Brunner 1

The nurse is planning client teaching for a client with end-stage kidney disease who is scheduled for the creation of a fistula. The nurse should teach the client what information about the fistula? "A vein and an artery in your arm will be attached surgically." "The arm should be immobilized for 4 to 6 days." "One needle will be inserted into the fistula for each dialysis treatment." "The fistula can be used 5 to 7 days after the surgery for dialysis treatment."

"A vein and an artery in your arm will be attached surgically."

A 45-year-old man with diabetic nephropathy has end-stage renal disease and is starting dialysis. What should the nurse teach the client about hemodialysis? "Hemodialysis is a treatment option that is usually required three times a week." "Hemodialysis is a program that will require you to commit to daily treatment." "This will require you to have surgery and a catheter will need to be inserted into your abdomen." "Hemodialysis is a treatment that is used for a few months until your kidney heals and starts to produce urine again."

"Hemodialysis is a treatment option that is usually required three times a week."

The nurse notes that a patient who is retaining fluid had a 1-kg weight gain. The nurse knows that this is equivalent to about how many mL? A.250 mL B.500 mL C.750 mL D. 1,000 mL

1,000 mL

Which of the following measurable urine output recorded indicates the patient is maintaining adequate fluid intake and balance?

A patient with a minimal urine output of 50 mL/hour

The nurse providing care for a client post PTCA knows to monitor the client closely. For what complications should the nurse monitor the client? Select all that apply. Abrupt closure of the coronary artery Venous insufficiency Bleeding at the insertion site Retroperitoneal bleeding Arterial occlusion

Abrupt closure of the coronary artery Bleeding at the insertion site Retroperitoneal bleeding Arterial occlusion

A client with chronic kidney disease has been hospitalized and is receiving hemodialysis on a scheduled basis. The nurse should include which of the following actions in the plan of care? A.Ensure that the client moves the extremity with the vascular access site as little as possible. B.Change the dressing over the vascular access site at least every 12 hours. C.Utilize the vascular access site for infusion of IV fluids. D.Assess for a thrill or bruit over the vascular access site each shift

Assess for a thrill or bruit over the vascular access site each shift.

A nurse is providing education to a client about monitoring blood pressure readings at home. What reminders will the nurse review with the client? Select all that apply. Avoid smoking cigarettes for 1 hour prior to taking blood pressure. Avoid talking during the measurement. Sit with both feet on the ground during the measurement. Ensure at least 5 minutes of quiet rest before measurements. Be sure the forearm is well supported at heart level while taking blood pressure

Avoid talking during the measurement. Sit with both feet on the ground during the measurement. Ensure at least 5 minutes of quiet rest before measurements. Be sure the forearm is well supported at heart level while taking blood pressure

A 54-year-old male patient is admitted to the hospital with a case of severe dehydration. The nurse reviews the patient's laboratory results. Which of the following results are consistent with the diagnosis? Select all that apply. Blood urea nitrogen (BUN) of 23 mg/dL Serum osmolality of 310 mOsm/kg Serum sodium of 148 mEq/L Urine specific gravity of 1.03

Blood urea nitrogen (BUN) of 23 mg/dL Serum osmolality of 310 mOsm/kg Serum sodium of 148 mEq/L Urine specific gravity of 1.03

A patient admitted with electrolyte imbalance has carpopedal spasm, ECG changes, and a positive Chvostek sign. What deficit does the nurse suspect the patient has? Calcium Magnesium Phosphorus Sodium

Calcium

A client who suffered hypovolemic shock during a cardiac incident has developed acute renal failure. Which is the best nursing rationale for this complication?

Decrease in the blood flow through the kidneys

Choose the statements that correctly match the hypertensive medication with its side effect. Select all that apply. With ACE inhibitors, assess for bradycardia. Beta-blockers may cause sedation. Direct vasodilators may cause headache and tachycardia. Cough is a common side effect of adrenergic inhibitors. With thiazide diuretics, monitor serum potassium concentration.

Direct vasodilators may cause headache and tachycardia. With thiazide diuretics, monitor serum potassium concentration.

The nurse is creating a care plan for a client diagnosed with heart failure. When addressing the problem of anxiety, what interventions should the nurse include in the care plan? Select all that apply. Facilitate the presence of friends and family whenever possible. Teach the client about the harmful effects of anxiety on cardiac function. Provide supplemental oxygen, as needed. Provide validation of the client's expressions of anxiety. Administer benzodiazepines two to three times daily.

Facilitate the presence of friends and family whenever possible. Provide supplemental oxygen, as needed. Provide validation of the client's expressions of anxiety.

An ED nurse is assessing a 71-year-old female client for a suspected MI. When planning the assessment, the nurse should be cognizant of what signs and symptoms of MI that are particularly common in female clients? Select all that apply. Shortness of breath Chest pain Anxiety Indigestion Nausea

Indigestion Nausea

A client with end-stage renal disease receives continuous ambulatory peritoneal dialysis. The nurse observes that the dialysate drainage fluid is cloudy. What is the nurse's most appropriate action? Inform the health care provider and assess the client for signs of infection. Flush the peritoneal catheter with normal saline. Remove the catheter promptly and have the catheter tip cultured. Administer a bolus of IV normal saline as prescribed.

Inform the health care provider and assess the client for signs of infection.

The nurse has been asked to teach a patient how to self-administer nitroglycerin. The nurse should instruct the patient to do which of the following? Select all of the teaching points that apply. Put some of the tablets in a small metal or plastic pillbox that can be easily carried at all times and be accessible quickly, when needed. Let the tablet dissolve in the mouth and keep the tongue still. The tablet can be crushed between the teeth but not swallowed. Keep the tablets at home on the kitchen counter or bedside table so they can be reached quickly. Renew the supply every 6 months. Take the tablet in anticipation of any activity that can produce pain. Call emergency services if, after taking three tablets (one every 5 minutes), pain persists.

Let the tablet dissolve in the mouth and keep the tongue still. The tablet can be crushed between the teeth but not swallowed. Renew the supply every 6 months. Take the tablet in anticipation of any activity that can produce pain. Call emergency services if, after taking three tablets (one every 5 minutes), pain persists.

The nurse is providing discharge teaching to a client who had hypophosphatemia during his time in hospital. The client has a diet prescribed that is high in phosphate. What foods should you teach this client to include in his diet? Select all that apply.

Milk Poultry Liver

Which assessments should a nurse perform when caring for a client following a cardiac catheterization? Select all that apply. Monitor BP and pulse frequently. Inspect pressure dressing for signs of bleeding. Palpate the pulse in different locations. Inspect the color in every extremity. Palpate the insertion site for tenderness.

Monitor BP and pulse frequently. Inspect pressure dressing for signs of bleeding. Palpate the pulse in different locations.

The nurse is assigned a client with calcium level of 4.0 mg/dL. Which system assessment would the nurse ask detailed questions?

Neurological system

The nurse is caring for a client who was admitted with fluid volume excess (FVE). Which nursing assessments should the nurse include in the ongoing monitoring of the client? Select all that apply.

Nutritional status and diet Blood pressure, heart rate, and rhythm Intake and output, urine volume, and color Skin assessment for edema and turgor

What disease processes contribute to chronic heart failure? Select all that apply. Tachydysrhythmias Valvular disease Pancreatic disease Renal failure Pulmonary insufficiency

Tachydysrhythmias Valvular disease Renal failure

Hyperkalemia is a serious side effect of acute renal failure. Identify the electrocardiogram (ECG) tracing that is diagnostic for hyperkalemia. Tall, peaked T waves Shortened QRS complex Multiple spiked P waves Prolonged ST segment

Tall, peaked T waves

The client asks the nurse why a stress test is needed. What statement best explains the rationale for the health care provider to order a cardiac stress test? The health care provider wants to identify if the heart failure is from coronary artery disease. The health care provider needs to evaluate everything. Heart failure is causing the client to be weak and tired. The stress test is the best diagnostic tool to monitor which stage of heart failure the client is experiencing.

The health care provider wants to identify if the heart failure is from coronary artery disease.

A client who had coronary artery bypass surgery is exhibiting signs of heart failure. What medications will the nurse anticipate administering for this client? Select all that apply. diuretics inotropic agents digoxin amlodipine nitroprusside

diuretics inotropic agents digoxin

A client is experiencing edema in the tissue. What type of intravenous fluid would the nurse expect to be prescribed?

hypertonic solution

Which test used to diagnose heart disease is least invasive? transthoracic echocardiography magnetic resonance imaging cardiac catheterization coronary arteriography

transthoracic echocardiography