20208 MOD 4 NCLEX

A student nurse is caring for a client with chronic kidney failure who is to be treated with continuous ambulatory peritoneal dialysis (CAPD). Which statement by the student nurse indicates to the primary nurse that the student nurse understands the purpose of this therapy?

"It uses the peritoneum as a semipermeable membrane to clear toxins by osmosis and diffusion."

A client receiving hemodialysis undergoes surgery to create an arteriovenous fistula. Before discharge, the nurse discusses care at home with the client and his wife. Which statement by the client's wife indicates that further teaching is required?

"I have to take his blood pressure every day in the arm with the fistula."

A client with acute kidney injury is to receive peritoneal dialysis and asks why the procedure is necessary. Which is the nurse's best response?

"It helps perform some of the work usually done by the kidneys."

The primary healthcare provider has prescribed rifampin to a client with tuberculosis. Which instructions by the nurse will be beneficial to the client? Select all that apply.

"You should report any yellow tinge to your skin." "Your soft contact lenses will be stained permanently." "You should report any increased tendency to bruising or bleeding."

The nurse is caring for a client with a 25-year history of excessive alcohol use. Which assessment finding is consistent with the client's history?

A small liver with a rough surface

While assessing the skin of a client, the nurse notices that the skin does not return to the normal position immediately after a gentle pinch. What can be appropriately attributed to this condition? Select all that apply.

Aging Cachexia Dehydration

When receiving hemodialysis, the client may develop hyponatremia. For which clinical findings associated with hyponatremia should the nurse assess the client? Select all that apply.

Diarrhea Seizures

A nurse teaches the signs of organ rejection to a client who had a kidney transplant. What should the nurse include in the education?

Elevated blood pressure

A nurse is caring for a client who just had a liver biopsy. After the procedure, the nurse should monitor for which common complication associated with the biopsy?

Hemorrhage

The nursing instructor determines that the student nurse understands the type(s) of hepatitis that most commonly are spread by consuming contaminated food and water or by fecal contamination if the student identifies which of these diseases? Select all that apply.

Hepatitis A Hepatitis E

An older adult client is admitted to the hospital with a diagnosis of chronic kidney disease. The nurse reviews the client's medical record. Which clinical finding is a priority to be communicated to the primary healthcare provider?

Potassium level

A client is diagnosed as having kidney failure. During the oliguric phase, what should the nurse assess for in this client?

Hyperphosphatemia

A client with a history of alcoholism and cirrhosis is admitted with severe dyspnea as a result of ascites. Which process that most likely caused the ascites should the nurse consider when planning care?

Increased pressure in the portal vein

A client with a long history of alcohol abuse is admitted to the hospital with ascites and jaundice. A diagnosis of hepatic cirrhosis is made. Which is a nursing priority?

Institute fall prevention/safety measures.

A nurse is caring for a client with hepatic encephalopathy and ascites. Which elements are important to include in this client's diet? Select all that apply.

Low sodium High vitamins Moderate protein

A client with a history of cirrhosis of the liver develops heart failure. When ventricular bigeminy develops, the provider orders lidocaine. What alterations in lidocaine dosages does the nurse anticipate?

Lower because the drug is metabolized at a diminished rate

A client who has had right upper quadrant pain for several months now experiences clay-colored stools. Laboratory results reveal elevated liver enzymes, and a needle biopsy of the liver is scheduled. What should the nurse include in the client's teaching about the procedure?

Lying on the right side after the procedure is required because it will decrease the risk of hemorrhage.

The nurse is caring for a client scheduled to have a percutaneous liver biopsy. Which assessment findings warrant the postponement of the procedure? Select all that apply.

Marked ascites Hemoglobin of less than 9 g/dL (90 mmol/L)

A client with chronic kidney disease is receiving medication to manage anemia. Which primary goal should the nurse include in the care plan from this information?

Prevention of chronic fatigue

A client with cirrhosis of the liver has a prolonged prothrombin time and a low platelet count. A regular diet is prescribed. What should the nurse instruct the client to do considering the client's condition?

Report signs of bleeding no matter how slight

A nurse is teaching a client about prophylactic measures that minimize the risk of contracting hepatitis B. Which actions should be included in this teaching plan? Select all that apply.

Screening of blood donors Maintaining a monogamous sexual relationship

A nurse is caring for a client with acute kidney injury who is receiving a protein-restricted diet. The client asks why this diet is necessary. Which information should the nurse include in a response to the client's questions?

This supplies only essential amino acids, reducing the amount of metabolic waste products, thus decreasing stress on the kidneys.

A nurse is caring for a client who is positive for hepatitis A. Which precautions should the nurse take?

Use gloves when removing client's bedpan

A client with liver dysfunction reports bleeding gums. In addition, the nurse observes small facial hemorrhagic lesions. What should the nurse conclude that the client needs?

Vitamin K

A client is to have hemodialysis. What must the nurse do before this treatment?

Weigh the client to establish a baseline for later comparison