GU Exam
A nurse removes an indwelling urinary catheter that an older adult client has had in place for 2 days. The nurse should monitor the client for the expected outcome of
Temporary urinary retentions
A nurse is collecting information on a group of clients who are experiencing renal disorders. Considering the general client selection criteria for hemodialysis, which of the following clients should qualify for hemodialysis?
The client who is bleeding from kidney trauma with minimal urine output
A nurse is caring for several clients on a medical-surgical unit. Which of the following client care situations would require the completion of a variance report by the nurse?
The discovery that a client's dentures are missing
A charge nurse is observing another nurse who is inserting an indwelling urinary catheter into a female client. Which of the following actions by the nurse should prompt the charge nurse to intervene?
The nurse separates the client's labia with her dominant hand
A nurse is caring for a client receiving ciprofloxacin (Cipro) for the treatment of an uncomplicated UTI. Which of the following should the nurse recognize as the most reliable indicator of therapeutic effect?
Urinalysis shows decreasing pyuria and bacteriuria
A nurse is reinforcing teaching for a client who has received treatment for kidney stones. The nurse should remind the client to increase his intake of which of the following?
Water
A nurse is caring for a client who has impaired renal function. The nurse should notify the provider if the client's hourly urine output falls below which of the following?
30 mL
A nurse is caring for a client who is dehydrated. Which of the following BUN levels should the nurse expect the client to have upon admission?
4 mg/dL
A nurse is caring for a client who has a diagnosis of acute glomerulonephritis. Which of the following should be reported immediately to provider?
Blood pressure 162/ 90 mm Hg
A nurse is planning care for a client who has urolithiasis. Which of the following is an appropriate nursing action?
Encourage at least 2 L of fluids per day
A nurse is calculating the protein needs of a client who weighs 154 lbs. Which of the following protein should the nurse provide if the client requires 0.8 g of protein/kg?
56 g of protein/day
The process of urine formation helps
maintain the normal composition, volume, pH of blood, and tissue fluid
A nurse is preparing a client for a kidney biopsy. Which of the following should the nurse identify as a contraindication for this diagnostic test?
Bleeding tendencies
A nurse is preparing to discontinue a client's urinary catheter. Which of the following is the nurse's priority action?
Deflating the balloon prior to catheter removal
A nurse is teaching a client who has a new diagnosis of urge incontinence. Which of the following treatments should the nurse include in the teaching? Select all that apply.
-Use of anticholinergic medications -Limiting fluids in the evening -Dietary restriction of caffeine
A nurse is planning a low-protein diet for a client who has chronic renal failure. The client states, "Why do I have to be concerned with protein?" Which of the following nursing responses is appropriate?
A waste product of protein called urea is unable to be excreted by the kidneys
A nurse is caring for a client who was just diagnosed with chronic renal failure. Which of the following client statements is an indication of anticipatory grieving?
"I just can't believe that my whole life is going to be ruined by dialysis"
Kidney Functions
*Filter and absorb* -Formation of urine -Excretion or conservation of water -Electrolyte balance -Acid-base balance -Activation of Vitamin D {deficinecy - bone fracture} -Production of Erythropoietin {bone marrow/anemia} -Production of Renin {bp, aldosterone}
A nurse is reinforcing discharge instructions with a client who has spontaneously passed calcium oxalate calculus. To decrease the change of recurrence the nurse should instruct the client to avoid which of the following foods?
-Black tea -Spinach
Atrophy happens due to
-Decrease in filtrate -Decrease n blood flow
Older adults are at risk for
-Drug toxicity due to a decrease in the filtering of kidneys -Dehydration
A nurse working on a postpartum unit is collecting data from a client who has urinary tract infection. Which of the following findings should the nurse expect? Select all that apply.
-Dysuria -Costovertebral angle tenderness -Urinary frequency -Hematuria
A nurse is reinforcing discharge instructions with a client who had spontaneous passage of a calcium phosphate renal calculus. Which of the following instructions should the nurse include? Select all that apply.
-Limit intake of food high in animal protein -Reduce sodium intake -Report burning with urination to the provider -Increase fluid intake to 3 L/day
A nurse is caring for a client who has chronic renal failure. When reinforcing teaching about foods to avoid that contain phosphorous he should recommend that the client avoid which of the following? Select all that apply.
-Milk -Whole grain bread -Poultry
A nurse is caring for a client following a renal biopsy. Which of the following interventions are appropriate? Select all that apply.
-Monitor for hematuria -Check for flank pain
A nurse is caring for an older adult client who was admitted to the hospital with confusion and weakness. Based on the client's laboratory findings, which of the following actions should the nurse take? Select all that apply. Hematocrit 53% | BUN 25 mg/dL | Urine specific gravity 1.032
-Monitor intake and output -Weigh the client daily -Instruct the client to sit on the side of the bed for a few minutes before standing -Check orientation to person, place, and time regularly
A nurse is assisting in the planning of care for a client who is scheduled to have a renal biopsy. Which of the following should the nurse recommend to include? Select all that apply.
-Obtain a urine specimen prior to procedure -Obtain written, informed consent -Maintain NPO status prior to the procedure -Obtain coagulation studies
A nurse is teaching a client who has chronic renal failure about limiting foods high in potassium in his diet. Which of the following should the nurse instruct the client to avoid? Select all that apply.
-Orange juice -Tomatoes -Bananas -Raisins
A nurse is discussing indications for the use of urinary catheterization with a newly licensed nurse. Which of the following should the nurse identify as an appropriate indication? Select all that apply.
-Relief of urinary retention -Measurement of residual urine after urination -Presence of an open perineal wound
A nurse on a medical unit is planning the shift assignments. The nurse can delegate collection of which of the following to an assistive personnel? Select all that apply.
-Sputum specimen -Stool for blood -Urinalysis
A nurse is planning to reinforce teaching for a client about a low-potassium diet. Which of the following foods should the nurse reinforce to the client to avoid? Select all that apply.
-Yogurt -Orange juice
A nurse is collecting data from a client about pitting edema and notes an indentation of 6 mm (0.25in.) at the point of pressure. Which of the following is appropriate documentation of edema?
3+
A client is to receive 400 mL of IV fluid over 8 hrs. The IV drop factor is 60 gtt/mL. The nurse should set the IV to deliver how many mL/hr?
50 mL/hr
A nursing unit is notified that IV pumps available for use are limited due to high census in the hospital. The nurse should use one of the available pumps for which of the following clients receiving IV therapy?
A client who has diabetic ketoacidosis who is receiving IV insulin
A nurse is caring for a client who has a left renal calculus and an indwelling catheter. Which of the following data collection findings is the priority for the nurse to report to the provider?
Absent urine output for 1 hour
A nurse is assisting in the planning of care for a client who has acute glomerulonephritis related to a streptococcal infection. Which of the following interventions is appropriate to recommend including in the plan of care?
Administer prescribed antibiotics
A nurse is planning to teach a client who is scheduled for an intravenous pyelogram (IVP). Which of the following statements should he include in the teaching?
After the procedure you will be encouraged to drink plenty of fluids
Normal Characteristics of Urine
Amount- 1,000-2,000 mL/24 hours Color - straw/amber Clarity - clear Specific gravity 1.002-1.035 {amount of solute - electrolytes} Lower - dilute higher - concentrated pH - 4.6-8.0 {average is 6.0
A nurse is reviewing the medication record for a client who has intrinsic kidney injury. The nurse should consider which of the following medications has nephrotoxic adverse effects?
Amphotericin (Amphotec)
A nurse is caring for a client who has urinary incontinence. Which of the following actions should the nurse implement to prevent the development of skin breakdown?
Apply a moisture barrier ointment to the skin
A nurse is temporarily assigned to a new unit and given a client assignment that requires the use of some unfamiliar skills and techniques. Which of the following is an appropriate nursing action?
Ask the charge nurse to change assignment
A nurse is obtaining a client's vital signs. The nurse suspects that the client is developing shock based on which of the following values?
BP 80/40 mm Hg, pulse 126/min
A nurse is caring for a client who has chronic renal failure. Which of the following laboratory reports is an expected finding?
BUN 35 mg/dL, serum creatinine 8 mg/dL
A nurse is reinforcing teaching with a client who takes furosemide (Lasix) and has a serum potassium level of 3.4 mEq/L. Which of the following foods should the nurse instruct the client to include in his daily diet?
Bananas
A nurse is caring for a client who is receiving hemodialysis. To determine how much fluid the client loses, the nurse should compare which of the following of the client's measurements before and after the treatment?
Body weight
A nurse is reinforcing dietary teaching for a client who has a history of recurring uric acid stones. The nurse should instruct the client that it is most important to avoid which of the following foods as part of a low-purine diet?
Brown gravy
A client who is taking nitrofurantoin (Macrodantin) for a urinary tract infection voices a concern to the clinic nurse about voiding brown-colored urine. Which of the following is an appropriate response by the nurse?
Brown-colored urine is a harmless side effect of the medication
A nurse is reinforcing teaching for a client who has chronic renal failure about the process of continuous ambulatory peritoneal dialysis (CAPD). Which of the following should the nurse include in the teaching?
CAPD requires the client to follow fewer dietary and fluid restrictions with hemodialysis
During report, the nurse is informed that the client's IV has 900 mL of fluid left in the bag. The nurse makes rounds 30 minutes later and notes the IV bag is empty. Which of the following is an appropriate nursing action?
Check the client's respiratory rate and lung sounds
A nurse is reviewing a client's admission laboratory findings, which indicate the client is hyponatremic. Which of the following laboratory findings should the nurse anticipate will also be below the expected reference range?
Chloride
A nurse is preparing to insert an indwelling urinary catheter. The first step by the nurse should be to
Cleanse the urinary meatus before catheterization
A nurse is caring for a client who requires catheterization for a urine specimen. The client tells the nurse that she is concerned about her privacy during the procedure. Which of the following actions should the nurse take to alleviate the client's concern?
Close the door and assure the client that she will be covered
A newly hired assistive personnel is assisting in the care of several clients who have indwelling catheters. Which of the following instructions should the nurse give to the AP?
Confirm that the tubing clamp is closed while transferring a client from the bed to a chair
A nurse is discussing the findings of a urinary tract infection with a newly licensed nurse. Which of the following should the nurse identify as a finding specifically associated with a UTI in the older adult client?
Confusion
A nurse is collecting data regarding a client's renal system. The nurse uses the landmark for locating the kidneys, which is located between the lower portion of the twelfth rib and the vertebral column. The nurse correctly identifies this area as the
Costovertebral angle
A nurse instructs a female client about collecting a midstream urine sample. Which of the following client statements indicates an understanding of the procedure?
I'll use the cleansing wipe from front to back
A nurse is collecting data on a client who has renal failure for fluid volume increase. Which of the following assessment methods is most reliable?
Daily weight
A nurse in a dialysis center is caring for a client who has a new diagnosis of end stage renal disease. Upon arrival for his first dialysis treatment he states to the nurse, "I decided to come today, but I am not sure if I will need to come back this week. I am feeling much better since my discharge from the hospital and I think my kidneys are working again." The patient is demonstrating which stage of Kubler-Ross's Stages of Grieving?
Denial
A nurse is discussing urinary tract infections with a client. Which of the following should the nurse include as a risk factor?
Diabetes mellitus
A nurse is assisting with the admission data collection of a client who has renal calculi. Which of the following findings should the nurse expect?
Diaphoresis
A nurse is caring for a client who has end-stage renal disease and must limit protein intake. Which of the following foods should the nurse plan to include in the client's diet?
Eggs
A nurse is caring for a client who has chronic renal failure. Which of the following is an expected laboratory finding?
Elevated creatinine
A nurse is caring for a client who has been prescribed a potassium wasting diuretic medication. Which recommendation should the nurse make for change in the diet?
Encourage oranges, bananas, and whole grain breads
renin-angiotensin-aldosterone system
End product H2O/Na Sodium and blood pressure
A nurse is caring for a client who has chronic renal disease and is taking epoetin alfa (Epogen). The nurse should reinforce to the client the need to increase dietary consumption of which of the following?
Iron
A nurse is caring for a client who has polycystic kidney disease. Which of the following is an expected finding?
Flank pain
A nurse is reinforcing teaching for a client, who has acute renal failure (ARF), about the oliguric phase. Which of the following is appropriate to include in the teaching?
Fluid output is less than 400 ml per 24 hours
A client has acute renal failure and is receiving IV fluids to treat acute renal failure. Which of the following findings should indicate to the nurse that therapeutic affect is being achieved?
Glomerular filtration rate 125 mL/min
A nurse is discussing renal transplant with a client who has end-stage renal disease. Which of the following should the nurse identify as contraindication for this treatment?
Having a chronic infection
A nurse is reviewing the laboratory test results from a client who has acute renal failure. Which of the following conditions determined from the lab values should the nurse expect to find?
Hypermagnesemia
A nurse is planning care for a client who has end-stage renal disease. On assessment, the client has a 20 lb. weight gain, crackle lung sounds, elevated blood pressure, and jugular neck vein distention. Which of the following findings explains the client's symptoms?
Hypervolemia
A nurse is providing teaching to a client who has an ileal conduit following bladder cancer. Which of the following statements by the client should indicate to the nurse a need for further teaching?
I need to catheterize the stoma several times a day
A nurse is teaching a client who has recurrent urinary tract infections about prevention measures. Which of the following client statements indicates the need for further teaching?
I will need to wipe my perineal area from back to front after urination
A nurse suspects that another nurse on the unit is removing small amount of morphine sulfate from the syringe before administering the medication to the client. Which of the following actions by the nurse is appropriate?
Inform the nurse manager about her suspicions
A nurse is assisting in planning care for a client who has interstitial cystitis. Which of the following interventions is appropriate to recommend including in the plan of care?
Instruct the client to avoid drinking carbonated beverages
Decreased BP
Kidney function is effected first
A nurse is caring for a client undergoing hemodialysis who will be discharged in the morning. Which of the following client statements most influences the current plan of care?
My neighbor who takes me everywhere wrecked the car this morning
A nurse is assessing a client who has a urine output 250 mL in a 24-hr period. Which of the following terms should the nurse include in the documentation on the electronic record?
Oliguria
A nurse is caring for a client who has urinary incontinence following surgery. Findings include the leakage of small amounts of urine frequently during the day and night, along with urinating frequently in small amounts. Her bladder is often distended and palpable upon examination. The nurse identifies these findings as associated with which of the following types of incontinence?
Overflow incontinence
A nurse is caring for a client following hemodialysis treatment. When reviewing the client's laboratory report she would expect to find decrease in which of the following?
Potassium
A nurse is caring for a client who is hospitalized for acute renal failure and is on fluid restrictions. Which of the following actions should the nurse take first?
Provide a variety of fluids in small containers
A nurse is caring for a client who has end-stage renal disease (ESRD). Which of the following is an expected finding?
Pruritus
A nurse is caring for a client diagnosed with chronic glomerulonephritis. The nurse would expect to find a decrease in which of the following serum laboratory values?
RBC
A nurse is reinforcing teaching for a client who has a new prescription of phenazopyridine (Pyridium). The nurse should reinforce to the client to expect which of the following while taking this medication?
Reddish orange urine
A nurse is teaching a client who has end-stage renal disease about a renal diet. Which of the following information should the nurse include?
Reduce intake of foods high in potassium
A nurse delegates the application of wrist restraints to a client who is confused to an assistive personnel. The AP padded the wrist restraints and secured the straps to the bed frame with a double knot. Which of the following actions should the nurse take?
Retie the restraints with a slip knot
A nurse is caring for a client who is postoperative following a kidney transplant. The client has a prescription for cyclosporine (Sandimmune) and is being followed by the transplant clinic. Which of the following laboratory results will the nurse need to monitor?
Serum creatinine
A nurse is collecting data on a client who receives chlorothiazide sodium/Diuril. Which of the following is a sign of hypokalemia?
Shallow respirations
A nurse is reviewing the laboratory report of a client and identifies a serum potassium level of 6.8 mEq/L. which of the following medications should the nurse plan to administer?
Sodium polystyrene/kayexalate
A nurse is reinforcing teaching to a client who is scheduled for an intravenous urography. Which of the following should the nurse include in her teaching?
Take a laxative the evening before the procedure
A newly licensed nurse is planning to perform a procedure on a client that she has not done before. Which of the following resources should the nurse use to help her perform the procedure?
The policy and procedure manual for the unit
A nurse is emptying a client's urinal when she notices the urine is dark amber, cloudy, and has an unpleasant odor. These findings are associated with which of the following?
Urinary tract infection
A nurse is caring for a client who is receiving IV fluids to correct dehydration. Which of the following lab values should indicate to the nurse that the client is effectively responding to treatment?
Urine specific gravity 1.020
A nursing supervisor overhears a newly licensed nurse providing instructions to a female client on the proper steps to collect a midstream urine specimen. Which of the following statements made by the nurse requires the supervisor to intervene?
Use the provided towelette to cleanse the area by moving in a back-and-forth motion
A nurse is reinforcing teaching to a female client who has acute cystitis and will start therapy with phenazopyridine (Pyridium). Which of the following information should the nurse give to the client?
Wear protective pad under clothing to prevent straining
A nurse is preparing to complete a daily weight on a client in renal failure. Which of the following actions should the nurse implement?
Weigh the client at the same time each day
The nurse should identify that the phases occur in which order? Onset phase, oliguric phase, diuretic phase, recovery phase
a. Onset phase b. Oliguric phase c. Diuretic phase d. Recovery phase
A nurse is preparing a sterile field for insertion of a urinary catheter. Identify the sequence the nurse should follow.
a. Perform hand hygiene b. Place package on work surface c. Open outermost flap away from body d. Open side flap, pulling to side e. Open innermost flap toward body f. Use inner surface of package as sterile field
Increased bilirubin urine color is
dark brown or red
A nurse is caring for a client who has chronic renal failure. Which of the following indicates that the client is experiencing metabolic acidosis from this disorder?
pH 7.25 HCO3 19 mEq/L PaCO2 30 mm Hg
A nurse is caring for a client who has acute renal failure. Which of the following arterial blood gas values would the nurse expect this client to have?
pH 7.26, HCO3 14, PaCO2 30
2 ureters
prevent backflow
30 mL/hour is or more
the normal production of urine
Perinium Medication for UTI
turns urine bright orange
Kidneys form
urine
