communicate safety concerns to the health care provider (HCP)? Select all that apply. A. Client with an allergy to shrimp B. Client with a history of asthma C. Client who requests morphine sulfate every 3 hours D. Client with a blood urea nitrogen of 62 mg/dL (22.1 mmol/L) and a creatinine of 2.0 mg/dL (177 umol/L) E. Client who took metformin (Glucophage) 4 hours ago
A, B, D, E
Which clients with an indwelling urinary catheter does the nurse reassess to determine whether the catheterization needs to be continued or can be discontinued? Select all that apply. A. Three-day postoperative client B. client in the step-down unit C. Comatose client with careful monitoring of intake and output (I&O) D. Incontinent client with perineal skin breakdown E. Incontinent older adult in long-term care
A, B, E
An older adult client diagnosed with urge incontinence is prescribed the medication oxybutynin (Ditropan). Which side effects does the nurse tell the client to expect? Select all that apply. A. Dry mouth B. Increased blood pressure C. Constipation D. Increased intraocular pressure E. Reddish-orange urine color
A, C, D
The nurse is teaching a group of older adult women about the signs and symptoms of urinary tract infection (UTI). Which concepts does the nurse explain in the presentation? Select all that apply. A. Dysuria B. Enuresis C. Frequency D. Nocturia E. Urgency F. Polyuria
A, C, D, E
Which assessment findings does the nurse expect in a client with kidney cancer? Select all that apply. A. Erythrocytosis B. Hypokalemia C. Hypercalcemia D. Hepatic dysfunction E. Increased sedimentation rate
A, C, D, E
A client is hesitant to talk to the nurse about genitourinary dysfunction symptoms. What is the nurse's best response? A. "Don't worry, no one else will know." B. "Take your time. What is bothering you the most?" C. "Why are you hesitant?" D. "You need to tell me so we can determine what is wrong."
B
A male client being treated for bladder cancer has a live virus compound instilled into his bladder as a treatment. What instruction does the nurse provide for post procedure home care? A. "After 12 hours, your toilet should be cleaned with a 10% solution of bleach." B. "Do not share your toilet with family members for the next 24 hours." C. "Please be sure to stand when you are urinating." D. "Your underwear worn during the procedure and for the first 12 hours afterward should be bagged and discarded."
B
A patient with kidney failure reports dyspnea. The patient's pulse oximeter reading is 95% on room air, but is visibly distressed with a respiratory rate of 32 breaths/min. What is the priority intervention? A. Notify the respiratory therapist. B. Administer oxygen by nasal cannula. C. Elevate the head of bed to 90 degrees. D. Administer a respiratory nebulizing treatment.
B
The RN is caring for a client who has just had a kidney biopsy. Which action does the nurse perform first? A. Obtain blood urea nitrogen (BUN) and creatinine. B. Position the client supine. C. Administer pain medications. D. Check urine for hematuria.
B
The RN is working with unlicensed assistive personnel (UAP) in caring for a group of clients. Which action is best for the RN to delegate to UAP? A. Assessing the vital signs of a client who was just admitted with blunt flank trauma and hematuria B. Assisting a client who had a radical nephrectomy 2 days ago to turn in bed C. Helping the primary health care provider with a kidney biopsy for a client admitted with acute glomerulonephritis D. Palpating for bladder distention on a client recently admitted with a ureteral stricture
B
The charge nurse is making client assignments for the day shift. Which client is best to assign to an LPN/LVN? A. Client who has just returned from having a kidney artery angioplasty B. Client with polycystic kidney disease who is having a kidney ultrasound C. Client who is going for a cystoscopy and cystourethroscopy D. Client with glomerulonephritis who is having a kidney biopsy
B
The nurse anticipates that a client who develops hypotension and oliguria post nephrectomy may need the addition of which element to the regimen? A. Increase in analgesics B. Addition of a corticosteroid C. Administration of a diuretic D. Course of antibiotic therapy
B
The nurse is caring for a patient who will soon receive a kidney transplant. When the patient says, "what will I do if this transplant doesn't work?", what is the appropriate nursing response? A. "Kidney transplants are almost always successful." B. "It sounds like you are concerned about the outcome of the procedure." C. "If this transplant doesn't work, I'm sure there will be another donor soon." D. "Try to focus on getting through the surgery first."
B
The nurse is caring for a patient with polycystic kidney disease. Which assessment finding requires immediate nursing intervention? A. Temperature of 99° F B. Blood pressure of 170/90 C. Heart rate of 100 beats/min D. Urine output less than 30 cc/hr
B
The nurse is caring for four patients. Which patient does the nurse identify as at highest risk for acute pyelonephritis? A. 19-year-old male with spinal cord injury B. 27-year-old female with urinary reflux C. 37-year-old male with HIV infection D. 44-year-old female with urinary tract stones
B
The nurse is teaching a client with a neurogenic bladder to use intermittent self-catheterization for bladder emptying. Which client statement indicates a need for further clarification? A. "A small-lumen catheter will help prevent injury to my urethra." B. "I will use a new, sterile catheter each time I do the procedure." C. "My family members can be taught to help me if I need it." D. "Proper handwashing before I start the procedure is very important."
B
The nurse receives the change-of-shift report on four clients. Which client does the nurse decide to assess first? A. A 26-year-old admitted 2 days ago with urosepsis with an oral temperature of 99.4°F (37.4°C) B. A 28-year-old with urolithiasis who has been receiving morphine sulfate and has not voided for 8 hours C. A 32-year-old admitted with hematuria and possible bladder cancer who is scheduled for cystoscopy D. A 40-year-old with noninfectious urethritis who is reporting "burning" and has estrogen cream prescribed
B
What is the appropriate range of urine output for the client who has just undergone a nephrectomy? A. 23 to 30 mL/hr B. 30 to 50 mL/hr C. 41 to 60 mL/hr D. 50 to 70 mL/hr
B
When assessing a client with acute glomerulonephritis, which finding causes the nurse to notify the primary health care provider? A. Purulent wound on the leg B. Crackles throughout the lung fields C. History of diabetes D. Cola-colored urine
B
Which clinical manifestation in a client with pyelonephritis indicates that treatment has been effective? A. Decreased urine output B. Decreased white blood cells in urine C. Increased red blood cell count D. Increased urine specific gravity
B
Which factor is an indicator for a diagnosis of hydronephrosis? A. History of nocturia B. History of urinary stones C. Recent weight loss D. Urinary incontinence
B
Which laboratory test is the best indicator of kidney function? A. Blood urea nitrogen (BUN) B. Creatinine C. Aspartate aminotransferase (AST) D. Alkaline phosphatase
B
Which percussion technique does the nurse use to assess a client who reports flank pain? A. Place outstretched fingers over the flank area and percuss with the fingertips. B. Place one hand with the palm down flat over the flank area and use the other fisted hand to thump the hand on the flank. C. Place one hand with the palm up over the flank area and cup the other hand to percuss the hand on the flank. D. Quickly tap the flank area with cupped hands.
B
Which sign or symptom, when assessed in a client with chronic glomerulonephritis (GN), warrants a call to the primary health care provider? A. Mild proteinuria B. Third heart sound (S3) C. Serum potassium of 5.0 mEq/L (5.0 mmol/L) D. Itchy skin
B
Which assessment finding does the nurse anticipate for a patient with chronic glomerulonephritis? (Select all that apply.) A. Increased urinary output B. Specific gravity of 1.010 C. Red blood cells in the urine D. Serum creatinine of > 6 mg/dL E. Sodium level of < 135 mEq/L
B, C
The nurse in the urology clinic is providing teaching for a female client with cystitis. Which instructions does the nurse include in the teaching plan? Select all that apply. A. Cleanse the perineum from back to front after using the bathroom. B. Try to take in 64 ounces (2 liters) of fluid each day. C. Be sure to complete the full course of antibiotics. D. If urine remains cloudy, call the clinic. E. Expect some flank discomfort until the antibiotic has worked.
B, C, D
A client diagnosed with urge incontinence is started on tolterodine (Detrol). What interventions does the nurse suggest to alleviate the side effects of this anticholinergic drug? Select all that apply. A. Take the drug at bedtime. B. Encourage increased fluids. C. Increase fiber intake. D. Limit the intake of dairy products. E. Use hard candy for dry mouth.
B, C, E
Which interventions are helpful in preventing bladder cancer? Select all that apply. A. Drinking 2½ liters of fluid a day B. Showering after working with or around chemicals C. Stopping the use of tobacco D. Using pelvic floor muscle exercises E. Wearing a lead apron when working with chemicals F. Wearing gloves and a mask when working around chemicals and fumes
B, C, F
A 32-year-old female with a urinary tract infection (UTI) reports urinary frequency, urgency, and some discomfort upon urination. Her vital signs are stable except for a temperature of 100°F (37.8°C). Which drug does the primary health care provider prescribe? A. Nitrofurantoin (Macrodantin) after intercourse B. Estrogen (Premarin) C. Trimethoprim/sulfamethoxazole (Bactrim) D. Phenazopyridine (Pyridium) with intercourse
C
A 53-year-old postmenopausal woman reports "leaking urine" when she laughs and is diagnosed with stress incontinence. What does the nurse tell the client about how certain drugs may be able to help with her stress incontinence? A. "They can relieve your anxiety associated with incontinence." B. "They help your bladder to empty." C. "They may be used to improve urethral resistance." D. "They decrease your bladder's tone."
C
A client is in the emergency department for an inability to void and for bladder distention. What is most important for the nurse to provide to the client? A. Increased oral fluids B. IV fluids C. Privacy D. Health history forms
C
A cognitively impaired client has urge incontinence. Which method for achieving continence does the nurse include in the client's care plan? A. Bladder training B. Credé method C. Habit training D. Kegel exercises
C
A newly admitted client who is diabetic and has pyelonephritis and prescriptions for intravenous antibiotics, blood glucose monitoring every 2 hours, and insulin administration would be cared for by which staff member? A. RN whose other assignments include a client receiving chemotherapy for renal cell carcinoma B. RN who is caring for a client who just returned after having renal artery balloon angioplasty C. RN who has just completed preoperative teaching for a client who is scheduled for nephrectomy D. RN who is currently admitting a client with acute hypertension and possible renal artery stenosis
C
After receiving change-of-shift report on the urology unit, which client does the nurse assess first? A. Client postradical nephrectomy whose temperature is 99.8°F (37.6°C) B. Client with glomerulonephritis who has cola-colored urine C. Client who was involved in a motor vehicle collision and has hematuria D. Client with nephrotic syndrome who has gained 2 kg since yesterday
C
The certified Wound, Ostomy, and Continence Nurse or enterostomal therapist teaches a client who has had a cystectomy about which care principles for the client's post-discharge activities? A. Nutritional and dietary care B. Respiratory care C. Stoma and pouch care D. Wiping from front to back (asepsis)
C
The nurse has placed an indwelling urinary catheter via sterile technique. The nurse recognizes that it is how long before bacterial colonization begins? A. 12 hours B. 24 hours C. 48 hours D. 72 hours
C
The nurse is educating a female client about hygiene measures to reduce her risk for urinary tract infection (UTI). What does the nurse instruct the client to do? A. "Douche—but only once a month." B. "Use only white toilet paper." C. "Wipe from front to back." D. "Wipe with the softest toilet paper available."
C
The nurse is instructing an older adult female client about interventions to decrease the risk for cystitis. Which client comment indicates that the teaching was effective? A. "I must avoid drinking carbonated beverages." B. "I need to douche vaginally once a week." C. "I need to drink 2½ liters of fluid every day." D. "I will not drink fluids after 8 PM each evening."
C
The nurse is reviewing the medical record for a client with polycystic kidney disease who is scheduled for computed tomographic angiography with contrast: History and Physical Assessment Medications Diagnostic Findings - Polycystic kidney disease, Diabetes, Hysterectomy, Abdomen - distended. Negative edema Glyburide Metformin Synthroid BUN 26 mg/dL (9.2 mmol/L)Creatinine 1.0 mg/dL (77 umol/L)HbA1c 6.9%Glucose 132 mg/dL (7.3 mmol/L) Which intervention is essential for the nurse to perform? A. Obtain a thyroid-stimulating hormone (TSH) level. B. Report the blood urea nitrogen (BUN) and creatinine. C. Hold the metformin 24 hours before and on the day of the procedure. D. Notify the provider regarding blood glucose and glycosylated hemoglobin (HbA1c) values.
C
The nurse is teaching a client how to provide a clean-catch urine specimen. Which statement by the client indicates that teaching was effective? A. "I must clean with the wipes and then urinate directly into the cup." B. "I will have to drink 2 liters of fluid before providing the sample." C. "I'll start to urinate in the toilet, stop, and then urinate into the cup." D. "It is best to provide the sample while I am bathing."
C
The nurse receives report on a client with hydronephrosis. Which laboratory study does the nurse monitor? A. Hemoglobin and hematocrit (H&H) B. White blood cell (WBC) count C. Blood urea nitrogen (BUN) and creatinine D. Lipid levels
C
The nurse visualizes blood clots in a client's urinary catheter after a cystoscopy. What nursing intervention does the nurse perform first? A. Administer heparin intravenously. B. Remove the urinary catheter. C. Notify the health care provider (HCP). D. Irrigate the catheter with sterile saline.
C
When a client with diabetes returns to the medical unit after a computed tomography (CT) scan with contrast dye, all of these interventions are prescribed. Which intervention does the nurse implement first? A. Give lispro (Humalog) insulin, 12 units subcutaneously. B. Request a breakfast tray for the client. C. Infuse 0.45% normal saline at 125 mL/hr. D. Administer captopril (Capoten).
C
When caring for a client who had a nephrostomy tube inserted 4 hours ago, which is essential for the nurse to report to the primary health care provider? A. Dark pink-colored urine B. Small amount of urine leaking around the catheter C. Tube that has stopped draining D. Creatinine of 1.8 mg/dL (160 mcmol/L)
C
When caring for a client with uremia, the nurse assesses for which symptom? A. Tenderness at the costovertebral angle (CVA) B. Cyanosis of the skin C. Nausea and vomiting D. Insomnia
C
When performing bladder scanning to detect residual urine in a female client, the nurse must first assess which factor? A. Abdominal girth B. Presence of urinary infection C. History of hysterectomy D. Hematuria
C
Which assessment finding alarms the nurse immediately after a client returns from the operating room for cystoscopy performed under conscious sedation? A. Pink-tinged urine B. Urinary frequency C. Temperature of 100.8°F (38.2°C) D. Lethargy
C
Which clinical data requires immediate nursing intervention to prevent progression of acute kidney injury? A. Heart rate of 120 beats/min B. Blood pressure of 156/88 C. Urine specific gravity of 1.001 mm Hg D. Intake of 2000 mL and output of 1500 mL in the past 24 hours
C
Which instruction does the nurse give a client who needs a clean-catch urine specimen? A. "Save all urine for 24 hours." B. "Use the sponges to cleanse the urethra, and then initiate voiding directly into the cup." C. "Do not touch the inside of the container." D. "You will receive an isotope injection, then I will collect your urine."
C
Which nursing activity illustrates proper aseptic technique during catheter care? A. Applying Betadine ointment to the perineal area after catheterization B. Irrigating the catheter daily C. Positioning the collection bag below the height of the bladder D. Sending a urine specimen to the laboratory for testing
C
Which type of incontinence benefits from pelvic floor muscle (Kegel) exercise? A. Functional B. Overflow C. Stress D. Urge
C
A client had a computed tomography (CT) scan with contrast dye 8 hours ago. Which nursing intervention is the priority for this client? A. Maintaining bedrest B. Medicating for pain C. Monitoring for hematuria D. Promoting fluid intake
D
A client is admitted for extracorporeal shock wave lithotripsy (ESWL). What information obtained on admission is most critical for a nurse to report to the primary health care provider before the ESWL procedure begins? A. "Blood in my urine has become less noticeable, so maybe I don't need this procedure." B. "I have been taking cephalexin (Keflex) for an infection." C. "I previously had several ESWL procedures performed." D. "I take over-the-counter naproxen (Aleve) twice a day for joint pain."
D
A client is referred to a home health agency after being hospitalized with overflow incontinence and a urinary tract infection. Which nursing action can the home health RN delegate to the home health aide (unlicensed assistive personnel [UAP])? A. Assisting the client in developing a schedule for when to take prescribed antibiotics B. Inserting a straight catheter as necessary if the client is unable to empty the bladder C. Teaching the client how to use the Credé maneuver to empty the bladder more fully D. Using a bladder scanner (with training) to check residual bladder volume after the client voids
D
A client is scheduled for a cystoscopy later this morning. The consent form is not signed, and the client has not had any preoperative medication. The nurse notes that the health care provider (HCP) visited the client the day before. What action does the nurse take? A. Asks the client to sign the informed consent B. Cancels the procedure C. Asks the client's spouse to sign the form D. Notifies the department and the HCP
D
A client who is 6 months pregnant comes to the prenatal clinic with a suspected urinary tract infection (UTI). What action does the nurse take with this client? A. Discharges the client to her home for strict bedrest for the duration of the pregnancy B. Instructs the client to drink a minimum of 3 liters of fluids, especially water, every day to "flush out" bacteria C. Recommends that the client refrain from having sexual intercourse until after she has delivered her baby D. Refers the client to the clinic nurse practitioner for immediate follow-up
D
A patient with a history of kidney disease is admitted with acute shoulder pain. Which order should the nurse question? A. Digoxin 0.125 mg by mouth daily B. Metoprolol 50 mg by mouth twice daily C. Pan cultures for a temperature >38.5º C D. Ibuprofen 800 mg by mouth every 4 hours as needed for pain
D
An older adult woman confides to the nurse, "I am so embarrassed about buying adult diapers for myself." How does the nurse respond? A. "Don't worry about it. You need them." B. "Shop at night, when stores are less crowded." C. "Tell everyone that they are for your husband." D. "That is tough. What do you think might help?"
D
During discharge teaching for a client with kidney disease, what does the nurse teach the client to do? A. "Drink 2 liters of fluid and urinate at the same time every day." B. "Eat breakfast and go to bed at the same time every day." C. "Check your blood sugar and do a urine dipstick test." D. "Weigh yourself and take your blood pressure."
D
One of the nurse's roles is talking to adult clients about urinary and sexual hygiene. Which words does the nurse use when referring to the client's reproductive body areas? A. Children's terms that are easily understood B. Slang words and terms that are heard "socially" C. Technical and medical terminology D. Words that the client uses
D
The nurse has these client assignments. Which client does the nurse encourage to consume 2 to 3 liters of fluid each day? A. Client with chronic kidney disease B. Client with heart failure C. Client with complete bowel obstruction D. Client with hyperparathyroidism
D
The nurse is performing discharge teaching for a client after a nephrectomy for renal cell carcinoma. Which statement by the client indicates that teaching has been effective? A. "Because renal cell carcinoma usually affects both kidneys, I'll need to be watched closely." B. "I'll eventually require some type of renal replacement therapy." C. "I'll need to decrease my fluid intake to prevent stress to my remaining kidney." D. "My remaining kidney will provide me with normal kidney function now."
D
The nurse is teaching a client about pelvic muscle exercises. What information does the nurse include? A. "For the best effect, perform all of your exercises while you are seated on the toilet." B. "Limit your exercises to 5 minutes twice a day, or you will injure yourself." C. "Results should be visible to you within 72 hours." D. "You know that you are exercising correct muscles if you can stop urine flow in midstream."
D
The nurse is teaching a client who is scheduled for a neobladder and a Kock pouch. Which client statement indicates a correct understanding of these procedures? A. "If I restrict my oral intake of fluids, the adjustment will be easier." B. "I must go to the restroom more often because my urine will be excreted through my anus." C. "I need to wear loose-fitting pants so the urine can flow into my ostomy bag." D. "I will have to drain my pouch with a catheter."
D
The nurse is teaching the importance of a low purine diet to a client admitted with urolithiasis consisting of uric acid. Which statement by the client indicates that teaching was effective? A. "I am so relieved that I can continue eating my fried fish meals every week." B. "I will quit growing rhubarb in my garden since I'm not supposed to eat it anymore." C. "My wife will be happy to know that I can keep enjoying her liver and onions recipe." D. "I will no longer be able to have red wine with my dinner."
D
What does the nurse teach a client to do to decrease the risk for urinary tract infection (UTI)? A. Limit fluid intake. B. Increase caffeine consumption. C. Limit sugar intake. D. Drink about 3 liters of fluid daily.
D
When caring for a client with hemorrhage secondary to kidney trauma, the nurse provides volume expansion. Which element does the nurse anticipate will be used? A. Fresh-frozen plasma B. Platelet infusions C. 5% dextrose in water D. Normal saline solution (NSS)
D
When planning an assessment of the urethra, what does the nurse do first? A. Examine the meatus. B. Note any unusual discharge. C. Record the presence of abnormalities. D. Don gloves.
D
When preparing a client for nephrostomy tube insertion, it is essential for the nurse to monitor which factor before the procedure? A. Blood urea nitrogen (BUN) and creatinine B. Hemoglobin and hematocrit (H&H) C. Intake and output (I&O) D. Prothrombin time (PT) and international normalized ratio (INR)
D
Which client does the nurse manager on the medical unit assign to an experienced LPN/LVN? A. A 42-year-old with painless hematuria who needs an admission assessment B. A 46-year-old scheduled for cystectomy who needs help in selecting a stoma site C. A 48-year-old receiving intravesical chemotherapy for bladder cancer D. A 55-year-old with incontinence who has intermittent catheterization prescribed
D
Which nursing intervention or practice is most effective in helping to prevent urinary tract infection (UTI) in hospitalized clients? A. Encouraging them to drink fluids B. Irrigating all catheters daily with sterile saline C. Recommending that catheters be placed in all clients D. Periodically reevaluating the need for indwelling catheters
D
Which patient is most likely to experience renal compromise assessed by decreased urine production? A. 10-year history of diabetes mellitus B. White blood cell count of 12,000/mm3 C. Recent history of myocardial infarction D. Blood pressure of 92/46 mm Hg for 12 hours
D
Which staff member does the charge nurse assign to a client who has benign prostatic hyperplasia (BPH) and hydronephrosis and needs an indwelling catheter inserted? A. RN float nurse who has 10 years of experience with pediatric clients B. LPN/LVN who has worked in the hospital's kidney dialysis unit until recently C. RN without recent experience who has just completed an RN refresher course D. LPN/LVN with 5 years of experience in an outclient urology surgery center
D
Which technique does the nurse use to obtain a sterile urine specimen from a client with a Foley catheter? A. Disconnect the Foley catheter from the drainage tube and collect urine directly from the Foley. B. Remove the existing catheter and obtain a sample during the process of inserting a new Foley. C. Use a sterile syringe to withdraw urine from the urine collection bag. D. Clamp the tubing, attach a syringe to the specimen, and withdraw at least 5 mL of urine.
D
