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The nurse is giving general instructions to a client receiving hemodialysis. Which statement would be most appropriate for the nurse to include? A "It is acceptable to eat whatever you want on the day before hemodialysis." B. "It is acceptable to exceed the fluid restriction on the day before hemodialysis." C. "Several types of medications would be withheld on the day of dialysis until after the procedure." D. "Medications should be double-dosed on the morning of hemodialysis because of potential loss."

"Several types of medications would be withheld on the day of dialysis until after the procedure." Many medications are dialyzable, which means that they are extracted from the bloodstream during dialysis. Therefore, many medications may be withheld on the day of dialysis until after the procedure. It is not typical for medications to be double-dosed because there is no way to be certain how much of each medication is cleared by dialysis. Clients receiving hemodialysis are not routinely taught that it is acceptable to disregard dietary and fluid restrictions.

A nurse is caring for a client who is receiving a blood transfusion. Which of the following actions should the nurse plan to take if an allergic transfusion reaction is suspected? SATA A. stop the transfusion B. monitor for hypertension C. Maintain an IV infusion with 0.9% sodium chloride D. Position the client in an upright position with the feet lower than the heart E. Administer diphenhydramine

-Stop the transfusion -Maintain an IV infusion with 0.9% sodium chloride -Administer diphenhydramine

A nurse is admitting a client who reports nausea, vomiting, and weakness. The client has dry oral mucous membranes and blood pressure 102/64mm Hg. Which of the following findings should nurse identify as manifestations of fluid volume deficit? (SATA) A. Decreased skin turgor B. Concentrated Urine C. Bradycardia D Low-grade fever E. Tachypnea

A. Decreased skin turgor B. Concentrated Urine D Low-grade fever E. Tachypnea

A nurse is admitting an older adult client who reports a weight gain of 2.3 (5lb) in 48 hours. Which of the following manifestations of fluid volume excess should the nurse expect? SATA A. Dyspnea B. Edema C. Bradycardia D. Hypertension E. Weakness

A. Dyspnea B. Edema D. Hypertension E. Weakness (Dyspnea is due to an excess of fluids within the body and lungs, and the client is struggling to breathe to obtain oxygen, hyper tension is a manifestation related to fluid volume excess, blood pressure rises as the heart must work harder due to the excess fluid, weakness is due to the excess fluid that is retained which depletes energy and increases the workload for the body)

A nurse is caring for a client who has emphysema and chronic respiratory acidosis. The nurse should monitor the client for which of the following electrolyte imbalances? A. Hyperkalemia B. Hyponatremia C. Hypercalcemia D. Hypomagnesemia

A. Hyperkalemia (chronic respiratory acidosis can result in high potassium levels due to potassium shifting out of cells into the extracellular fluid)

A nurse is caring for a client with a hip fracture who has bucks extension traction in place. Which of the following pieces of information should the nurse give the client about this type of traction? A. You'll have considerably less pain with the traction in place B. You'll have the traction in place for a week or so C. The traction will help decrease muscle spasms D. The weights act as a pulling force to keep your leg and hip still E. We have to make sure the weights are just barely touching the floor

A. You'll have considerably less pain with the traction in place C. The traction will help decrease muscle spasms D. The weights act as a pulling force to keep your leg and hip still

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

A. hemodialysis B. Biopsy C. Immunosuppression Client who develops ATN after transplantation surgery might need dialysis until they have an adequate urine output and their BUN and creatinine levels stabilize. Because the development of ATN after transplantation mimics the symptoms of rejection of the transplanted kidney, the clients have to undergo a biopsy to determine the correct diagnosis. Immunosuppressive medication therapy is essential after kidney transplantation to protect the new kidney

A nurse is assessing a client who has isotonic dehydration. Which of the following findings should the nurse expect? A. increased hematocrit level B. bradycardia C. Distended neck veins D. Decreased urine specific gravity

A. increased hematocrit level Due to hemoconcentration caused by reduced plasma fluid volume

The nurse is assessing the patency of a client's left arm arteriovenous fistula prior to initiating hemodialysis. Which finding indicates that the fistula is patent? A. Palpation of a thrill over the fistula B. Presence of a radial pulse in the left wrist C. Visualization of enlarged blood vessels at the fistula site D. Capillary refill less than 3 seconds in the nail beds of the fingers on the left hand

A. palpation of a thrill over the fistula The nurse assesses the patency of the fistula by palpating for the presence of a thrill or auscultating for a bruit. The presence of a thrill or bruit indicates patency of the fistula. Enlarged visible blood vessels at the fistula site are a normal observation but are not indicative of fistula patency. Although the presence of a radial pulse in the left wrist and capillary refill less than 3 seconds in the nail beds of the fingers on the left hand indicate adequate circulation to the hand, they do not assess fistula patency.

a nurse is preparing to provide self care teaching to a client who is 4 days postoperative following the creation of a colostomy and refuses to look at the stoma. Which of the following actions should the nurse take? A. Postpone any teaching with the client at this time B. Reinforce the preoperative information with the client C. encourage the client to empty the colostomy bad first D. Ask the client to being assuming responsibility for self-care of the colostomy

A. postpone any teaching with the cient at this time Encourage the patient to look and touch the stoma before continuing to teach about self-care. Refusal to look at the stoma indicates the client is in the denial stage of grief and might not be able to learn anything further at this time about self care of the colostomy

A nurse is assessing a client who has urolithiasis and reports pain in his thigh. This finding indicates that the stones is in which of the following structures? A. ureter B. bladder C. Renal pelvis D. Renal tubules

A. ureter

A nurse is caring for a client who has acute diverticulitis. While the client has active inflammation, the nurse should instruct the client to include which of the following foods in her diet? A. white bread and plain yogurt B. Shredded wheat cereal and blueberries C. Broccoli and kidney beans D. Oatmeal and fresh pears

A. white bread and plain yogurt

A nurse is preparing to administer packed RBCs to a client who has a Hgb of 8 g/dL. Which of the following actions should the nurse plan to take during the first 15 min of the transfusion? A. Obtain consent from the client for the transfusion B. Assess for an acute hemolytic reaction C. Explain the transfusion procedure to the client D. Obtain blood culture specimens to send to the lab

Assess for an acute hemolytic reaction

a nurse is providing teaching about food-drug interactions to a client who is prescribed sirolimus following a kidney transplant. Which of the following pieces of information should the nurse include in the teaching? A. increase your intake of high-fat foods B. Avoid eating grapefruit while taking sirolimus C. Drink apple juice before dosing D. Reduce your intake of gluten

Avoid eating grapefruit while taking sirolimus grapefruit can inhibit the metabolism of sirolimus this means that consuming grapefruit juice would cause the levels of the medication to rise in the clients body which could have an adverse effect.

The nurse is teaching a client with renal cancer who is scheduled for a renal artery embolization about the procedure. Which statement by the client indicates that the educational session was effective? A. "This will cause the tumor to become tougher and easier to take out in surgery with the scalpel." B. "This will decrease the size of the tumor because it will cut off the blood supply after a special sponge is put in." C. "This will prevent the risk of getting a lung clot by blocking the arteries in my kidney." D. "This will reduce the time needed for surgery by at least half because it stops the bleeding."

B. "This will decrease the size of the tumor because it will cut off the blood supply after a special sponge is put in." Rationale:Renal artery embolization may be done instead of radiation therapy to shrink the kidney tumor by cutting off its blood supply and impairing its overall vascularity. A secondary benefit is that it reduces the risk of hemorrhage during surgery. This procedure can be accomplished in a number of ways, including placement of an absorbable gelatin sponge, a balloon, a metal coil, or any of various other substances.

A nurse is caring for an older adult client who has chronic obstructive pulmonary disease with pneumonia. The nurse should monitor the client for which of the following acid-base imbalances A. respiratory alkalosis B. Respiratory acidosis C. Metabolic alkalosis D. metabolic acidosis

B. Respiratory acidosis (respiratory acidosis is a common complication of COPD. this complication occurs because clients who have COPD are unable to exhale carbon dioxide due to loss of elastic recoil in lungs)

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

B. Wipe from front to back after defecation Pyelonephritis is a bacterial infection of the kidney and renal pelvis. The nurse should instruct the client about the importance of wiping from the front to back following fecal elimination to avoid introducing bacteria into the urinary tract, which can ultimately cause pyelonephritis

a nurse is planning care for a client who has Cushing's syndrome due to chronic corticoid steroid. Which of the following actions should the nurse include in the plan of care? A. check the clients blood glucose for hypoglycemia B. check the clients urine specific gravity C. Weigh the client weekly D. Insert an indwelling urinary catheter for the client

B. check the clients urine specific gravity to assess for fluid volume overload

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

B. interference with renal perfusion causes prerenal azotemia, such as from heart failure or hypovolemic shock

A nurse is caring for a client with pseudomonas infection who has a new prescription called ticarcillin-clavulanate. Which of the following data should the nurse collect before administering this medication? A. indication of superinfection B. Peak and trough medication levels C. Baseline BUN and creatinine D. History of allergy to aminoglycosides antibiotics

Baseline BUN and creatinine Ticarcillin-clavulanate is a penicillin antibiotic and is excreted by the kidneys. Therefore, any renal impairment could result in a toxic level of the medication. The nurse should assess baseline BUN and creatinine levels and monitor these values throughout therapy.

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

Blood pressure 160/90 (due to the kidneys role in fluid and blood pressure regulation, a client who is experiencing rejection can have hypertension)

The nurse is preparing to perform a discharge teaching with a client who is started on hemodialysis. Which information would the nurse provide regarding the hemodialysis schedule? A. 5 hours of treatment, 2 days per week B. 2 hours of treatment, 6 days per week C. 3 to 4 hours of treatment, 3 days per week D. 2 to 3 hours of treatment, 5 days per week

C. 3 to 4 hours of treatment, 3 days per week Rationale: The typical schedule for hemodialysis is 3 to 4 hours of treatment, 3 days per week. Individual adjustments are made according to variables such as the size of the client, type of dialyzer, rate of blood flow, personal client preferences, and other factors.

A nurse is providing preoperative care teaching to a client who will undergo surgery to create a temporary colostomy. The client asks the nurse about the difference between colostomies and ileostomies. Which of the following responses should the nurse make? A. A colostomy drains stool and an ileostomy drains urine B. A colostomy is temporary and an ileostomy is permanent C. A colostomy is from the large intestine and the ileostomy if from the small intestine D. An ileostomy requires dietary restrictions while a colostomy does not

C. A colostomy is from the large intestine and the ileostomy if from the small intestine

A nurse is providing teaching to a client who has a history of UTI. Which of the following client statements indicates the need for additional teaching? A. I will empty my bladder every 4 hours B. I will drink 2 L of fluids per day C. I will use a vaginal douche daily D. I will wear cotton underwear

C. I will use a vaginal douche daily

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

C. Urinary output is 35-50 mL/hr consistently ( a lower ourput of 30 mL/hr indicates inadequate blood flow to the remaining kidney)

A nurse is caring for a client who is receiving peritoneal dialysis. The nurse notes that the clients dialysate output is less than the input and that his abdomen is distended. Which of the following actions should the nurse take? A. Insert an indwelling urinary catheter B. Administer pain medication to the client C. Change the clients position D. Place the drainage bad above the clients abdomen

Change the clients position (the client is retaining the dialysate solution after the dwell time. The nurse should ensure that the clamp is open, and the tubing is not kinked and should reposition the client to facilitate the drainage of the solution from the peritoneal cavity)

A nurse is assessing a client who is receiving hemodialysis for the first time. Which of the following indicates the client is developing dialysis disequilibrium syndrome?

Clients beginning hemodialysis are at greatest risk particularly if their BUN level is above 175. DDS causes headaches, nausea, vomiting, a decreased level of consciousness, seizures, and restlessness. When the condition is severe, clients progress to confusion seizures coma and death

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

Cloudy effluent (A cloudy or opaque effluent indicates the client is at high risk for peritonitis, a bacterial infection of the peritoneum. Therefore, this is the priority finding for the nurse to report to the provider)

A nurse is reviewing the laboratory data for a client who has Alzheimer's disease and a new prescription for memantine. The nurse should identify that which of the following findings increases the clients risk for reduced clearance of the medication? A. Alanine aminotransferase 60 international units B. Creatinine clearance 35 mL/min C. HbA1c 5% D. BMI 31

Creatinine clearance 35 mL/min

a nurse is caring for a cient who is in hypovolemic shock. while waiting for a unit of blood, the nurse should administer which of the following? A. 0.45% sodium chloride B. Dextrose 5% in 0.9% sodium chloride C. dextrose 10% in water D. 0.9% sodium chloride

D. 0.9% sodium chloride (used for fluid volume replacement. replaces lost volume in the bloodstream and is the only solution to use when infusing blood products)

A nurse is reviewing the laboratory data of a client who reports manifestations suggesting systemic lupus erythematosus. The nurse should expect an increase in which of the following parameters for a client who has SLE? A. platelet B. RBC count C. Hct D. ESR (erythrocyte sedimentation rate)

D. ESR (erythrocyte sedimentation rate)

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

D. Hyperkalemia Can include palpitations, dysrhythmias, nausea. and muscle weakness

a nurse is providing preoperative teaching to a client who is to undergo a pneumonectomy. The client states I am afraid coughing will hurt after the surgery. Which of the following statements by the nurse is appropriate? A. After the surgeon removes the lung you will not need to cough B. Ill make sure you get a cough suppressant to keep you from straining the incision when you cough C. Don't worry. you will have a pump that delivers pain medication as needed so you will have very little pain D. I will shod you how to splint your incision while coughing

D. I will shod you how to splint your incision while coughing

The nurse is performing an assessment on a client who has returned from the dialysis unit following hemodialysis. The client is complaining of headache and nausea and is extremely restless. Which is the priority nursing action? A. Monitor the client. B. Elevate the head of the bed. C. Assess the fistula site and dressing. D. Notify the primary health care provider (PHCP).

D. Notify the primary health care provider (PHCP). Disequilibrium syndrome may be caused by rapid removal of solutes from the body during hemodialysis. These changes can cause cerebral edema that leads to increased intracranial pressure. The client is exhibiting early signs and symptoms of disequilibrium syndrome, and appropriate treatments with anticonvulsive medications and barbiturates may be necessary to prevent a life-threatening situation. The PHCP must be notified. Monitoring the client, elevating the head of the bed, and assessing the fistula site are correct actions, but the priority action is to notify the PHCP.

A nurse is planning care for a client who is having a percutaneous transluminal coronary angioplasty with stent placement. Which of the following actions should the nurse anticipate in the post-procedure plan of care? A. instruct the client about a long term cardiac conditioning program B. administer scheduled doses of acetaminophen C. Check for peak laboratory markers of myocardial damage D. monitor for bleeding

D. monitor for bleeding Bleeding is a post procedure complication of PTCA because of the administration of heparin during the procedure and the removal of the femoral or brachial sheath. Manual pressure or a closure device is used to obtain hemostasis to the site. The client should remain on bed rest until hemostasis is assured

A nurse is assessing a client who has hyperkalemia. The nurse should identify which of the following conditions as being associated with this electrolyte imbalance? A. diabetic ketoacidosis B. Heart failure C. Cushings syndrome D. Thyroidectomy

Diabetic ketoacidosis Hyperkalemia an increase in blood potassium, is a laboratory finding associated with diabetic ketoacidosis

A nurse is caring for a client who has a blood potassium 5.4 mEq/L. The nurse should assess for which of the following manifestations? A. ECG changes B. Constipation C. Polyuria D. Paresthesia

ECG changes Assess for ECG changes. Potassium levels can affect the heart and result in arrhythmias

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

Expect to have pink-tinged urine after this procedure A cystoscopy is a procedure in which a scope is inserted into the urethra to diagnose or treat bladder problems. Following the procedure pink tinged urine is expected

The nurse is providing instructions regarding the complications of peritoneal dialysis. The nurse emphasizes that onset of peritonitis, a serious complication, is most likely to be associated with which clinical manifestation? A. Fever B. Fatigue C. Clear dialysate output D. Leaking around the catheter site

Fever The signs of peritonitis include fever, nausea, malaise, rebound abdominal tenderness, and cloudy dialysate output. Fatigue may be associated with peritonitis, but fever is the most likely sign. Leaking around the catheter site is not an indication of peritonitis.

Shorten QT intervals

Hypercalcemia

A nurse is caring for a client who has osteoporosis and has been taking a vitamin D supplement. The nurse notes that the client reports also taking a multivitamin daily. Which of the following findings should indicate to the nurse that the client be experiencing vitamin D toxicity? A. Hyperkalemia B. Hypermagnesemia C. Hypercalcemia D. Hypernatremia

Hypercalcemia Vitamin D with a multivitamin daily might be taking too much calcium

Widen QRS complexes

Hyperkalemia

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

Hyperkalemia causes potassium retention

a nurse is providing teaching to a client who has anemia and a new prescription for epoetin alfa. Which of the following pieces of information should the nurse include in teaching? A. Hospitalization is required when administering each treatment B. The maximum effect of the medication will occur in 6 months C. Hypertension is a common adverse effect of this medication D. Blood transfusions are needed with each treatment

Hypertension is a common adverse effect of this medication

Flattened T waves and cardiac dysrhythmias

Hypokalemia

A nurse is caring for a client who has a nasogastric tube attached to low intermittent suctioning. The nurse should monitor for which of the following electrolytes imbalances? A. Hypercalcemia B. Hyponatremia C. Hyperphosphatemia D. Hyperkalemia

Hyponatremia Nasogastric losses are isotonic and contain sodium

A nurse is caring for a client who has a new prescription for enalapril. The nurse should monitor the client for which of the following adverse effects of this medication? A. ecchymosis B. jaundice C. Hypotension D. Hypokalemia

Hypotension (enalapril, an angiotensin-converting enzyme inhibitor, can cause hypotension and postural hypotension, especially during the first 3 hours following the initial dosage.)

A nurse is providing discharge teaching about lithium toxicity to a client who has a new prescription for lithium. Which of the following statements by the client indicates an understanding of the teaching. A. I should take naproxen if I have a headache because aspiring can cause lithium toxicity B. I can develop lithium toxicity if i eat foods with lots of sodium C. I can develop lithium toxicity if i experience vomiting of diarrhea D. I might need to take a daily diuretic along with my lithium to prevent lithium toxicity

I can develop lithium toxicity if i experience vomiting of diarrhea (vomiting or diarrhea can cause electrolyte imbalances. If serum sodium decreases, lithium is retained by the kidneys, and the risk of lithium toxicity increases)

A nurse is providing preoperative teaching for a client who is scheduled for total knee arthroplasty. Which of the following statements by the client indicates an understanding of the teaching? A. I will wear a continuous movement machine on my knee for 24 hours a day B. i should avoid taking NSAID medication for pain after surgery C. I should wear elastic stockings on both of my legs D. i will being exercising my legs the day after surgery

I should wear elastic stockings on both of my legs prevent venous thromboembolism which is a common complication following orthopedic surgery/

The nurse checks the serum myoglobin level for a client with a crush injury to the right lower leg because the client is at risk for developing which type of acute kidney injury? A. Prerenal B. Postrenal C. Intrarenal D. Extrarenal

Intrarenal Rationale:Serum myoglobin levels increase in crush injuries when large amounts of myoglobin and hemoglobin are released from damaged muscle and blood cells. The accumulation may cause acute tubular necrosis, an intrarenal cause of renal failure. Prerenal causes are conditions that interfere with the perfusion of blood to the kidney. Postrenal causes include conditions that cause urinary obstruction distal to the kidney. The cause and the type of renal failure may determine the interventions used in treatment.

A nurse is caring for a client who has type 1 diabetes mellitus and is scheduled to receive hemodialysis. The client says " i don't even know why I'm doing this. There is no cure." Which of the following statements should the nurse make? A. It sounds as though you have give up B. Dialysis will help you live longer C. You shouldn't complain. You are fortunate to have this option available to you D. Lets talk about what you are doing to do after dialysis today

It sounds as though you have given up " the nurse is using the therapeutic communication technique of restatement to encourage the clients expression of feelings"

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

Limit fluid intake should limit intake to prevent hypovolemia (excessive fluid overload)

A nurse is caring for a client who is postoperative following a lumbar disk excision. Which of the following interventions should the nurse include in the clients plan of care? A. keep the clients legs flat with the knees extended B. Encourage the client to sit up in a chair for as long as possible C. Logroll the client in bed for care procedures D. Expect urinary retention for the first postoperative day

Logroll the client in bed for care procedures The client should receive instructions about logrolling preoperatively. The nurse may need to engage other staff members in assisting with logrolling to maintain proper alignment of the clients spine at all times postoperatively

A nurse is caring for a client in a long-term care facility who has become weak, confused and experienced dizziness when standing. The clients temperature is 38.3 c (100.9 f), pulse 92/min, respiration 20/min and blood pressure 108/60 mm Hg. Which of the following actions should the nurse take? A. Initiate fluid restrictions to limit intake B. Check for peripheral edema C. Encourage the client to ambulate to promote oxygenation D. Monitor for orthostatic hypotension

Monitor for orthostatic hypotension

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

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

A nurse is caring for an adolescent who has end-stage renal disease and is scheduled for peritoneal dialysis. Which of the following actions should the nurse take? A. Position the adolescent supine during the procedure B. Have the adolescent drink 240 mL (8 0z_ of fluid prior to the procedure C. Obtain the adolescents weight prior to the procedure D. Monitor the adolescent's vital signs every 4 hours during the procedure

Obtain the adolescents weight prior to the procedure (obtain weight prior to the procedure and after)

A nurse preceptor is observing a newly licensed nurse on the unit who is preparing to administer a blood transfusion to an older adult client. Which of the following actions by the newly licensed nurse indicates an understanding of the procedure? A. Inserts an 18 gauge IV catheter in the client B. Verifies blood compatibility and expiration date of the blood with an assistive personnel C. Administers dextrose 5% in 0.9% sodium chloride IV with the transfusion D. Obtains vital signs every 15 min throughout the procedure

Obtains vital signs every 15 min throughout the procedure Monitor for early detection of fluid overload or other transfusion reactions

A nurse is planning care for a client who has a seizure disorder and a new prescription for valproic acid. Which of the following laboratory values should the nurse plan to monitor? A. BUN B. PTT C. Aspartate aminotransferase D. Urinalysis E. Alanine aminotransferase

PTT Aspartate aminotransferase Alanine aminotransferase

A nurse is caring for a client who has urolithiasis and requires further diagnostic testing after an initial test indicated hypercalcemia. Which of the following structures controls calcium concentration? A. pancreas B. thyroid gland C. anterior pituitary gland D. Parathyroid gland

Parathyroid gland (The parathyroid gland secretes parathyroid hormones, which are substances that help the kidneys reabsorb calcium and increase calcium absorption from the gastrointestinal tract)

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

Peritonitis ( peritonitis is an adverse effect of peritoneal dialysis. Prevention requires using sterile technique and frequently assessing the catheter exit site. The nurse should obtain cultures of the dialysate outflow (effluent) if peritonitis is suspected

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

Potassium (Potassium level of 3.0 is below the expected reference range and can cause dysrhythmias. Dialysis removes fluid, waste products, and electrolytes from the blood and can cause hypokalemia)

A nurse is monitoring the electrocardiogram of a client who has hypocalcemia. Which of the following findings should the nurse expect? A. flattened T waves B. Prolonged QT intervals C. Shortened QT intervals D. Widened QRS complexes

Prolonged QT intervals

A nurse is monitoring the electrocardiogram of a client who has hypocalcemia. Which of the following findings should the nurse expect? A. flattened T waves B. prolonged QT intervals C. Shortened qt intervals D. Widened QRS complexes

Prolonged QT intervals

A nurse is providing teaching to a client who has chronic kidney failure with an AV fistula for hemodialysis and a new prescription for epoetin alfa. Which of the following therapeutic effects of epoetin alfa should the nurse include in the teaching? A. Reduces blood pressure B. Inhibits clotting of fistula C. Promotes RBC production D. Stimulates growth of neutrophils

Promotes RBC production (Epoetin alfa stimulates erythropoiesis in the bone marrow to increase RBC production and reduce anemia. Anemia is common in clients who have chronic kidney failure since erythropoietin is produced by the kidney.)

A nurse is providing teaching to a client who has chronic kidney failure with an AV fistula for hemodialysis and a new prescription for epoetin alfa. Which of the following therapeutic effects of epoetin alfa should the nurse include in the teaching? A. Reduces blood pressure B. Inhibits clotting of fistula C. Promotes RBC production D. Stimulates growth of neutrophils

Promotes RBC production Epoetin alfa stimulates erythropoiesis in the bone marrow to increase RBC production and reduce anemia. Anemia is common to clients who have chronic kidney failure since erythropoietin is produced by the kidney.

A nurse is caring for a client who has a diagnosis of renal calculi and reports severe flank pain. Which of the following is the priority nursing action? A. Relieve the clients pain B. encourage the client to increase fluid intake C. Monitor the clients intake and output D. Strain the clients urine

Relieve the clients pain (the pain associated with renal calculi is severe and can lead to shock)

The nurse reviews the arterial blood gas results of a client with emphysema and notes that the laboratory report indicates a pH of 7.30, Paco2 of 58 mm Hg, Pao2 of 80 mm Hg, and Hco3 of 27 mEq/L. The nurse interprets that the client has which acid-base disturbance? Respiratory acidosis Rationale:The normal pH is 7.35 to 7.45. Normal Paco2 is 35 to 45 mm Hg. In respiratory acidosis, the pH is low and Paco2 is elevated. Options 1, 2, and 4 are incorrect interpretations of the values identified in the question.

Respiratory acidosis Rationale:The normal pH is 7.35 to 7.45. Normal Paco2 is 35 to 45 mm Hg. In respiratory acidosis, the pH is low and Paco2 is elevated. Options 1, 2, and 4 are incorrect interpretations of

Hyperventilation, inhale to much carbon dioxide

Respiratory alkalosis

A nurse is assessing a client who is receiving a transfusion of packed red blood cells. Which of the following findings should the nurse identify as an indication of an acute intravascular hemolytic reaction? A. Severe hypertension B. Low body temperature C. Sudden oliguria D. Decreased respiration

Sudden oliguria The nurse should identify sudden oliguria as an indication of an acute intravascular hemolytic reaction. This type of transfusion reaction causes acute kidney injury resulting in sudden oliguria and hemoglobinuria. This reaction results from the clients antibodies reacting to the transfused RBC

A nurse is assessing a client who is dehydrated. Which of the following findings should the nurse expect? A. Moist skin B. distended neck veins C. Increased urinary output D. Tachycardia

Tachycardia (tachycardia is an attempt to maintain blood pressure, a manifestation of fluid volume deficit)

A nurse is providing teaching to a client who is scheduled to start taking hydrochlorothiazide for hypertension. The nurse instructs the client to eat foods that are rich in potassium. Which of the following statements by the client indicates an understanding of the teaching? A. This medication will not work unless I have enough potassium B. Potassium will increase the therapeutic effect of my blood pressure medication C. Potassium will lower my blood pressure D. This medication can cause a loss of potassium

This medication can cause a loss of potassium Hydrochlorothiazide can result in hypokalemia caused by excessive potassium excretion from the kidneys. the client should supplement his diet with potassium rich foods to avoid the occurrence of hypokalemia. Foods that are high in potassium include bananas, raisins, baked potatoes, pumpkins and milk

A nurse is caring for a client who is receiving intermittent peritoneal dialysis. The nurse observes that the peritoneal fluid is not adequately draining. Which of the following actions should the nurse take? A. Turn the client from side to side B. Elevate the height of the dialysis bag C. Lower the head of the clients bed D, Advance the catheter approximately 2.5 Cm further

Turn the client from side to side (the nurse should assist the client in turning from side to side to facilitate the removal of peritoneal drainage. This action helps ensure there are no kinks in the tubing or an air lock in the peritoneal catheter)

A nurse is assessing a client who has urolithiasis and reports pain in his thigh. The finding indicates the stone is in which of the following structures? A. Ureter B. Bladder C. Renal pelvis D. Renal tubules

Ureter (when stones are in ureters, pain radiates to the genitalia and to the thighs)

A nurse is caring for a client who is scheduled to receive peritoneal dialysis. Which of the following actions should the nurse take? A. Warm the dialysate solution prior to administration B. cleanse the catheter site using a back and forth motion, beginning at the end of the catheter and moving inward C. Place the drainage bag at the level of the clients chest D. Apply clean gloves and cleanse the clients catheter site with cold water

Warm the dialysate solution prior to administration (to prevent pain and abdominal cramping)

A nurse if caring for a client who has acute diverticulitis. While the client has active inflammation, the nurse should instruct the client to include which of the following foods in her diet? A. white bread and plain yogurt B. Shredded wheat cereal and blueberries C. Broccoli and kidney beans D. Oatmeal and fresh pears

White bread and plain yogurt (maintain a diet very low in fiber, can consume low-fiber foods like white bread, low fat milk, yogurt with active cultures, poached eggs and canned soft fruit)

A nurse is providing preoperative teaching for a client who requests autologous donation in preparation for a scheduled orthopedic surgical procedure. Which of the following statements should the nurse include in the teaching? A. You should make an appointment to donate blood 8 weeks prior to the surgery B. If you need an autologous transfusion, the blood your brother donates can be used C. You can donate blood each week if your hemoglobin is stable D. Any unused blood that is donated can be used for other clients

You can donate blood each week if your hemoglobin is stable

A nurse is providing teaching to a client who is preoperative for a renal biopsy. Which of the following statements should the nurse make? A. You will be NPO fir 8 hr following the procedure B. al allergy to shellfish is a contraindication to this procedure C. You will need to be on bed rest following the procedure D. A creatinine clearance is needed prior to the procedure

You will need to be on bed rest following the procedure A renal biopsy involves a tissue biopsy through needle insertion into the lower lobe of the kidney. The client should maintain bed rest in a supine position with a back roll for support for 2 to 24 hours following the procedure to reduce the risk of bleeding. The nurse can elevate the head of the bed

A nurse is teaching a client about UTI, which of the following manifestations should the nurse include? A. Weight gain B. Back Pain C. Vaginal discharge D. Muscle cramp

back pain (back pain and flank pain are manifestations of a UTI. other manifestations include frequency, urgency, and cloudy, foul-smelling urine)

A nurse is planning to administer epoetin alfa to a client who has chronic kidney failure. Which of the following should the nurse plan to review prior to administering this medication? A. blood pressure B. Temperature C. Blood glucose levels D. Total protein

blood pressure epoetin alfa causes hypertension which can lead to stroke or other cardiovascular complications. The nurse should monitor the clients blood pressure and notify the provider about increases

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

check the clients electrolyte values The nurse should check the clients most recent potassium value because these findings are manifestations of hyperkalemia, which can lead to cardiac dysrhythmias.

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

drink 3.8 L of water throughout the day (the nurse should instruct the client to drink 3.8 L of water per day to keep urine diluted and decrease the risk of kidney stone formation)

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

dysrhythmias

A nurse is assessing a client who is receiving hemodialysis for the first time. Which of the following findings indicates that the client is developing dialysis disequilibrium syndrome? A. elevated BUN B. Bradycardia C. Headache D. Temperature of 102.5

headache DDS is a CNS disorder that can develop in clients who are new to dialysis due to the rapid removal of solutes and changes in the blood ph. clients beginning hemodialysis are at greatest risk, particularly if their BUN is about 175. DDS causes headaches, nausea, vomiting, a decreased level of consciousness, seizures, and restlessness. When the condition is severe, clients progress to confusion seizures coma and death

A nurse is monitoring a client who began receiving a unit of packed RBCs 10 min ago. Which of the following findings should the nurse identify as an indication of a febrile transfusion reaction? SATA A. temperature change from 37 (98.6 F) pretransfusion to 37.2 (99F) B. Current blood pressure 178/90 mm Hg C. heart rate change from 88/min pretransfusion to 120/min D. Client report of itching E. Client appears flushed

heart rate change from 88/min pretransfusion to 120/min -Client appears flushed Tachycardia and flushed appearance is an indication of a febrile transfusion reaction

A nurse is reviewing the laboratory results of a client who is taking a medication and notes that the clients blood tests show an elevated level of the enzymes aspartate aminotransferase and alanine aminotransferase. The nurse should recognize that these findings are potential indications of which of the following conditions? A. Renal dysfunction B. Myelotoxicity C. Hepatic toxicity D. Cardiac dysrhythmia

hepatic toxicity

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

hyperkalemia (Oliguria resulting from chronic glomerulonephritis causes potassium retentions leading to levels above the expected reference of 3.5 to 5)

A nurse is reviewing the laboratory report of a client who has chronic kidney disease. The nurse finds the following laboratory test results. Potassium 6.8, calcium 7.4, hemoglobin 10.2 and phosphate 4.8. Which findings is the priority for the nurse to report to the provider? A. hypocalcemia B. Hyperkalemia C. Anemia D. Hypoalbuminemia

hyperkalemia Hyperkalemia which can cause life-threatening cardiac dysrhythmias With chronic kidney disease hypocalcemia, anemia, and hyperphosphatemia is expected

a nurse is caring for a client who is taking fludrocortisone. Which of the following findings indicates to the nurse that the client is experiencing an adverse effect of the medication? A. Hypotension B. weight loss C. Hypokalemia D. Anorexia

hypokalemia due to excessive sodium and water retention, resulting in the loss of excessive amounts of potassium

A nurse is caring for a client who has a new prescription for enalapril. The nurse should monitor the client for which of the following adverse effects of this medication? A. Ecchymosis B. Jaundice C. Hypotension D. Hypokalemia

hypotension ACE inhibitors can cause hypotension and postural hypotension, especially during the first 3 hours following the intial dose

a nurse is providing discharge teaching to a client who had a kidney transplant and has a prescription for oral cyclosporine. Which of the following statements by the client indicates an understanding of the teaching? A. I will be able to stop taking this medication within 6 months after my surgery B. I am likely to develop higher blood pressure while taking this medication C. I am likely to lose my hair while taking this medication D. I am taking this medication to boost my immune system

i am likely to develop higher blood pressure while taking this medication

A nurse is teaching a client who had kidney transplant surgery about immunosuppressive medications. Which of the following adverse effects of these medications should the nurse include in the teaching? A. Increased urinary output B. Increased susceptibility to infection C. Increased hair loss D. Increased risk of autoimmune disorders

increased susceptibility to infection (immunosuppressive medications such as cyclosporine increase the risk of infection. As the medication classification indicates, these medications impair immunity and adversely affect the clients ability to resist and fight infection)

A nurse is caring for a client who has a prescription for silver sulfadiazine cream to be applied to her burn wounds. The nurse should evaluate the client for which of the following laboratory findings? A. Hyponatremia B. Leukopenia C. Hyperchloremia D. Elevated BUN

leukopenia ( transient leukopenia is an adverse effect of silver sulfadiazine)

Decrease in bicarbonate, client who have severe diarrhea or kidney failure are at risk of developing

metabolic acidosis

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

potassium and magnesium Clients who have chronic kidney disease have hyperkalemia, hyperphosphatemia, and hypermagnesemia as well as elevations in serum creatinine and blood urea nitrogen

A nurse is assessing a client who is postoperative following a craniotomy and has a urine output of 600 mL/hr. The nurse suspects the client has manifestations of diabetes insipidus. Which of the following laboratory values should the nurse plan to obtain to assess for DI? A. Blood urea Nitrogen B. Blood glucose C. Urine Ketones D. Specific gravity

specific gravity A low specific gravity of 1.001 to 1.003 is manifestation of diabetes insipidus.

A nurse is assessing a client for Chvostek's sign. Which of the following techniques should the nurse use to perform this test? A. Apply a blood pressure cuff to the clients arm B. Place the stethoscope bell over the clients carotid artery C. tap lightly on the clients cheek D. Ask the client to lower their chin to their chest

tap lightly on the clients cheek tap the clients cheek over the facial nerve just below and anterior to the ear to elicit Chvostek's sign. A positive response is indicated when the client exhibits facial twitching on this side of the face

A nurse is caring for a client who has a blood sodium level 133 mEq/L and blood potassium level 3.4 mEq/L. The nurse should recognize that which of the following treatments can result in these laboratory findings? A. three tap water enemas B. 0.9% sodium chloride solution IV at 50 mL/hr C. 5% dextrose with 0.45% sodium chloride solution with 20 mEq of K+ IV at 80 mL/hr D. Antibiotic therapy

three tap water enemas Three tap water enemas can result in a decrease in blood sodium and potassium. Tap water is hypotonic and gastrointestinal losses are isotonic. This creates an imbalance and solute dilution

A nurse is preparing an in-service presentation about the basics of hematology. Which of the following factors provides a stimulus for the production of RBCs? A. Venous stasis B. Thrombocytopenia C. Inflammation D. Tissue hypoxia

tissue hypoxia ( in response to tissue hypoxia, the kidneys release erythropoietin, which stimulates the production of erythrocytes (RBCs) in the bone marrow

a nurse is providing preoperative teaching for a client who will undergo laser-assisted in situ keratomileusis (LASIK) surgery. Which of the following pieces of information should the nurse include? A. You might need glasses after the surgery B. You may drive home after the procedure C. Continue to wear your contact lenses until the day of surgery D. expect complete healing and clear vision in about a week

you might need glasses after the surgery there is a possibility of over correction or under correction so some clients will need prescription glasses despite having LASIK surgery

A nurse is providing teaching to a client who is preoperative for a renal biopsy. Which of the following statements should the nurse make? A. You will be NPO for 8 hr following the procedure B. an allergy to shellfish is a contraindication to this procedure C. You will need to be on bed rest following the procedure D. a creatinine clearance is needed prior to this procedure

you will need to be on bed rest following the procedure The client should maintain bed rest in a supine position with a back roll for support for 2 to 24 hours following the procedure to reduce the risk of bleeding. The nurse can elevate the head of the bed