ATI_Med-Surg_Renal & Reproductive Systems

A nurse is collecting data from a client who has returned to the medical-surgical unit following a CT scan of the kidneys with IV contrast. Which of the following findings should the nurse identify as an indication the client is experiencing an allergic reaction to the contrast material? A. Bradycardia B. Pink-tinged urine C. Hyperpyrexia D. Skin hives

Skin hives *A client who has an allergic reaction to contrast media can experience tachycardia rather than bradycardia. A client who undergoes cystoscopic examination can have pink-tinged urine. However, this is not an indication of an allergic reaction to contrast media. A client who develops a urinary tract infection following an invasive renal diagnostic test (cystogram, pyelogram) can develop a fever. However, hyperpyrexia is not an indication of an allergic response. A client who develops an allergic reaction to contrast media used during a CT of the renal pelvis can experience manifestations (tachycardia, dyspnea, rash, and hives)

A nurse is reinforcing teaching with a newly licensed nurse about caring for a client who has anew left arteriovenous fistula. Which of the following statements should the nurse make? A. "Check the fistula daily for a vibration." B. "Instruct the client to restrict movement of his left arm." C. "Avoid taking blood pressure on the client's left arm." D. "Instruct the client to sleep on his left side."

"Avoid taking blood pressure on the client's left arm." *The nurse should avoid taking blood pressure measurements on the client's left arm, as this can decrease blood flow and cause clotting

A nurse is reinforcing teaching with a young adult client who has a history of calcium oxalate renal calculi. Which of the following instructions should the nurse include in the teaching? A. "Drink fruit punch of juice with every meal." B. "Consume 1,000 milligrams of dietary calcium daily." C. "Take 1 gram of a vitamin C supplement daily." D. "Increase your daily bran intake."

"Consume 1,000 milligrams of dietary calcium daily." *Clients who are prone to the development of calcium oxalate stones should consume the recommended daily allowance (RDA) of calcium for their age. The RDA for calcium for adults 19 to 50 years old is 1,000 mg daily. Calcium should be obtained from dietary sources rather than supplements that can promote the development of renal calculi

A nurse is reinforcing teaching with a client prior to an initial mammogram. Which of the following information should the nurse provide prior to the procedure? A. "You should not take any aspirin products prior to the mammogram." B. "Do not use apply any deodorant the day of the exam." C. "You will need to avoid sexual intercourse the day before the mammogram." D. "You should avoid exercise prior to the exam."

"Do not use apply any deodorant the day of the exam." *Taking aspirin products does not alter the accuracy of a mammogram. Applying deodorant or powder can alter the accuracy of a mammogram by causing a shadow to appear. Having sexual intercourse does not alter the accuracy of a mammogram. Exercising does not alter the accuracy of a mammogram

A nurse is reinforcing teaching with a client prior to 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 prodedure." 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

A nurse is collecting data for a client who is scheduled for an anterior colporrhapy. Which of the following client statements should the nurse expect as an indication for this procedure? A. "I have to push the feces out of pouch in my vagina with my fingers." B. "I have pain and bleeding when I have a bowel movement." C. "I have had frequent urinary tract infections." D. "I am embarrassed by uncontrollable flatus."

"I have had frequent urinary tract infections." *Pouching of feces is an expected finding associated with a rectocele. The surgical procedure for a rectocele is posterior colporrhaphy. Pain and bleeding with a bowel movement is an expected finding associated with a rectocele. Due to urinary stasis associated with a cystocele, this finding is an expected finding of a cystocele. The surgery for a cystocele. The surgery for a cystocele is an anterior colporrhapy. Uncontrollable flatus is an expected finding associated with a rectocele.

A female client who has recurrent cystitis asks the nurse about preventing future episodes. For which of the following statements should the nurse provide teaching reinforcement? A. "I drink at least 2 L of fluid per day." B. "I prefer tub baths to showering." C. "I urinate after sexual relations." D. "I wipe from front to back after urinating."

"I prefer tub baths to showering." *Cystitis is an inflammation of the bladder lining that commonly occurs with a urinary tract infection (UTI). Women who are at risk for UTIs should avoid tub baths because they increase the risk of infection. The nurse should remind the client to take showers instead of tub baths

A nurse is reinforcing teaching with a client who is preoperative prior to a transurethral resection of the prostate (TURP). Which of the following client statements indicates an understanding of the information? A. "I will not need to have a urinary catheter following this procedure." B. "I will expect my urine to be cloudy after having this procedure." C. "At least I won't have any urine leakage after this procedure." D. "I will feel the urge to urinate following this procedure."

"I will feel the urge to urinate following this procedure." *After a TURP, the client will feel the urge to urinate. The nurse should reassure him that he will receive analgesics to help relieve this discomfort

A nurse is reinforcing teaching with a client who has a spinal cord injury and will need to perform intermittent urinary self-catherization at home after discharge. Which of the following indicates that the client understands the procedure? A. "I'll drink less water so I don't have to catheterize myself too often." B. "I must use sterile technique to do each of the catheterizations." C. "I should stop the catheterization when I have removed 150 mL of urine." D. "I will perform intermittent self-catherization every 2 to 3 hours."

"I will perform intermittent self-catherization every 2 to 3 hours." *The client may initially require self-catheterization every 2 to 3 hours and increase the frequency eventually to every 4 to 6 hours. A longer interval can result in bladder distention and increase the risk of urinary tract infection

A nurse is reinforcing teaching with a client who has a history of urinary tract infections (UTIs). Which of the following client statements indicates the need for additional instruction? A. "I will empty my bladder every 2 to 4 hr." B. "I will drink 2 liters of fluids per day." C. "I will use a vaginal douche daily." D. "I will wear cotton underwear."

"I will use a vaginal douche daily." *The client should avoid vaginal douches, bubble baths, and any substances that can increase the risk of UTIs. The client should use mild soap and water to wash the perineal area

A nurse is reinforcing teaching with a client who is scheduled for a transrectal ultrasound (TRUS). Which of the following information should the nurse include? A. "This procedure will determine whether you have prostate cancer." B. "The procedure is contraindicated if you have an allergy to eggs." C. "Sound waves will be used to create a picture of your prostate." D. "You should avoid having a bowel movement for 1 hr prior to the procedure."

"Sound waves will be used to create a picture of your prostate." *A biopsy or EPCA-2 is used to make the diagnosis of prostate cancer. A TRUS is contraindicated if the client has an allergy to latex. A transrectal ultrasound creates an image of the prostate using sound waves. The provider can prescribe an enema prior to the procedure to decrease the interference of feces with obtaining accurate test results

A nurse is reinforcing teaching with a client who is scheduled for extracorporeal shock wave lithotripsy (ESWL). Which of the following statements by the client indicates understanding of the instruction? A. "I will be fully awake during the procedure." B. "Lithotripsy will reduce my chances of having stones in the future." C. "I will report any bruising that occurs to my doctor." D. "Straining my urine following the procedure is important."

"Straining my urine following the procedure is important." *The client receives moderate (conscious) sedation for this procedure. The client is not fully awake. Lithotripsy does not decrease the recurrence rate of renal calculi. The procedure breaks the calculi into fragments so they will pass into urine. Bruising is an expected finding following lithotripsy and does not need to be reported to the provider. A client is instructed to strain urine following lithotripsy to verify that the calculi have passed.

A nurse is reinforcing teaching a client who will have an x-ray of the kidneys, ureters, and bladder. Which of the following statements should the nurse include? A. "You will receive contrast dye during the procedure." B. "An enema is necessary before the procedure." C. "You will need to lie in a prone position during the procedure." D. "The procedure determines whether you have a kidney stone."

"The procedure determines whether you have a kidney stone." *Client do not receive any contrast media for this procedure, as they would for excretory urography. Clients do not receive an enema before this procedure, because it does not affect the gastrointestinal system. The client will lie supine, not prone. Explain to the client that a KUB can identify renal calculi, strictures, calcium deposits, and obstructions of the urinary system

A nurse is reinforcing teaching with 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 in high in phosphate." D. "Add yogurt to your diet regularly."

"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 front to back following fecal elimination to prevent introducing bacteria into the urinary tract, which can ultimately cause pyelonephritis

A nurse is reinforcing teaching about a prostate-specific antigen (PSA) test with a client. Which of the following statements should the nurse make? A. "You don't need to fast prior to the PSA test." B. "Annual PSA screening should begin at age 40." C. "Expected PSA values will derease as you get older." D. :You should not ejaculate for 24 hours after the PSA test."

"You don't need to fast prior to the PSA test." *Fasting is not required for the PSA test. The client may or may not drink up util the time of the test. annual screening should begin at age of 50

A nurse is preparing a client prior to an initial Papanicolaou (Pap) test. Which of the following statements should the nurse make? A. "You should urinate immediately after the procedure is over." B. "You will not feel any discomfort." C. "You may experience some bleeding after the procedure." D. "You will need to hold your breath during the procedure."

"You may experience some bleeding after the procedure." *The client is instructed to urinate immediately before the procedure. The client can experience discomfort when the provider obtains the cervical sample. The client can experience a small amount of vaginal bleeding due to scraping of the cervix. The client should use relaxation techniques, such as taking deep breaths during the procedure

A nurse is reinforcing teaching with a client who is scheduled for a transurethral resection of the prostate (TURP)_ about postoperative care. Which of the following information should the nurse include? A. "You might have a continuous sensation of needing to void even though you have a catheter." B. "You will be on bed rest for the first 2 days after the procedure." C. "You will be instructed to limit your fluid intake after the procedure." D. "Your urine should be clear yellow the evening after the surgery."

"You might have a continuous sensation of needing to void even though you have a catheter." *To reduce the risk of postoperative bleeding, the client will have a catheter with a large balloon that places pressure on the internal sphincter of the bladder. Pressure on the sphincter causes a continuous sensation of needing to void. The client is ambulated early in the postoperative period to reduce the risk of deep-vein thrombosis and other complications that occur due to immobility. The client is encouraged to increase their fluid intake unless contraindicated by another condition. A liberal fluid intake reduces the risks of urinary tract infection and dysuria. The client's urine is expected to be pink the first 24 hr after surgery.

A nurse is reinforcing teaching with a client who has acute pyelonephritis. Which of the following instructions should the nurse include in the teaching? A. "You should avoid taking NSAIDs for pain." B. "You should maintain complete bed rest until the manifestations decrease." C. "You should drink 1,000 milliliters of fluid per day." D. "You should complete the entire cycle of antibiotic therapy."

"You should complete the entire cycle of antibiotic therapy." *The client should complete the full prescription of the antibiotic therapy to decrease the chance of regrowth of the causative organism

A nurse is reinforcing teaching with a client prior to a renal biopsy. Which of the following statements should the nurse make? A. "You will be NPO for 8 hours following the procedure." B. "An allergy to shellfish is a contraindication for 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 collecting data from a client who has prerenal AKI. Which of the following findings should the nurse expect? (select all that apply) A. Reduced BUN B. Elevated cardiac enzymes C. Reduced urine output D. Elevated blood creatinine E. Elevated blood calcium

1. Reduced urine output 2. Elevated blood creatinine *A manifestation of prerenal AKI is an elevated BUN caused by the retention of nitrogenous wastes in the blood. Elevated cardiac enzymes is a manifestation of cardiac tissue injury, not AKI. A manifestation of prerenal AKI is reduced urine output. A manifestation of prerenal AKI is elevated blood creatinine. A manifestation of prerenal AKI is reduced calcium level

A nurse is reinforcing teaching to a client who is to to undergo a cervical biopsy. Which of the following information should the nurse include? (select all that apply) A. "The procedure is painless." B. "Heavy bleeding is expected for the first few weeks." C. "A fever is common during the first 12 hours after the procedure." D. "Plan to rest for the first 72 hours after the procedure." E. "Avoid the use of tampons for 2 weeks after the procedure."

1. "Heavy bleeding is expected for the first few weeks." 2. "Avoid the use of tampons for 2 weeks after the procedure." *Typically the client will experience temporary discomfort and cramping when the specimen is obtained. Minor bleeding is to be expected for the first few weeks. A fever can be indication of an infection and is a complication that should be reported to the provider. The client should plan to rest for the first 24 hr after the procedure. The client should not use tampons until the cervix has healed, which takes approximately 1 week.

A nurse in a provider's office is providing information to a client who has dysfunctional uterine bleeding (DUB). Which of the following statements by the client indicate understanding of the information? (Select all that apply) A. "My heart bleeding can be due to a hormonal imbalance." B. "If I experience menstrual pain, I should take aspirin." C. "Oral contraceptives are contraindicated for clients, who have heavy uterine bleeding like mine." D. "My doctor can perform a D&C to find out what's causing my abnormal bleeding." E. "My condition is more common in clients who are in their 30s."

1. "My heart bleeding can be due to a hormonal imbalance." 2. "My doctor can perform a D&C to find out what's causing my abnormal bleeding." *The client should be aware that DUB can be caused by a progesterone deficiency. The client should avoid aspirin due to the increased risk for bleeding. NSAIDs can be recommended as needed for menstrual pain or discomfort. The client should be aware that contraceptives can be prescribed to treat DUB. The client should be aware that when the provider performs a dilatation and curettage, endometrium scraped from the uterine wall is sent to the laboratory for evaluation. The client should be aware that DUB is more common in adolescents and in clients who are nearing menopause

The nurse is reinforcing teaching about menstruation with an adolescent client. Which of the following statements should the nurse include? (select all that apply) A. "The average age of onset of menstruation is 10." B. "The typical menstrual cycles is approximately 28 days." C. "The first day of the menstrual cycle begins with the last day of the menstrual period." D. "Ovulation typically occurs around the 14th day of the menstrual cycle." E. "A menstrual period can last as long as 8 days."

1. "The typical menstrual cycles is approximately 28 days." 2. "Ovulation typically occurs around the 14th day of the menstrual cycle." 3. "A menstrual period can last as long as 8 days." *Although some client experience the onset of menstruation as early age 9, the average age is 12.4 years of age. A typical menstrual cycle consists of28 days. The first day of the menstrual cycle begins with the first day of the menstrual period. The first half of the menstrual cycle is the follicular phase, and the second half is the luteal phase. Ovulation typically occurs around the middle of the cycle, or day 14 in a 28-day cycle. A menstrual period typically lasts 2 to 8 days.

A nurse is reviewing information with a female client who has frequent urinary tract infections. Which of the following information should the nurse include? (select all that apply) A. Avoid sitting in a wet bathing suit B. Wipe the perineal area back to front following elimination C. Empty the bladder when there is an urge to void D. Wear synthetic fabric underwear E. Take a shower instead of a bath

1. Avoid sitting in a wet bathing suit 2. Empty the bladder when there is an urge to void 3. Take a shower instead of a bath *The client should avoid sitting in a wet bathing suit, which can increase the risk for a UTI by colonization of bacteria in a moist, warm environment. The client should wipe the perineal area from front to back after elimination to prevent contaminating the urethra with bacteria. The client should empty the bladder when there is an urge to void rather than retain urine for an extended period of time, which increases the risk for a UTI. The client should wear cotton underwear that absorbs moisture and keeps the perineal area drier, thus decreasing colonization of bacteria that can cause a UTI. The client should take a shower instead of a bath to promote good body hygiene and decrease colonization of bacteria in the perineal area that can cause a UTI

A nurse is reinforcing discharge instructions with a client who has spontaneously passed a calcium oxalate calculus. To decrease the chance of recurrence, the nurse should instruct the client to avoid which of the following foods? (select all that apply) A. Red meat B. Black tea C. Cheese D. Whole grains E. Spinach

1. Black tea 2. Spinach *A client who has renal calculi composed of calcium phosphate, struvite, uric acid, or cysteine should limit intake of animal protein, dairy products, and whole grains. A client who has renal calculi composed of calcium oxalate should avoid intake of black tea and spinach because of its source of oxalate

A nurse is contributing to the plan of care for a client who received hemodialysis. Which of the following interventions should the nurse suggest to include in the plan of care? (select all that apply) A. Check BUN and blood creatinine B. Administer medications the nurse withheld prior to dialysis C. Observe for findings of hypovolemia D. Monitor the access site for bleeding E. Obtain blood pressure on the arm with AV access

1. Check BUN and blood creatinine 2. Administer medications the nurse withheld prior to dialysis 3. Observe for findings of hypovolemia 4. Monitor the access site for bleeding *Check the BUN and blood creatinine to determine the presence and degree of uremia or waste products that remain following dialysis. Withhold medications the treatment can partially dialyze. After the treatment, administer the medications. Antihypertensive medications might need to be withheld until the next day if the client is hypotensive. A client who is post-dialysis is at risk for hypovolemia due to a rapid decrease in fluid volume. Monitor the access site for bleeding because the client receives heparin during the procedure to prevent clotting of blood. Never measure blood pressure on the extremity that has the AV access site because it can cause collapse of the AV fistula or graft

A nurse is reviewing the medical record of a client who is menopausal. Which of the following findings should the nurse expect? (select all that apply) A. Increased vaginal secretions B. Decreased bone density C. Increased HDL level D Decreased skin elasticity E. Increased pubic hair growth F. Decreased follicle stimulating hormone level

1. Decreased bone density 2 Decreased skin elasticity *Clients who are menopausal are expected to have decreased vaginal secretions, decreased bone density, decreased HDL level and increased LDL level, decreased skin elasticity, loss of hair on the head and pubic area, and have an increased follicle stimulating (FSH) level

A nurse is reinforcing teaching with a female client who is taking testosterone to treat advanced breast cancer. The nurse should tell the client that which of the following are adverse effects of this medication? (select all that apply) A. Deepening voice B. Weight gain C. Low blood pressure D. Dry mouth E. Facial hair

1. Deepening voice 2. Weight gain 3. Facial hair *Virilization, the development of adult male characteristics, can be an adverse effect of testosterone, which includes deepening of the voice and the development of facial hair. Edema and weight gain are adverse effects of testosterone. High blood pressure is an adverse effect of this medication. Nasal congestion is an adverse effect of this medication, not dry mouth.

A nurse is reviewing the medical record of a client who has premenstrual syndrome (PMS). The nurse should identify that which of the following medications are used to treat PMS? (select all that apply) A. Fluoxetine B. Spironolactone C. Ethynyl estradiol/drospireone D. Ferrous sulfate E. Methylergonovine

1. Fluoxetine 2. Spironolactone 3. Ethynyl estradiol/drospireone *Fluoxetine, an SSRI, is used to treat the emotional manifestations of PMS (irritability, mood swings) and has an added effect of treating physical manifestations. Spironolactone is a diuretic and can reduce bloating and weight gain associated with PMS. Oral contraceptives can be prescribed to reduce the manifestations of PMS. Oral iron supplements (ferrous sulfate) are used to treat anemia associated with dysfunctional uterine bleeding. Methylergonovine is used to treat postpartum hemorrhage

A nurse is collecting data from a client who is undergoing an evaluation for benign prostatic hyperplasia (BPH). The nurse should identify that which of the following findings are indicative of this condition? (select all that apply) A. Backache B. Frequent urinary tract infections C. Weight loss D. Hematuria E. Urinary incontinence

1. Frequent urinary tract infections 2. Hematuria 3. Urinary incontinence *Backache occurs in the presence of prostate cancer that has spread to other areas of the body. In the presence of BPH, pressure on urinary structures leads to urinary stasis, which in turn promotes the occurrence of urinary tract infections. Weight loss occurs in the presence of prostate cancer. Hematuria occurs in the presence of BPH. Overflow incontinence occurs in the presence of BPH due to an increased volume of residual urine

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

1. Hemodialysis 2. Biopsy 3. Immunosuppression *Clients who develop ATN after transplantation surgery might need dialysis unti they have an adequate urine output and their BUN and creatinine levels stabilize. Because the development of ATN after transplantation surgery mimics the symptoms of rejection of the transplanted kidney, clients have to udergo a biopsy to determine the correct diagnosis. Immunosuppressive medication therapy is essential after kidney transplantation to protect the new kidney

A nurse is caring for a client who has type 2 diabetes mellitus and will excretory urography. Prior to the procedure, which of the following actions should the nurse take? (select all that apply) A. Identify an allergy to seafood B. Withhold metformin for 24 hr C. Administer an enema D. Obtain a blood coagulation profile E. Monitor for asthma

1. Identify an allergy to seafood 2. Withhold metformin for 24 hr 3. Administer an enema 4. Monitor for asthma *Clients who have an allergy to seafood are at higher risk for an allergic reaction to the contrast media they will receive during the procedure. Clients who take metformin are at risk for lactic acidosis from the contrast media with iodine they will receive during the procedure. Clients should receive an enema to remove fecal contents, fluid, and gas from the colon for a more clear visualization. A blood coagulation profile is essential for a client prior to a kidney biopsy because of the risk of hemorrhage from the procedure. Clients who have asthma have a higher risk of an exacerbation as an allergic response to the contrast media they will receive during the procedure

A nurse is contributing to the plan of care for a client who has chronic pyelonephritis. Which of the following actions should the nurse plan to include? (select all that apply) A. Recommend a referral for nutrition counseling B. Encourage daily fluid intake of 1 L C. Palpate the costovertebral angle D. Monitor urinary output E. Administer antibiotics

1. Recommend a referral for nutrition counseling 2. Palpate the costovertebral angle 3. Monitor urinary output 4. Administer antibiotics *The client requires adequate nutrition to promote healing. Encourage fluid intake of 8 to 10 glasses daily to maintain dilute urine. Gently palpate the costovertebral angle for flank tenderness, which can indicate inflammation and infection. Monitor urinary output to determine that 1 to 3 L of urine is excreted daily. Administer antibiotics to treat the bacteriuria and decrease progressive damage to the kidney

A nurse is reinforcing discharge instructions to a client who is postoperative following a TURP. Which of the following instructions should the nurse include? (select all that apply) A. Avoid sexual intercourse for 3 months after the surgery B. If urine appears bloody, stop activity and rest C. Avoid drinking caffeinated beverages D. Take a stool softener once a day E. Treat pain with ibuprofen

1. If urine appears bloody, stop activity and rest 2. Avoid drinking caffeinated beverages 3. Take a stool softener once a day *The client should following the provider's instructions, which typically include avoidance of sexual intercourse for 2 to 6 weeks after the surgery. Excessive activity can cause recurrence of bleeding. The client should rest to promote reclotting at the incisional site. The client should avoid caffeine and other bladder stimulants. The client should take a stool softener to keep the stool soft and thus prevent the complication of bleeding at the time of a bowel movement. The client should avoid taking nonsteroidal anti-inflammatory drugs because they can cause bleeding.

A nurse is reinforcing discharge instructions with a client who had spontaneous passage of a calcium phosphate renal calculus. Which of the following instructions should the nurse include? (select all that apply) A. Limit intake of food high in animal protein B. Reduce sodium intake C. Strain urine for 48 hr D. Report burning with urination to the provider E. Increase fluid intake to 3 L/day

1. Limit intake of food high in animal protein 2. Reduce sodium intake 3. Report burning with urination to the provider 4. Increase fluid intake to 3 L/day *The client should limit the intake of food high in animal protein, which contains calcium phosphate. The client should limit intake of sodium, which affects the precipitation of calcium phosphate in the urine. The client does not need to continue straining urine once the calculus has passed. The client should report burning with urination to the provider because this can indicate a urinary tract infection. The client should increase fluid intake to 2 to 3 L/day. A decrease in fluid intake can cause dehydration, which increases the risk of calculi formation

A nurse is contributing to the plan of care for a client who will undergo peritoneal dialysis. Which of the following actions should the nurse take? (select all that apply) A. Monitor blood glucose levels B. Report cloudy dialysate return C. Warm the dialysate in a microwave oven D. Monitor for shortness of breath E. Maintain medical asepsis when accessing the catheter insertion site

1. Monitor blood glucose levels 2. Report cloudy dialysis return 3. Monitor for shortness of breath *Monitor blood glucose levels because the dialysate solution contains glucose. Monitor for cloudy dialysate return, which indicates an infection. Clear, light-yellow solution is typical during the outflow process. Avoid warming the dialysate in a microwave oven, which causes uneven heating of the solution. Monitor for shortness of breath, which can indicate inability to tolerate a large volume of dialysate. Maintain surgical, not medical, asepsis when accessing the catheter insertion site to prevent infection from contamination

A nurse is reinforcing teaching with a client how to perform Kegel exercises. Which of the following instructions should the nurse include? (select all that apply) A. Perform exercises once daily B. Contract the cicumvaginal and/or perirectal muscles C. Gradually increase the contraction period to 10 to 15 seconds D. Follow each contraction with at least a 10-15 second relaxation period E. Perform while sitting, lying, and standing F. Tighten abdominal muscles during contractions

1. Perform exercises once daily 2. Contract the cicumvaginal and/or perirectal muscles 3. Gradually increase the contraction period to 10 to 15 seconds 4. Follow each contraction with at least a 10-15 second relaxation period 5. Perform while sitting, lying, and standing *The client should perform Kegel exercises once daily and then up to twice or four times daily. The client should contract the circumvaginal and perirectal muscles as if trying to stop the flow of urine or passing flatus. The client should hold the contraction for 10-15 seconds. They might need to gradually increase the contraction period to reach this goal. The client should follow each contraction with a relaxation period of 10-15 seconds. The client can perform the exercises while lying, sitting, or standing. The client should relax their other muscles, such as those in the abdomen and thighs

A nurse at a provider's office is caring for an older adult client who is having an annual physical exam. Which of the following findings indicates additional follow-up is needed in regard to the prostate gland? (select all that apply) A. Prostate-specific antigen (PSA) is 7.1 ng/mL B. A digital rectal exam (DRE) reveals an enlarged and nodular prostate C. The client reports a weak urine stream D. The client reports urinating once during the night E. Smegma is present below the glans of the penis

1. Prostate-specific antigen (PSA) is 7.1 ng/mL 2. A digital rectal exam (DRE) reveals an enlarged and nodular prostate 3. The client reports a weak urine stream *Although the PSA level is typically elevated in an older adult male, a PSA level greater than 4 ng/mL warrants additional follow-up. An enlarged and nodular prostate is a possible indication of prostate cancer and requires further evaluation. A weak urine stream is a manifestation of benign prostatic hyperplasia and warrants follow-up. Urinating once during the night is an expected finding for an older adult male. Smegma is a normal secretion that can accumulate beneath the glans penis

A nurse is contributing to the plan of care for a client who has postrenal AKI due to metastatic cancer. The client has a blood creatinine of 5 mg/dL. Which of the following interventions should the nurse recommend to include in the plan? (select all that apply) A. Provide a high-protein diet B. Monitor the urine for blood C. Monitor for intermittent anuria D. Weight the client once per week E. Provide NSAIDs for pain

1. Provide a high-protein diet 2. Monitor the urine for blood 3. Monitor for intermittent anuria *Provide a high-protein diet due to the high rate of protein breakdown that occurs with acute kidney injury. Monitor urine for blood, stones, and particles indicating an obstruction of the urinary structures that leave the kidney. Monitor for intermittent anuria due to obstruction or damage to kidneys or urinary structures. Weight the client daily to monitor for fluid retention due to acute kidney injury. Do not administer NSAIDs, which are toxic to the nephrons in the kidney

A nurse is caring for a client who has acute kidney injury and is scheduled for hemodialysis. Which of the following actions should the nurse take? (select all that apply) A. Review the medications the client currently takes B. Check the AV fistula for a bruit C. Calculate the client's hourly urine output D. Measure the client's weight E. Check serum electrolytes F. Use the access site area for venipuncture

1. Review the medications the client currently takes 2. Check the AV fistula for a bruit 3. Measure the client's weight 4. Check serum electrolytes *Reviewing the medications the client currently takes determines which medications to withhold until after dialysis. Checking the AV fistula for a bruit determines the patency of the fistula for dialysis. The client's hourly urine output can vary with the remaining kidney function and does not determine the need for dialysis. Measuring the client's weight before dialysis is essential for comparing it with the client's weight after dialysis. Checking the serum electrolytes determines the need for dialysis and can help with evaluating effectiveness of the dialysis. Never use the access site for venipuncture because compression from the tourniquet can cause loss of the vascular access.

A nurse is caring for a client who has glomerulonephritis. Which of the following manifestations should the nurse expect? A. Smoky-colored urine B. Weight loss C. Flank pain D. Visual disturbances E. Headache

1. Smoky-colored urine 2. Flank pain 3. Visual disturbances *Smoky-colored urine, flank pain, and visual disturbances are a manifestation of glomerulonephritis. Other manifestations include fever, chills, puffiness around the eyes, and hypertension. Weight loss and headaches are a manifestation of pyelonephritis.

A nurse is reinforcing teaching with a client who has gout and urolithiasis. The client asks how to prevent future uric acid stones. Which of the following suggestions should the nurse provide? (Select all that apply) A. Take allopurinol as prescribed B. Exercise several times a week C. Limit intake of foods high in purine D. Decrease daily fluid intake E. Avoid lemonade

1. Take allopurinol as prescribed 2. Exercise several times a week 3. Limit intake of foods high in purine *The nurse should inform the client that allopurinol is an antigout medication that reduces the levels of uric acid, which helps prevent uric acid stone formation. Immobility is a risk factor for urinary stasis and stone formation; therefore the client should maintain a healthy lifestyle, including regular exercise, to prevent stone formation. Purine increases the risk of uric stone formation. The nurse should identify that organ meats, poultry, fish, red wine, and gravies are high in purine

A nurse is reinforcing teaching about the mechanism of action of combination oral contraceptives with a group of clients. The nurse should tell the clients that which of the following actions occur with the use of combination oral contraceptives? (select all that apply) A. Thickening the cervical mucus B. Increasing maturation of ovarian follicle C. Increasing development of the corpus luteum D. Altering the endometrial lining E. Inhibiting ovulation

1. Thickening the cervical mucus 2. Altering the endometrial lining 3. Inhibiting ovulation *Oral contraceptives cause thickening of the cervical mucus, which slows sperm passage. Inducing maturation of ovarian follicle is not an action of oral contraceptives. Increasing the development of the corpus luteum is not an action of oral contraceptives. Oral contraceptives alter the lining of the endometrium, which inhibits implantation of the fertilized egg. Oral contraceptives prevent pregnancy by inhibiting ovulation.

A nurse is contributing to the plan of care for a client who has chronic kidney disease. Which of the following actions should the nurse recommend to include in the plan of care? (select all that apply) A. Monitor for pulmonary edema B. Provide frequent mouth rinses C. Restrict fluids based on urinary output D. Provide a high-sodium diet E. Monitor for weight gain trends

1.. Monitor for pulmonary edema 2. Provide frequent mouth rinses 3. Restrict fluids based on urinary output 4. Monitor for weight gain trends *Auscultate the client's lungs for pulmonary edema, which can indicate fluid overload and heart failure. Provide frequent mouth rinses due to uremic halitosis caused by urea waste in the blood. Restrict fluids based on urinary output to prevent fluid volume overload. Monitor blood sodium and reduce the client's dietary sodium intake. Monitor for weight gain trends that can indicate fluid volume overload

A nurse is caring for a client who has a left renal calculus and an indwelling urinary catheter. Which of the following data collecting findings is the priority for the nurse to report to the provider? A. Flank pain that radiates to the lower abdomen B. Client report of nausea C. Absent urine output for 1 hr D. Blood WBC count 15,000/mm3

Absent urine output for 1 hr *The greatest risk to this client is damage to the kidney resulting from obstruction of urine flow by the renal calculus. Therefore, the priority finding to report to the provider is anuria

A nurse is contributing to the plan of care for a client who has prerenal acute kidney injury (AKI) following abdominal aortic aneurysm repair. Urinary output is 60 mL in the past 2 hr, and blood pressure is 92/58 mm Hg. The nurse should recommend which of the following interventions? A. Prepare the client for a CT scan with contrast dye B. Administer ketorolac for pain C. Administer a fluid challenge D. Position the client in Trendelenburg

Administer a fluid challenge *Do not plan for a CT scan. Contrast dye is contraindicated for a client who has possible acute kidney injury. Ketorolac is an NSAID that can cause further injury to the kidney nephrons and is contraindicated for a client who has acute kidney injury. Administer a fluid challenge for hypovolemia, which is indicated by the client's low urinary output and blood pressure. Position the client in reverse Trendelenburg, with the head down and feet up, if a client becomes hypotensive

A nurse is caring for a client who has a urinary tract infection (UTI). Which of the following is the priority intervention by the nurse? A. Offer a warm sitz bath B. Recommend drinking cranberry juice C. Encourage increased fluids D. Administer an antibiotic

Administer an antibiotic *The greatest risk to the client is injury to the renal system and sepsis from the UTI. The priority intervention is to administer antibiotics

A nurse is reinforcing teaching about urinary tract infections (UTSs) with a client. Which of the following manifestations should the nurse include? A. Weight gain B. Back pain C. Vaginal discharge D. Muscle cramps

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

Blood pressure 160/90 mmHg *Due to the kidney's role in fluid and blood pressure regulation, a client who is experiencing rejection can have hypertension

A nurse is collecting data on a client who is 4 hours postoperative following a transurethral resection of the prostate and has an indwelling urinary catheter in place. Which of the following findings should the nurse expect? A. Blood-tinged urine in the drainage bag B. Catheter tubing coiled at the client's side C. Client report of severe bladder spasms D. Urinary output of 20 ml/hr

Blood-tinged urine in the drainage bag *The nurse should identify that blood-tinged urine in the drainage bag is an expected finding for the first few days following surgery

A nurse is reinforcing dietary teaching with a client who has late-stage chronic kidney disease (CKD). Which of the following nutrients should the nurse instruct the client to increase in her diet? A. Calcium B. Phosphorus C. Potassium D. Sodium

Calcium *A client who has CKD can develop hypocalcemia due to the reduced production of active vitamin D, which is needed for calcium absorption. The client should supplement her diet with dietary calcium

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

Change the client's 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 reposition the client to facilitate the drainage of the solution from the peritoneal cavity

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 client's electrolyte values C. Measure the client's weight D. Restrict the client's protein intake

Check the client's electrolyte values *The nurse should check the client's most recent potassium value because these findings are manifestations of hyperkalemia, which can lead to cardiac dysrhythmias

A nurse is assisting with planning care for a client who has a nephrostomy tube inserted 8 hr ago. Which of the following actions should the nurse include in the client's plan of care? A. Flush the nephrostomy tube every 4 hr with sterile water B. Clamp the nephrostomy tube intermittently to establish continence C. Check the skin at the nephrostomy site for irritation from urine leakage D. Monitor for and report any blood-tinged drainage to the provider immediately

Check the skin at the nephrostomy site for irritation from urine leakage *The nurse should monitor for complications (e.g. bleeding, hematuria, fistula formation, infection), impairment of skin integrity (e.g. inflammation, infection, bleeding, urine leakage, irritation), and tube obstruction. The nurse should necer clamp the nephrostomy tube or irrigate without a specific prescription

A nurse is collecting data from a client who is receiving peritoneal dialysis. Which of the following findings should the nurse report to the provider immediately? A. Difficulty draining the 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 greatest 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 collecting data from 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/mm3 B. Potassium 4.0 mEq/L C. Cloudy, yellow drainage D. Report of abdominal fullness

Cloudy, yellow drainage *Cloudy drainage is an early manifestation of peritonitis, and the nurse should report this finding to the provider. Other manifestation include a fever and abdominal tenderness

A nurse is caring for a client who has a rectocele. Which of the following findings should the nurse contributing risk factor? A. Urinary tract infection B. Urinary incontinence C. Constipation D. Perimenopausal

Constipation *Urinary tract infections is a contributing factor to a cystocele. Urinary incontinence is a contributing factor for a cystocele. Constipation is a contributing factor along with pain when having a bowel movement. Postmenopausal is a contributing factor for a cystocele.

A nurse is collecting data from a client who is postoperative following a transurethral resection of the prostate (TURP). After the nurse discontinues the client's urinary catheter, which of the following findings should the nurse report to the provider? A. Pink-tinged urine B. Report of burning upon urination C. Stress incontinence D. Decreased urine output

Decreased urine output *A decrease in urine output after a TURP indicates an obstruction to urine flow by a clot or residual prostatic tissue and should be reported to the provider

A nurse is caring for a client who develops disequilibrium syndrome after receiving hemodialysis. Which of the following actions should the nurse take? A. Administer an opioid medication B. Monitor for hypertension C. Determine level of consciousness D. Increase the dialysis exchange rate

Determine level of consciousness *Do not administer an opioid medication because it could worsen the client's condition. The provider can prescribe medication to decrease seizure activity. Monitor for hypotension due to rapid change in fluids and electrolytes causing disequilibrium syndrome. Determine the client's level of consciousness. A change in urea levels can cause increased intracranial pressure. Subsequently, the client's level of consciousness decreases. Decrease the dialysis exchange rate to slow the rapid changes in fluid and electrolyte status when a client develops disequilibrium syndrome

A nurse is assisting with the admission data collection of a client who has renal calculi. Which of the following findings should the nurse expect? A. Bradycardia B. Diaphoresis C. Nocturia D. Bradypnea

Diaphoresis *Tachycardia, Diaphoresis, oliguria, and tachypnea are signs associated with a client who has renal calculi

A nurse is preparing to being a 24-hr urine collection for a client. Which of the following actions should the nurse take? A. Store collected urine in a designated container at room temperature B. Discard the first voiding when beginning the test C. Post a notice on the client's door regarding the testing D. Document any urine collection that was missed during the 24 hr of the testing

Discard the first voiding when beginning the test *Store collected urine in an approved container that is kept on ice or refrigerated. Begin the testing period after discarding the first voiding. Post notices on the client's medical record and over the toilet alerting all personnel of the ongoing test.. However, placing a notice on the client's door is a violation of privacy laws. In the event the client urinates without collecting it in the approved container, the test must be started again. A full 24 hr of urine collection is needed for accurate testing.

A nurse is reinforcing dietary teaching with a client who has a history of kidneys stones. Which of the the following instructions should the nurse include in the teaching? A. Consume foods containing vitamin C B. Drink 3.8 L (4 quarts) of water throughout the day C. Suggest almonds as a snack D. Limit sodium intake to 3 g per day

Drink 3.8 L (4 quarts) of water throughout the day *The nurse should instruct the client to Drink 3.8 L (4 quarts) of water per day to keep urine diluted and decrease the chance of kidney stone formation

A nurse in a provider's office is reviewing a client's laboratory results, which shows a positive rapid plasma regain (RPR). Which of the following tests will be administered to confirm the diagnosis of syphilis? A. Venereal Disease Research Laboratory (VDRL) B. D-dimer C. Fluorescent treponemal antibody absorbed (FTA-ABS) D. Sickledex

Fluorescent treponemal antibody absorbed (FTA-ABS) *The VDRL is another screening test for syphilis. The D-dimer is a test used measure fibrin and is used to diagnose disseminated intravascular coagulation. The fluorescent treponemal antibody absorbed is used to confirm the diagnosis of syphilis. The Sickledex is used to diagnose sickle cell anemia

A nurse is reviewing client laboratory date. Which of the following findings is expected for a client who has Stage 4 chronic kidney disease? A. Blood urea nitrogen (BUN) 15 mg/dL B. Glomerular filtration rate (GFR) 20 mL/min C. Blood creatinine 1.1 mg/dL D. Blood potassium 5.0 mEq/L

Glomerular filtration rate (GFR) 20 mL/min *Expect the BUN to be above the expected balance reference range, about 10 to 20 times the BUN finding. The GFR is severely decreased to approximately 20 mL/min, which is indicative of stage 4 chronic kidney disease. In stage 4 chronic kidney disease, a blood creatinine level can be as high as 15 to 30 mg/dL. A client in stage 4 chronic kidney disease would have a blood potassium level greater than 5.0 mEq/L.

A nurse is reinforcing dietary teaching with a client who has chronic renal failure. Which of the following food choices by the client indicates the teaching has been understood? A. Canned soup B. Grilled fish C. Pastrami D. Peanut butter

Grilled fish *Proteins such as fresh fish or poultry can minimize the risk of chronic renal failure worsening

A nurse is reinforcing teaching with a client who has chronic kidney disease and is to begin hemodialysis. Which of the following information should the nurse include? A. Hemodialysis restores kidney function B. Hemodialysis replaces hormonal function of the renal system C. Hemodialysis allows an unrestricted diet D. Hemodialysis returns a balance to blood electrolytes

Hemodialysis returns a balance to blood electrolytes *Hemodialysis does not restore kidney function, but it sustains the life of a client who has kidney disease. Hemodialysis does not replace hormonal function of the renal system due to tissue damage causing dysfunction of the renin-angiotensin-aldosterone system. Hemodialysis does not allow an unrestricted diet. It requires a diet high in folate and more protein than predialysis restrictions allowed, and low in sodium, potassium, and phosphorus. Explain to the client that hemodialysis restores electrolyte balance by removing excess sodium, potassium, fluids, and waste products, and also restores acid-base balance.

A nurse is monitoring a client who had a kidney biopsy for postoperative complications. Which of the following complications should the nurse identify as causing the greatest risk to the client? A. Infection B. Hemorrhage C. Hematuria D. Pain

Hemorrhage *The greatest risk to the client following a kidney biopsy is hemorrhage due to a lack of clotting at the puncture site. Report this finding to the provider immediately

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

Hyperkalemia *A client who has chronic kidney disease can have hyperkalemia, which is a potassium level greater than 5.0 mEq/L. The expected reference range for a potassium level is 3.5 to 5.0 mEq/L. Other manifestations of hyperkalemia can include palpitations, dysrhythmias, nausea, and muscle weakness

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. Hypophoshatemia

Hyperkalemia *Oliguria resulting from chronic glomerulonephritis causes potassium retention, leading to levels above the expected reference range of 3.5 to 5 mEq/L. Other electrolyte imbalances common with this disorder affect sodium and phosphorus levels. Chronic glomerulonephritis eventually leads to end-stage kidney disease

A nurse us reviewing the laboratory report of a client who has chronic kidney diseaw (CKD). The nurse notes the following laboratory test results: potassium 6.8 mEq/L, calcium 7.4 mg/dL, hemoglobin 10.2 g/dL, and phosphate 4.8 mg/dL. Which of the following findings is the priority for the nurse to report to the provider? A. Hypocalcemia B. Hyperkalemia C. Anemia D. Hyperphosphatemia

Hyperkalemia Hyperkalemia can cause life-threatening cardiac dysrhythmias and is the priority for the nurse to report to the provider

A nurse is reinforcing teaching with a client who will start alfuzosin for treatment of benign prostatic hyperplasia. The nurse should instruct the client that which of the following is an adverse effect of this medication? A. Bradycardia B. Edema C. Hypotension D. Tremor

Hypotension *Alfuzosin can cause tachycardia, diarrhea, constipation, and dizziness. Edema is not an adverse effect of this medication. Alfuzosin relaxes muscle tone in veins and cardiac output decreases, which leads to hypotension. Clients taking this medication are advised to rise slowly from a sitting or lying position. Alfuzosin can cause dizziness. Tremor is not an adverse effect of this medication.

A nurse is providing support to a client who has a new diagnosis of endometriosis. The nurse should inform the client that which of the following conditions is a possible complication of endometriosis? A. Insulin resistance B. Infertility C. Vaginitis D. Pelvic Inflammatory disease

Infertility *Insulin resistance is a complication of polycystic ovary syndrome. Infertility is a complication of endometriosis because endometrial tissue overgrowth can block the fallopian tubes. Vaginitis is typically caused by an infection. Pelvic inflammatory disease is caused by an infection of the pelvic organs

A nurse is assisting with the preparation of an in-service program about the stages of acute kidney injury (AKI). Which of the following pieces of information should the nurse suggest 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 early stages D. Infections and tumors cause prerenal azotemia

Interference with renal perfusion causes prerenal azotemia *Prerenal azotemia results from interference with renal perfusion (e.g. heart failure or hypovolemic shock)

A nurse is collecting data from a client who is postoperative following a transurethral resection of the prostate (TURP) and has continuous bladder irrigation. The nurse notes no drainage in the client's urinary drainage bag over 1 h our. Which of the following actions should the nurse take? A. Instruct the client to attempt to void around the indwelling urinary catheter B. Increase the rate of irrigation fluid instillation C. Irrigate the indwelling urinary catheter with a syringe D. Prepare to administer a diuretic

Irrigate the indwelling urinary catheter with a syringe *The nurse should identify that no drainage in the urinary drainage bag indicates an obstruction. The nurse should gently irrigate the indwelling urinary catheter as prescribed to clear the obstruction and allow urine and irrigating fluid to drain

A nurse is caring for a client who has angina and asks about obtaining a prescription for sildenafil to treat erectile dysfunction. Which of the following medications should the nurse recognize as contraindicated with sildenafil? A. Aspirin B. Isosorbide C. Clopidogrel D. Atorvastatin

Isosorbide *Aspirin is contraindicated in client who have a bleeding disorder, but there are no contraindications for concurrent use of sildenafil. Isosorbide is an organic nitrate that manages pain from angina. Concurrent use of it is contraindicated because fatal hypotension can occur. The client should avoid taking a nitrate medication for 24 hr after taking isosorbide. Clopidogrel is contraindicated in clients who are actively bleeding, but there is no contraindication for concurrent use of clopidogrel and sildenafil. Atorvastatin is contraindicated in clients who have hepatic disease, but there is no contraindication for concurrent use of atorvastatin and sildenafil.

A nurse is reinforcing teaching with a client who has chronic kidney disease (CKD). 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 *A client who has CKD should limit fluid intake to prevent hypovolemia (excessive fluid overload)

A nurse is collecting data from a client who has acute kidney injury (AKI). According to the RIFLE classification system, which of the following findings should the nurse identify as an indication that the client has end-stage kidney disease? A. Less than 0.5 mL/kg or urine output for 12 hours B. No urine output for 12 hours 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 *In the RIFLE classification, R is for Risk, F is for Failure, L is for Loss, and E is for End-stage kidney disease. No urine output without renal replacement therapy for more than 3 months indicates end-stage kidney disease

A nurse is contributing to the plan of care for a client who had a stroke. The client has hemiplegia and occasional urinary incontinence. Which of the following interventions should the nurse recommend? A. Offer the client a bedpan every 2 hours B. Limit the client's daily fluid intake until he is no longer incontinent C. Request a prescription for an indwelling urinary catheter from the client's provider D. Ambulate the client to th bathroom every 30 minutes

Offer the client a bedpan every 2 hours *Following a stroke, the client might have bladder incontinence due to confusion, impaired sensation in response to bladder fullness, and decreased sphincter control. The nurse should encourage and assist the client to void every 2 hours while awake to promote bladder control. By offering a bedpan, the nurse promotes client safety

A nurse in a provider's office is reviewing the medical record of a client who has fibrocystic breast condition. Which of the following findings should the nurse expect? A. Palpable rubberlike lump in the upper outer quadrant B. BRCA1 gene mutation C. Elevated CA-125 D. Peau d'orange dimpling of the breast

Palpable rubberlike lump in the upper outer quadrant *Clients who have fibrocystic breast condition typically have breast pain and rubbery palpable lumps in the upper outer quadrant of the breasts. BRCA1 gene mutation is a risk factor for breast cancer. An elevated CA-125 is a finding associated with ovarian cancer. Peau d'orange dimpling of the breast is a finding associated with breast cancer

A nurse is reinforcing teaching about collecting a 24 hour urine specimen for creatinine clearance with a newly licensed nurse. Which of the following instructions should the nurse nurse include? A. Include the first voided specimen at the start of the collection B. Discard the last voided specimen at the end of the collection period C. Place signs in the bathroom as a reminder about the test in progress D. Instruct the client to increase exercise during the 24 hour period

Place signs in the bathroom as a reminder about the test in progress *The nurse should place signs in the bathroom and alert the family members of the test in progress so that everyone saves the specimens throughout the test

A nurse is reviewing urinalysis results for four clients. Which of the following urinalysis results indicates a urinary tract infection? A. Positive for hyaline casts B. Positive for leukocyte esterase C. Positive for ketones D. Positive for crystals

Positive for leukocyte esterase *Hyaline casts in the urine can indicate proteinuria and can occur following exercise. A positive leukocyte esterase indicates a urinary tract infection. Ketones in the urine is a manifestation of poorly-controlled diabetes mellitus or starvation. Crystals in the urine can indicate a potential for kidney stone formation

A nurse is reviewing the medical record of a client who has a cystocele. Which of the following findings should the nurse identify as a risk factor for the development of this disorder? A. BMI of 18 B. Nulliparity C. Chronic constipation D. Postmenopausal

Postmenopausal *Obesity is a risk factor for the development of a cystocele. ABMI of 18 indicates the client is underweight. Multiparity is a risk factor for the development of a cystocele. Constipation is a risk factor for the development of a rectocele. The advancing age and loss of estrogen that correlate with postmenopausal status are risk factors for the development of a cystocele

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 collecting data from a client who has an injury to the lower abdomen following a motor-vehicle crash. The nurse should identify that which of the following findings is a manifestation of bladder trauma? a. Stress incontinence B. Hematuria C. Pyruria D. Fever

Pyruria *Manifestations of bladder trauma include hematuria, or blood in the urine; blood at the urinary meatus; pelvic pain; and anuria, or the absence of urine

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 client's pain B. Encourage the client to increase fluid intake C. Monitor the client's intake and output D. Strain the client's urine

Relieve the client's pain *The pain associated with renal calculi is severe and can lead to shock; therefore, this is the nurse's priority action

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

Report of palpitations *ESWL is the application of sound, laser, or dry shockwave energies to break a kidney stone into small pieces. The shockwaves are initiated during the R wave of the ECG to prevet dysrhythmias. When using the ABC approach to client care, the nurse should determine that a report of palpitations is a manifestation of dysrhythmias and is the priority finding

A nurse is caring for a client who has continuous bladder irrigation following a transurethral resection of the prostate (TURP). Which of the following actions should the nurse take? A. Irrigate the catheter with sterile water B. Clamp the drainage catheter during ambulation C. Report viscous drainage with clots to the provider D. Remove the catheter if the client feels a strong urge to urinate

Report viscous drainage with clots to the provider *The nurse should report urine output that is bright red with clots or urine that resembles ketchup to the provider, as this is an indication of hemorrhage

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. Hypoglcyemia D. Respiratory distress

Respiratory distress *Respiratory distress can occur during peritoneal dialysis due to fluid overload

A nurse is caring for a client who has a new diagnosis of benign prostatic hyperplasia (BPH). The nurse should expect a prescription for which of the following medications? A. Oxybutynin B. Diphenhydramine C. Ipratropium D. Tamsulosin

Tamsulosin *Oxybutynin is an anticholinergic medication that is used to treat overactive bladder. Anticholinergic medications are contraindicated for a client who has BPH. Oxybutynin causes urinary retention. Diphenhydramine is an antihistamine and is contraindicated for a client who has BPH. Diphenhydramine causes urinary retention. Ipratropium is an anticholinergic medication used to treat asthma and other respiratory conditions. Ipratropium causes urinary retention. Tamsulosin is an alpha adrenergic receptor antagonist that relaxes the bladder outlet and the prostate gland, which improves urinary flow.

A nurse in a clinic is reviewing the facility's testing process and procedures for human immune deficiency virus (HIV) with a new employee. Which of the following information should the nurse include? A. In the presence of HIV, the enzyme immunoassay (EIA) test is typically reactive within 72 hr after the client is infected B. The Western blot assay is used to confirm diagnosis of HIV C. The polymerase chain reaction (PRC) test D. CD4+ cell counts will be elevated in a client who is infected with HIV

The Western blot assay is used to confirm diagnosis of HIV *The EIA test is typically reactive 3 weeks to 3 months after the infection occurs, but it can be delayed for as long as 46 months. Confirming HIV is a two-step process. If the EIA is positive, a second test (the Western blot assay) is done. The PRC test is used to confirm the diagnosis of genital herpes. The EIA test is typically reactive 3 weeks to 3 months after the infection occurs, but it can be delayed for as long as 36 months.

A nurse is reviewing the health care record of a client who is asking about conjugated equine estrogens. The nurse should inform the client this medication is contraindicated in which of the following conditions? A. Atrophic vaginitis B. Dysfunctional uterine bleeding C. Osteoporosis D. Thrombophlebitis

Thrombophlebitis *Atrophic vaginitis occurs when there is estrogen deficiency. This medication is used to treat atrophic vaginitis. Dysfunctional uterine bleeding can occur when there is estrogen deficiency. This medication is used to treat dysfunctional uterine bleeding. Females are at risk for osteoporosis after the onset of menopause. Estrogen is used to slow the progression of osteoporosis. Estrogen increases the risk of thrombolytic events. Estrogen use is contraindicated for a client who has a history of thrombophlebitis.

A nurse is collecting data from a client who has urolithiasis and reports pain in his thigh. The nurse should identify that this 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 the ureters, pain radiates to the genitalia and to the thighs

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 X-ray shows consolidation in the right lower lobe C. Urinary output is 35 to 50 mL/hr consistently D. The client has slight abdominal distention

Urinary output is 35 to 50 mL/hr consistently *Following a nephrectomy, the client should have a client should a urine output of at least 30 mL/hr consistently. Less than that indicates inadequate blood flow to the remaining kidney

A nurse is preparing a client who is scheduled for an intravenous pyelogram (IVP). Which of the following findings should the nurse report to the provider? A. Allergy to egg products B. Vomiting and diarrhea for the last 6 hours C. Serum potassium of 3.6 mEq/L D. Serum creatinine of 1.2 mg/dL

Vomiting and diarrhea for the last 6 hours *The nurse should identify that vomiting and diarrhea for 6 hours deplete the client's fluid volume, which results in dehydration that can cause renal failure following a procedure that uses contrast dye. Therefore, the nurse should notify the provider.

A nurse is caring for a client who is scheduled to receive intermittent peritoneal dialysis. Which of the following actions should the nurse take? A. Weigh the client before and after each dialysis treatment B. Apply clean gloves when handling the bags of dialysate fluid C. Refrigerate the bags of dialysate fluid until ready for instillation D. Check peripheral circulation of the client's arms prior to treatment

Weigh the client before and after each dialysis treatment *The nurse should weight the client before and after each peritonial dialysis treatment to maintain accurate intake and output records and ensure adequate drainage of the dialysate solution