GU/Renal

Your Pyxis contains Potassium chloride 8 mEq/tab. Potassium chloride 20 mEq is ordered. How many tablets will you administer?

2.5

The nurse is to give a client 80 mg of Benadryl by IV push. The vial contains a solution with a concentration of 25 mg/mL. How many milliliters of Benadryl does the nurse administer? __________ml

3.2

A client presents to the ED with severe dehydration and is ordered to receive 3 L of fluid over 6 hours. The nurse sets the IV pump at what rate?

500

An IV with nitroglycerin is infusing at 8 ml/hr. The concentration of the IV is 50mg in 250mL of D%W. How many mg/min is the patient receiving? (Round to the nearest hunjdredth)

???

A patient came to the clinic with erectile dysfunction. What are some possible causes of this condition that the nurse could discuss with the patient during history taking? SATA A. Hour-long exercise sessions B. Recent prostatectomy C. Long-term hypertension D. Consumption of beer each night E. Diabetes mellitus

??? C,D,???

A client is 12 hours post-kidney transplantation. The nurse notes that the client has put out 2000 mL of urine in 10 hours. Which assessment does the nurse carry out first? A. Skin turgor B. Blood pressure C. Serum BUN level D. Weight of the client

??? Not D

The nurse monitors for which clinical manifestations in a client with nephrotic syndrome? SATA A. Proteinurea >3.5 g/24hr B. Hypoalbuminemia C. Dehydration D. Lipidemia E. Dysurea F. Costovertebral angle tenderness

A,B,D, A. Proteinurea >3.5 g/24hr B. Hypoalbuminemia D. Lipidemia

Which results are normal in a urinalysis? SATA 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. pH 6 B. Specific gravity 1.015 D. Glucose, negative

A client asks the nurse, "What are the advantages of peritoneal dialysis over hemodialysis?" Which response by the nurse is accurate? SATA A. It will give you greater freedom in your scheduling. B. You have less chance of getting an infection. C. You need to do it only 3 times a week. D. You will have fewer dietary restrictions.

A,D, A. It will give you greater freedom in your scheduling D. You will have fewer dietary restrictions

The nurse completes which assessment in a client with acute glomerulonephritis and periorbital edema? A. Auscultating breath sounds B. Checking blood glucose levels C. Measuring deep tendon reflexes D. Testing urine for protein

A. Auscultating breath sounds

A client was admitted for a myocardial infarction and cardiogenic shock. Two days later, which laboratory test results does the nurse expect to see? A. BUN of 52 mg/dL B. Creatinine of 2.3 mg/dL C. BUN of 10 mg/dL D. BUN-Creatinine ration of 8:1

A. BUN of 52 mg/dL

A client scheduled to have intravenous urography has diabetes and is taking the antidiabetic agent metformin. What does the nurse tell this client? A. Call your diabetes doctor and tell him or her that you are having an intravenous urogram performed using dye. B. Do not take your metformin the morning of the test because you are not going to be eating anything and you could become hypoglycemic. C. You must start on an antibiotic before this test because your risk of infection is greater as a result of your diabetes. D. You must take your metformin immediately before the test is performed because the IV fluid and the dye contain significant amounts of sugar

A. Call your diabetes doctor and tell him or her that you are having an intravenous urogram performed using dye.

Which client is most at risk for developing postrenal kidney failure? A. Client diagnosed with renal calculi B. Client with CHF C. Client taking NSAIDs for arthritis pain D. Client recovering from glomerulonephritis

A. Client diagnosed with renal calculi

The nurse is working in an incontinence clinic and sees older clients. The nurse plans a habit training program for the client with which condition? A. Confusion B. Diabetes C. Early kidney failure D. Arthritis

A. Confusion

The nursing assistant is using a bladder scanner on a client. Which action by the nursing assistant requires further education on the use of this device? A. Consistently choosing the female icon for all female clients. B. Consistently choosing the male icon for all male clients. C. Applying ultrasound gel to the scanning head and removing it when finished. D. Taking at least 2 readings by using the aiming icon to place the scanning head

A. Consistently choosing the female icon for all female clients.

Assessment findings reveal that a client with chronic kidney disease is refusing to take prescribed medications because of the cost. The client is also having difficulty performing ADLs and prefers to sleep most of the day. To which health care team member does the nurse refer the client? A. Home health aide B. Physical therapist C. Psychiatric nurse practitioner D. Physician

A. Home health aide

Which statement made by a client with stress incontinence indicates a need for clarification of nutrition therapy? A. I will limit my total intake of fluids. B. I will avoid drinking alcoholic beverages. C. I will avoid drinking caffeinated beverages. D. I will try to lose about 10% of my body weight.

A. I will limit my total intake of fluids.

Which response by a client indicates an understanding of measures to facilitate the flow of peritoneal dialysate fluid? A. I will take my stool softeners every day. B. I will keep the drainage bag at the level of my abdomen. C. Flushing the catheter is needed with each exchange. D. Warmed dialysate infusion increased the speed of flow.

A. I will take my stool softeners every day.

A client's urinalysis results show a protein level of 1.8 mg/dL. Which action by the nurse is best? A. Inform the health care provider. B. Ask the client about his or her protein intake. C. Obtain the client's weight. D. Document the finding in the chart.

A. Inform the health care provider.

A nurse contacts the health care provider after reviewing a client's laboratory results and noting a BUN of 35 mg/dL and a creatinine of 1.0 mg/dL. For which action should the nurse recommend an order? A. Intravenous fluids B. Hemodialysis C. Fluid restriction D. Urine culture and sensitivity

A. Intravenous fluids

A client with acute kidney injury had normal assessments 1 hour ago. Now the nurse finds that the client's respiration rate is 44 breaths/min and the client is restless. Which assessment does the nurse perform? A. Obtain an oxygen saturation level. B. Send blood for a creatinine level. C. Assess the client for dehydration. D. Perform a bedside blood glucose.

A. Obtain an oxygen saturation level.

Which client is at greatest risk for development of a bacterial cystitis? A. Older woman not taking estrogen replacement. B. Older man with mild congestive heart failure. C. Middle-aged woman who has never been pregnant. D. Middle-aged man taking cyclophosphamide for cancer therapy.

A. Older woman not taking estrogen replacement.

A client is on hospice care and has an indwelling catheter for comfort. Which intervention does the nurse add to the care plan to address the priority problem for this client? A. Perform catheter care per policy every shift. B. Encourage fluid intake to 1 liter/day. C. Apply a moisture barrier cream daily. D. Document accurate I&O each shift.

A. Perform catheter care per policy every shift.

Which statements about urge incontinence and stress incontinence are true? SATA A. Urge incontinence involves a post-voiding residual volume less than 50 mL. B. Stress incontinence occurs because of weak pelvic floor muscles. C. Stress incontinence usually occurs in people with dementia. D. Urge incontinence can be managed by increasing fluid intake. E. Urge incontinence occurs because of abnormal bladder contractions.

B,E, B. Stress incontinence occurs because of weak pelvic floor muscles. E. Urge incontinence occurs because of abnormal bladder contractions.

A client with renal calculus has just returned from an extracorporeal shock wave lithotripsy procedure, and the nurse finds an ecchymotic area on the client's right lower back. Which is the nurse's priority intervention? A. Notify the health care provider. B. Apply ice to the site and document the finding. C. Place the client in the prone position. D. Document the observation in the chart.

B. Apply ice to the site and document the finding.

The visiting nurse has many clients who are African American. Which intervention is most important for the nurse to accomplish when seeing these clients? A. Weigh the clients and compart their weights. B. Assess the clients' blood pressure. C. Observe the clients for any signs of abuse. D. Aske the clients about their medications.

B. Assess the clients' blood pressure.

A client has a fungal urinary tract infection. Which assessment by the nurse is most helpful? A. Palpating and percussing the kidneys and bladder B. Assessing medical history and current medical problems and medications C. Performing a bladder scan to assess post-void residual D. Inquiring about recent travel to foreign countries

B. Assessing medical history and current medical problems and medications

The nurse is working in a long-term care facility where many clients use habit training to manage incontinence. Which action by unlicensed assistive personnel requires intervention by the nurse? A. Toileting clients after meals B. Changing incontinence briefs when wet C. Encouraging clients to drink fluids D. Recording incontinence episodes

B. Changing incontinence briefs when wet

Which condition would trigger the release of antidiuretic hormone (ADH)? A. Overhydration B. Dehydration C. Hemorrhage D. Edema

B. Dehydration

A client who is admitted to the hospital with a history of kidney disease begins to have difficulty breathing. Vital signs are as follows: BP 90/70, HR, difficult to feel peripheral pulses. His heart sounds are difficult to hear. Which intervention does the nurse prepare for? A. Administration of digoxin B. Draining of pericardial fluid with a needle C. Emergency hemodialysis D. Placement of a pacemaker

B. Draining of pericardial fluid with a needle

A client is scheduled to have dialysis in 30 minutes and is due for the following medications: Vitamin C, B-complex vitamin, and cimetidine (Tagamet). Which action by the nurse is best? A. Give medications with a small sip of water. B. Hold all medications until after dialysis. C. Give the supplements, but hold the Tagamet. D. Give the Tagamet, but hold the supplements.

B. Hold all medications until after dialysis.

A nurse reviews the health history of a client with an oversecretion of renin. Which disorder should the nurse correlate with this assessment finding? A. Alzheimer's B. Hypertension C. Diabetes mellitus D. Diabetes insipidus

B. Hypertension

A client with polycystic kidney disease has received extensive teaching in the clinic. Which statement by the client indicates that an important goal related to nutrition is being met? A. I take a laxative every night before going to bed. B. I have a soft bowel movement every morning. C. Food tastes so much better since I can use salt again. D. The white bead I am eating does not cause gas.

B. I have a soft bowel movement every morning.

A client has nephrotic syndrome and normal glomerular filtration. Which dietary selection shows that the client understands nutritional therapy for this condition? A. Decreased intake of protein B. Increased intake of protein C. Decreased intake of carbohydrates D. Increased intake of carbohydrates

B. Increased intake of protein

The female client's urinalysis shows all the following results. Which does the nurse document as abnormal? A. pH 5.6 B. Ketone bodies present C. Specific gravity of 1.030 D. Two white blood cells per high-power field

B. Ketone bodies present

A postmenopausal female client has had two episodes of bacterial urethritis in the last 6 months. She asks her nurse why this is happening to her now. Which is the nurse's best response? 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 carful with your personal hygiene in this area. D. It is likely that you have an untreated sexually transmitted infection.

B. Low estrogen levels can make the tissue more susceptible to infection.

The nurse is assessing the laboratory findings of a client with a urinary tract infection. The laboratory report notes a "shift to the left" in a client's white blood cell count. Which action by the nurse is most appropriate? A. Request that the laboratory perform a differential analysis on the white blood cells. B. Notify the health care provider and start an IV line for parenteral antibiotics. C. Instruct the client to begin straining all urine for renal calculi. D. Document the finding in the client's chart and continue to monitor.

B. Notify the health care provider and start an IV line for parenteral antibiotics.

When providing care for a client receiving peritoneal dialysis, the nurse notices that the effluent is cloudy. Which intervention is most important for the nurse to carry out? A. Irrigate the peritoneal catheter with saline. B. Send a specimen for culture and sensitivity. C. Document the finding in the client's chart. D. Change the dialysate solution and catheter tubing.

B. Send a specimen for culture and sensitivity.

A client has nephrotic syndrome. Which finding shows that therapy is effective? A. Serum albumin level is 2.8 g/dL B. Serum albumin level is 4 g/dL C. Urine protein level is 3.7 g/24hr D. Potassium is 4.2 mEq/L

B. Serum albumin level is 4 g/dL

A client is beginning to undergo urinary bladder training. Which is an effective instruction to give to this client? A. Use the toilet at the first urge, rather than at specific intervals. B. Try to consciously hold your urine until the scheduled toileting time. C. Initially try to use the toilet at least every half-hour for 24 hours. D. The toileting interval can be increased once you have been continent for 1 week.

B. Try to consciously hold your urine until the scheduled toileting time.

An emergency department nurse assesses a client with a history of urinary incontinence who presents with extreme dry mouth, constipation, and an inability to void. Which question should the nurse ask first? A. Are you drinking plenty of water? B. What medications are you taking? C. Have you tried laxatives or enemas? D. Has this type of thing ever happened before?

B. What medications are you taking?

A client with acute kidney failure and on dialysis asks how much fluid will be permitted each day. Which is the nurse's best response? A. This is based on the amount of damage to your kidneys. B. You can drink an amount equal to your urine output, plus 700mL. C. It is based on your body weight and changes daily. D. You can drink approximately 2 liters of fluid each day.

B. You can drink an amount equal to your urine output, plus 700mL.

A nurse reviews lab results for a patient with glomerulonephritis. The patient's GFR is 40 mL/min as measured by a 24 hour creatinine clearance. How would the nurse interpret this finding? SATA A. Excessive GFR B. Normal GFR C. Reduced GFR D. Potential for fluid overload E. Potential for dehydration

C,D, C. Reduced GFR D. Potential for fluid overload

A client with severe bacterial cystitis is prescribed cefadroxil and phenazopyridine. What statement by the client indicates an accurate understanding of these medications? A. I will not take these drugs with food or milk. B. I will stop these drugs if I think I am pregnant. C. An orange color in my urine won't alarm me. D. I will try to drink a liter of cranberry juice daily.

C. An orange color in my urine won't alarm me.

Two hours after a closed percutaneous kidney biopsy, the client reports a dramatic increase in pain. What is the nurse's best first action? A. Reposition the client on the operative side. B. Administer the prescribed opioid analgesic. C. Assess the pulse rate and blood pressure. D. Check the Foley catheter for kinks.

C. Assess the pulse rate and blood pressure

A client with a decreased glomerular filtration rate asks how to prevent further damage to the kidneys. Which is the nurse's best response? A. The diuretics you are taking will prevent further damage. B. Kidney damage is inevitable as you age. C. Avoid taking NSAIDs. D. You will need to follow a high-protein diet.

C. Avoid taking NSAIDs.

A client is going home after urography. Which instruction or precaution does the nurse teach this client? A. Avoid direct contact with the 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.

C. Be sure to drink at least 3 liters of fluids today to help eliminate the dye faster.

To obtain a sterile urine specimen form a client with a Foley catheter, the nurse begins by applying a clamp to the drainage tubing distal to the injection port. What does the nurse do 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 10 ml more for the sample.

C. Clean the injection port cap of the drainage tubing with povidone-iodine solution

A middle-aged client with diabetes mellitus is being treated for the third episode of acute pyelonephritis in the past year and asks what can be done to help prevent these infections. Which is the nurse's best response? 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 every 2-3 hours during the day. D. Keep your hemoglobin A1c under 9% by keeping our blood sugar controlled.

C. Drink more water and empty your bladder every 2-3 hours during the day.

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 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.

C. Erythropoietin is usually released from the kidneys and stimulates red blood cell production in the bone marrow.

A client has been diagnosed with acute postrenal kidney injury. Which assessment finding does the nurse assess most carefully for? A. BUN 35 B. Creatinine 2.5 C. Feeling of urgency D. Weight gain and edema

C. Feeling of urgency

A client is hospitalized with a urinary tract infection. Which clinical manifestation alerts the nurse to the possibility of a complication from the UTI? A. Burning on urination B. Cloudy, dark urine C. Fever and chills D. Hematuria

C. Fever and chills

A client who has undergone a nephrolithotomy procedure 24 hours ago now has a fever of 101 degrees F. What is the nurse's priority intervention? A. Apply a cooling blanket B. Strain the client's urine C. Notify the health care provider D. Document the finding in the client's chart

C. Notify the health care provider

A client is receiving continuous arteriovenous hemofiltration (CAVH). Which lab value does the nurse monitor most closely? A. Hemoglobin B. GFR C. Sodium D. WBC

C. Sodium

In assessing a client 6 hours after a radical nephrectomy for renal cell carcinoma, the nurse notes that the client's BP has decreased from 134/90 to 100/56 and urine output is 20 mL for this past hour. Which is the nurse's best action? A. Position the client so that the remaining kidney is not dependent. B. Measure the specific gravity of the client's urine. C. Document the findings in the client's record. D. Assess the pulse rate and quality, and then notify the provider.

D. Assess the pulse rate and quality, and then notify the provider.

A client has functional urinary incontinence. Which instruction by the nurse to the client and family helps meet an expected outcome for this condition? A. You must clean around your catheter daily with soap and water. B. Wash the vaginal weights with a 10% bleach solution after each use. C. Operations to repair your bladder are available, and you can consider these. D. Buy slacks with elastic waistbands that are easy to pull down.

D. Buy slacks with elastic waistbands that are easy to pull down.

The caretaker of a confused client with functional incontinence asks about having an in-dwelling catheter placed. Which is the nurse's best response? A. You must be very aggravated about this situation. I will call the provider with this request. B. I will teach you how to insert the catheter, which should be used just at night. C. We can teach you how to perform intermittent catheterization to drain the bladder. D. Catheters are not the best choice because of risk for infection, but we will place a priority on keeping the skin clean and dry.

D. Catheters are not the best choice because of risk for infection, but we will place a priority on keeping the skin clean and dry.

A client with autosomal dominant polycystic kidney disease (ADPKD) asks whether his children could develop this disease. Which is the nurse's best response? A. No genetic link is known, so your children are not at increased risk. B. The disease is sex linked, so only your sons could be affected. C. Both you and your wife must have the disease for your children to develop it. D. Each of your children has a 50% risk of having ADPKD.

D. Each of your children has a 50% risk of having ADPKD.

A client's urinalysis results reveal a urine osmolarity of 1200 mOsm/L. Which action by the nurse is most appropriate? A. Initiate a fluid restriction B. Prepare to administer a diuretic C. Institute seizure precautions D. Encourage the client to increase fluid intake

D. Encourage the client to increase fluid intake

In assessing a client recently diagnosed with acute glomerulonephritis, the nurse asks which question to determine potential contributing factors? A. Are you sexually active? B. Do you have pain or burning on urination? C. has anyone in your family had chronic kidney problems? D. Have you had a cold or sore throat within the last 2 weeks?

D. Have you had a cold or sore throat within the last 2 weeks?

A client's urine specific gravity is 1.040. Which action by the nurse is best? A. Obtain a urine culture and sensitivity. B. Place the client on restricted fluids. C. Review the client's creatinine level. D. Increase the client's fluid intake.

D. Increase the client's fluid intake.

The nurse is reviewing a client's urinalysis and notes a positive glucose. Which action by the nurse is best? A. Document the finding. B. Collect and send another urinalysis sample to the laboratory. C. Review the client's recent dietary selections. D. Perform a finger stick blood glucose on the client.

D. Perform a finger stick blood glucose on the client.

A client hospitalized for worsening kidney injury suddenly becomes restless and agitated. Assessment reveals tachycardia and crackles bilaterally at the bases of the lungs. Which is the nurse's first intervention? A. Begin ultrafiltration B. Administer an antianxiety agent C. Place the client on mechanical ventilation D. Place the client in high Fowler's position

D. Place the client in high Fowler's position

A client with glomerulonephritis has a glomerular filtration rate (GFR) of 40 ml/min, as measured by a 24-hour creatinine clearance. Which is the nurse's interpretation of this finding? A. Excessive GFR, client at risk for dehydration B. Excessive GFR, client at risk for fluid overload C. Reduced GFR, client at risk for dehydration D. Reduced GFR, client at risk for fluid overload

D. Reduced GFR, client at risk for fluid overload

Which intervention is most important for the nurse to implement in a client after kidney transplant surgery? A. Promote acceptance of new body image. B. Monitor magnesium levels daily. C. Place the client on protective isolation. D. Remove the indwelling Foley catheter as soon as possible.

D. Remove the indwelling Foley catheter as soon as possible.

The nurse is caring for a client with chronic kidney disease who has developed uremia. Which assessment finding does the nurse correlate with this problem? A. Decreased breath sounds B. Foul-smelling urine C. Heart rate of 50 beats/min D. Respiratory rate of 40 breaths/min

D. Respiratory rate of 40 breaths/min

A nurse assesses a client with bladder cancer who is recovering from a complete cystectomy with ileal conduit. Which assessment finding should alert the nurse to urgently contact the health care provider? A. The ileostomy is draining blood-tinged urine. B. There is serous sanguineous drainage present on the surgical dressing. C. Oxygen saturations are 92% on room air. D. The ileostomy stoma is pale and cyanotic in appearance.

D. The ileostomy stoma is pale and cyanotic in appearance.

A client has overflow incontinence. Which intervention does the nurse add to this client's care plan to assist with elimination? A. Stroking the medial aspect of the thigh B. Using intermittent catheterization C. Providing digital anal stimulation D. Using the Valsalva maneuver

D. Using the Valsalva maneuver

Which assessment parameter does the nurse monitor in a client with chronic kidney disease to determine fluid and sodium retention status? A. Capillary refill B. Intake and output C. Muscle strength D. Weight and blood pressure

D. Weight and blood pressure

A client with polycystic kidney disease and hypertension is prescribed a diuretic for blood pressure control. Which statement by the client indicates the need for further teaching regarding these orders? A. I will weigh myself every day at the same time. B. I will drink only 1 liter of fluid each day. C. I will avoid aspirin and aspirin-containing drugs. D. I will avoid nonsteroidal anti-inflammatory drugs.

I will drink only 1 liter of fluid each day.

Which clinical manifestation indicates to the nurse that a client with glomerulonephritis is responding as expected to the prescribed treatment? A. The client has lost 11 pounds 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

The client has lost 11 pounds in the past 10 days.