EXAM- 5

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After a subtotal gastrectomy, the drainage in the nasogastric tube is expected to be what color for about 12 to 24 hours after surgery? 1. dark brown 2. bile green 3. bright red 4. cloudy white

which intervention should the nurse include when preparing a teaching plan for the client with chronic prostatitis? 1. Sit in a warm sitz bath for 10 to 20 minutes several times daily. 2. Sit in the chair with the feet elevated for two (2) hours daily. 3. Drink at least 3,000 mL of oral fluids, especially tea and coffee, daily. 4. Stop broad-spectrum antibiotics as soon as the symptoms subside.

A client has been placed on long-term sulfasalazine therapy for treatment of ulcerative colitis. The nurse should encourage the client to eat which foods to help avoid the nutrient deficiencies that may develop as a result of this medication? 1. citrus fruits 2. green, leafy vegetables 3. eggs 4. milk products

A client with Crohn's disease has concentrated urine; decreased urinary output; dry skin with decreased turgor; hypotension; and weak, thready pulses. What should the nurse do first? 1. Encourage the client to drink at least 1,000 mL/day. 2. Provide parenteral rehydration therapy as prescribed. 3. Turn and reposition every 2 hours. 4. Monitor vital signs every shift.

Postoperative nursing care for a client after an appendectomy should include: 1. administering sitz baths four times a day. 2. noting the first bowel movement after surgery. 3. limiting the client's activity to bathroom privileges. 4. measuring abdominal girth every 2 hours.

The healthcare provider is preparing a patient for a total colectomy and the placement of an ileostomy. The patient asks where the stoma will be located. The healthcare provider identifies which of the following areas as the correct stoma site? 1. RUQ 2. RLQ 3. LUQ 4. LLQ

Which clinical manifestation would the nurse expect to find when assessing a client who has acute glomerulonephritis? 1 Nocturia 2 Periorbital edema 3 Increased appetite 4 Recent weight loss

While changing the client's colostomy bag and dressing, the nurse determines that the client is ready to participate in self-care when the client: 1. asks if the healthcare provider (HCP) will change the dressing soon. 2. asks about the supplies used during the dressing change. 3. talks about the news on the television. 4. is upset about the way the night nurse changed the dressing.

Which foods would the nurse encourage the client to eat to prevent constipation after a suprapubic prostatectomy? Select all that apply. 1 Milk 2 Apples 3 Oatmeal 4 Green peas 5 Scrambled eggs

2, 3, 4

The client is diagnosed with ulcerative colitis. Which clinical manifestation warrants immediate intervention by the nurse? 1. The client has 20 bloody stools a day. 2. The client's oral temperature is 99.8°F. 3. The client's abdomen is hard and rigid. 4. The client reports urinating when coughing.

Which instructions should be discussed with the client diagnosed with GERD? Select all that apply. 1. Eat a low-carbohydrate, low-sodium diet. 2. Lie down for 30 minutes after eating. 3. Do not eat spicy foods or acidic foods. 4. Drink two glasses of water before bedtime. 5. Do not wear tight-fitting clothes or belts.

3, 5

A client with acute appendicitis develops a fever, tachycardia, and hypotension. Based on these assessment findings, the nurse should further assess the client for which of the following complications? 1. Deficient fluid volume. 2. Intestinal obstruction. 3. Bowel ischemia. 4. Peritonitis.

The client is diagnosed with an acute episode of ureteral calculi. Which client problem is priority when caring for this client? 1. Fluid volume loss 2. Knowledge deficit 3. Impaired urinary elimination 4. Alteration in comfort

A client with chronic kidney disease (CKD) is experiencing nausea, vomiting, visual changes, and anorexia. Which action by the nurse is best? a. Check the clients digoxin (Lanoxin) level. b. Administer an anti-nausea medication. c. Ask if the client is able to eat crackers. d. Get a referral to a gastrointestinal provider.

The nurse is assessing a client with acute pyelonephritis. What assessment findings would the nurse expect? (Select all that apply.) a. Fever b. Chills c. Tachycardia d. Tachypnea e. Flank or back pain f. Fatigue

A, B, C, D, E, F

Which new-onset assessment findings in a client with Laennec cirrhosis indicates to the nurse that the client may be starting to have delirium tremens (DTs) from alcohol withdrawal? Select all that apply. A. Anxiety B. Tachycardia C. Hypotension D. Hypertension E. Cool, clammy skin F. Psychotic behavior

A, B, D, F

A nurse prepares a client for a percutaneous kidney biopsy. What actions should the nurse take prior to this procedure? (Select all that apply.) a. Keep the client NPO for 4 to 6 hours. b. Review coagulation study results. c. Maintain strict bedrest in a supine position. d. Assess for blood in the client's urine. e. Administer client's antihypertensive medications

A, B, E

A nurse reviews a client's laboratory results. Which results from the client's urinalysis would the nurse recognize as abnormal? a. pH of 5.6 b. Ketone bodies present c. Specific gravity of 1.020 d. Clear and yellow color

The nurse is assessing a group of clients for their risk of kidney disease. Which racial/ethnic group is at the greatest risk as they age? a. Latino Americans b. African Americans c. Jewish Americans d. Asian Americans

The nurse is assessing a client who has hepatitis C. What extrahepatic complications would the nurse anticipate? (Select all that apply.) a. Pancreatitis b. Polyarthritis c. Heart disease d. Myalgia e. Peptic ulcer disease f. Ulcerative colitis

B, C, D

A nurse assesses a client who has cholecystitis. Which sign or symptom indicates that this condition is chronic rather than acute? a. Temperature of 100.1° F (37.8° C) b. Positive Murphy sign c. Clay-colored stools d. Upper abdominal pain after eating

The nurse assists the client with acute kidney injury (AKI) to modify the diet in which way? Select all that apply: A. Restricted protein B. Liberal sodium C. Fluid restriction D. Low potassium E. Low fat

a,c,d

To prevent recurrence of uric acid renal calculi, the nurse teaches the patient to avoid eating a. milk and cheese. b. sardines and liver. c. legumes and dried fruit. d. spinach, chocolate, and tea.

A 37-year-old female patient is hospitalized with acute kidney injury (AKI). Which information will be most useful to the nurse in evaluating improvement in kidney function? A. Urine volume B. Creatinine level C. Glomerular filtration rate (GFR) D. Blood urea nitrogen (BUN) level

A 68-year-old male patient who has bladder cancer had a cystectomy with creation of an Indiana pouch. Which topic will be included in patient teaching? a. Application of ostomy appliances b. Barrier products for skin protection c. Catheterization technique and schedule d. Analgesic use before emptying the pouch

A patient who has acute glomerulonephritis is hospitalized with hyperkalemia. Which information will the nurse monitor to evaluate the effectiveness of the prescribed calcium gluconate IV? A. Urine volume B. Calcium level C. Cardiac rhythm D. Neurologic status

The nurse is caring for a client who has cirrhosis from substance abuse. The client states, "All of my family hates me." How would the nurse respond? a. "You should make peace with your family." b. "This is not unusual. My family hates me too." c. "I will help you identify a support system." d. "You must attend Alcoholics Anonymous."

The nurse will anticipate teaching a patient with nephrotic syndrome who develops flank pain about treatment with a. antibiotics. b. antifungals. c. anticoagulants. d. antihypertensives.

The pathologic process for post-infectious glomerulonephritis is believed to be: a. Infarction of renal vessels b. Bacterial endotoxin deposition and destruction of glomeruli c. Immune complex formation and glomerular deposition d. Glomeruli blocked by bacteria from endocardial vegetation

Which condition will the nurse recognize increases the risk for a client with benign prostatic hyperplasia (BPH) to develop? A. Perfusion reduction (prerenal failure) B. Intrinsic or intrarenal failure C. Urine flow obstruction (postrenal failure) D. End-stage kidney disea

Which assessment data reported by a 28-year-old male patient is consistent with a lower urinary tract infection (UTI)? a. Poor urine output b. Bilateral flank pain c. Nausea and vomiting d. Burning on urination

Which drug will the nurse avoid administering to a client with chronic kidney disease (CKD) to prevent harm? A. Opioids B. Antibiotics C. Oral antihyperglycemics D. Magnesium antacids

The nurse is caring for the client 1 day post-upper gastrointestinal (UGI) series. Which assessment data warrant intervention? 1. No bowel movement. 2. Oxygen saturation 96%. 3. Vital signs within normal baseline. 4. Intact gag reflex.

Which data support to the nurse the client's diagnosis of acute bacterial prostatitis? 1. Terminal dribbling. 2. Urinary frequency. 3. Stress incontinence. 4. Sudden fever and chills.

Sildenafil is prescribed for a man with erectile dysfunction. Which side effects of this medication would the nurse mention in teaching? Select all that apply. 1 Flushing 2 Headache 3 Dyspepsia 4 Constipation 5 Hypertension

1, 2, 3

The client returned from surgery after having a TURP and has a P 110, R 24, BP 90/40, and cool and clammy skin. Which interventions should the nurse implement? Select all that apply. 1. Assess the urine in the continuous irrigation drainage bag. 2. Decrease the irrigation fluid in the continuous irrigation catheter. 3. Lower the head of the bed while raising the foot of the bed. 4. Contact the surgeon to give an update on the client's condition. 5. Check the client's postoperative creatinine and BUN.

1, 3,4

Client is one day post op major abdominal surgery. Which problem is priority? 1. Impaired skin integrity 2. Fluid and Electrolyte imbalance 3. Altered bowel elimination 4. Altered body image

The client is diagnosed with esophageal diverticula. Which lifestyle modification should be taught by the nurse? 1. Raise the foot of the bed to 45 degrees to increase peristalsis. 2. Eat the evening meal at least 2 hours before bed. 3. Eat a low-fat, low-cholesterol, high-fiber diet. 4. Wear an abdominal binder to strengthen the abdominal muscles.

The nurse is assessing the client diagnosed with chronic gastritis. Which clinical manifestation(s) support this diagnosis? 1. Rapid onset of midsternal discomfort. 2. Epigastric pain relieved by eating food. 3. Dyspepsia and hematemesis. 4. Nausea and projectile vomiting.

The nurse reviews the medical record of an older adult client admitted with chronic kidney disease. Which clinical finding is the priority requiring collaboration with the primary health care provider? 1 Sodium level: 135 2 Potassium level: 6 3 Creatinine results: 20 4 Blood pressure results: 150/100

A client with cancer of the prostate requests the urinal frequently but either does not void or voids in very small amounts. Which factor is the likely cause? 1 Edema 2 Dysuria 3 Retention 4 Suppression

A client with peptic ulcer disease (PUD) is admitted to the hospital for a gastric resection. The client reports a sudden sharp pain in the mi epigastric area that radiates to the shoulder. The nurse should first: 1. establish an IV line. 2. administer pain medication. 3. notify the surgeon. 4. call for a stat ECG.

The nurse is notified that the latest potassium level for a client who has acute kidney injury is 6.2 mEq (6.2 mmol/L). Which action would the nurse take? 1 Alert the cardiac arrest team. 2 Call the laboratory to repeat the test. 3 Notify the primary health care provider. 4 Obtain an antiarrhythmic medication.

You have a patient with pre-renal AKI. Which condition would you expect to find in the patients history 1. Pyelonephritis 2. Myocardial infarction 3. Bladder cancer 4. Kidney stones

client is to take one daily dose of ranitidine at home to treat a peptic ulcer. The client understands proper drug administration of ranitidine when the client will take the drug: 1. before meals. 2. with meals. 3. at bedtime. 4. when pain occurs.

A client receiving peritoneal dialysis develops symptoms of severe respiratory difficulty during the infusion of the dialysate solution. Which action would the nurse take? 1 Increase the rate of infusion. 2 Auscultate the lungs for breath sounds. 3 Place the client in a supine position. 4 Drain the fluid from the peritoneal cavity.

A client with peptic ulcer disease is taking ranitidine. What is the expected outcome of this drug? 1. heal the ulcer 2. protect the ulcer surface from acids 3. reduce acid concentration 4. limit gastric acid secretion

The nurse is caring for clients on a renal surgery unit. After the afternoon report, which client should the nurse assess first? 1. The male client who just returned from a CT scan who states he left his glasses in the x-ray department. 2. The client who is one (1) day postoperative and has a moderate amount of serous drainage on the dressing. 3. The client who is scheduled for surgery in the morning and wants an explanation of the operative procedure before signing the permit. 4. The client who had ileal conduit surgery this morning and has not had any drainage in the drainage bag.

The nurse is evaluating a client's understanding of peritoneal dialysis. Which information in the client's response indicates understanding the purpose of the procedure? 1 Reestablishing normal kidney function 2 Cleaning the peritoneal membrane 3 Providing fluid for intracellular spaces 4 Removing toxins and metabolic wastes

The nurse should instruct the client to avoid which drug while taking metoclopramide hydrochloride? 1. antacids 2. antihypertensives 3. anticoagulants 4. alcohol

Which type of cytokine is used to treat anemia secondary to chronic kidney disease? 1 α-Interferon 2 Interleukin-2 3 Interleukin-11 4 Erythropoietin

A 70-kg adult client with chronic kidney disease (CKD) is on a 40-g protein diet. The patient has a reduced glomerular filtration rate and is not undergoing dialysis. Which result would be of most concern to the nurse? a. Albumin level of 2.5 g/dL (3.63 mcmol/L) b. Phosphorus level of 5 mg/dL (1.62 mmol/L) c. Sodium level of 135 mEq/L (135 mmol/L) d. Potassium level of 5.5 mEq/L (5.5 mmol/L)

A client comes into the emergency department with a serum creatinine of 2.2 mg/dL (1944 mcmol/L) and a blood urea nitrogen (BUN) of 24 mL/dL (8.57 mmol/L). What question would the nurse ask first when taking this client's history? a. "Have you been taking any aspirin, ibuprofen, or naproxen recently?" b. "Do you have anyone in your family with renal failure?" c. "Have you had a diet that is low in protein recently?" d. "Has a relative had a kidney transplant lately?"

A client has a serum potassium level of 6.5 mEq/L (6.5 mmol/L), a serum creatinine level of 2 mg/dL (176 mcmol/L), and a urine output of 350 mL/day. What is the best action by the nurse? a. Place the client on a cardiac monitor immediately. b. Teach the client to limit high-potassium foods. c. Continue to monitor the client's intake and output. d. Ask to have the laboratory redraw the blood specimen

A nurse cares for a client with an increased blood urea nitrogen (BUN)/creatinine ratio. Which action should the nurse take first? a. Assess the client's dietary habits. b. Inquire about the use of nonsteroidal anti-inflammatory drugs (NSAIDs). c. Hold the client's metformin (Glucophage). d. Contact the health care provider immediately.

The nurse teaches the client recovering from acute kidney disease to avoid which of these? A. Nonsteroidal anti-inflammatory drugs B. Angiotensin-converting enzyme (ACE) inhibitors C. Opiates D. Acetaminophen

Which client will the nurse recognize as having the greatest risk for nonacoholic fatty liver disease (NAFLD)? A. 45-year-old Latino man who is 30 lb (13.9 kg) overweight and has type 2 diabetes B. 50-year-old white woman who drinks one glass of wine daily and has breast cancer C. 60-year-old black woman who is hypertensive and takes a diuretic daily D. 70-year-old Asian man who has gastroesophageal reflux disease (GERD)

Which nutritional supplements does the nurse expect the health care provider will prescribe for a client with chronic kidney disease? Select all that apply. A. Water-soluble vitamins B. Calcium C. Iron D. Magnesium E. Vitamin D F. Phosphorus

A, B , C, E

What urinalysis findings does the nurse expect when a client is in the early stage of chronic kidney disease? Select all that apply. A. Proteinuria B. Increased specific gravity C. Red blood cells (RBCs) D. Increased urine osmolarity E. White blood cells (WBCs) F. Glucosuria

A, C, E, F

The nurse is caring for a client who was recently diagnosed with pancreatic cancer. What factors present risks for developing this type of cancer? (Select all that apply.) a. Diabetes mellitus b. Cirrhosis c. Smoking d. Female gender e. Family history f. Older ag

ALL BUT D

A 74-year-old who is progressing to stage 5 chronic kidney disease asks the nurse, "Do you think I should go on dialysis? Which initial response by the nurse is best? A. "It depends on which type of dialysis you are considering." B. "Tell me more about what you are thinking regarding dialysis." C. "You are the only one who can make the decision about dialysis." D. "Many people your age use dialysis and have a good quality of life."

When administering medications to the client with chronic kidney disease, the nurse recognizes that which of these medications is most effective in slowing the progression of kidney failure? A. Diltiazem (Cardizem) B. Lisinopril (Zestril) C. Clonidine (Catapres) D. Doxazosin (Cardura)

Which activities are most important for the nurse to teach a client with esophageal varices to prevent harm from bleeding or hemorrhage? Select all that apply. A. Avoid alcoholic beverages. B. Eat soft foods and cool liquids. C. Do not engage in strenuous exercise or heavy lifting. D. Try to eat six smaller meals daily instead of three larger ones. E. Be sure to keep your mouth open when sneezing or coughing. F. Cross your legs only at the ankles when sitting, rather than the knees.

B, C

A client is admitted with acute kidney injury (AKI) and a urine output of 2000 mL/day. What is the major concern of the nurse regarding this patient's care? a. Edema and pain b. Cardiac and respiratory status c. Electrolyte and fluid imbalance d. Mental health status

The nurse is caring for a client who has chronic pyelonephritis. What assessment finding would the nurse expect? a. Fever b. Flank pain c. Hypertension d. Nausea and vomiting

A client had an open traditional Whipple procedure this morning. For what priority complication would the nurse assess? a. Urinary tract infection b. Chronic kidney disease c. Heart failure d. Fluid and electrolyte imbalances

A client is scheduled for a hepatobiliary iminodiacetic acid (HIDA) scan. What would the nurse include in client teaching about this diagnostic test? a. "You'll have to drink a contrast medium right before the test." b. "You'll need to do a bowel prep the nursing before the test." c. "You'll be able to drink liquids up until the test begins." d. "You'll have a large camera close to you during the test."

A nurse cares for a client who has kidney stones from gout ricemia. Which medication does the nurse anticipate administering? a. Phenazopyridine b. Doxycyline c. Tolterodine d. Allopurinol

Which precaution is most important for the nurse to instruct a client with cirrhosis and his or her family about continuing care in the home? A. Avoid taking acetaminophen or drinking alcohol. B. Maintain one-floor living to prevent excessive fatigue. C. Use cool baths to reduce the sensation of itching. D. Report any change in cognition to the health care provider.

Which instruction would the nurse include when teaching the client how to perform peritoneal dialysis and the importance of preventing peritonitis? Select all that apply 1 Wear a mask during the procedure. 2 Clean the catheter exit site every day. 3 Maintain meticulous aseptic technique. 4 Wash your hands before the exchange. 5 Store supplies in a clean and dry location.

all

A 34-year-old male patient seen at the primary care clinic complains of feeling continued fullness after voiding and a split, spraying urine stream. The nurse will ask about a history of a. recent kidney trauma. b. gonococcal urethritis. (Maternity) c. recurrent bladder infection. d. benign prostatic hyperplasia.

A 48-year-old patient with stage 2 chronic kidney disease (CKD) is scheduled for an intravenous pyelogram (IVP). Which order for the patient will the nurse question? A. NPO for 6 hours before procedure B. Ibuprofen (Advil) 400 mg PO PRN for pain C. Dulcolax suppository 4 hours before procedure D. Normal saline 500 mL IV infused before procedure

A 56-year-old female patient is admitted to the hospital with new onset nephrotic syndrome. Which assessment data will the nurse expect? a. Poor skin turgor b. Recent weight gain c. Elevated urine ketones d. Decreased blood pressure

A client is recovering from a kidney transplant. The clients urine output was 1500 mL over the last 12-hour period since transplantation. What is the priority assessment by the nurse? a. Checking skin turgor b. Taking blood pressure c. Assessing lung sounds d. Weighing the client

Before administration of captopril (Capoten) to a patient with stage 2 chronic kidney disease (CKD), the nurse will check the patient's A. glucose. B. potassium. C. creatinine. D. phosphate.

The nurse is caring for four clients with chronic kidney disease. Which client should the nurse assess first upon initial rounding? a. Woman with a blood pressure of 158/90 mm Hg b. Client with Kussmaul respirations c. Man with skin itching from head to toe d. Client with halitosis and stomatitis

The nurse will plan to teach a 27-year-old female who smokes 2 packs of cigarettes daily about the increased risk for a. kidney stones. b. bladder cancer. c. bladder infection. d. interstitial cystitis.

t is most important that the nurse ask a patient admitted with acute glomerulonephritis about a. history of kidney stones. b. recent sore throat and fever. c. history of high blood pressure. d. frequency of bladder infections.

A 28-year-old male patient is diagnosed with polycystic kidney disease. Which information is most appropriate for the nurse to include in teaching at this time? a. Complications of renal transplantation b. Methods for treating severe chronic pain c. Discussion of options for genetic counseling d. Differences between hemodialysis and peritoneal dialysis

A 46-year-old female patient returns to the clinic with recurrent dysuria after being treated with trimethoprim and sulfamethoxazole (Bactrim) for 3 days. Which action will the nurse plan to take? a. Teach the patient to take the prescribed Bactrim for 3 more days. b. Remind the patient about the need to drink 1000 mL of fluids daily. c. Obtain a midstream urine specimen for culture and sensitivity testing. d. Suggest that the patient use acetaminophen (Tylenol) to treat the symptoms.

A patient with acute kidney injury (AKI) has longer QRS intervals on the electrocardiogram (ECG) than were noted on the previous shift. Which action should the nurse take first? A. Notify the patient's health care provider. B. Document the QRS interval measurement. C. Check the medical record for most recent potassium level. D. Check the chart for the patient's current creatinine level.

The charge nurse of the medical-surgical unit is making staff assignments. Which staff member should be assigned to a client with chronic kidney disease who is exhibiting a low-grade fever and a pericardial friction rub? a. Registered nurse who just floated from the surgical unit b. Registered nurse who just floated from the dialysis unit c. Registered nurse who was assigned the same client yesterday d. Licensed practical nurse with 5 years experience on this floor

Which assessment finding does the nurse associate with the PTs AKI, postrenal type a. Elevated BUN b. Elevated creatinine c. Feeling of urgency d. Weight gain

You have a PT with chronic hypertension. What indicates that the PTs BP is not under control a. HR 55 b. irregular heart sounds c. Elevated creatinine d. Blood glucose of 128

A 55-year-old woman admitted for shoulder surgery asks the nurse for a perineal pad, stating that laughing or coughing causes leakage of urine. Which intervention is most appropriate to include in the care plan? a. Assist the patient to the bathroom q3hr. b. Place a commode at the patient's bedside. c. Demonstrate how to perform the Credé maneuver. d. Teach the patient how to perform Kegel exercises.

Colon cancer is most closely associated with which of the following conditions? A. Appendicitis B. Hemorrhoids C. Hiatal hernia D. Ulcerative colitis

The nurse teaches a 64-year-old woman to prevent the recurrence of renal calculi by a. using a filter to strain all urine. b. avoiding dietary sources of calcium. c. choosing diuretic fluids such as coffee. d. drinking 2000 to 3000 mL of fluid a day.

Which finding by the nurse will be most helpful in determining whether a 67-year-old patient with benign prostatic hyperplasia has an upper urinary tract infection (UTI)? a. Bladder distention b. Foul-smelling urine c. Suprapubic discomfort d. Costovertebral tenderness

Which finding for a patient admitted with glomerulonephritis indicates to the nurse that treatment has been effective? a. The patient denies pain with voiding. b. The urine dipstick is negative for nitrites. c. The antistreptolysin-O (ASO) titer is decreased. d. The periorbital and peripheral edema is resolved.

The nurse is facilitating a support group for clients diagnosed with Crohn's disease. Which information is most important for the nurse to discuss with the clients? 1. Discuss coping skills to assist with the adaptation to lifestyle modifications. 2. Teach about drug administration, dosages, and scheduled times. 3. Teach dietary changes necessary to control symptoms. 4. Explain the care of the ileostomy and necessary equipment.

The nurse is obtaining a health history from a client who has a sliding hiatal hernia associated with reflux. The nurse should ask the client about the presence of which symptom? 1. heartburn 2. jaundice 3. anorexia 4. stomatitis

The nurse is planning the care of a postoperative client with an ileal conduit. Which intervention should be included in the plan of care? 1. Provide meticulous skin care and pouching. 2. Apply sterile drainage bags daily. 3. Monitor the pH of the urine weekly. 4. Assess the stoma site every day.

Which clinical manifestations should the nurse expect to assess for the client diagnosed with a ureteral renal stone? 1. Dull, aching flank pain and microscopic hematuria. 2. Nausea; vomiting; pallor; and cool, clammy skin. 3. Gross hematuria and dull suprapubic pain with voiding. 4. The client will be asymptomatic.

Which condition can be prevented when a client with chronic kidney disease receives medication to manage anemia? 1 Uremic frost 2 Chronic fatigue 3 Tubular necrosis 4 Dependent edema

Which diet would be most appropriate for the client with ulcerative colitis? 1. high-calorie, low-protein 2. high-protein, low-residue 3. low-fat, high-fiber. 4. low-sodium, high-carbohydrate

Which element would the nurse teach the client with chronic kidney disease to limit as an intervention to control uremia associated with end-stage renal disease? 1 Fluid 2 Protein 3 Sodium 4 Potassium

Which goal for the client's care should take priority during the first days of hospitalization for an exacerbation of ulcerative colitis? 1. promoting self-care and independence 2. managing diarrhea 3. maintaining adequate nutrition 4. promoting rest and comfort

Which instruction should the nurse include in the teaching plan for a client who is experiencing gastroesophageal reflux disease (GERD)? 1. Limit caffeine intake to two cups of coffee per day. 2. Do not lie down for 2 hours after eating. 3. Follow a low-protein diet. 4. Take medications with milk to decrease irritation.

Which intervention is most important for the nurse to implement for the client diagnosed with rule-out renal calculi? 1. Assess the client's neurological status every two (2) hours. 2. Strain all urine and send any sediment to the laboratory. 3. Monitor the client's creatinine and BUN levels. 4. Take a 24-hour dietary recall during the client interview.

Which intervention should the nurse implement when administering a potassium supplement? 1. Determine the client's allergies. 2. Ask the client about leg cramps. 3. Monitor the client's blood pressure. 4. Monitor the client's complete blood count.

Which is an expected outcome for a client with peptic ulcer disease? The client will: 1. demonstrate appropriate use of analgesics to control pain. 2. explain the rationale for eliminating alcohol from the diet. 3. verbalize the importance of monitoring hemoglobin and hematocrit every 3 months. 4. eliminate engaging in contact sports.

When planning care for a client with ulcerative colitis who is experiencing an exacerbation of symptoms, which client care activities can the nurse appropriately delegate to unlicensed assistive personnel (UAP)? Select all that apply. 1. assessing the client's bowel sounds 2. providing skin care following bowel movements 3. evaluating the client's response to antidiarrheal medications 4. maintaining intake and output records 5. obtaining the client's weight

2, 4,5

A client with peptic ulcer disease reports being nauseated most of the day and now feeling light-headed and dizzy. Based upon these findings, which nursing actions would be most appropriate for the nurse to take? Select all that apply. 1. administering an antacid hourly until nausea subsides 2. monitoring the client's vital signs 3. notifying the healthcare provider (HCP) of the client's symptoms 4. initiating oxygen therapy 5. reassessing the client in an hour

2,3

Which interventions should the nurse discuss regarding the prevention of an acute exacerbation of diverticulosis? Select all that apply. 1. Eat a low-fiber diet. 2. Drink 2,500 mL of water daily. 3. Avoid eating foods with seeds. 4. Walk 30 minutes a day. 5. Take an antacid every 2 hours.

2,3,4

A client with cancer of the stomach had a total gastrectomy 2 days earlier. Which indicates the client is ready to try a liquid diet? The client: 1. is hungry. 2. has not requested pain medication for 8 hours. 3. has frequent bowel sounds. 4. has had a bowel movement.

Following a gastrectomy, the nurse should place the client in which position? 1. prone 2. supine 3. low Fowler's 4. right or left Sims

The client is diagnosed with a uric acid stone. Which foods should the client eliminate from the diet to help prevent reoccurrence? 1. Beer and colas 2. Asparagus and cabbage 3. Venison and sardines 4. Cheese and eggs

The nurse is teaching a client with a peptic ulcer about the diet that should be followed after discharge. The nurse should explain that the diet should include: 1. bland foods. 2. high-protein foods. 3. any foods that are tolerated. 4. a glass of milk with each meal.

The nurse teaches a client with chronic kidney disease to avoid all salt substitutes in his or her diet. Which rationale supports the nurse's instruction? 1 A person's body tends to retain fluid when a salt substitute is included in the diet. 2 Limiting salt substitutes in the diet prevents a buildup of waste products in the blood. 3 Salt substitutes contain potassium, which must be limited to prevent abnormal heartbeats. 4 The salt substitute substances interfere with capillary membrane transfer, resulting in anasarca.

Two days following a colon resection, an elderly client shows new onset of confusion. When contacting the healthcare provider (HCP), the nurse should make which recommendation? 1. "Do you want a CT scan to rule out stroke?" 2. "May we have a prescription for restraining this client?" 3. "Shall I collect and send a urine sample for culture and sensitivity?" 4. "Would you like a stat potassium level done?"

When obtaining a nursing history from a client with a suspected gastric ulcer, which signs and symptoms should the nurse assess? Select all that apply. 1. epigastric pain at night 2. relief of epigastric pain after eating 3. vomiting 4. weight loss 5. melena

3,4,5

A 75-year-old male who has a history of prostate cancer is admitted for a prostatectomy. The client's prostate specific antigen (PSA) levels have been increasing. Which intervention would the nurse to include in the client's plan of care? 1 Encourage the client to drink extra fluids. 2 Institute seizure precautions. 3 Monitor the plasma pH for acidosis. 4 Handle the client gently when turning.

A client is taking an antacid for treatment of a peptic ulcer. Which statement best indicates that the client understands how to correctly take the antacid? 1. "I should take my antacid before I take my other medications." 2. "I need to decrease my intake of fluids so that I do not dilute the effects of my antacid." 3. "My antacid will be most effective if I take it whenever I experience stomach pains." 4. "It is best for me to take my antacid 1 to 3 hours after meals."

A client refuses to look at or care for her colostomy. Which statement by the nurse would be most appropriate? 1. "It has been 4 days since your surgery, and you will soon be discharged. You have to learn to care for your colostomy before you leave the hospital." 2. "I think we will need to teach your husband to care for your colostomy if you are not going to be able to do it." 3. "I understand how you are feeling. It is important for you to feel attractive, and you think having a colostomy changes your attractiveness." 4. "I can see that you are upset. Would you like to share your concerns with me?"

A client who has ulcerative colitis says to the nurse, "I cannot take this anymore; I am constantly in pain, and I cannot leave my room because I need to stay by the toilet. I do not know how to deal with this." Based on these comments, the nurse should determine the client is experiencing: 1. extreme fatigue. 2. disturbed thought. 3. a sense of isolation. 4. difficulty coping.

A patient has been admitted to the medical unit after several days of watery diarrhea related to Crohn's disease. The healthcare provider recognizes which of the following symptoms as most concerning? 1. Right upper quadrant pain 2. Elevated hematocrit 3. Elevated leukocytes 4. Palpitations

The nurse is teaching a client receiving peritoneal dialysis about the reason dialysis solution is warmed before it is instilled. Which information would the nurse share with the client? 1 It forces potassium back into the cells, thereby decreasing serum levels. 2 It adds extra warmth to the body because metabolic processes are disturbed. 3 It helps prevent cardiac dysrhythmias by speeding up removal of excess potassium. 4 It encourages removal of urea by preventing constriction of peritoneal blood vessels.

The parents of a 7-year-old child who has acute glomerulonephritis (AGN) are fearful that their other child may contract the illness. Which would the nurse explain to them about the disorder? 1 The cause of AGN is unknown, so it is difficult to know how to prevent it. 2 AGN is inherited as a sex-linked recessive trait that usually occurs only in males. 3 The cause of AGN is the formation of a clot in the renal tubules resulting from a systemic infection. 4 AGN is caused by an antigen-antibody response that is usually associated with Streptococcus infection.

The primary health care provider for a client with chronic kidney disease prescribed immediate hemodialysis for the first time. Which clinical manifestation indicates the need for immediate hemodialysis in this client? 1 Ascites 2 Acidosis 3 Hypertension 4 Hyperkalemia

Which assessment is necessary for the nurse to complete in a client with chronic kidney disease receiving loop diuretics? 1 Hemoglobin levels 2 Occurrence of nausea 3 Presence of constipation 4 Intake and output measurement

Which instruction would the nurse provide to a client receiving brachytherapy for prostate cancer to prevent injury? 1 "Use bleach when doing laundry." 2 "Wear a mask when around others." 3 "Flush the toilet several times after use." 4 "Refrain from close contact with others."

Which nursing diagnosis is priority for the client who has undergone a TURP? 1. Potential for sexual dysfunction. 2. Potential for an altered body image. 3. Potential for chronic infection. 4. Potential for hemorrhage.

Which patient is most likely to have renal compromise assessed by decreased urine production? 1. 10 year history of diabetes mellites 2. Recent history of stroke 3. White blood cell count of 12,000 4. Blood pressure of 82/40 for 12 hours

Within 6 hours following a subtotal gastrectomy, the drainage from the client's NG tube is bright red. The nurse should first: 1. clamp the NG tube. 2. remove the existing NG tube. 3. irrigate the NG tube with iced saline. 4. chart the finding in the client's medical record.

A client is taking furosemide 40 mg/day for management of early chronic kidney disease (CKD). To assess the therapeutic effect of the medication, what action of the nurse is best? a. Obtain daily weights of the client. b. Auscultate heart and breath sounds. c. Palpate the client's abdomen. d. Assess the client's diet history

A client with chronic kidney disease (CKD) has an elevated serum phosphorus level. What drug would the nurse anticipate to be prescribed for this client? a. Calcium acetate b. Doxycyline c. Magnesium sulfate d. Lisinopril

A nurse assesses a client with nephrotic syndrome. Which assessment findings would the nurse expect? (Select all that apply.) a. Proteinuria b. Hypoalbuminemia c. Dehydration d. Lipiduria e. Dysuria f. Costovertebral angle (CVA) tenderness

A, B, D

A client is admitted with acute pancreatitis. What priority problem would the nurse expect the client to report? a. Nausea and vomiting b. Severe boring abdominal pain c. Jaundice and itching d. Elevated temperature

The nurse is caring for four clients with chronic kidney disease (CKD). Which client would the nurse assess first upon initial rounding? a. Client with a blood pressure of 158/90 mm Hg b. Client with Kussmaul respirations c. Client with skin itching from head to toe d. Client with halitosis and stomatitis

The nurse is titrating the IV fluid infusion rate immediately after a patient has had kidney transplantation. Which parameter will be most important for the nurse to consider? A. Heart rate B. Urine output C. Creatinine clearance D. Blood urea nitrogen (BUN) level

What liver problem does the nurse suspect in a client whose liver is hard with a nodular texture and the hepatic enzymes remain normal? A. Prenecrotic inflammation B. Postnecrotic inflammation C. Compensated cirrhosis D. Decompensated cirrhosis

A client with acute kidney injury (AKI) has a blood pressure of 76/55 mm Hg. The primary health care provider prescribed 1000mL of normal saline to be infused over 1 hour to maintain perfusion. The client starts to develop shortness of breath. What is the nurse's priority action? a. Calculate the mean arterial pressure (MAP). b. Ask for insertion of a pulmonary artery catheter. c. Take the client's pulse. d. Decrease the rate of the IV infusion

What instructions will the nurse give to the assistive personnel (AP) regarding care of a client with an arteriovenous fistula? A. Assess for bleeding at the needle insertion sites every 2 hours. B. Monitor the client's distal pulses and capillary refill for circulation. C. Palpate the dialysis site for thrills and auscultate for a bruit every 4 hours. D. Avoid taking blood pressure readings on the client's arm with the arteriovenous fistula.

When caring for a client who receives peritoneal dialysis (PD), which of these findings must the nurse report to the provider immediately? A. Pulse oximetry reading of 95% B. Sinus bradycardia, rate of 58 C. Blood pressure of 148/90 D. Temperature of 101.2 F

Which of the following represents a positive response to administration of erythropoietin (Epogen, Procrit)? A. Hematocrit of 26.7% B. Potassium within normal range C. Free from spontaneous fractures D. Less fatigue

Which neuromuscular assessment change indicates to the nurse that a client who has late-stage liver cirrhosis now has encephalopathy? A. Asterixis B. Positive Chvostek sign C. Increased deep tendon reflex responses D. Decreased deep tendon reflex responses

A client is undergoing hemodialysis. The client's blood pressure at the beginning of the procedure was 136/88 mm Hg, and now it is 110/54 mm Hg. What actions would the nurse perform to maintain blood pressure? (Select all that apply.) a. Adjust the rate of extracorporeal blood flow. b. Place the patient in the Trendelenburg position. c. Stop the hemodialysis treatment. d. Administer a 250-mL bolus of normal saline. e. Contact the primary health care provider

a, b, c

The nurse assesses a client who has chronic pancreatitis. What assessment findings would the nurse expect for this client? (Select all that apply.) a. Ascites b. Weight gain c. Steatorrhea d. Jaundice e. Polydipsia f. Polyuria

a, c, d, e, f

A 22-year-old female patient seen in the clinic for a bladder infection describes the following symptoms. Which information is most important for the nurse to report to the health care provider? a. Urinary urgency b. Left-sided flank pain c. Intermittent hematuria d. Burning with urination

A client is admitted with acute kidney injury (AKI) and a urine output of 2000 mL/day. What is the major concern of the nurse regarding this clients care? a. Edema and pain b. Electrolyte and fluid imbalance c. Cardiac and respiratory status d. Mental health status

A patient who had surgery for creation of an ileal conduit 3 days ago will not look at the stoma and requests that only the ostomy nurse specialist does the stoma care. The nurse identifies a nursing diagnosis of a. anxiety related to effects of procedure on lifestyle. b. disturbed body image related to change in function. c. readiness for enhanced coping related to need for information. d. self-care deficit, toileting, related to denial of altered body function.

Which patient statement about nutrition and nephrotic syndrome which normal GFR is correct a. I must decrease my intake of fat b. I will increased my intake of protein c. A decreased intake of carbohydrates will be required d. An increased intake of vitamin C in necessary

Which priority teaching will the nurse provide to the client receiving peritoneal dialysis (PD) when the effluent becomes cloudy? A. The change means that more waste products are being removed from the blood. B. The presence of cloudiness is an early sign of an infection called peritonitis and is very serious. C. Effluent cloudiness is the result of eating foods that contain too much protein and electrolytes. D. The effluent is expected to be cloudy because it has spent time (dwelled) in the abdomen, in close contact with the intestines.

Which serum electrolyte value in a client with early-stage ascites from chronic liver disease who is taking spironolactone will the nurse report immediately to the primary health care provider? A. Sodium 133 mEq/L (mmol/L) B. Potassium 6.4 mEq/L (mmol/L) C. Chloride 101 mEq/L (mmol/L) D. Calcium 8.9 mg/dL (2.2 mmol/L)

A nurse assesses a client who is recovering from an open traditional Whipple surgical procedure. Which assessment finding(s) alert(s) the nurse to a complication from this surgery? (Select all that apply.) a. Clay-colored stools b. Substernal chest pain c. Shortness of breath d. Lack of bowel sounds or flatus e. Urine output of 20 mL/6 hr

b, c, d, e

The nurse is caring for a client who has a risk gene for developing cirrhosis. Which racial/ethnic group has this gene most often? a. Blacks b. Asian/Pacific Islanders c. Latinos d. French

A 68-year-old female patient admitted to the hospital with dehydration is confused and incontinent of urine. Which nursing action will be best to include in the plan of care? a. Restrict fluids between meals and after the evening meal. b. Apply absorbent incontinent pads liberally over the bed linens. c. Insert an indwelling catheter until the symptoms have resolved. d. Assist the patient to the bathroom every 2 hours during the day.

A client has just had a central line catheter placed that is specific for hemodialysis. What is the most appropriate action by the nurse? a. Use the catheter for the next laboratory blood draw. b. Monitor the central venous pressure through this line. c. Access the line for the next intravenous medication. d. Place a heparin or heparin/saline dwell after hemodialysis.

The nurse is caring for a client scheduled to have a transjugular intrahepatic portal-systemic shunt (TIPS) procedure. What client assessment would the nurse perform prior to this procedure? a. Musculoskeletal assessment b. Neurologic assessment c. Mental health assessment d. Cardiovascular assessment

The nurse is preparing to teach a client with chronic hepatitis B about lamivudine therapy. What health teaching would the nurse include? a. "Follow up on all appointments to monitor your lab values." b. "Do not take amiodorone at any time while on this drug." c. "Monitor for jaundice, rash, and itchy skin while on this drug." d. "Report any changes in urinary elimination while on this drug."

The nurse is teaching a client with chronic kidney disease (CKD) about the sodium restriction needed in the diet to prevent edema and hypertension. Which statement by the client indicates that more teaching is needed? a. "I will probably lose weight by cutting out potato chips." b. "I will cut out bacon with my eggs every morning." c. "My cooking style will change by not adding salt." d. "I am thrilled that I can continue to eat fast food."

To avoid harm and prevent osteodystrophy, which intracollaborative action does the nurse implement? A. Encouraging high-quality protein foods B. Administering iron supplements twice a day C. Encouraging extra milk with meals and snacks D. Administering phosphate binders with each meal

A child who has a history of a 5-lb (2.3 kg) weight gain in 1 week and periorbital edema is admitted with a diagnosis of acute glomerulonephritis. How can the nurse obtain the most accurate information on the status of the child's edema? 1 Weighing daily 2 Observing body changes 3 Measuring intake and output 4 Monitoring electrolyte values

A client is diagnosed with acute kidney failure secondary to dehydration. An intravenous (IV) infusion of 50% glucose with regular insulin is prescribed to address which purpose? 1 To correct hyperkalemia 2 To increase urinary output 3 To prevent respiratory acidosis 4 To increase serum calcium levels

A client who has been diagnosed with gastroesophageal reflux disease (GERD) has heartburn. To decrease the heartburn, the nurse should instruct the client to eliminate which item from the diet? 1. lean beef 2. air-popped popcorn 3. hot chocolate 4. raw vegetables

A client who has had ulcerative colitis for the past 5 years is admitted to the hospital with an exacerbation of the disease. Which factor is of greatest significance in causing an exacerbation of ulcerative colitis? 1. a demanding and stressful job 2. changing to a modified vegetarian diet 3. beginning a weight-training program 4. walking 2 miles (3.2 km) every day

A client who is receiving peritoneal dialysis reports severe respiratory difficulty. Which immediate action would the nurse implement? 1 Auscultate the lungs. 2 Obtain arterial blood gases. 3 Notify the health care provider. 4 Apply pressure to the abdomen.

A patient diagnosed with Crohn's disease has a new colostomy. When assessing the patient's stoma, which of these will alert the healthcare provider that the stoma has retracted? 1. Concave and bowl-shaped 2. Narrowed and flattened 3. Pinkish-red and moist 4. Dry and reddish-purple

A school-aged child with acute glomerulonephritis has fluid intake restricted to the previous day's output plus 40 mL. The child's output over the past 24 hours was 140 mL. From 3:00 PM to 11:00 PM the child is to receive one-third of the total daily fluid permitted. How much fluid would the nurse provide for the evening intake? 1 60 mL 2 70 mL 3 80 mL 4 90 mL

An adult with appendicitis has severe abdominal pain. Which action will be the most effective to assist the client to manage pain prior to surgery? 1. Place the client in semi-Fowler's position with the knees to the chest. 2. Apply moist heat to the abdomen. 3. Teach client to massage the painful area. 4. Provide distraction with music.

The client asks, "What does an elevated PSA test mean?" On which scientific rationale should the nurse base the response? 1. An elevated PSA can result from several different causes. 2. An elevated PSA can be only from prostate cancer. 3. An elevated PSA can be diagnostic for testicular cancer. 4. An elevated PSA is the only test used to diagnose BPH.

The client diagnosed with a hiatal hernia is scheduled for a laparoscopic Nissen fundoplication. Which statement indicates the nurse's teaching is effective? 1. "I will have four to five small incisions." 2. "I will be in the hospital for at least 1 week." 3. "I will not have any pain because this is laparoscopic surgery." 4. "I will be returning to work the day after my surgery."

The client diagnosed with cancer of the bladder is undergoing intravesical chemotherapy. Which instruction should the nurse provide the client about the pretherapy routine? 1. Instruct the client to remain NPO after midnight before the procedure. 2. Explain the use of chemotherapy in bladder cancer. 3. Teach the client to administer Neupogen, a biologic response modifier. 4. Have the client take Tylenol, an analgesic, before coming to the clinic.

The client diagnosed with liver failure is experiencing pruritus secondary to severe jaundice. Which action by the unlicensed assistive personnel (UAP) warrants intervention by the nurse? 1. The UAP is assisting the client to take a hot soapy shower. 2. The UAP applies an emollient to the client's legs and back. 3. The UAP puts mittens on both hands of the client. 4. The UAP pats the client's skin dry with a clean towel

The client has end-stage liver failure secondary to alcoholic cirrhosis. Which complication indicates the client is at risk for developing hepatic encephalopathy? 1. Gastrointestinal bleeding. 2. Hypoalbuminemia. 3. Splenomegaly. 4. Hyperaldosteronism.

The client receiving antibiotic therapy reports white, cheesy plaques in the mouth. Which intervention should the nurse implement? 1. Notify the HCP to obtain an antifungal medication. 2. Explain the patches will go away naturally in about 2 weeks. 3. Instruct to rinse the mouth with diluted hydrogen peroxide and water daily. 4. Allow the client to verbalize feelings about having the plaques.

The client with a continent urinary diversion is being discharged. Which discharge instructions should the nurse include in the teaching? 1. Have the client demonstrate catheterizing the stoma. 2. Instruct the client on how to pouch the stoma. 3. Explain the use of a bedside drainage bag at night. 4. Tell the client to call the HCP if the temperature is 99°F or less.

The female client diagnosed with bladder cancer who has a cutaneous urinary diversion states, "Will I be able to have children now?" Which statement is the nurse's best response? 1. "Cancer does not make you sterile, but sometimes the therapy can." 2. "Are you concerned you can't have children?" 3. "You will be able to have as many children as you want." 4. "Let me have the chaplain come to talk with you about this."

The nurse is administering a proton pump inhibitor to a client diagnosed with peptic ulcer disease. Which statement supports the rationale for administering this medication? 1. It prevents the final transport of hydrogen ions into the gastric lumen. 2. It blocks receptors controlling hydrochloric acid secretion by the parietal cells. 3. It protects the ulcer from the destructive action of the digestive enzyme pepsin. 4. It neutralizes the hydrochloric acid secreted by the stomach.

The nurse is assessing the client diagnosed with end-stage liver disease and portal hypertension. Which intervention should the nurse include in the plan of care? 1. Assess the abdomen for a tympanic wave. 2. Monitor the client's blood pressure. 3. Percuss the liver for size and location. 4. Weigh the client twice each week.

The nurse is developing standards of care for a client with gastroesophageal reflux disease and wants to review current evidence for practice. Which resource will provide the most helpful information? 1. a review in the Cochrane Library 2. a literature search in a database, such as the Cumulative Index to Nursing and Allied Health Literature (CINAHL) 3. an online nursing textbook 4. the policy and procedure manual at the healthcare agency

The nurse is teaching the client scheduled for a colostomy and diagnosed with colon cancer. Which behavior indicates the nurse is utilizing adult learning principles? 1. The nurse repeats the information as indicated by the client's questions. 2. The nurse teaches in one session all the information the client needs. 3. The nurse uses a video so the client can hear the medical terms. 4. The nurse waits until the client asks questions about the surgery.

The nurse writes the problem "risk for impaired skin integrity" for a client with a sigmoid colostomy. Which expected outcome would be appropriate for this client? 1. The client will have intact skin around the stoma. 2. The client will be able to change the ostomy bag. 3. The client will express anxiety about body changes. 4. The client will maintain fluid balance.

What is an expected outcome for a client during the first 2 weeks who is recovering from an abdominal-perineal resection with a colostomy? The client will: 1. maintain a fluid intake of 3,000 mL/day. 2. eliminate fiber from the diet. 3. limit physical activity to light exercise. 4. accept that sexual activity will be diminished.

Where is the blood pressure cuff placed on a client with a dialysis access fistula in the right arm? 1 On the left arm 2 Over the fistula 3 Below the fistula 4 Above the fistula

Which dietary measures would be useful in preventing esophageal reflux? 1. eating small, frequent meals 2. increasing fluid intake 3. avoiding air swallowing with meals 4. adding a bedtime snack to the dietary plan

Which food would the nurse encourage the client requiring hemodialysis to include in his or her dietary intake? 1 Rice 2 Potatoes 3 Canned salmon 4 Barbecued beef

Which history statement would be expected when admitting a child with acute glomerulonephritis to the inpatient unit? 1 The child had a sore throat a few weeks ago. 2 The child has just recovered from the measles. 3 The child's father has a family history of urinary tract infections. 4 The child's immunizations were administered at the start of school.

Which information regarding the care of a cutaneous ileal conduit should the nurse discuss with the client? 1. Teach the client to instill a few drops of vinegar into the pouch. 2. Tell the client the stoma should be slightly dusky colored. 3. Inform the client large clumps of mucus are expected. 4. Tell the client it is normal for the urine to be pink or red in color.

Which intervention should the nurse implement specifically for the client diagnosed with end-stage liver disease experiencing hepatic encephalopathy? 1. Assess the client's neurological status. 2. Prepare to administer a loop diuretic. 3. Check the client's stool for blood. 4. Assess for an abdominal fluid wave.

Which problem is most appropriate for the nurse to identify for the client diagnosed with diarrhea? 1. Alteration in skin integrity. 2. Chronic pain perception. 3. Fluid volume excess. 4. Ineffective coping.

Which skin preparation would be best to apply around the client's colostomy? 1. adhesive skin barrier 2. petroleum jelly 3. cornstarch 4. antiseptic cream

Which statement indicates discharge teaching has been effective for the client who is postoperative TURP? 1. "I will call the surgeon if I experience any difficulty urinating." 2. "I will take my Proscar daily, the same as before my surgery." 3. "I will continue restricting my oral fluid intake." 4. "I will take my pain medication routinely even if I do not hurt."1

Which statement indicates the client diagnosed with calcium phosphate renal calculi understands the discharge teaching for ways to prevent future calculi formation? 1. "I should increase my fluid intake, especially in warm weather." 2. "I should eat foods containing cocoa and chocolate." 3. "I will walk about a mile every week and not exercise often." 4. "I should take one (1) vitamin a day with extra calcium."

The client diagnosed with renal calculi is scheduled for a 24-hour urine specimen collection. Which interventions should the nurse implement? Select all that apply. 1. Check for the ordered diet and medication modifications. 2. Instruct the client to urinate, and discard this urine when starting collection. 3. Collect all urine during 24 hours and place in appropriate specimen container. 4. Insert an indwelling catheter in client after having the client empty the bladder. 5. Instruct the UAP to notify the nurse when the client urinates.

1, 2, 3

A client with a peptic ulcer reports epigastric pain that frequently causes the client to wake up during the night. The nurse should instruct the client to do which activities? Select all that apply. 1. Obtain adequate rest to reduce stimulation. 2. Eat small, frequent meals throughout the day. 3. Take all medications on time as prescribed. 4. Sit up for 1 hour when awakened at night. 5. Stay away from crowded areas.

1,2,3,4

A client with ulcerative colitis is to take sulfasalazine. Which instructions should the nurse give the client about taking this medication at home? Select all that apply. 1. Drink enough fluids to maintain a urine output of at least 1,200 to 1,500 mL/day. 2. Discontinue therapy if symptoms of acute intolerance develop, and notify the healthcare provider (HCP). 3. Stop taking the medication if the urine turns orange-yellow. 4. Avoid activities that require alertness. 5. If dose is missed, skip and continue with the next dose.

1,2,4

The nurse is developing a care management plan with a client who has been diagnosed with gastroesophageal reflux disease (GERD). What should the nurse instruct the client to do? Select all that apply. 1. Avoid a diet high in fatty foods. 2. Avoid beverages that contain caffeine. 3. Eat three meals a day, with the largest meal being at dinner in the evening. 4. Avoid all alcoholic beverages. 5. Lie down after consuming each meal for 30 minutes. 6. Use over-the-counter (OTC) antisecretory agents rather than prescriptions.

1,2,4

The client is newly diagnosed with irritable bowel syndrome (IBS). Which interventions should the nurse teach the client to reduce symptoms? Select all that apply. 1. Instruct the client to avoid drinking fluids with meals. 2. Explain the need to decrease gluten and foods that contain FODMAPs. 3. Teach the client how to perform gentle perianal care. 4. Encourage the client to attend a support group meeting. 5. Reinforce the need to take a probiotic tablet daily.

1,2,4,5

A child who has nephrotic syndrome is prescribed steroid therapy. Which explanation would the nurse give the parents regarding the goal of this treatment? 1 Prevents infection 2 Stimulates diuresis 3 Provides hemopoiesis 4 Reduces blood pressure

A client newly diagnosed with ulcerative colitis who has been placed on steroids asks the nurse why steroids are prescribed. The nurse should tell the client: 1. "Ulcerative colitis can be cured by the use of steroids." 2. "Steroids are used in severe flare-ups because they can decrease the incidence of bleeding." 3. "Long-term use of steroids will prolong periods of remission." 4. "The side effects of steroids outweigh their benefits to clients with ulcerative colitis."

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? 1 "I must touch the shunt several times a day to feel for the bruit." 2 "I have to take his blood pressure every day in the arm with the fistula." 3 "He will have to be very careful at night not to lie on the arm with the fistula." 4 "We really should check the fistula every day for signs of redness and swelling."

A client who had an appendectomy for a perforated appendix returns from surgery with a drain inserted in the incisional site. The purpose of the drain is to: 1. provide access for wound irrigation. 2. promote drainage of wound exudates. 3. minimize development of scar tissue. 4. decrease postoperative discomfort.

A client with a history of chronic kidney disease is hospitalized. Which assessment findings would alert the nurse to suspect kidney insufficiency? 1 Facial flushing 2 Edema and pruritus 3 Dribbling after voiding 4 Diminished force of urination2

A client with acute kidney injury states, "Why am I experiencing twitching and tingling of my fingers and toes?" Which process would the nurse consider when formulating a response to this client? 1 Acidosis 2 Calcium depletion 3 Potassium retention 4 Sodium chloride depletion

A client with an acute kidney injury has peritoneal dialysis (PD) prescribed and asks why the procedure is necessary. Which response statement would the nurse use? 1 "PD prevents the development of serious heart problems by removing the damaged tissues." 2 "PD helps perform some of the work usually performed by your kidneys." 3 "PD stabilizes the kidney damage and may 'restart' your kidneys to perform better than before." 4 "PD speeds recovery because the kidneys are not responding to regulating hormones."

A patient diagnosed with ulcerative colitis is prescribed the aminosalicylate sulfasalazine. When teaching the patient about this medication, which of the following statements is a priority for the healthcare provider include? 1. "Be sure to limit your intake of fluids during therapy." 2. "Avoid exposure to sunlight while taking this medication." 3. "Call our office immediately if your urine turns an orangish color." 4. "You may crush the enteric-coated tablet and mix it with applesauce."

Bethanechol has been prescribed for a client with gastroesophageal reflux disease (GERD). The nurse should assess the client for which adverse effect? 1. constipation 2. urinary urgency 3. hypertension 4. dry oral mucosa

In developing a teaching plan for the client with a hiatal hernia, the nurse's assessment of which work-related factors would be most useful? 1. number and length of breaks 2. body mechanics used in lifting 3. temperature in the work area 4. cleaning solvents used

Monitoring vital signs, particularly the blood pressure and the pulse rate and quality, is essential in detecting physiological adaptations in a preschool child with nephrotic syndrome. Which clinical manifestation would the nurse be able to detect from these vital signs? 1 Heart failure 2 Hypovolemia 3 Pulmonary embolus 4 Increased serum potassium

The client diagnosed with cancer of the bladder is scheduled to have a cutaneous urinary diversion procedure. Which preoperative teaching intervention specific to the procedure should be included? 1. Demonstrate turn, cough, and deep breathing. 2. Explain a bag will drain the urine from now on. 3. Instruct the client on the use of a PCA pump. 4. Take the client to the ICD so the client can become familiar with it.

The client diagnosed with renal calculi is admitted to the medical unit. Which intervention should the nurse implement first? 1. Monitor the client's urinary output. 2. Assess the client's pain and rule out complications. 3. Increase the client's oral fluid intake.4. Use a safety gait belt when ambulating the client

The client diagnosed with renal calculi is admitted to the medical unit. Which intervention should the nurse implement first? 1. Monitor the client's urinary output. 2. Assess the client's pain and rule out complications. 3. Increase the client's oral fluid intake. 4. Use a safety gait belt when ambulating the client.

The client is admitted with end-stage liver failure and is prescribed the laxative lactulose (Chronulac). Which statement indicates the client needs more teaching concerning this medication? 1. "I should have two to three soft stools a day." 2. "I must check my ammonia level daily." 3. "If I have diarrhea, I will call my doctor." 4. "I should check my stool for any blood."

The client is one (1) day postoperative TURP. Which task should the nurse delegate to the UAP? 1. Increase the irrigation fluid to clear clots from the tubing. 2. Elevate the scrotum on a towel roll for support. 3. Change the dressing on the first postoperative day. 4. Teach the client how to care for the continuous irrigation catheter.

The client with type 2 diabetes is diagnosed with gout and prescribed allopurinol (Zyloprim). Which instruction should the nurse discuss when teaching about this medication. 1. The client will probably develop a red rash on the body. 2. The client should drink 2-3 L of water a day. 3. The client should take this medication on an empty stomach. 4. The client will need to increase oral diabetic medications.

The client with ulcerative colitis is to be on bed rest with bathroom privileges. When evaluating the effectiveness of this level of activity, the nurse should determine if the client has: 1. conserved energy. 2. reduced intestinal peristalsis. 3. obtained needed rest. 4. minimized stress.

The healthcare provider is teaching a patient diagnosed with Crohn's disease who is recovering from a bowel resection. Which of the following statements made by the patient indicates the teaching has been effective? 1. "Now that the bowel has been removed, the disease is cured." 2. "The disease might reappear in another part of the bowel." 3. "Now I can discontinue taking my multivitamin supplements." 4. "I might develop ulcerative colitis because some of my bowel is missing."

The male client diagnosed with metastatic cancer of the bladder is emaciated and refuses to eat. Which nursing action is an example of the ethical principle of paternalism? 1. The nurse allows the client to talk about not wanting to eat. 2. The nurse tells the client if he does not eat, a feeding tube will be placed. 3. The nurse consults the dietitian about the client's nutritional needs. 4. The nurse asks the family to bring favorite foods for the client to eat.

The nurse assesses the client's stoma during the initial postoperative period. What observation should the nurse report to the healthcare provider (HCP) immediately? 1. The stoma is slightly edematous. 2. The stoma is dark red to purple. 3. The stoma oozes a small amount of blood. 4. The stoma does not expel stool.

The nurse identifies the client problem "excess fluid volume" for the client in liver failure. Which short-term goal would be most appropriate for this problem? 1. The client will not gain more than two (2) kg a day. 2. The client will have no increase in abdominal girth. 3. The client's vital signs will remain within normal limits. 4. The client will receive a low-sodium diet.

The nurse is caring for the client 1 day postoperative sigmoid colostomy. Which independent nursing intervention should the nurse implement? 1. Change the infusion rate of the intravenous fluid. 2. Encourage the client to verbalize feelings about body image. 3. Administer opioid narcotic medications for pain management. 4. Assist the client out of bed to sit in the chair twice daily.

The nurse is caring for the client diagnosed with hepatic encephalopathy. Which clinical manifestation indicates the disease is progressing? 1. The client has a decrease in serum ammonia level. 2. The client is not able to circle choices on the menu. 3. The client is able to take deep breaths as directed. 4. The client is able to eat previously restricted food items.

The nurse observes red urine and several large clots in the tubing of the normal saline continuous irrigation catheter for the client who is one (1) day postoperative TURP. Which intervention should the nurse implement? 1. Remove the indwelling catheter. 2. Titrate the NS irrigation to run faster. 3. Administer protamine sulfate IVP. 4. Administer vitamin K slowly.

Which action would the nurse plan for a client during the early postoperative period after a prostatectomy? 1 Have the client stand to void. 2 Discourage straining for a bowel movement. 3 Use a bulb syringe to aspirate urine from the retention catheter. 4 Notify the primary health care provider if the client does not void by bedtime.

Which action would the nurse take before a client's scheduled hemodialysis treatment? 1 Obtain the client's urine specimen to evaluate kidney function. 2 Weigh the client to establish a baseline for later comparison. 3 Administer medications that are scheduled to be given within the next hour. 4 Explain that the peritoneum serves as a semipermeable membrane to remove wastes.

he client diagnosed with end-stage liver failure is admitted with esophageal bleeding. The HCP inserts and inflates a triple-lumen nasogastric tube (Sengstaken-Blakemore). Which nursing intervention should the nurse implement for this treatment? 1. Assess the gag reflex every shift. 2. Stay with the client at all times. 3. Administer the laxative lactulose (Chronulac). 4. Monitor the client's ammonia level.

The nurse is caring for a client who has had a gastroscopy. Which findings indicate that the client is developing a complication related to the procedure? Select all that apply. 1. The client has a sore throat. 2. The client has a temperature of 100°F (37.8°C). 3. The client appears drowsy following the procedure. 4. The client has epigastric pain. 5. The client experiences hematemesis.

2,4,5

A PT with a history of CKD is admitted with acute shoulder pain. What order should you question 1. Metoprolol 50mg PO bid 2. Digoxin 0.125mg daily 3. Ibuprofen 800mg q4hr for pain 4. Pan cultures for a temperature >38.5 C

A child is admitted to the pediatric unit with a tentative diagnosis of acute glomerulonephritis (AGN). Which would the nurse expect the laboratory report to reveal? 1 Low sedimentation rate 2 Increased serum complement 3 Increased antistreptolysin O (ASO) titer 4 Decreased blood urea nitrogen level

A client has had an exacerbation of ulcerative colitis with cramping and diarrhea persisting longer than 1 week. The nurse should assess the client for which complication? 1. heart failure 2. deep vein thrombosis 3. hypokalemia 4. hypocalcemia

A client is taking cimetidine to treat a hiatal hernia. The nurse should evaluate the client to determine that the drug has been effective in preventing which health problem? 1. esophageal reflux 2. dysphagia 3. esophagitis 4. ulcer formation

A client who has a history of Crohn's disease is admitted to the hospital with fever, diarrhea, cramping, abdominal pain, and weight loss. The nurse should monitor the client for: 1. hyperalbuminemia. 2. thrombocytopenia. 3. hypokalemia. 4. hypercalcemia.

A client who has ulcerative colitis has persistent diarrhea and has lost 12 lb (5.5 kg) since the exacerbation of the disease. Which approach will be most effective in helping the client meet nutritional needs? 1. continuous enteral feedings 2. following a high-calorie, high-protein diet 3. total parenteral nutrition (TPN) 4. eating six small meals a day

A client with abdominal surgery tells the nurse, "I felt something give way in my stomach." Which intervention should the nurse implement first? 1. Notify the surgeon immediately. 2. Instruct the client to splint the incision. 3. Assess the abdominal wound incision. 4. Administer pain medication intravenously.

A client with chronic renal failure has an internal venous access site for hemodialysis on her left forearm. What action will the nurse take to protect this access site? 1) Irrigate with heparin and NS q8 hrs 2) Apply warm moist packs to the area after hemodialysis 3) Do not use the left arm to take blood pressure readings. 4) Keep the arm elevated above the level of the heart.

A client with end-stage renal failure begins hemodialysis for the first time. Which prescribed hemodialysis protocol would the nurse implement when the client reports nausea and a headache, and then appears to become confused? 1 Administer an analgesic for the headache. 2 Administer an antiemetic for the nausea. 3 Decrease the rate of the hemodialysis exchange. 4 Discontinue the procedure immediately.

Following a subtotal gastrectomy, a client has a nasogastric (NG) tube connected to low suction. The nurse should: 1. irrigate the tube with 30 mL of sterile water every hour, if needed. 2. reposition the tube if it is not draining well. 3. monitor the client for nausea, vomiting, and abdominal distention. 4. change to high suction if the drainage is sluggish on low suction.

The client diagnosed with cancer of the bladder states, "I have young children. I am too young to die." Which statement is the nurse's best response? 1. "This cancer is treatable and you should not give up." 2. "Cancer occurs at any age. It is just one of those things." 3. "You are afraid of dying and what will happen to your children." 4. "Have you talked to your children about your dying?"

The client diagnosed with end-stage renal failure and ascites is scheduled for a paracentesis. Which client teaching should the nurse discuss with the client? 1. Explain the procedure will be done in the operating room. 2. Instruct the client a Foley catheter will have to be inserted. 3. Tell the client vital signs will be taken frequently after the procedure. 4. Provide instructions on holding the breath when the HCP inserts the catheter.

The client diagnosed with renal calculi is scheduled for lithotripsy. Which post procedure nursing task is the most appropriate to delegate to the UAP? 1. Monitor the amount, color, and consistency of urine output. 2. Teach the client about care of the indwelling Foley catheter. 3. Assist the client to the car when being discharged home. 4. Take the client's postprocedural vital signs.

The client has had a liver biopsy. Which post procedure intervention should the nurse implement? 1. Instruct the client to void immediately. 2. Keep the client NPO for eight (8) hours. 3. Place the client on the right side. 4. Monitor BUN and creatinine level.

The client is being prepared for discharge after a laparoscopic cholecystectomy. Which intervention should the nurse implement? 1. Discuss the need to change the abdominal dressing daily. 2. Tell the client to check the T-tube output every 8 hours. 3. Include the significant other in the discharge teaching. 4. Instruct the client to stay off clear liquids for 2 days.

The client is diagnosed with a uric acid stone. Which foods should the client eliminate from the diet to help prevent reoccurrence? 1. Beer and colas. 2. Asparagus and cabbage. 3. Venison and sardines. 4. Cheese and eggs.

The client is diagnosed with end-stage liver failure. The client asks the nurse, "Why is my doctor decreasing the doses of my medications?" Which statement is the nurse's best response? 1. "You are worried because your doctor has decreased the dosage." 2. "You really should ask your doctor. I am sure there is a good reason." 3. "You may have an overdose of the medications because your liver is damaged." 4. "The half-life of the medications is altered because the liver is damaged."

The client is diagnosed with peritonitis. Which assessment data indicate to the nurse the client's condition is improving? 1. The client is using more pain medication on a daily basis. 2. The client's nasogastric tube is draining coffee-ground material. 3. The client has a decrease in temperature and a soft abdomen. 4. The client has had two soft, formed bowel movements.

The client who is postoperative TURP asks the nurse, "When will I know if I will be able to have sex after my TURP?" Which response is most appropriate by the nurse? 1. "You seem anxious about your surgery." 2. "Tell me about your fears of impotency." 3. "Potency can return in six (6) to eight (8) weeks." 4. "Did you ask your doctor about your concern?"

The client with a history of renal calculi calls the clinic and reports having burning on urination, chills, and an elevated temperature. Which instruction should the nurse discuss with the client? 1. Increase water intake for the next 24 hours. 2. Take 2 Tylenol to help decrease the temperature. 3. Come to the clinic and provide a urinalysis specimen. 4. Use a sterile 4 × 4 gauze to strain the client's urine.

The client with a history of renal calculi calls the clinic and reports having burning on urination, chills, and an elevated temperature. Which instruction should the nurse discuss with the client? 1. Increase water intake for the next 24 hours. 2. Take two (2) Tylenol to help decrease the temperature. 3. Come to the clinic and provide a urinalysis specimen. 4. Use a sterile 4 × 4 gauze to strain the client's urine.

The healthcare provider is assessing a patient diagnosed with ulcerative colitis. The patient has an altered level of consciousness, fever, and lower abdominal distension. Which of these additional findings would confirm a diagnosis of toxic megacolon? 1. Bradycardia 2. Splenomegaly 3. Leukocytosis 4. Constipation

The laboratory data reveal a calcium phosphate renal stone for a client diagnosed with renal calculi. Which discharge teaching intervention should the nurse implement? 1. Encourage the client to eat a low-purine diet and limit foods such as organ meats. 2. Explain the importance of not drinking water 2 hours before bedtime. 3. Discuss the importance of limiting vitamin D-enriched foods. 4. Prepare the client for extracorporeal shock wave lithotripsy (ESWL).

The laboratory data reveal a calcium phosphate renal stone for a client diagnosed with renal calculi. Which discharge teaching intervention should the nurse implement? 1. Encourage the client to eat a low-purine diet and limit foods such as organ meats. 2. Explain the importance of not drinking water two (2) hours before bedtime. 3. Discuss the importance of limiting vitamin D-enriched foods. 4. Prepare the client for extracorporeal shock wave lithotripsy (ESWL).

The nurse is caring for a client diagnosed with ulcerative colitis. Which clinical manifestation(s) support this diagnosis? 1. Increased appetite and thirst. 2. Elevated hemoglobin. 3. Multiple bloody, liquid stools. 4. Exacerbations unrelated to stress.

The nurse is caring for the client diagnosed with ascites secondary to hepatic cirrhosis. Which information should the nurse report to the HCP? 1. A decrease in the client's daily weight of 1 pound. 2. An increase in urine output after administration of a diuretic. 3. An increase in abdominal girth of 2 inches. 4. A decrease in the serum direct bilirubin to 0.6 mg/dL.

When planning diet teaching for the client with a colostomy, the nurse should develop a plan that emphasizes which dietary instruction? 1. Foods containing roughage should not be eaten. 2. Liquids are best limited to prevent diarrhea. 3. Clients should experiment to find the diet that is best for them. 4. A high-fiber diet will produce a regular passage of stool.

Which assessment question is priority for the nurse to ask the client diagnosed with end-stage liver failure secondary to alcoholic cirrhosis? 1. "How many years have you been drinking alcohol?" 2. "Have you completed an advance directive?" 3. "When did you have your last alcoholic drink?" 4. "What foods did you eat at your last meal?"

Which gastrointestinal assessment data should the nurse expect to find when assessing the client in end-stage liver failure? 1. Hypoalbuminemia and muscle wasting. 2. Oligomenorrhea and decreased body hair. 3. Clay-colored stools and hemorrhoids. 4. Dyspnea and caput medusae.

Which information should the nurse teach the client post-barium enema procedure? 1. The client should not eat or drink anything for 4 hours. 2. The client should remain on bedrest until the sedative wears off. 3. The client should take a mild laxative to help expel the barium. 4. The client will have a normal elimination color and pattern.

Which information would the nurse include in response to a client's questioning a protein-restricted dietary change required for his or her acute kidney injury? 1 "A high-protein intake ensures an adequate daily supply of amino acids to compensate for losses." 2 "Essential and nonessential amino acids are necessary in the diet to supply materials for tissue protein synthesis." 3 "This diet supplies only essential amino acids, reducing the amount of metabolic waste products, thus decreasing stress on the kidneys." 4 "Currently, your body is unable to synthesize amino acids, so the nitrogen for amino acid synthesis must come from the dietary protein."

Which medication may be useful in managing hypertension in a child with acute glomerulonephritis? 1 Digoxin 2 Diazepam 3 Captopril 4 Phenytoin

Which modifiable risk factor should the nurse identify for the development of cancer of the bladder in a client? 1. Previous exposure to chemicals. 2. Pelvic radiation therapy. 3. Cigarette smoking. 4. Parasitic infections of the bladder.

Which sign and symptom is an associated complication of chronic kidney disease while undergoing peritoneal dialysis? 1 Petechiae 2 Abdominal bruit 3 Cloudy return dialysate 4 Increased blood glucose level

Which symptom is indicative of the need for dialysis in the child with chronic kidney disease? 1 Hypotension 2 Hypokalemia 3 Hypervolemia 4 Hypercalcemia

a nurse is planning care for a client who has prerenal acute kidney injury. The client's urinary output is 80mL in the past 4 hr. and blood pressure is 92/58mm Hg. which of the following should be included in the plan of care? 1. prepare the client for a CAT scan with contrast die 2. anticipate urine specific gravity to be 1.010 3. plan to administer a fluid challenge 4. place client in trendelenburg position

A client with chronic kidney disease is admitted to the hospital with severe infection and anemia. The client reports feeling depressed and irritable. The client's spouse asks the nurse about the anticipated plan of care. Which response would the nurse provide? 1 "The staff will provide total care, because the infection causes severe fatigue." 2 "Mood elevators will be prescribed to improve the depression and irritability." 3 "Vitamin B12 will be prescribed for the anemia, and the stools will be dark." 4 "Protein foods will be restricted so the kidneys can clear the waste products."

A client with chronic kidney disease selects treatment using continuous ambulatory peritoneal dialysis (CAPD). Which statement indicates the client understands the purpose of this therapy? 1 "The treatment provides continuous contact of dialyzer and blood to clear toxins by ultrafiltration." 2 "The treatment exchanges and cleanses blood by correction of electrolytes and excretion of creatinine." 3 "The treatment decreases the need for immobility, because the fluids clear the toxins in short and intermittent periods." 4 "The treatment uses the peritoneum as a semipermeable membrane to clear toxins by osmosis and diffusion."

A client's clinical manifestations include dysuria, hesitancy, urinary urgency, and urinary leakage. The client's serum prostate-specific antigen (PSA) level is 5 ng/mL, and the client has an elevated prostatic acid phosphatase (PAP) level. Which disorder would the nurse suspect? 1 Orchitis 2 Hydrocele 3 Prostatitis 4 Prostate cancer

A male client had abdominal surgery and the nurse suspects he has peritonitis. Which assessment data support the diagnosis of peritonitis? 1. Absent bowel sounds & potassium level of 3.9 mEq/L 2. Abdominal cramping & hemoglobin of 14 g/dL 3. Profuse diarrhea & stool specimen shows Campylobacter. 4. Hard, rigid abdomen & white blood cell count 22,000/mm^3

A nurse is providing wound care to a client 1 day following an appendectomy. A drain was inserted into the incisional site during surgery. When providing wound care, the nurse should: 1. remove the dressing and leave the incision open to air. 2. remove the drain if wound drainage is minimal. 3. gently irrigate the drain to remove exudate. 4. clean the area around the drain moving away from the drain.

A school-age child is admitted with hypertensive acute glomerulonephritis. Which medication would the nurse anticipate being prescribed initially in addition to hydralazine? 1 Digoxin 2 Alprazolam 3 Phenytoin 4 Furosemide

Before a transurethral resection of the prostate (TURP), a client asks about what to expect postoperatively. Which response would the nurse provide? 1 "Your urine will be pink and free of clots." 2 "You will have an abdominal incision and a dressing." 3 "There will be an incision between your scrotum and rectum." 4 "There will be a urinary catheter and a continuous bladder irrigation."

The client asks the clinic nurse if he should take 2,000 mg of vitamin C a day to prevent getting a cold. On which scientific rational should the nurse base the response? 1. Vitamin C in this dosage will help cure the common cold. 2. The vitamin must be taken with echinacea to be effective. 3. This dose of vitamin C is not high enough to help prevent colds. 4. Megadose of vitamin C may cause crystals to form in the urine.

The client diagnosed with end-stage liver failure is admitted with hepatic encephalopathy. Which dietary restriction should be implemented by the nurse to address this complication? 1. Restrict sodium intake to 2 g/day. 2. Limit oral fluids to 1,500 mL/day. 3. Decrease the daily fat intake. 4. Reduce protein intake to 60 to 80 g/day.

The client had surgery to remove a kidney stone. Which laboratory assessment data warrant immediate intervention by the nurse? 1. A serum potassium level of 3.8 mEq/L. 2. A urinalysis shows microscopic hematuria. 3. A creatinine level of 0.8 mg/100 mL. 4. A white blood cell count of 14,000/mm3.

The client is diagnosed with an acute episode of ureteral calculi. Which client problem is priority when caring for this client? 1. Fluid volume loss. 2. Knowledge deficit. 3. Impaired urinary elimination. 4. Alteration in comfort.

The client is diagnosed with an acute exacerbation of IBD. Which food selection would be the best choice for a meal? 1. Roast beef on wheat bread and a milkshake. 2. Hamburger, french fries, and a cola. 3. Pepper steak, brown rice, and iced tea. 4. Roasted turkey, instant mashed potatoes, and water.

The client is two (2) days postureterosigmoidostomy for cancer of the bladder. Which assessment data warrant notification of the HCP by the nurse? 1. The client complains of pain at a "3," 30 minutes after being medicated. 2. The client complains it hurts to cough and deep breathe. 3. The client ambulates to the end of the hall and back before lunch. 4. The client is lying in a fetal position and has a rigid abdomen.

The client with a TURP who has a continuous irrigation catheter complains of the need to urinate. Which intervention should the nurse implement first? 1. Call the surgeon to inform the HCP of the client's complaint. 2. Administer the client a narcotic medication for pain. 3. Explain to the client this sensation happens frequently. 4. Assess the continuous irrigation catheter for patency.

The client with a diagnosis of possible colon cancer is 2 hours post-sigmoidoscopy procedure. Which assessment data warrant immediate intervention by the nurse? 1. The client has hyperactive bowel sounds. 2. The client is eating a hamburger the family brought. 3. The client is sleepy and wants to sleep. 4. The client's BP is 96/60 and an apical pulse is 108.

The client with possible renal calculi is scheduled for a renal ultrasound. Which intervention should the nurse implement for this procedure? 1. Ask if the client is allergic to shellfish or iodine. 2. Keep the client NPO 8 hours prior to the ultrasound. 3. Ensure the client has a signed informed consent form. 4. Explain the test is noninvasive and there is no discomfort.

The client with possible renal calculi is scheduled for a renal ultrasound. Which intervention should the nurse implement for this procedure? 1. Ask if the client is allergic to shellfish or iodine. 2. Keep the client NPO eight (8) hours prior to the ultrasound. 3. Ensure the client has a signed informed consent form. 4. Explain the test is noninvasive and there is no discomfort.

The nurse and a licensed practical nurse (LPN) are caring for a group of clients. Which intervention should be assigned to the LPN? 1. Assessment of the client who has had a Kock pouch procedure. 2. Monitoring of the postop client with a WBC of 22,000/mm3. 3. Administration of the prescribed antineoplastic medications. 4. Care for the client going for an MRI of the kidneys.

The nurse identifies the client problem "alteration in gastrointestinal system" for the older client. Which statement reflects the most appropriate rationale for this problem? 1. Older clients have the ability to chew food more thoroughly with dentures. 2. Older clients have an increase in digestive enzymes, which helps with digestion. 3. Older clients have an increased need for laxatives because of a decrease in bile. 4. Older clients have an increase in bacteria in the GI system, resulting in diarrhea.

The nurse identifies the problem of "fluid volume deficit" for a client diagnosed with gastritis. Which intervention should be included in the plan of care? 1. Obtain permission for a blood transfusion. 2. Prepare the client for TPN. 3. Monitor the client's lung sounds every shift. 4. Assess the client's intravenous site.

client admitted to the hospital with peptic ulcer disease tells the nurse about having black, tarry stools. The nurse should: 1. encourage the client to increase fluid intake. 2. advise the client to avoid iron-rich foods. 3. place the client on contact precautions. 4. report the finding to the healthcare provider (HCP).

o reduce the risk of dumping syndrome, the nurse should teach the client to: 1. sit upright for 30 minutes after meals. 2. drink liquids with meals, avoiding caffeine. 3. avoid milk and other dairy products. 4. decrease the carbohydrate content of meals.

A client with chronic kidney disease (CKD) is refusing to take his medication and has missed two hemodialysis appointments. What is the best initial action for the nurse? a. Discuss what the treatment regimen means to the client. b. Refer the client to a mental health nurse practitioner. c. Reschedule the appointments to another date and time. d. Discuss the option of peritoneal dialysis

A marathon runner comes into the clinic and states "I have not urinated very much in the last few days." The nurse notes a heart rate of 110 beats/min and a blood pressure of 86/58 mm Hg. Which action by the nurse is most appropriate? a. Give the client a bottle of water immediately. b. Start an intravenous line for fluids. c. Teach the patient to drink 2 to 3 L of water daily. d. Perform an electrocardiogram.

A nurse assesses a client who is recovering from a Whipple procedure. Which assessment finding alerts the nurse to immediately contact the primary health care provider? a. Drainage from a fistula b. Diminished bowel sounds c. Pain at the incision site d. Nasogastric (NG) tube drainage

A nurse assesses a client who presents with renal calculi. Which question would the nurse ask? a. "Do any of your family members have this problem?" b. "Do you drink any cranberry juice?" c. "Do you urinate after sexual intercourse?" d. "Do you experience burning with urination?"

A nurse cares for a client with diabetes mellitus who is prescribed metformin (Glucophage) and is scheduled for an intravenous urography. Which action should the nurse take first? a. Contact the provider and recommend discontinuing the metformin. b. Keep the client NPO for at least 6 hours prior to the examination. c. Check the client's capillary artery blood glucose and administer prescribed insulin. d. Administer intravenous fluids to dilute and increase the excretion of dye.

A nurse cares for a client with end-stage pancreatic cancer. The client asks, "Why is this happening to me?" How would the nurse respond? a. "I don't know. I wish I had an answer for you, but I don't." b. "It's important to keep a positive attitude for your family right now." c. "Scientists have not determined why cancer develops in certain people." d. "I think that this is a trial so you can become a better person because of it."

A nurse contacts the health care provider after reviewing a client's laboratory results and noting a blood urea nitrogen (BUN) of 35 mg/dL and a creatinine of 1.0 mg/dL. For which action should the nurse recommend a prescription? a. Intravenous fluids b. Hemodialysis c. Fluid restriction d. Urine culture and sensitivity

A nurse evaluates a client with acute glomerulonephritis (GN). Which assessment finding would the nurse recognize as a positive response to the prescribed treatment? a. The client lost 11 lb (5 kg) in the past 10 days. b. The client's urine specific gravity is 1.048. c. No blood is observed in the client's urine. d. The client's blood pressure is 152/88 mm Hg.

A nurse reviews laboratory results for a client who was admitted for a myocardial infarction and cardiogenic shock 2 days ago. Which laboratory test result should the nurse expect to find? a. Blood urea nitrogen (BUN) of 52 mg/dL b. Creatinine of 2.3 mg/dL c. BUN of 10 mg/dL d. BUN/creatinine ratio of 8:1

A nurse reviews the allergy list of a client who is scheduled for an intravenous urography. Which client allergy should alert the nurse to urgently contact the health care provider? a. Seafood b. Penicillin c. Bee stings d. Red food dye

After delegating to an unlicensed assistive personnel (UAP) the task of completing a bladder scan examination for a client, the nurse evaluates the UAP's performance. Which action by the UAP indicates the nurse must provide additional instructions when delegating this task? a. Selecting the female icon for all female clients and male icon for all male clients b. Telling the client, "This test measures the amount of urine in your bladder." c. Applying ultrasound gel to the scanning head and removing it when finished d. Taking at least two readings using the aiming icon to place the scanning head

After teaching a client with a history of renal calculi, the nurse assesses the client's understanding. Which statement made by the client indicates a correct understanding of the teaching? a. "I should drink at least 3 L of fluid every day." b. "I will eliminate all dairy or sources of calcium from my diet." c. "Aspirin and aspirin-containing products can lead to stones." d. "The doctor can give me antibiotics at the first sign of a stone."

The nurse assesses a client who is recovering from a paracentesis 1 hour ago. Which assessment finding would require immediate action by the nurse? a. Urine output via indwelling urinary catheter is 20 mL/hr b. Blood pressure increases from 110/58 to 120/62 mm Hg c. Respiratory rate decreases from 22 to 16 breaths/min d. A decrease in the client's weight by 3 lb (1.4 kg)

The nurse delegates completing a bladder scan to assistive personnel (AP). Which action by the AP indicates that the nurse must provide additional instructions when delegating this task? a. Selecting the female icon for all female patients and male icon for all male patients b. Telling the client, "This test measures the amount of urine in your bladder." c. Applying ultrasound gel to the scanning head and removing it when finished d. Taking at least two readings using the aiming icon to place the scanning head

What will the nurse recognize as the cause of splenomegaly in a client who has cirrhosis? A. Increased pressure in the portal vein causing backflow of blood into the spleen B. The loss of cellular regulation in the liver spreading to the spleen and causing extensive scarring C. Chronic inflammation and infection increasing the spleen's maturation and release of white blood cells D. Direct destruction of spleen cells from alcohol or other toxins causing replacement with scar tissue formation

The nurse is caring for five clients on the medical-surgical unit. Which clients would the nurse consider to be at risk for post-renal acute kidney injury (AKI)? (Select all that apply.) a. Man with prostate cancer b. Woman with blood clots in the urinary tract c. Client with ureterolithiasis d. Firefighter with severe burns e. Young woman with lupus

A, B, C

The nurse is preparing a client who has chronic pancreatitis about how to prevent exacerbations of the disease. Which health teaching will the nurse include? (Select all that apply.) a. "Avoid alcohol ingestion." b. "Be sure and balance rest with activity." c. "Avoid caffeinated beverages." d. "Avoid green, leafy vegetables." e. "Eat small meals and high-calorie snacks."

A, B, C, E

A, B, D

A client is undergoing hemodialysis. The clients blood pressure at the beginning of the procedure was 136/88 mm Hg, and now it is 110/54 mm Hg. What actions should the nurse perform to maintain blood pressure? (Select all that apply.) a. Adjust the rate of extracorporeal blood flow. b. Place the client in the Trendelenburg position. c. Stop the hemodialysis treatment. d. Administer a 250-mL bolus of normal saline. e. Contact the health care provider for orders.

A, B, D

A client is unsure of the decision to undergo peritoneal dialysis (PD) and wishes to discuss the advantages of this treatment with the nurse. Which statements by the nurse are accurate regarding PD? (Select all that apply.) a. You will not need vascular access to perform PD. b. There is less restriction of protein and fluids. c. You will have no risk for infection with PD. d. You have flexible scheduling for the exchanges. e. It takes less time than hemodialysis treatments.

A, B, D

A client is unsure of the decision to undergo peritoneal dialysis (PD) and wishes to discuss the advantages of this treatment with the nurse. Which statements by the nurse are correct regarding PD? (Select all that apply.) a. "You will not need vascular access to perform PD." b. "There is less restriction of protein and fluids." c. "You will have no risk for infection with PD." d. "You have flexible scheduling for the exchanges." e. "It takes less time than hemodialysis treatments."

A, B, D

A nurse assesses a client who has had two episodes of bacterial cystitis in the last 6 months. Which question(s) would the nurse ask? (Select all that apply.) a. "How much water do you drink every day?" b. "Do you take estrogen replacement therapy?" c. "Does anyone in your family have a history of cystitis?" d. "Are you on steroids or other immune-suppressing drugs?" e. "Do you drink grapefruit juice or orange juice daily?"

A, B, D

A nurse reviews a client's laboratory results. Which results from the client's urinalysis would the nurse identify as normal? (Select all that apply.) a. pH: 6 b. Specific gravity: 1.015 c. Protein: 1.2 mg/dL d. Glucose: negative e. Nitrate: small f. Leukocyte esterase: positive

A, B, D

A nurse teaches a client with polycystic kidney disease (PKD). Which statements would the nurse include in this client's discharge teaching? (Select all that apply.) a. "Take your blood pressure every morning." b. "Weigh yourself at the same time each day." c. "Adjust your diet to prevent diarrhea." d. "Contact your provider if you have visual disturbances." e. "Assess your urine for renal stones.

A, B, D

Which assessment findings will the nurse expect in a client with late-stage liver cirrhosis whose total serum albumin level is low? Select all that apply. A. Ascites B. Hypotension C. Hyperkalemia D. Hyponatremia E. Dependent edema F. Decreased serum ammonia levels

A, B, D, E

Which signs and symptoms will the nurse expect to find on assessment of a client with chronic liver disease who has an elevated serum bilirubin level? Select all that apply. A. Pruritus B. Icterus C. Hypertension D. Jaundice E. Pale, clay-colored stools F. Dark, coffee-colored urine.

A, B, D, E, F

The nurse is caring for a client with early encephalopathy due to cirrhosis of the liver. Which factors may contribute to increased encephalopathy for which the nurse would assess? (Select all that apply.) a. Infection b. GI bleeding c. Irritable bowel syndrome d. Constipation e. Anemia f. Hypovolemia

A, B, D, F

A nurse plans care for an older adult patient. Which interventions should the nurse include in this client's plan of care to promote kidney health? (Select all that apply.) a. Ensure adequate fluid intake. b. Leave the bathroom light on at night. c. Encourage use of the toilet every 6 hours. d. Delegate bladder training instructions to the assistive personnel (AP). e. Provide thorough perineal care after each voiding. f. Assess for urinary retention and urinary tract infection

A, B, E, F

The nurse is preparing a client for a percutaneous kidney biopsy. Which laboratory tests results would the nurse review prior to the procedure? (Select all that apply.) a. Hemoglobin b. Hematocrit c. Sodium d. Potassium e. Platelet count f. Prothrombin time

A, B, E, F

For which causes will the nurse monitor clients for development of intrarenal (intrinsic) acute kidney injury (AKI)? Select all that apply. A. Glomerulonephritis B. Bladder cancer C. Exposure to nephrotoxins D. Embolism in renal blood vessels E. Severe dehydration F. Kidney stones

A, C, D

The nurse is reviewing the results of a client's urinalysis. The client has a diagnosis of acute glomerulonephritis. Which urine findings would the nurse expect? (Select all that apply.) a. Presence of protein b. Presence of red blood cells c. Presence of white blood cells d. Acidic urine e. Dilute urine

A, C, D

The nurse is teaching assistive personnel (AP) about care of a client who has advanced cirrhosis. Which statements would the nurse include in the staff teaching? (Select all that apply.) a. "Apply lotion to the client's dry skin areas." b. "Use a basin with warm water to bathe the patient." c. "For the patient's oral care, use a soft toothbrush." d. "Provide clippers so the patient can trim the fingernails." e. "Bathe with antibacterial and water-based soaps."

A, C, D

Which actions are appropriate for the nurse to perform to prevent harm in a client with cirrhosis and ascites who has just undergone an esophagogastroduodenoscopy (EGD)? Select all that apply. A. Measuring oxygen saturation B. Checking for leakage from the site C. Assessing for return of the gag reflex D. Monitoring heart rate and blood pressure E. Auscultating bowel sounds in all four quadrants F. Comparing weight with that obtained before the procedure

A, C, D

Which information will be included when the nurse is teaching self-management to a patient who is receiving peritoneal dialysis (select all that apply)? A. Avoid commercial salt substitutes. B. Drink 1500 to 2000 mL of fluids daily. C. Take phosphate-binders with each meal. D. Choose high-protein foods for most meals. E. Have several servings of dairy products daily.

A, C, D

Which are the goals of nutritional support for a client with acute kidney injury (AKI) when the nurse collaborates with the registered dietitian nutritionist (RDN)? Select all that apply. A. Maintaining or improving nutritional status B. Creating a program for weight loss C. Preserving lean body mass D. Restoring or maintaining fluid balance E. Preserving kidney function F. Preventing end-state kidney disease

A, C, D, E

The nurse plans care for a patient who has hepatopulmonary syndrome. Which interventions would the nurse include in this client's plan of care? (Select all that apply.) a. Oxygen therapy b. Prone position c. Feet elevated on pillows d. Daily weights e. Physical therapy f. Respiratory therapy

A, C, D, F

A client is hospitalized in the oliguric phase of acute kidney injury (AKI) and is receiving tube feedings. The nurse is teaching the client's spouse about the renal-specific formulation for the enteral solution compared to standard formulas. What components would be discussed in the teaching plan? (Select all that apply.) a. Lower sodium b. Higher calcium c. Lower potassium d. Higher phosphorus e. Higher calories

A, C, E

A client is hospitalized in the oliguric phase of acute kidney injury (AKI) and is receiving tube feedings. The nurse is teaching the clients spouse about the kidney-specific formulation for the enteral solution compared to standard formulas. What components should be discussed in the teaching plan? (Select all that apply.) a. Lower sodium b. Higher calcium c. Lower potassium d. Higher phosphorus e. Higher calories

A, C, E

A nurse is caring for a postoperative 70-kg client who had major blood loss during surgery. Which findings by the nurse should prompt immediate action to prevent acute kidney injury? (Select all that apply.) a. Urine output of 100 mL in 4 hours b. Urine output of 500 mL in 12 hours c. Large amount of sediment in the urine d. Amber, odorless urine e. Blood pressure of 90/60 mm Hg

A, C, E

A nurse is caring for a postoperative 70-kg client who had major blood loss during surgery. Which findings by the nurse would prompt immediate action to prevent acute kidney injury? (Select all that apply.) a. Urine output of 100 mL in 4 hours b. Urine output of 500 mL in 12 hours c. Large amount of sediment in the urine d. Amber, odorless urine e. Blood pressure of 90/60 mm Hg

A, C, E

The nurse plans care for a client who has acute pancreatitis and is prescribed nothing by mouth (NPO). With which health care team members would the nurse collaborate to provide appropriate nutrition to this client? (Select all that apply.) a. Registered dietitian nutritionist b. Nursing assistant c. Clinical pharmacist d. Certified herbalist e. Primary health care provider

A, C, E

When prerenal and postrenal causes of acute kidney injury occur, how does the nurse expect a client's kidneys to compensate? Select all that apply. A. Constricting of blood vessels in the kidneys B. Restricting of secretion of glucocorticoids C. Releasing antidiuretic hormone (ADH) D. Crushing then passing fragments of kidney stones E. Dilating of peripheral arteries throughout the body F. Activating the renin-angiotensin-aldosterone pathway

A, C, F

A nurse assesses a client recovering from a cystoscopy. Which assessment findings would alert the nurse to urgently contact the primary health care provider? (Select all that apply.) a. Decrease in urine output b. Tolerating oral fluids c. Prescription for metformin d. Blood clots present in the urine e. Burning sensation when urinating

A, D

Which assessment questions are most appropriate for the nurse to ask a client at risk for acute kidney injury (AKI)? Select all that apply. A. "Have you noticed any changes in your urine's appearance, frequency, or volume?" B. "Have you experienced any leakage of urine when coughing or laughing?" C. "Do you weigh yourself and have you noticed any unexpected weight loss?" D. "Do you have a history of diabetes, hypertension, or peripheral vascular disease?" E. "Do you use any nonsteroidal anti-inflammatory drugs regularly?" F. "Have you had and recent surgeries, traumas, or transfusions?"

A, D, E, F

Which symptoms in a client with cirrhosis and encephalopathy indicate to the nurse that the prescribed lactulose therapy is effective? Select all that apply. A. Decreased confusion B. Increased urine output C. Musty odor to the breath D. Two to three soft stools daily E. Lower serum bilirubin levels F. Lower serum ammonia levels

A, D, F

The nurse is caring for five clients on the medical-surgical unit. Which clients would the nurse consider to be at risk for postrenal acute kidney injury (AKI)? (Select all that apply.) a. Client with prostate cancer b. Client with blood clots in the urinary tract c. Client with ureterolithiasis d. Client with severe burns e. Client with lupus

A,B, C

The nurse is assessing a client with hepatitis C. The client asks the nurse how it was possible to have this disease. What questions might the nurse ask to help the client determine how the disease was contracted? (Select all that apply.) a. "How old are you?" b. "Do you work in health care? c. "Are you receiving hemodialysis?" d. "Do you use IV drugs?" e. "Did you receive blood before 1992?" f. "Have you even been in prison or jail?"

ALL

The nurse is caring for a client who has late-stage (advanced) cirrhosis. What assessment findings would the nurse expect? (Select all that apply.) a. Jaundice b. Clay-colored stools c. Icterus d. Ascites e. Petechiae f. Dark urine

ALL

The nurse is caring for a client who has possible acute pancreatitis. What serum laboratory findings would the nurse expect for this client? (Select all that apply.) a. Elevated amylase b. Elevated lipase c. Elevated glucose d. Decreased calcium e. Elevated bilirubin f. Elevated leukocyte count

ALL

When caring for the client with a left forearm arteriovenous (AV) fistula created for hemodialysis, the nurse must do which of these? Select all that apply. A. Check brachial pulses daily B. Auscultate for a bruit each shift C. Teach the client to palpate for a thrill over the site D. Elevate the arm above heart level E. Ensure that no blood pressures are taken in that arm

b,c,e

A 32-year-old patient with a history of polycystic kidney disease is admitted to the surgical unit after having shoulder surgery. Which of the routine postoperative orders is most important for the nurse to discuss with the health care provider? a. Infuse 5% dextrose in normal saline at 75 mL/hr. b. Order regular diet after patient is awake and alert. c. Give ketorolac (Toradol) 10 mg PO PRN for pain. d. Draw blood urea nitrogen (BUN) and creatinine in 2 hours.

A 55-year-old patient with end-stage kidney disease (ESKD) is scheduled to receive a prescribed dose of epoetin alfa (Procrit). Which information should the nurse report to the health care provider before giving the medication? A. Creatinine 1.6 mg/dL B. Oxygen saturation 89% C. Hemoglobin level 13 g/dL D. Blood pressure 98/56 mm Hg

A 63-year-old male patient had a cystectomy with an ileal conduit yesterday. Which new assessment data is most important for the nurse to communicate to the physician? a. Cloudy appearing urine b. Hypotonic bowel sounds c. Heart rate 102 beats/minute d. Continuous stoma drainage

A 64-year-old male patient who has had progressive chronic kidney disease (CKD) for several years has just begun regular hemodialysis. Which information about diet will the nurse include in patient teaching? A. Increased calories are needed because glucose is lost during hemodialysis. B. Unlimited fluids are allowed because retained fluid is removed during dialysis. C. More protein is allowed because urea and creatinine are removed by dialysis. D. Dietary potassium is not restricted because the level is normalized by dialysis.

A client is diagnosed with chronic kidney disease (CKD). What is an ideal goal of treatment set by the nurse in the care plan to reduce the risk of pulmonary edema? a. Maintaining oxygen saturation of 89% b. Minimal crackles and wheezes in lung sounds c. Maintaining a balanced intake and output d. Limited shortness of breath upon exertion

A client is placed on fluid restrictions because of chronic kidney disease (CKD). Which assessment finding would alert the nurse that the clients fluid balance is stable at this time? a. Decreased calcium levels b. Increased phosphorus levels c. No adventitious sounds in the lungs d. Increased edema in the legs

A licensed practical/vocational nurse (LPN/LVN) is caring for a patient with stage 2 chronic kidney disease. Which observation by the RN requires an intervention? A. The LPN/LVN administers the erythropoietin subcutaneously. B. The LPN/LVN assists the patient to ambulate out in the hallway. C. The LPN/LVN administers the iron supplement and phosphate binder with lunch. D. The LPN/LVN carries a tray containing low-protein foods into the patient's room.

A nurse cares for a middle-age female client with diabetes mellitus who is being treated for the third episode of acute pyelonephritis in the past year. The client asks, "What can I do to help prevent these infections?" How would the nurse respond? a. "Test your urine daily for the presence of ketone bodies and proteins." b. "Use tampons rather than sanitary napkins during your menstrual period." c. "Drink more water and empty your bladder more frequently during the day." d. "Keep your hemoglobin A1C under 9% by keeping your blood sugar controlled.

A patient admitted to the hospital with pneumonia has a history of functional urinary incontinence. Which nursing action will be included in the plan of care? a. Demonstrate the use of the Credé maneuver. b. Teach exercises to strengthen the pelvic floor. c. Place a bedside commode close to the patient's bed. d. Use an ultrasound scanner to check postvoiding residuals.

A patient with diabetes who has bacterial pneumonia is being treated with IV gentamicin (Garamycin) 60 mg IV BID. The nurse will monitor for adverse effects of the medication by evaluating the patient's A. blood glucose. B. urine osmolality. C. serum creatinine. D. serum potassium.

After a ureterolithotomy, a female patient has a left ureteral catheter and a urethral catheter in place. Which action will the nurse include in the plan of care? a. Provide teaching about home care for both catheters. b. Apply continuous steady tension to the ureteral catheter. c. Call the health care provider if the ureteral catheter output drops suddenly. d. Clamp the ureteral catheter off when output from the urethral catheter stops.

After teaching a client who has alcohol-induced cirrhosis, a nurse assesses the client's understanding. Which statement made by the client indicates a need for further teaching? a. "I cannot drink any alcohol at all anymore." b. "I should not take over-the-counter medications." c. "I need to avoid protein in my diet." d. "I should eat small, frequent, balanced meals."

After teaching a client who is prescribed pancreatic enzyme replacement therapy, the nurse assesses the client's understanding. Which statement by the client indicates a need for further teaching? a. "The capsules can be opened and the powder sprinkled on applesauce if needed." b. "I will wipe my lips carefully after I drink the enzyme preparation." c. "The best time to take the enzymes is immediately after I have a meal or a snack." d. "I will not mix the enzyme powder with food or liquids that contain protein."

Before administration of calcium carbonate (Caltrate) to a patient with chronic kidney disease (CKD), the nurse should check laboratory results for: A. potassium level. B. total cholesterol. C. serum phosphate. D. serum creatinine.

Following hemodialysis, a PT begins bleeding profusely from his IV site and nose. Why? a. Liver disease b. Low albumin c. He received heparin during hemodialysis d. Elevated platelets

Following rectal surgery, a patient voids about 50 mL of urine every 30 to 60 minutes for the first 4 hours. Which nursing action is most appropriate? a. Monitor the patient's intake and output over night. b. Have the patient drink small amounts of fluid frequently. c. Use an ultrasound scanner to check the post-voiding residual volume. d. Reassure the patient that this is normal after rectal surgery because of anesthesia.

For a client diagnosed with acute kidney injury (AKI), the nurse considers questions an order for which diagnostic test? A. Ultrasonography B. Kidney-ureter-bladder x-ray (KUB) C. Computed tomography with contrast D. Kidney biopsy

For which condition does the nurse suspect a client with chronic kidney disease (CKD) is attempting to compensate for when respirations increase in rate and depth? A. Hypoxia B. Alkalosis C. Acidosis D. Hypoxemia

Nursing staff on a hospital unit are reviewing rates of hospital-acquired infections (HAI) of the urinary tract. Which nursing action will be most helpful in decreasing the risk for HAI in patients admitted to the hospital? a. Encouraging adequate oral fluid intake b. Testing urine with a dipstick daily for nitrites c. Avoiding unnecessary urinary catheterizations d. Providing frequent perineal hygiene to patients

The charge nurse is orienting a float nurse to an assigned client with an arteriovenous (AV) fistula for hemodialysis in her left arm. Which action by the float nurse would be considered unsafe? a. Palpating the access site for a bruit or thrill b. Using the right arm for a blood pressure reading c. Administering intravenous fluids through the AV fistula d. Checking distal pulses in the left arm

The home health nurse teaches a patient with a neurogenic bladder how to use intermittent catheterization for bladder emptying. Which patient statement indicates that the teaching has been effective? a. "I will buy seven new catheters weekly and use a new one every day." b. "I will use a sterile catheter and gloves for each time I self-catheterize." c. "I will clean the catheter carefully before and after each catheterization." d. "I will need to take prophylactic antibiotics to prevent any urinary tract infections."

The nurse determines that further instruction is needed for a patient with interstitial cystitis when the patient says which of the following? a. "I should stop having coffee and orange juice for breakfast." b. "I will buy calcium glycerophosphate (Prelief) at the pharmacy." c. "I will start taking high potency multiple vitamins every morning." d. "I should call the doctor about increased bladder pain or odorous urine."

The nurse documents the vital signs of a client diagnosed with acute pancreatitis: Apical pulse = 116 beats/min Respirations = 28 breaths/min Blood pressure = 92/50 What complication of acute pancreatitis would the nurse suspect that the client might have? a. Electrolyte imbalance b. Pleural effusion c. Internal bleeding d. Pancreatic pseudocyst

The nurse is caring for a client who has chronic pyelonephritis. What assessment finding would the nurse expect? a. Fever b. Flank pain c. Hypertension d. Nausea and vomiting

The nurse is taking the vital signs of a client after hemodialysis. Blood pressure is 110/58 mm Hg, pulse 66 beats/min, and temperature is 99.8 F (37.6 C). What is the most appropriate action by the nurse? a. Administer fluid to increase blood pressure. b. Check the white blood cell count. c. Monitor the clients temperature. d. Connect the client to an electrocardiographic (ECG) monitor.

The nurse is teaching a client how to increase the flow of dialysate into the peritoneal cavity during dialysis. Which statement by the client demonstrates a correct understanding of the teaching? a. I should leave the drainage bag above the level of my abdomen. b. I could flush the tubing with normal saline if the flow stops. c. I should take a stool softener every morning to avoid constipation. d. My diet should have low fiber in it to prevent any irritation.

The nurse observes unlicensed assistive personnel (UAP) taking the following actions when caring for a female patient with a urethral catheter. Which action requires that the nurse intervene? a. Taping the catheter to the skin on the patient's upper inner thigh b. Cleaning around the patient's urinary meatus with soap and water c. Disconnecting the catheter from the drainage tube to obtain a specimen d. Using an alcohol-based gel hand cleaner before performing catheter care

The nurse recognizes that the client with end-stage kidney disease has difficulty adhering to the fluid restriction when which of these is found? A. Blood pressure 118/78 B. Weight loss of 3 lbs during hospitalization C. Dyspnea and anxiety at rest D. Central venous pressure (CVP) of 6 mm Hg

What is the best method for the nurse to monitor the weight of a client who is receiving peritoneal dialysis (PD)? A. Calculating the client's dry weight by comparing daily weights to baseline weights B. Determining dry weight by comparing the client's weight to a standard weight chart C. Checking the weight after a drain and before the next fill to monitor the dry weight D. Weighing the client daily and subtracting dialysate volume to determine dry weight

What is the nurse's best action when a client receiving PD has slightly less outflow than inflow? A. Placing the client on an oral fluid intake restriction B. Notifying the nephrology health care provider C. Recording the difference as intake on the flow sheet D. Instructing the client to stand and walk then measuring the next outflow

What is the nurse's best response to a client who fears he may have been exposed to hepatitis A while attending a banquet last week after which three restaurant workers were diagnosed with hepatitis A? A. "Which types of food did you eat at the banquet?" B. "If you have no symptoms at this time, you are probably safe." C. "You can receive an immunoglobulin injection to prevent the infection." D. "Contact your primary health care provider about receiving the hepatitis A vaccine."

What is the priority info for the nurse to provide the PT with a hip fracture and CKD prior to discharge a. Increased intake of foods with protein b. Monitor daily intake and output c. Take your aluminum hydroxide (Nephrox) with meals d. Maintain bedrest until the fracture is healed

When preparing a female patient with bladder cancer for intravesical chemotherapy, the nurse will teach about a. premedicating to prevent nausea. b. obtaining wigs and scarves to wear. c. emptying the bladder before the medication. d. maintaining oral care during the treatments.

Which action by a 70-year-old patient who is using peritoneal dialysis (PD) indicates that the nurse should provide more teaching about PD? A. The patient leaves the catheter exit site without a dressing. B. The patient plans 30 to 60 minutes for a dialysate exchange. C. The patient cleans the catheter while taking a bath each day. D. The patient slows the inflow rate when experiencing abdominal pain.

Which assessment finding may indicate that a patient is experiencing adverse effects to a corticosteroid prescribed after kidney transplantation? A. Postural hypotension B. Recurrent tachycardia C. Knee and hip joint pain D. Increased serum creatinine

Which information about a patient with Goodpasture syndrome requires the most rapid action by the nurse? a. Blood urea nitrogen level is 70 mg/dL. b. Urine output over the last 2 hours is 30 mL. c. Audible crackles bilaterally over the posterior chest to the midscapular level. d. Elevated level of antiglomerular basement membrane (anti-GBM) antibodies.

Which information from a patient who had a transurethral resection with fulguration for bladder cancer 3 days ago is most important to report to the health care provider? a. The patient is voiding every 4 hours. b. The patient is using opioids for pain. c. The patient has seen clots in the urine. d. The patient is anxious about the cancer.

Which is most important for the nurse to implement a PT after renal transplant surgery a. Flushing peritoneal dialysis catheter once per shift b. Monitoring magnesium levels daily c. Removing indwelling catheter as soon as possible d. Placing the client on contact isolation

Which menu choice by the patient who is receiving hemodialysis indicates that the nurse's teaching has been successful? a. Split-pea soup, English muffin, and nonfat milk b. Oatmeal with cream, half a banana, and herbal tea c. Poached eggs, whole-wheat toast, and apple juice d. Cheese sandwich, tomato soup, and cranberry juice

Which outcome statement indicates to the nurse that the goal of giving a client IV therapy after a diagnostic imaging test with contrast media has been met? A. Lung sounds are clear and there are no signs or symptoms of fluid overload. B. The client has no signs or symptoms of contrast-induced immune response. C. Urine output is 150 mL/hr for 6 hours after the use of the contrast agent. D. Urine output is 0.5mL/kg/hr for 6 hours and the client remains euvolemic.

Which statement by a 62-year-old patient with stage 5 chronic kidney disease (CKD) indicates that the nurse's teaching about management of CKD has been effective? A. "I need to get most of my protein from low-fat dairy products." B. "I will increase my intake of fruits and vegetables to 5 per day." C. "I will measure my urinary output each day to help calculate the amount I can drink." D. "I need to take erythropoietin to boost my immune system and help prevent infection."

Which type of medication does the nurse expect the health care provider to prescribe for a client with acute kidney injury to improve blood flow to the kidneys? A. Loop diuretics B. Phosphate binders C. Calcium channel blockers D. Erythropoietin-stimulating agents

nurse reviews these laboratory values of a client who returned from kidney transplantation 12 hours ago: Sodium 136 mEq/L Potassium 5 mEq/L Blood urea nitrogen (BUN) 44 mg/dL Serum creatinine 2.5 mg/dL What initial intervention would the nurse anticipate? a. Start hemodialysis immediately. b. Discuss the need for peritoneal dialysis. c. Increase the dose of immunosuppression. d. Return the client to surgery for exploration.

A client is assessed by the nurse after a hemodialysis session. The nurse notes bleeding from the clients nose and around the intravenous catheter. What action by the nurse is the priority? a. Hold pressure over the clients nose for 10 minutes. b. Take the clients pulse, blood pressure, and temperature. c. Assess for a bruit or thrill over the arteriovenous fistula. d. Prepare protamine sulfate for administration.

A client with acute kidney injury has a blood pressure of 76/55 mm Hg. The health care provider ordered 1000 mL of normal saline to be infused over 1 hour to maintain perfusion. The client is starting to develop shortness of breath. What is the nurses priority action? a. Calculate the mean arterial pressure (MAP). b. Ask for insertion of a pulmonary artery catheter. c. Take the clients pulse. d. Slow down the normal saline infusion.

A client with chronic kidney disease states, I feel chained to the hemodialysis machine. What is the nurses best response to the clients statement? a. That feeling will gradually go away as you get used to the treatment. b. You probably need to see a psychiatrist to see if you are depressed. c. Do you need help from social services to discuss financial aid? d. Tell me more about your feelings regarding hemodialysis treatment.

A nurse is caring for a client who is scheduled for a dose of cefazolin and vitamins at this time. Hemodialysis for this client is also scheduled in 60 minutes. Which action by the nurse is best? a. Administer cefazolin since the level of the antibiotic must be maintained. b. Hold the vitamins but administer the cefazolin. c. Hold the cefazolin but administer the vitamins. d. Hold all medications since both cefazolin and vitamins are dialyzable.

A nurse reviews the urinalysis of a client and notes the presence of glucose. What action would the nurse take? a. Document findings and continue to monitor the client. b. Contact the primary health care provider and recommend a 24-hour urine test. c. Review the client's recent dietary selections over 3 days. d. Perform a finger stick blood glucose assessment.

The nurse determines that instruction regarding prevention of future urinary tract infections (UTIs) has been effective for a 22-year-old female patient with cystitis when the patient states which of the following? a. "I can use vaginal antiseptic sprays to reduce bacteria." b. "I will drink a quart of water or other fluids every day." c. "I will wash with soap and water before sexual intercourse." d. "I will empty my bladder every 3 to 4 hours during the day."

Which assessment finding is most important to report to the health care provider regarding a patient who has had left-sided extracorporeal shock wave lithotripsy? a. Blood in urine b. Left flank bruising c. Left flank discomfort d. Decreased urine output

Which assessment technique will the nurse use to most accurately determine increasing ascites in a client with advanced liver cirrhosis and portal hypertension? A. Interpreting the serum albumin value B. Measuring the client's abdominal girth C. Testing stool for the presence of occult blood D. Weighing the client daily at the same time of the day

Which client does the nurse understand has the greatest risk of developing acute kidney injury (AKI)? A. 23-year-old female who was recently treated for a urinary tract infection B. 32-year-old female who is pregnant and has gestational diabetes C. 49-year-old male who is obese and has a history of skin cancer D. 73-year-old male who has hypertension and peripheral vascular disease

Which essential nutrient will the nurse expect to be deficient in a client who has liver cirrhosis and ascites? A. Sodium B. Potassium C. Vitamin C D. Vitamin K

Which laboratory result will the nurse expect when a client with chronic kidney disease reports fatigue, lethargy with weakness, and mild shortness of breath with dizziness when rising to a standing position? A. Low blood glucose B. Low white blood cell count C. Low blood urea nitrogen (BUN) D. Low hemoglobin/hematocrit

A client has an external percutaneous transhepatic biliary catheter inserted for a biliary obstruction. What health teaching about catheter care would the nurse provide for the client? a. "Cap the catheter drain at night to prevent leakage and skin damage." b. "Position the drainage bag lower than the catheter insertion site." c. "Irrigate the catheter with an ounce of saline every night." d. "Pierce a hole in the top of the drainage bag to get rid of odors."

A client is having a peritoneal dialysis treatment. The nurse notes an opaque color to the effluent. What is the priority action by the nurse? a. Warm the dialysate solution in a microwave before instillation. b. Obtain a sample of the effluent and send to the laboratory. c. Flush the tubing with normal saline to maintain patency of the catheter. d. Check the peritoneal catheter for kinking and curling

A nurse assesses a client with polycystic kidney disease (PKD). Which assessment finding should alert the nurse to immediately contact the health care provider? a. Flank pain b. Periorbital edema c. Bloody and cloudy urine d. Enlarged abdomen

A nurse cares for a client who has elevated levels of antidiuretic hormone (ADH). Which disorder should the nurse identify as a trigger for the release of this hormone? a. Pneumonia b. Dehydration c. Renal failure d. Edema

A nurse cares for a client with a urine specific gravity of 1.018. Which action should the nurse take? a. Evaluate the client's intake and output for the past 24 hours. b. Document the finding in the chart and continue to monitor. c. Obtain a specimen for a urine culture and sensitivity. d. Encourage the client to drink more fluids, especially water.

A nurse cares for a postmenopausal client who has had two episodes of bacterial urethritis in the last 6 months. The client asks, "I never have urinary tract infections. Why is this happening now?" How would the nurse respond? a. "Your immune system becomes less effective as you age." b. "Low estrogen levels can make the tissue more susceptible to infection." c. "You should be more careful with your personal hygiene in this area." d. "It is likely that you have an untreated sexually transmitted disease."

A nurse reviews a female client's laboratory results. Which results from the client's urinalysis should the nurse recognize as abnormal? a. pH 5.6 b. Ketone bodies present c. Specific gravity of 1.020 d. Clear and yellow color

A nurse reviews the health history of a client with an over secretion of renin. Which disorder should the nurse correlate with this assessment finding? a. Alzheimer's disease b. Hypertension c. Diabetes mellitus d. Viral hepatitis

A nurse reviews the laboratory findings of a client with a urinary tract infection (bacterial cystitis). The laboratory report notes a "shift to the left" in the client's white blood cell count. What action would the nurse take? a. Request that the laboratory perform a differential analysis on the white blood cells. b. Notify the primary health care provider and start an intravenous line for parenteral antibiotics.c. c. Ask assistive personnel (AP) to strain the client's urine for renal calculi. d. Assess the client for a potential allergic reaction and anaphylactic shock

After teaching a client with early polycystic kidney disease (PKD) about nutritional therapy, the nurse assesses the clients understanding. Which statement made by the client indicates a correct understanding of the teaching? a. I will take a laxative every night before going to bed. b. I must increase my intake of dietary fiber and fluids. c. I shall only use salt when I am cooking my own food. d. Ill eat white bread to minimize gastrointestinal gas.

After teaching a client with hypertension secondary to renal disease, the nurse assesses the client's understanding. Which statement made by the client indicates a need for additional teaching? a. "I can prevent more damage to my kidneys by managing my blood pressure." b. "If I have increased urination at night, I need to drink less fluid during the day." c. "I need to see the registered dietitian to discuss limiting my protein intake." d. "It is important that I take my antihypertensive medications as directed.

After teaching a client with nephrotic syndrome and a normal glomerular filtration, the nurse assesses the client's understanding. Which statement made by the client indicates a correct understanding of the diet therapy for this condition? a. "I must decrease my intake of fat." b. "I will increase my intake of protein." c. "A decreased intake of carbohydrates will be required." d. "An increased intake of vitamin C is necessary."

The nurse is caring for a client who is recovering from an open traditional Whipple surgical procedure. What action would the nurse take? a. Clamp the nasogastric tube. b. Place the patient in semi-Fowler position. c. Assess vital signs once every shift. d. Provide oral rehydration

What is the nurse's first action when a client with chronic kidney disease (CKD) develops restlessness, anxiousness, shortness of breath, a rapid heart rate, frothy sputum, and crackles in the bases of the lungs? A. Facilitating transfer to the intensive care unit for aggressive treatment B. Placing the client's head of bed in the high-Fowler position C. Monitoring vital signs and assessing the lungs every 15 minutes D. Administering an IV loop diuretic such as furosemide

When a client is in the diuretic phase of acute kidney injury (AKI), what priority action will the nurse take? A. Assessing for hypertension and fluid overload B. Monitoring for hypovolemia and electrolyte loss C. Adjusting the dosage of diuretic medications D. Balancing diuretic therapy with intake and output

A nurse is giving discharge instructions to a client recently diagnosed with chronic kidney disease (CKD). Which statements made by the client indicate a correct understanding of the teaching? (Select all that apply.) a. "I can continue to take antacids to relieve heartburn." b. "I need to ask for an antibiotic when scheduling a dental appointment." c. "I'll need to check my blood sugar often to prevent hypoglycemia." d. "The dose of my pain medication may have to be adjusted." e. "I should watch for bleeding when taking my anticoagulants."

B, C, D, E

A nurse is giving discharge instructions to a client recently diagnosed with chronic kidney disease (CKD). Which statements made by the client indicate a correct understanding of the teaching? (Select all that apply.) a. I can continue to take antacids to relieve heartburn. b. I need to ask for an antibiotic when scheduling a dental appointment. c. Ill need to check my blood sugar often to prevent hypoglycemia. d. The dose of my pain medication may have to be adjusted. e. I should watch for bleeding when taking my anticoagulants.

B, C, D, E

The nurse is caring for a client with a new diagnosis of chronic kidney disease. Which priority complications would the nurse anticipate? (Select all that apply.) a. Dehydration b. Anemia c. Hypertension d. Dysrhythmias e. Heart failure

B, C, D, E

The nurse collaborates with the registered dietician nutritionist (RDN) to teach a client about which recommendations for management of chronic kidney disease? Select all that apply. A. Reducing calories B. Controlling protein intake C. Limiting fluid intake D. Restricting potassium E. Increasing sodium F. Restricting phosphorus

B, C, D, F

A nurse assesses a client who has a family history of polycystic kidney disease (PKD). Which assessment findings would the nurse expect? (Select all that apply.) a. Nocturia b. Flank pain c. Increased abdominal girth d. Dysuria e. Hematuria f. Diarrhea

B, C, E

Which common factors will the nurse recognize as contributing to or worsening of hepatic encephalopathy in clients with liver cirrhosis? Select all that apply. A. Anorexia B. Infection C. Opioids D. Diarrhea E. GI bleeding F. High-protein diet G. Diabetes mellitus H. Chronic confusion

B, C, E, F

A patient has been diagnosed with urinary tract calculi that are high in uric acid. Which foods will the nurse teach the patient to avoid (select all that apply)? a. Milk b. Liver c. Spinach d. Chicken e. Cabbage f. Chocolate

B, D

A nurse assesses a client who is recovering from a nephrostomy. Which assessment findings would alert the nurse to urgently contact the primary health care provider? (Select all that apply.) a. Clear drainage b. Bloody drainage at site c. Patient reports headache d. Foul-smelling drainage e. Urine draining from site

B, D, E

The nurse is teaching a client with diabetes mellitus how to prevent or delay chronic kidney disease (CKD). Which client statements indicate a lack of understanding of the teaching? (Select all that apply.) a. I need to decrease sodium, cholesterol, and protein in my diet. b. My weight should be maintained at a body mass index of 30. c. Smoking should be stopped as soon as I possibly can. d. I can continue to take an aspirin every 4 to 8 hours for my pain. e. I really only need to drink a couple of glasses of water each day.

B, D, E

Which criteria does the nurse understand are included in the current definition of acute kidney injury (AKI)? Select all that apply. A. Signs and symptoms of fluid overload such as peripheral edema and crackles in the lungs B. Urine volume of less than 0.5 mL/kg/hr for 6 hours C. Presence of polyuria, nocturia, and very dilute pale yellow urine D. Increase in serum creatinine by 0.3 mg/dL (26.2 µmol/L) or more within 48 hours E. Hypotension and tachycardia with progressively decreased amounts of urine F. Increase in serum creatinine to 1.5 times or more from baseline in the previous 7 da

B, D, F

A nurse assesses a client who has cirrhosis of the liver. Which laboratory findings would the nurse expect in clients with this disorder? (Select all that apply.) a. Elevated aspartate transaminase b. Elevated international normalized ratio (INR) c. Decreased serum globulin levels d. Decreased serum alkaline phosphatase e. Elevated serum ammonia f. Elevated prothrombin time (PT)

B, E, F

A client is placed on fluid restriction because of chronic kidney disease (CKD). Which assessment finding would alert the nurse that the client's fluid balance is stable at this time? A. Decreased calcium levels B. Increased phosphorus levels C. No adventitious sounds in the lungs D. Increased edema in the legs

A client is placed on fluid restriction because of chronic kidney disease (CKD). Which assessment finding would alert the nurse that the client's fluid balance is stable at this time? a. Decreased calcium levels b. Increased phosphorus levels c. No adventitious sounds in the lungs d. Increased edema in the legs

A client is started on continuous venovenous hemofiltration (CVVH). Which finding would require immediate action by the nurse? a. Potassium level of 5.5 mEq/L (5.5 mmol/L) b. Sodium level of 138 mEq/L (138 mmol/L) c. Blood pressure of 76/58 mm Hg d. Pulse rate of 88 beats/min

A client with diabetes mellitus type 2 has been well controlled with metformin. The client is scheduled for magnetic resonance imaging (MRI) scan with contrast. What priority would the nurse take at this time? a. Teach the client about the purpose of the MRI. b. Assess the client's blood urea nitrogen and creatinine. c. Tell the client to withhold metformin for 24 hours before the MRI. d. Ask the client if he or she is taking antibiotics

A client with pneumonia and dementia is admitted with an indwelling urinary catheter in place. During interprofessional rounds the following day, which question would the nurse ask the primary health care provider? a. "Do you want daily weights on this client?" b. "Will the client be able to return home?" c. "May we discontinue the indwelling catheter?" d. "Should we get another chest x-ray today?"

A nurse assesses a client with renal insufficiency and a low red blood cell count. The client asks, "Is my anemia related to the renal insufficiency?" How should the nurse respond? a. "Red blood cells produce erythropoietin, which increases blood flow to the kidneys." b. "Your anemia and renal insufficiency are related to inadequate vitamin D and a loss of bone density." c. "Erythropoietin is usually released from the kidneys and stimulates red blood cell production in the bone marrow." d. "Kidney insufficiency inhibits active transportation of red blood cells throughout the blood."

A nurse cares for a client who has pyelonephritis. The client states, "I am embarrassed to talk about my symptoms." How would the nurse respond? a. "I am a professional. Your symptoms will be kept in confidence." b. "I understand. Elimination is a private topic and shouldn't be discussed." c. "Take your time. It is okay to use words that are familiar to you." d. "You seem anxious. Would you like a nurse of the same gender to care for you?

A nurse cares for a client who is recovering from a closed percutaneous kidney biopsy. The client states, "My pain has suddenly increased from a 3 to a 10 on a scale of 0 to 10." Which action should the nurse take first? a. Reposition the client on the operative side. b. Administer the prescribed opioid analgesic. c. Assess the pulse rate and blood pressure. d. Examine the color of the client's urine.

A nurse cares for a client who is recovering from a closed percutaneous kidney biopsy. The client states, "My pain has suddenly increased from a 3 to a 10 on a scale of 0-10." Which action would the nurse take first? a. Reposition the client on the operative side. b. Administer the prescribed opioid analgesic. c. Assess the client's pulse rate and blood pressure. d. Examine the color of the client's urine.

A nurse obtains a sterile urine specimen from a client's Foley catheter. After applying a clamp to the drainage tubing distal to the injection port, which action should the nurse take next? a. Clamp another section of the tube to create a fixed sample section for retrieval. b. Insert a syringe into the injection port and aspirate the quantity of urine required. c. Clean the injection port cap of the drainage tubing with povidone-iodine solution. d. Withdraw 10 mL of urine and discard it; then withdraw a fresh sample of urine.

A nurse reviews the laboratory values of a client who returned from kidney transplantation 12 hours ago: Sodium 136 mEq/L (135 mmol/L) Potassium 5 mEq/L (5 mmol/L) Blood urea nitrogen (BUN) 44 mg/dL (15.7 mmol/L) Serum creatinine 2.5 mg/dL (221 mcmol/L) What initial intervention would the nurse anticipate? a. Start hemodialysis immediately. b. Discuss the need for peritoneal dialysis. c. Increase the dose of immunosuppression. d. Return the client to surgery for exploration

A nurse teaches a client who is recovering from a urography. Which instruction should the nurse include in this client's discharge teaching? a. "Avoid direct contact with your urine for 24 hours until the radioisotope clears." b. "You may have some dribbling of urine for several weeks after this procedure." c. "Be sure to drink at least 3 liters of fluids today to help eliminate the dye faster." d. "Your skin may become slightly yellow from the dye used in this procedure."

After teaching a client with bacterial cystitis who is prescribed phenazopyridine, the nurse assesses the client's understanding. Which statement made by the client indicates a correct understanding of the teaching? a. "I will not take this drug with food or milk." b. "I will have my partners tested for STIs." c. "An orange color in my urine should not alarm me." d. "I will drink two glasses of cranberry juice daily."

The charge nurse is orienting a new nurse about care for an assigned client with an arteriovenous (AV) fistula for hemodialysis in her left arm. Which action by the float nurse would be considered unsafe? a. Palpating the access site for a bruit or thrill b. Using the right arm for a blood pressure reading c. Administering intravenous fluids through the AV fistula d. Checking distal pulses in the left arm

The nurse is teaching a client how to increase the flow of dialysate into the peritoneal cavity during dialysis. Which statement by the client demonstrates a correct understanding of the teaching? a. "I should leave the drainage bag above the level of my abdomen." b. "I could flush the tubing with normal saline if the flow stops." c. "I should take a stool softener every morning to avoid constipation." d. "My diet should have low fiber in it to prevent any irritation."

The nurse is teaching assistive personnel (AP) about fluid restriction for a client who has acute kidney injury (AKI). The client's 24-hour urinary output is 120 mL. How much fluid would the client be allowed to have over the next 24 hours? a. 380 mL b. 500 mL c. 620 mL d. 750 mL

What is the nurse's priority action when a client with ascites reports increased abdominal pain and chills? A. Applying oxygen and making the client NPO B. Notifying the primary health care provider immediately C. Assessing for abdominal rigidity and taking the client's temperature D. Applying a heating blanket and raising the head of the bed to a 45-degree angle

Which health promotion teaching will the nurse stress to healthy adults to prevent harm from acute kidney injury (AKI)? A. Check your blood pressure every day. B. Find out if you have a family history of diabetes. C. Avoid dehydration by drinking 2 to 3 liters of water daily. D. Have annual testing for blood urea nitrogen (BUN), creatinine, protein, and glucose.

Which actions will the nurse perform when preparing a client for paracentesis? Select all that apply. A. Obtaining informed consent B. Maintaining the client on NPO status C. Asking the client to void before the procedure D. Placing the client in the flat supine position E. Weighing the client before the procedure F. Assessing the respiratory rate and blood pressure

C, E, F

Which laboratory results will the nurse monitor when a client is receiving IV gentamicin? Select all that apply. A. Platelet count B. Hemoglobin and hematocrit C. Blood urea nitrogen (BUN) D. Prothrombin time E. Creatinine F. Gentamicin peak and trough levels

C, E, F

A nurse assesses a client who is recovering from a radical nephrectomy for renal cell carcinoma. The nurse notes that the client's blood pressure has decreased from 134/90 to 100/56 mm Hg and urine output is 20 mL for this past hour. What action would the nurse take? a. Position the client to lay on the surgical incision. b. Measure the specific gravity of the client's urine. c. Administer intravenous pain medications. d. Assess the rate and quality of the client's pulse.

A nurse cares for a client who is having trouble voiding. The client states, "I cannot urinate in public places." How should the nurse respond? a. "I will turn on the faucet in the bathroom to help stimulate your urination." b. "I can recommend a prescription for a diuretic to improve your urine output." c. "I'll move you to a room with a private bathroom to increase your comfort." d. "I will close the curtain to provide you with as much privacy as possible."

A nurse cares for a client with a urine specific gravity of 1.040. What action would the nurse take? a. Obtain a urine culture and sensitivity. b. Place the client on restricted fluids. c. Assess the client's creatinine level. d. Increase the client's fluid intake

A nurse cares for a client with a urine specific gravity of 1.040. Which action should the nurse take? a. Obtain a urine culture and sensitivity. b. Place the client on restricted fluids. c. Assess the client's creatinine level. d. Increase the client's fluid intake.

A nurse reviews the urinalysis results of a client and notes a urine osmolality of 1200 mOsm/L. Which action should the nurse take? a. Contact the provider and recommend a low-sodium diet. b. Prepare to administer an intravenous diuretic. c. Obtain a suction device and implement seizure precautions. d. Encourage the client to drink more fluids.

A patient complains of leg cramps during hemodialysis. The nurse should first: A. massage the patient's legs. B. reposition the patient supine. C. give acetaminophen (Tylenol). D. infuse a bolus of normal saline.

After receiving change-of-shift report, which patient should the nurse assess first? A. Patient who is scheduled for the drain phase of a peritoneal dialysis exchange B. Patient with stage 4 chronic kidney disease who has an elevated phosphate level C. Patient with stage 5 chronic kidney disease who has a potassium level of 3.4 mEq/L D. Patient who has just returned from having hemodialysis and has a heart rate of 124/min

After teaching a client who has a history of cholelithiasis, the nurse assesses the client's understanding. Which menu selection indicates that the client understands the dietary teaching? a. Lasagna, tossed salad with Italian dressing, and low-fat milk b. Grilled cheese sandwich, tomato soup, and coffee with cream c. Cream of potato soup, Caesar salad with chicken, and a diet cola d. Roasted chicken breast, baked potato with chives, and orange juice

The nurse administers epoetin alfa to a client who has chronic kidney disease (CKD). Which laboratory test value would the nurse monitor to determine this drug's effectiveness? a. Potassium b. Sodium c. Renin d. Hemoglobin

The nurse is admitting a client who has acute glomerulonephritis caused by beta streptococcus. What drug therapy would the nurse expect to be prescribed for this client? a. Antihypertensives b. Antilipidemics c. Antidepressants d. Antibiotics

The nurse is caring for a client who has cirrhosis of the liver. Which risk factor is the leading cause of cirrhosis? a. Metabolic syndrome b. Liver cancer c. Nonalcoholic fatty liver disease d. Hepatitis C

The nurse is caring for a client who is scheduled for a paracentesis. Which action is appropriate for the nurse to take? a. Have the client sign the informed consent form. b. Get the patient into a chair before the procedure. c. Help the client lie flat in bed on the right side. d. Assist the client to void before the procedure.

What does the nurse expect when comparing a client's posthemodialysis weight and blood pressure with predialysis data? A. Blood pressure is increased and weight is decreased B. Blood pressure and weight are slightly increased C. Blood pressure and weight are the same D. Blood pressure and weight are decreased

A 44-year-old patient is unable to void after having an open loop resection and fulguration of the bladder. Which nursing action should be implemented first? a. Assist the patient to soak in a 15-minute sitz bath. b. Insert a straight urethral catheter and drain the bladder. c. Encourage the patient to drink several glasses of water. d. Teach the patient how to do isometric perineal exercises

A 72-year-old patient with a history of benign prostatic hyperplasia (BPH) is admitted with acute urinary retention and elevated blood urea nitrogen (BUN) and creatinine levels. Which prescribed therapy should the nurse implement first? A. Insert urethral catheter. B. Obtain renal ultrasound. C. Draw a complete blood count. D. Infuse normal saline at 50 mL/hour.

A 76-year-old with benign prostatic hyperplasia (BPH) is agitated and confused, with a markedly distended bladder. Which intervention prescribed by the health care provider should the nurse implement first? a. Insert a urinary retention catheter. b. Schedule an intravenous pyelogram (IVP). c. Draw blood for a serum creatinine level. d. Administer lorazepam (Ativan) 0.5 mg PO.

A client has a serum potassium level of 6.5 mmol/L, a serum creatinine level of 2 mg/dL, and a urine output of 350 mL/day. What is the best action by the nurse? a. Place the client on a cardiac monitor immediately. b. Teach the client to limit high-potassium foods. c. Continue to monitor the clients intake and output. d. Ask to have the laboratory redraw the blood specimen.

A client in the intensive care unit is started on continuous venovenous hemofiltration (CVVH). Which finding is the cause of immediate action by the nurse? a. Blood pressure of 76/58 mm Hg b. Sodium level of 138 mEq/L c. Potassium level of 5.5 mEq/L d. Pulse rate of 90 beats/min

A client is taking furosemide (Lasix) 40 mg/day for management of chronic kidney disease (CKD). To detect the positive effect of the medication, what action of the nurse is best? a. Obtain daily weights of the client. b. Auscultate heart and breath sounds. c. Palpate the clients abdomen. d. Assess the clients diet history.

A male client comes into the emergency department with a serum creatinine of 2.2 mg/dL and a blood urea nitrogen (BUN) of 24 mL/dL. What question should the nurse ask first when taking this clients history? a. Have you been taking any aspirin, ibuprofen, or naproxen recently? b. Do you have anyone in your family with renal failure? c. Have you had a diet that is low in protein recently? d. Has a relative had a kidney transplant lately?

A male client with chronic kidney disease (CKD) is refusing to take his medication and has missed two hemodialysis appointments. What is the best initial action for the nurse? a. Discuss what the treatment regimen means to him. b. Refer the client to a mental health nurse practitioner. c. Reschedule the appointments to another date and time. d. Discuss the option of peritoneal dialysis.

A patient in the urology clinic is diagnosed with monilial urethritis. Which action will the nurse include in the plan of care? a. Teach the patient about the use of antifungal medications. b. Tell the patient to avoid tub baths until the symptoms resolve. c. Instruct the patient to refer recent sexual partners for treatment. d. Teach the patient to avoid nonsteroidal anti-inflammatory drugs (NSAIDs).

A patient is admitted to the emergency department with possible renal trauma after an automobile accident. Which prescribed intervention will the nurse implement first? a. Check blood pressure and heart rate. b. Administer morphine sulfate 4 mg IV. c. Transport to radiology for an intravenous pyelogram. d. Insert a urethral catheter and obtain a urine specimen.

A patient will need vascular access for hemodialysis. Which statement by the nurse accurately describes an advantage of a fistula over a graft? A. A fistula is much less likely to clot. B. A fistula increases patient mobility. C. A fistula can accommodate larger needles. D. A fistula can be used sooner after surgery.

After change-of-shift report, which patient should the nurse assess first? a. Patient with a urethral stricture who has not voided for 12 hours b. Patient who has cloudy urine after orthotopic bladder reconstruction c. Patient with polycystic kidney disease whose blood pressure is 186/98 mm Hg d. Patient who voided bright red urine immediately after returning from lithotripsy

How does the nurse best interpret a condition when a client is undergoing hemodialysis (HD) and develops symptoms including headache, nausea, vomiting, and fatigue? A. Mild dialysis disequilibrium syndrome B. Adverse reaction to the dialysate solution C. Transient symptoms in a client new to hemodialysis D. Expected manifestations of end-stage kidney disease

The nurse is caring for a client who is prescribed lactulose. The client states, "I do not want to take this medication because it causes diarrhea." How would the nurse respond? a. "Diarrhea is expected, that's how your body gets rid of ammonia." b. "You may take antidiarrheal medication to prevent loose stools." c. "Do not take any more of the medication until your stools firm up." d. "We will need to send a stool specimen to the laboratory as soon as possible."

The nurse is caring for a client with hepatitis C. The client's brother states, "I do not want to get this infection, so I'm not going into his hospital room." How would the nurse respond? a. "Hepatitis C is not spread through casual contact." b. "If you wear a gown and gloves, you will not get this virus." c. "This virus is only transmitted through a fecal specimen." d. "I can give you an update on your brother's status from here."

The nurse is caring for a patient who has had an ileal conduit for several years. Which nursing action could be delegated to unlicensed assistive personnel (UAP)? a. Change the ostomy appliance. b. Choose the appropriate ostomy bag. c. Monitor the appearance of the stoma. d. Assess for possible urinary tract infection (UTI).

The nurse is teaching a client a client about taking elbasvir for hepatitis C. What information in the client's history would the nurse need prior to drug administration? a. History of hepatitis B b. History of kidney disease c. History of cardiac disease d. History of rectal bleeding

What is the nurse's priority action when the health care provider orders IV fluids at a rate of 1 mL/kg/hr for 12 hours prior to a CT scan with contrast media for a client who weighs 152 lbs? A. Set the IV pump to deliver fluid at 69 mL/hr. B. Set the IV pump to deliver fluid at 152 mL/hr. C. Call the health care provider for clarification of the order. D. Ask the radiologist for clarification of the order.

When caring for a patient with a left arm arteriovenous fistula, which action will the nurse include in the plan of care to maintain the patency of the fistula? A. Auscultate for a bruit at the fistula site. B. Assess the quality of the left radial pulse. C. Compare blood pressures in the left and right arms. D. Irrigate the fistula site with saline every 8 to 12 hours.

When the nurse reviews the laboratory results and finds that a client with chronic kidney disease (CKD) has a serum potassium level of 8 mEq/L (mmol/L), which assessment will be completed before notifying the health care provider? A. Cardiac rhythm B. Respiratory rate and depth C. Tremors of the hands D. Change in urine appearance

Which nursing action is of highest priority for a 68-year-old patient with renal calculi who is being admitted to the hospital with gross hematuria and severe colicky left flank pain? a. Administer prescribed analgesics. b. Monitor temperature every 4 hours. c. Encourage increased oral fluid intake. d. Give antiemetics as needed for nausea.

Which of the following clients is most likely at risk for developing postrenal renal failure a. Client diagnosed with renal calculi b. Client taking drugs (NSAIDs) for arthritis pain c. Client with congestive heart failure d. Client recovering from glomerulonephritis

After teaching a client who has chronic pancreatitis and will be discharged with enzyme replacement therapy, a nurse assesses the client's understanding. Which statement by the client indicates a need for further teaching? (Select all that apply.) a. "I will take the enzymes between meals." b. "The enteric-coated preparations cannot be crushed." c. "Swallowing the tables without chewing is best." d. "I will wipe my lips after taking the enzymes." e. "Enzymes should be taken with high-protein foods."

a, e

A 25-year-old male patient has been admitted with a severe crushing injury after an industrial accident. Which laboratory result will be most important to report to the health care provider? A. Serum creatinine level 2.1 mg/dL B. Serum potassium level 6.5 mEq/L C. White blood cell count 11,500/µL D. Blood urea nitrogen (BUN) 56 mg/dL

A 34-year-old male patient seen at the primary care clinic complains of feeling continued fullness after voiding and a split, spraying urine stream. The nurse will ask about a history of a. recent kidney trauma. b. gonococcal urethritis. c. recurrent bladder infection. d. benign prostatic hyperplasia

A 38-year-old patient who had a kidney transplant 8 years ago is receiving the immunosuppressants tacrolimus (Prograf), cyclosporine (Sandimmune), and prednisone (Deltasone). Which assessment data will be of most concern to the nurse? A. The blood glucose is 144 mg/dL. B. There is a nontender axillary lump. C. The patient's skin is thin and fragile. D. The patient's blood pressure is 150/92.

A 42-year-old patient admitted with acute kidney injury due to dehydration has oliguria, anemia, and hyperkalemia. Which prescribed actions should the nurse take first? A. Insert a urinary retention catheter. B. Place the patient on a cardiac monitor. C. Administer epoetin alfa (Epogen, Procrit). D. Give sodium polystyrene sulfonate (Kayexalate).

A 58-year-old male patient who is diagnosed with nephrotic syndrome has ascites and 4+ leg edema. Which nursing diagnosis is a priority for the patient? a. Activity intolerance related to rapidly increased weight b. Excess fluid volume related to low serum protein levels c. Disturbed body image related to peripheral edema and ascites d. Altered nutrition: less than required related to protein restriction

A 58-year-old male patient who weighs 242 lb (110 kg) undergoes a nephrectomy for massive kidney trauma due to a motor vehicle crash. Which postoperative assessment finding is most important to communicate to the surgeon? a. Blood pressure is 102/58. b. Urine output is 20 mL/hr for 2 hours. c. Incisional pain level is reported as 9/10. d. Crackles are heard at bilateral lung bases.

A 62-year-old female patient has been hospitalized for 8 days with acute kidney injury (AKI) caused by dehydration. Which information will be most important for the nurse to report to the health care provider? A. The creatinine level is 3.0 mg/dL. B. Urine output over an 8-hour period is 2500 mL. C. The blood urea nitrogen (BUN) level is 67 mg/dL. D. The glomerular filtration rate is <30 mL/min/1.73m2.

A client is having a peritoneal dialysis treatment. The nurse notes an opaque color to the effluent. What is the priority action by the nurse? a. Warm the dialysate solution in a microwave before instillation. b. Take a sample of the effluent and send to the laboratory. c. Flush the tubing with normal saline to maintain patency of the catheter. d. Check the peritoneal catheter for kinking and curling.

A female patient with chronic kidney disease (CKD) is receiving peritoneal dialysis with 2 L inflows. Which information should the nurse report immediately to the health care provider? A. The patient has an outflow volume of 1800 mL. B. The patient's peritoneal effluent appears cloudy. C. The patient has abdominal pain during the inflow phase. D. The patient's abdomen appears bloated after the inflow.

A patient has arrived for a scheduled hemodialysis session. Which nursing action is most appropriate for the registered nurse (RN) to delegate to a dialysis technician? A. Teach the patient about fluid restrictions. B. Check blood pressure before starting dialysis. C. Assess for causes of an increase in predialysis weight. D Determine the ultrafiltration rate for the hemodialysis.

A telehealth nurse speaks with a client who is recovering from a liver transplant 2 weeks ago. The client states, "I'm having right belly pain and have a temperature of 101° F (38.3° C)." How would the nurse respond? a. "The anti-rejection drugs you are taking make you susceptible to infection." b. "You should go to the hospital immediately to get checked out." c. "You should take an additional dose of cyclosporine today." d. "Take acetaminophen every 4 hours until you feel better soon."

After teaching a client who has been diagnosed with hepatitis A, the nurse assesses the client's understanding. Which statement by the client indicates correct understanding of the teaching? a. "Some medications have been known to cause hepatitis A." b. "I may have been exposed when we ate shrimp last weekend." c. "I was infected with hepatitis A through a recent blood transfusion." d. "My infection with Epstein-Barr virus can co-infect me with hepatitis A."

During routine hemodialysis, the 68-year-old patient complains of nausea and dizziness. Which action should the nurse take first? a. Slow down the rate of dialysis. b. Check patient's blood pressure (BP). c. Review the hematocrit (Hct) level. d. Give prescribed PRN antiemetic drugs.

First priority for a PT with history of vomiting and diarrhea, BP pf 85/60 and HR of 105 a. Finding source of infection b. Replacing fluid loss c. Preventing nutritional deficit d. Releif of nausea

For which emergency procedure does the nurse prepare when a client with chronic kidney disease develops chest pain, tachycardia, low-grade fever, friction rub, and muffled heart tones? A. Hemodialysis B. Removal of pericardial fluid C. Cardioversion D. Endotracheal intubation

The nurse in the dialysis clinic is reviewing the home medications of a patient with chronic kidney disease (CKD). Which medication reported by the patient indicates that patient teaching is required? A. Multivitamin with iron B. Magnesium hydroxide C. Acetaminophen (Tylenol) D. Calcium phosphate (PhosLo)

The nurse is assessing a client with a diagnosis of pre-renal acute kidney injury (AKI). Which condition would the nurse expect to find in the clients recent history? a. Pyelonephritis b. Myocardial infarction c. Bladder cancer d. Kidney stones

The nurse is assessing a client with a diagnosis of prerenal acute kidney injury (AKI). Which condition would the nurse expect to find in the patient's recent history? a. Pyelonephritis b. Dehydration c. Bladder cancer d. Kidney stones

The nurse is assessing a patient 4 hours after a kidney transplant. Which information is most important to communicate to the health care provider? A. The urine output is 900 to 1100 mL/hr. B. The patient's central venous pressure (CVP) is decreased. C. The patient has a level 7 (0 to 10 point scale) incisional pain. D. The blood urea nitrogen (BUN) and creatinine levels are elevated.

The nurse is caring for a client who has cirrhosis of the liver. What nursing action is appropriate to help control ascites? a. Monitor intake and output. b. Provide a low-sodium diet. c. Increase oral fluid intake. d. Weigh the patient daily.

The nurse is caring for a client with hepatic portal-systemic encephalopathy (PSE). The client is thin and cachectic, and the family expresses distress that the patient is receiving little dietary protein. How would the nurse respond? a. "A low-protein diet will help the liver rest and will restore liver function." b. "Less protein in the diet will help prevent confusion associated with liver failure." c. "Increasing dietary protein will help the patient gain weight and muscle mass." d. "Low dietary protein is needed to prevent fluid from leaking into the abdomen."

The nurse is planning care for a patient with severe heart failure who has developed elevated blood urea nitrogen (BUN) and creatinine levels. The primary collaborative treatment goal in the plan will be: A. augmenting fluid volume. B. maintaining cardiac output. C. diluting nephrotoxic substances. D. preventing systemic hypertension.

The nurse is teaching the main principles of hemodialysis to a client with chronic kidney disease. Which statement by the client indicates a need for further teaching by the nurse? a. My sodium level changes by movement from the blood into the dialysate. b. Dialysis works by movement of wastes from lower to higher concentration. c. Extra fluid can be pulled from the blood by osmosis. d. The dialysate is similar to blood but without any toxins.

What is the nurse's best response when a client asks how often and for how long he or she will have to go for hemodialysis (HD)? A. "It varies and you will need to discuss this with your nephrology health care provider for specific instructions." B. "Most clients require about 12 hours per week, which is usually divided into three 4-hour treatments." C. "If you follow the diet and fluid therapies you will spend less time in dialysis, about 8 hours each week." D. "Many clients prefer to have home treatment dialysis that occurs every night while sleeping."

When a patient with acute kidney injury (AKI) has an arterial blood pH of 7.30, the nurse will expect an assessment finding of a. persistent skin tenting b. rapid, deep respirations. c. bounding peripheral pulses. d. hot, flushed face and neck.

When planning teaching for a 59-year-old male patient with benign nephrosclerosis the nurse should include instructions regarding a. preventing bleeding with anticoagulants. b. monitoring and recording blood pressure. c. obtaining and documenting daily weights. d. measuring daily intake and output volumes.

Which action will the nurse anticipate taking for an otherwise healthy 50-year-old who has just been diagnosed with Stage 1 renal cell carcinoma? a. Prepare patient for a renal biopsy. b. Provide preoperative teaching about nephrectomy. c. Teach the patient about chemotherapy medications. d. Schedule for a follow-up appointment in 3 months.

Which assessment finding for a patient who has just been admitted with acute pyelonephritis is most important for the nurse to report to the health care provider? a. Complaint of flank pain b. Blood pressure 90/48 mm Hg c. Cloudy and foul-smelling urine d. Temperature 100.1° F (57.8° C)

Which client's previous health history will the nurse most associate with a risk for developing postnecrotic cirrhosis of the liver? A. 28-year-old woman who had gallstones 1 year ago and has recently lost 20 lb (9 kg) on a low-calorie, low-fat diet B. 45-year-old man with hepatitis C infection and chronic use of acetaminophen C. 50-year-old man who has many years of excessive alcohol consumption D. 55-year-old woman who has chronic biliary obstruction

Which electrolyte imbalance does the nurse expect when a client is in the early phase of chronic kidney disease (CKD)? A. Hyperkalemia B. Hyponatremia C. Hypercalcemia D. Hypokalemia

Which information in a patient's history indicates to the nurse that the patient is not an appropriate candidate for kidney transplantation? A. The patient has type 1 diabetes. B. The patient has metastatic lung cancer. C. The patient has a history of chronic hepatitis C infection. D. The patient is infected with the human immunodeficiency virus.

Which information will the nurse include when teaching the patient with a urinary tract infection (UTI) about the use of phenazopyridine (Pyridium)? a. Pyridium may cause photosensitivity b. Pyridium may change the urine color. c. Take the Pyridium for at least 7 days. d. Take Pyridium before sexual intercourse.

Which information will the nurse monitor in order to determine the effectiveness of prescribed calcium carbonate (Caltrate) for a patient with chronic kidney disease (CKD)? A. Blood pressure B. Phosphate level C. Neurologic status D. Creatinine clearance

Which intervention will be included in the plan of care for a male patient with acute kidney injury (AKI) who has a temporary vascular access catheter in the left femoral vein? A. Start continuous pulse oximetry. B. Restrict physical activity to bed rest. C. Restrict the patient's oral protein intake. D. Discontinue the urethral retention catheter.

Which is a result of stimulation of erythropoietin production in the kidney tissue a. Increased blood flow to the kidney b. Increased bone marrow production of RBCs c. Inhibition of the transport of Na, leading to hyponatremia d. Inhibition of vitamin D and loss of bone density

Which parameter will you monitor in a PT with CKD to determine fluid and NA retention status a. Capillary refill b. Weight and blood pressure c. Intake and output d. Muscle growth

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