Med Surg Exam 4 - Renal and Endocrine
Which laboratory value supports the presence of diabetic ketoacidosis? a) Increased serum lipids b) Decreased hematocrit level c) Increased serum calcium levels d) Decreased BUN
a) Increased serum lipids Rationale: With diabetic ketoacidosis, serum lipid levels are high because of the increased breakdown of fat.
Which manifestations are exhibited with SIADH? a) Increased BUN and hypotension b) Hyperkalemia and poor skin turgor c) Hyponatremia and decreased urine output d) Polyuria and increased specific gravity of urine
c) Hyponatremia and decreased urine output
Which instructions would the nurse give to the client with renal calculi? SATA. a) "Drink plenty of water." b) "Have spinach soup every day." c) "Substitute lemon juice for tea." d) "Include high amounts of protein in the diet." e) "Consume foods rich in omega-3 fatty acids."
a) "Drink plenty of water." c) "Substitute lemon juice for tea."
The nurse is evaluating the results of treatment with erythropoietin. Which assessment finding indicates an improvement in the underlying condition being treated? a) 2+ pedal pulses b) Decreased pallor c) Decreased jaundice d) 2+ deep tendon reflexes
b) Decreased pallor Rationale: Erythropoietin stimulates RBC production, thereby decreasing the pallor that accompanies anemia.
The nurse is caring for a client who has renal calculi secondary to hyperparathyroidism. Which type of diet would the nurse teach the client? a) Low purine b) Low calcium c) High phosphorus d) High alkaline ash
b) Low calcium
Which assessment in a female client suggests an abnormal endocrine finding? a) Facial hair b) Protruding eyes c) Pulse of 90 d) BP of 120/80
b) Protruding eyes
The nurse provides preop teaching for a client scheduled for a TURP. To prepare the client for postop care, which instructions would the nurse include in the teaching session? a) The urine will be bright red for 24-48 hours. b) Spasms of the bladder occur during the first 24-48 hours. c) To decrease bladder contractions, the Valsalva maneuver and Kegel exercises will be encouraged. d) To maintain proper fluid balance, oral fluids are restricted during continuous urinary bladder irrigations.
b) Spams of the bladder occur during the first 24-48 hours. Rationale: Spasms are common postoperatively as a result of irritation of the bladder during surgery. However, it is important to let the client know that the spasms typically decrease in intensity and frequency as healing occurs.
The nurse is planning care for a client with DI. Which intervention made by the nurse requires correction? a) Assessing sodium levels b) Measuring urine output c) Restricting fluids at night d) Changing positions slowly
c) Restricting fluids at night Rationale: A client with DI is at risk for severe fluid volume deficit due to increased urination. Therefore the nurse would never restrict fluids for longer than 4 hours, because it can lead to severe dehydration.
A client with a large calculus in the calyces of the right kidney has surgery scheduled for removal of the stone. Which information would the nurse include when teaching postoperative care? a) The calculi are too large for transurethral removal. b) During the surgery, removal of the right ureter occurs. c) After surgery, a suprapubic catheter will be in place. d) After surgery, there will be a small incision in the right flank area.
d) After surgery, there will be a small incision in the right flank area.
Which assessment is necessary for the nurse to complete in a client with chronic kidney disease receiving loop diuretics? a) Hemoglobin levels b) Occurrence of nausea c) Presence of constipation d) Intake and output measurement
d) Intake and output measurement
An adolescent with a history of type 1 diabetes is admitted in ketoacidosis. Which cause would the nurse suspect as precipitating this episode of ketoacidosis? a) Infection b) Increased exercise c) Recent weight loss d) Overdose of insulin
a) Infection
A client is admitted to the hospital with severe renal colic caused by a ureteral calculus. Later that evening, the client's urinary output is much less than the intake. The client's bladder in not distended. Which condition would the nurse suspect? a) Oliguria b) Hydroureter c) Renal shutdown d) Urethral obstruction
b) Hydroureter
A client complains of nocturia, bladder pain, urinary frequency, urgency, and dribbling at the end of urination. The digital rectal examination report indicates smooth, firm, and enlarged prostate tissue surrounding the urethra. Which condition would the nurse suspect? a) Prostatitis b) Paraphimosis c) Prostate cancer d) BPH
d) BPH
Which finding in a client with SIADH is an expected finding? a) Preservation of salt b) Retention of water c) Decrease of vasopressin d) Presence of pedal edema
b) Retention of water
The nurse assesses a male client with a preliminary diagnosis of cancer of the urinary bladder. Which clinical manifestation would indicate the cancer is in an early stage? a) Dysuria b) Retention c) Hesitancy d) Hematuria
d) Hematuria Rationale: Hematuria is the most common early sign of cancer of the urinary system, probably because of the urinary system's rich vascular network. Dysuria, retention, and hesitancy are not specific for bladder cancer; usually they are associated with BPH.
Which findings would the nurse expect when assessing a client who has a ureteral calculus? a) Foul odor and dark urine b) Urgency and mild aching pain c) Frequency with small amounts of urine d) Hematuria with sharp pain when voiding
d) Hematuria with sharp pain when voiding
Which factor may contribute to a client developing urinary calculi. a) Increased fluid intake b) Urine specific gravity of 1.017 c) Jogging 3 miles per day d) Hx of hyperparathyroidism
d) Hx of hyperparathyroidism Rationale: Hyperparathyroidism results in high serum calcium levels; as the blood is filtered through the nephron, precipitates of calcium may form calculi.
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? a) Ascites b) Acidosis c) Hypertension d) Hyperkalemia
d) Hyperkalemia Rationale: Protein breakdown liberates cellular potassium ions, leading to hyperkalemia, which can cause a cardiac dysrhythmia and standstill. The failure of the kidneys to maintain a balance of potassium is one of the main indication for dialysis.
Which responses would the nurse expect a client experiencing hypoglycemia to exhibit? SATA. a) Nausea b) Palpitations c) Tachycardia d) Nervousness e) Warm, dry skin f) Increased respirations
b) Palpitations c) Tachycardia d) Nervousness
An ambulatory client with benign prostatic hyperplasia reports to the morning nurse his inability to void all night long. Upon assessment, the nurse identifies distention of the client's bladder. Which action would the nurse implement? a) Ask him to use a urinal. b) Encourage increased fluids. c) Assist him into a warm shower. d) Exert pressure over the pubic area.
c) Assist him into a warm shower. Rationale: Warm water often will relax the urinary sphincter, enabling a client to void.
Which intervention would be included in the plan of care for a client diagnosed with hyperthyroidism? a) Monitor for hypoglycemia b) Protect visitors from radiation c) Provide foods to increase appetite d) Arrange for sufficient rest periods
d) Arrange for sufficient rest periods
Which interventions would the nurse implement when providing care to a client after a subtotal thyroidectomy? SATA. a) Assess for frequent swallowing. b) Ambulate the client the evening of surgery. c) Assess for facial spasms, apprehension, or tingling of the lips, fingers, or toes. d) Instruct the client to support the head and maintain the neck in a flexed position. e) Ensure that O2, suction equipment, and tracheostomy tray are at the bedside.
a) Assess for frequent swallowing. b) Ambulate the client the evening of surgery. c) Assess for facial spasms, apprehension, or tingling of the lips, fingers, or toes. e) Ensure that O2, suction equipment, and tracheostomy tray are at the bedside.
Which intervention would prevent urinary stasis and formation of renal calculi in an immobile client? a) Increasing oral fluid intake to 2-3 L/day b) Maintaining bed rest after discharge c) Limiting fluid intake to 1 L/day d) Voiding at least every hour
a) Increasing oral fluid intake to 2-3 L/day Rationale: Increasing fluids will dilute urine and promote urine flow.
A client with type 1 diabetes has dry, hot, flushed skin; a fruity odor to the breath; and is having Kussmaul respirations. Which complication does the nurse suspect that the client is experiencing? a) Ketoacidosis b) Somogyi phenomenon c) Hypoglycemic reaction d) hyperosmolar nonketotic coma
a) Ketoacidosis
The nurse provides dietary teaching for a client with calcium oxalate kidney stones. The nurse would instruct the client to limit the intake of which item? a) Sodium b) Gravies c) Red wines d) Organ meat
a) Sodium Rationale: High sodium intake in clients with calcium oxalate kidney stones will reduce kidney tubular reabsorption of calcium.
The nurse is providing postop care 8 hours after a client had a total cystectomy and the formation of an ileal conduit. Which assessment finding would be reported to the HCP immediately? a) Edematous stoma b) Dusky-colored stoma c) Absence of bowel sounds d) Pink-tinged urinary drainage
b) Dusky-colored stoma Rationale: A dusky-colored stoma may denote a compromised blood supply to the stoma and impending necrosis. An edematous stoma and absence of BS are expected in the early postop period. Pink-tinged urine may be present in the immediate postop period.
A client admitted with severe renal colic secondary to a ureteral calculus has less urinary output than intake over the past 8 hours. A bedside bladder scan indicates 40 mL of residual urine. Which potential complication would the nurse suspect? a) Oliguria b) Hydroureter c) Renal shutdown d) Urethral obstruction
b) Hydroureter Rationale: Calculi may obstruct the flow of urine to the bladder, allowing the urine to distend the ureter, causing hydroureter.
A client is admitted to the hospital with severe renal colic caused by a ureteral calculus. Later that evening, the client's urinary output is much less than intake. The client's bladder is not distended. Which condition would the nurse suspect? a) Oliguria b) Hydroureter c) Renal shutdown d) Urethral obstruction
b) Hydroureter Rationale: Calculi may obstruct the flow of urine to the bladder, allowing the urine to distend the ureter, causing hydroureter.
A client admitted with severe renal colic secondary to ureteral calculus has less urinary output than intake over the past 8 hours. A bedside bladder scan indicates 40 mL of residual urine. Which potential complication would the nurse suspect? a) Oliguria b) Hydroureter c) Renal shutdown d) Urethral obstruction
b) Hydroureter Rationale: Calculi may obstruct the flow of urine to the bladder, allowing the urine to distend the ureter, causing hydroureter.
The nurse is caring for a client with the clinical manifestation of hypotension associated with a diagnosis of Addison disease. Which hormone can be impaired in its production because of this disease? a) Estrogen b) Androgens c) Cortisol d) Aldosterone
d) Aldosterone
Which finding is expected in a client diagnosed with early glomerulonephritis? a) Anuria b) Dysuria c) Polyuria d) Proteinuria
d) Proteinuria
Which client's laboratory result is consistent with a diagnosis of Cushing syndrome? a) Salivary cortisol level of 1 ng/mL b) Salivary cortisol level of 1.2 c) Salivary cortisol level of 1.9 d) Salivary coritsol level of 2.3
d) Salivary coritsol level of 2.3 Rationale: Normal salivary cortisol level is lower than 2.0 ng/mL.
Which intervention would the nurse include in the plan of care for a client iwth Addison disease? a) Encourage exercise b) Protect from exertion c) Restrict fluid intake d) Monitor for hypokalemia
b) Protect from exertion
A female client's urinalysis indicates the 17-ketosteroids value is 25 mg/ 24 h. For which condition would the nurse monitor? a) Addison disease b) Ovarian neoplasms c) Ovarian dysfunction d) Cushing syndrome
d) Cushing syndrome Rationale: Urinary steroids such as 17-ketosteroids range from 6-17 mg/ 24 h in females. Higher levels may indicate possible Cushing syndrome.
Which cause of Cushing syndrome would the nurse consider before assessing the client for physiological responses? a) Pituitary hypoplasia b) Hyperplasia of the adrenal cortex c) Deprivation of adrenocortical hormones d) Insufficient ACTH production
b) Hyperplasia of the adrenal cortex
Which clinical findings would the nurse expect to see when assessing a client with hyperthyroidism? SATA? a) Dry skin b) Weight loss c) Tachycardia d) Restlessness e) Constipation f) Exophthalmos
b) Weight loss c) Tachycardia d) Restlessness f) Exophthalmos
A client is admitted to the hospital with a tentative diagnosis of urinary retention related to BPH. The HCP notes a secondary diagnosis of delirium related to urosepsis and prescribes the insertion of an indwelling urinary retention catheter. Which nursing action is most important at this time? a) Secure a prescription for wrist restraints. b) Orient the client to time, place, and person. c) Involve family members in the client's care. d) Determine whether any unsafe behavior patterns exist.
d) Determine whether any unsafe behavior patterns exist.
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? a) Fluid b) Protein c) Sodium d) Potassium
b) Protein Rationale: The waste products of protein metabolism are the main cause of uremia.
A client arrives at a health clinic reporting a recent onset of hematuria, frequency, urgency, and pain on urination. Which diagnosis will the nurse observe in the client's medical record? a) Chronic glomerulonephritis b) Nephrotic syndrome c) Pyelonephritis d) Cystitis
d) Cystitis Rationale: Cystitis is an inflammation of the bladder that causes frequency and urgency of urination, pain on micturition, and hematuria.
A client is diagnosed with testicular cancer. Which treament would be first? a) Radiotherapy b) Chemotherapy c) Testicular biopsy d) Radical inguinal orchiectomy
d) Radical inguinal orchiectomy Rationale: Treatment for the testicular cancer may include a radial inguinal orchiectomy, which is the surgical removal of the diseased testicle.
Which electrolyte imbalance response would the nurse assess for in a client with a diagnosis of Cushing syndrome? a) Hypovolemia b) Hyperkalemia c) Hypoglycemia d) Hypernatremia
d) Hypernatremia Rationale: A client with Cushing syndrome secretes excess amounts of cortisol, a corticosteroid that acts to retain sodium and water, resulting in hypernatremia and edema.
Which instruction would the nurse provide to a client receiving brachytherapy for prostate cancer to prevent injury? a) Use bleach when doing laundry b) Wear a mask when around others c) Flush the toilet several times after use d) Refrain from close contact with others
d) Refrain from close contact with others Rationale: Brachytherapy involves the implantation of radioactive isotopes near the tumor to destroy cancer cells. Clients are radioactive while receiving treatment, making them potentially hazardous to others.
Which clinical manifestations would the nurse expect a client to exhibit with a diagnosis of Cushing syndrome? SATA. a) Emaciation b) Weakness c) HTN d) Truncal obesity e) Intermittent tonic spasms
b) Weakness c) HTN d) Truncal obesity
A client with malignant not nodules of the thyroid gland has a thyroidectomy. Which is the nurse's priority action immediately postop? a) Check the neck dressing for bleeding b) Monitor the trachea for deviation to the right or left c) Assess the client's level of discomfort and medicate as prescribed d) Encourage coughing and deep breathing to prevent atelectasis
b) Monitor the trachea for deviation to the right or left
Which interventions would the nurse implement for a client with a urethral calculus? SATA. a) Limiting fluid intake at night b) Monitoring intake and output c) Straining the urine at each voiding d) Recording the client's blood pressure e) Administering the prescribed analgesic
b) Monitoring intake and output c) Straining the urine at each voiding e) Administering the prescribed analgesic
Which interventions would the nurse implement for a client with a ureteral calculus? SATA. a) Limiting fluid intake at night b) Monitoring intake and output c) Straining the urine at each voiding d) Recording the client's BP e) Administering the prescribed analgesic
b) Monitoring intake and output c) Straining the urine at each voiding e) Administering the prescribed analgesic
A client with renal colic is scheduled for extracorporeal shock-wave lithotripsy. The night before a scheduled extracorporeal shock-wave lithotripsy procedure, the client frequently uses the call light and has many demands. Which statement would the nurse use in response to the client's needs? a) "I know how you feel; I had this same procedure last year." b) "We'll take good care of you, so you have nothing to worry about." c) "You are facing a new experience tomorrow; tell me what concerns you have." d) "Your behavior tells me that you are scared of what you are facing tomorrow."
c) "You are facing a new experience tomorrow; tell me what concerns you have."
A 75-year-old male who has a history of prostate cancer is admitted for a prostatectomy. The client's PSA levels have been increasing. Which intervention would the nurse include in the client's plan of care? a) Encourage the client to drink extra fluids. b) Institute seizure precautions. c) Monitor the plasma pH for acidosis. d) Handle the client gently when turning.
d) Handle the client gently when turning. Rationale: Increasingly elevated PSA levels may indicate a worsening of the client's condition with possible metastasis to the bone, increasing the risk of pathological fractures; therefore handling must be gentle.
To prevent the development of ureteral colic from renal calculi in the future, which strategy would the nurse include in the client's plan of care? a) Instruct the client to drink at least 3L of fluid daily. b) Suggest interventions to decrease the serum creatinine level. c) Establish a urinary output goal of 2000 mL per 24 hours. d) Teach the client to exclude milk products from their diet.
a) Instruct the client to drink at least 3L of fluid daily.
Which assessment findings would the nurse expect in the client hospitalized with a diagnosis of severe chronic kidney disease? SATA. a) Polyuria b) Paresthesias c) Hypertension d) Metabolic alkalosis e) Widening pulse pressure
b) Paresthesias c) Hypertension Rationale: Paresthesias occur as a result of excess nitrogenous wastes, altered fluid and electrolytes, and altered regulatory functions. Nonfunctioning kidneys cause fluid retention that may result in hypovolemia and hypertension.
The nurse is reviewing the clinical record of a client with BPH. Which test result would confirm the diagnosis? a) Digital rectal examination b) Serum phosphatase level c) Biopsy of prostatic tissue d) Massage of prostatic fluid
c) Biopsy of prostatic tissue Rationale: A definitive diagnosis of the cellular changes associated with BPH is made by biopsy, with subsequent microscopic evaluation. Palpation of the prostate gland through rectal examination is not a definitive diagnosis; this only reveals the size and configuration of the prostate.
Which symptom would the nurse assess in a client with a diagnosis of Addison disease? a) Pyrexia b) HTN c) Hirsutism d) Hypoglycemia
d) Hypoglycemia
Which disorder is caused by the deficiency of antidiuretic hormone? a) Acromegaly b) Diabetes insipidus c) Cushing syndrome d) SIADH
b) Diabetes insipidus
The nurse teaches a client with chronic kidney disease to avoid all salt substitutes in their diet. Which rationale supports the nurse's instruction? a) A person's body tends to retain fluid when a salt substitute is included in the diet. b) Limiting salt substitutes in the diet prevents a buildup of waste products in the blood. c) Salt substitutes contain potassium, which must be limited to prevent abnormal heartbeats. d) The salt substitute substances interfere with capillary membrane transfer, resulting in anasarca.
c) Salt substitutes contain potassium, which must be limited to prevent abnormal heartbeats. Rationale: Salt substitutes usually contain potassium, which can lead to hyperkalemia; dysrhythmias are associated with hyperkalemia. CKD already places the client at higher risk for hyperkalemia because of poor elimination of fluids and electrolytes.
The nurse is caring for a client with Addison's disease. Which dietary modification should the nurse include in the client's teaching plan? a) Increase potassium intake to replace renal losses. b) Increase protein intake to heal the adrenal tissue and thus cure the disease. c) Take supplemental vitamins to supply energy and assist in regaining the weight that was lost. d) Consume extra salt to replace the amount being lost due to a lack of sufficient aldosterone needed to conserve sodium.
d) Consume extra salt to replace the amount being lost due to a lack of sufficient aldosterone needed to conserve sodium.
When performing presurgical teaching for a client pending a TURP, which statement would the nurse include? a) "Urinary control may be permanently lost to some degree." b) "An indwelling urinary catheter is required for at least 1 day." c) "Your ability to perform sexually will be impaired permanently." d) "Burning on urination will last while the cystostomy tube is in place."
b) "An indwelling urinary catheter is required for at least 1 day."
Which information would the nurse include in the home care instructions for a client being discharged post-lithotripsy for renal calculi? a) "Increase your intake of dairy products for 5 days." b) "Drink at least 3 L of fluid daily for 4 weeks." c) "Do not take any medications after this treatment." d) "Call us immediately if you see blood in your urine."
b) "Drink at least 3 L of fluid daily for 4 weeks."
Which instruction would the nurse use when preparing a client who successfully passed his or her renal calculus for discharge home? a) "Continue to strain all urine." b) "Increase your fluid intake." c) "Limit dietary potassium." d) "Maintain bed rest for 24 hours."
b) "Increase your fluid intake."
Which condition would the nurse anticipate in a client who complains of weight gain and has purplish-blue striae on the abdomen? a) Hypothyroidism b) Addison disease c) Cushing syndrome d) Pheochromocytoma
c) Cushing syndrome
Which outcome would be expected after a client received treatment for Cushing disease? a) Increased cortisol levels b) Increased sodium levels c) Decreased blood glucose levels d) Decreased serum calcium levels
c) Decreased blood glucose levels Rationale: Cushing disease affects the glucose metabolism and results in reduced glucose uptake by tissues and increased blood glucose levels.
Which disease increases the risk of hyperkalemia? a) Crohn's disease b) Cushing disease c) End-stage renal disease d) Gastroesophageal reflux disease
c) End-stage renal disease
Which clinical findings are associated with nephrotic syndrome (NS) rather than acute glomerulonephritis (AGN)? a) Lethargic and appears unwell b) Gross hematuria c) Generalized edema d) Massive proteinuria e) Unchanged BP
c) Generalized edema d) Massive proteinuria e) Unchanged BP
A client, transferred to the post anesthesia care unit after a TURP, has an IV line and a urinary retention catheter. During the immediate postop period, for which potentially critical complication would the nurse monitor? a) Sepsis b) Phlebitis c) Hemorrhage d) Leakage around urinary catheter
c) Hemorrhage
Which situation in a client with hyperthyroidism may precipitate thyroid crisis (thyroid storm)? a) Increased iodine in the blood b) Removal of the parathyroid glands c) High levels of the hormone triiodothyronine d) Rebound increase in the metabolism after anesthesia
c) High levels of the hormone triiodothyronine Rationale: Thyroid trauma, thyroid surgery, or physiological stress in a client with hyperthyroidism may lead to a release of abnormally high levels of thyroid hormones. High levels of T3 intensify all the SxS of hyperthyroidism, such as increased temperature, pulse, respirations, restlessness, vomiting, and often death.
Most probable cause of primary DI
A defect in the hypothalamus (thirst center)
The HCP prescribes finasteride for a client with BPH. The client would like to take saw palmetto instead. Which information would the nurse provide to the client about this herbal supplement? a) "Research has shown that saw palmetto is no better than a placebo." b) "You can take both; saw palmetto does not require a prescription." c) "The herbal supplement will relieve symptoms by altering the size of the prostate." d) "Substituting saw palmetto is a good option to avoid all the bad side effects of finasteride."
a) "Research has shown that saw palmetto is no better than a placebo."
The nurse is caring for a client with Addison disease. Which dietary instruction would the nurse provide? a) Add extra salt to food. b) Consume high-potassium foods. c) Omit protein foods at each meal. d) Restrict the daily intake of fluids to 1 L.
a) Add extra salt to food.
The nurse reviews the medical records of four male clients. Which client would the nurse note as having the highest risk for the development of clinical manifestations related to prostate cancer? a) African American 55 yo b) White 45 yo c) Asian 55 yo d) Hispanic 45 yo
a) African American 55 yo
A client has phosphate renal calculi. Which food item would the nurse teach the client to include regularly in the diet? a) Apples b) Chocolate c) Rye bread d) Cheddar cheese
a) Apples
Which characteristic of urine changes in the presence of a urinary tract infection? a) Clarity b) Viscosity c) Glucose level d) Specific gravity
a) Clarity
Which clinical findings would the nurse expect to identify when completing a nursing admission history and physical on a client with suspected hyperthyroidism? SATA. a) Palpitations b) Tachycardia c) Thickened skin d) Apathetic attitude e) Missed menstrual periods
a) Palpitations b) Tachycardia e) Missed menstrual periods
Which are SxS of hyperglycemia? SATA. a) Irritability b) Dry skin c) Diaphoresis d) Increased thirst e) Deep, rapid breathing
b) Dry skin d) Increased thirst e) Deep, rapid breathing
Which symptom would the nurse identify when assessing a client with Graves disease? a) Constipation b) Lethargy c) Exophthalmos d) Weight gain
c) Exophthalmos
Which assessment finding differentiates central and nephrogenic DI? a) Urine output b) Specific gravity c) Urine osmolarity d) Serum osmolarity
c) Urine osmolarity
Which physical assessment findings would the nurse document on a client who is experiencing Cushing triad? SATA. a) Bradycardia b) Tachycardia c) Irregular respirations d) Systolic HTN e) Diastolic HTN f) Widening pulse pressure
a) Bradycardia c) Irregular respirations d) Systolic HTN f) Widening pulse pressure
Which SxS would the nurse include when teaching a client about ketoacidosis? SATA. a) Confusion b) Hyperactivity c) Excessive thirst d) Fruity-scented breath e) Decreased urinary output
a) Confusion c) Excessive thirst d) Fruity-scented breath
The nurse identifies which clinical manifestations as being characteristics of hyperthyroidism? SATA. a) Diaphoresis b) Weight loss c) Constipation d) Protruding eyes e) Cold intolerance
a) Diaphoresis b) Weight loss d) Protruding eyes
Before a TURP, a client asks about what to expect postoperatively. Which response would the nurse provide? a) "Your urine will be pink and free of clots." b) "You will have an abdominal incision and a dressing." c) "There will be an incision between your scrotum and rectum." d) "There will be a urinary catheter and a continuous bladder irrigation."
d) "There will be a urinary catheter and a continuous bladder irrigation."
Which clinical manifestations would the nurse anticipate when assessing a client with hypothyroidism? SATA. a) Dry skin b) Brittle hair c) Weight loss d) Resting tremors e) Heat intolerance
a) Dry skin b) Brittle hair
Which goal would the nurse establish when providing care for a client recovering from a transurethral resection of the prostate (TURP)? a) Maintain patency of the cystostomy tube. b) Prevent wound hemorrhage and infection. c) Maintain patency of the indwelling catheter. d) Prevent the abdominal dressing from draining.
c) Maintain patency of the indwelling catheter.
After a transurethral prostatectomy (TURP), a client returns to the postanesthesia care unit with a three-way indwelling catheter and continuous bladder irrigation. Which nursing action would the nurse monitor during the initial recovery phase? a) Observe the suprapubic dressing for drainage. b) Maintain the client in a semi-Fowler position. c) Monitor for bright red blood in the urinary drainage bag. d) Encourage fluids by mouth as soon as the gag reflex returns.
c) Monitor for bright red blood in the urinary drainage bag. Rationale: Blood clots are normal 24-36 hours after the TURP surgery, but bright red blood can indicate hemorrhage.
To prepare for hemodialysis, a client schedules his or her surgical procedure for an internal arteriovenous fistula in one arm and placement of an external arteriovenous shunt in the other arm. Which considerations would the nurse integrate into this client's postop plan of care? a) The graft has a higher risk of hemorrhage, clotting, and infection than the fistula does. b) Staff will obtain blood pressure readings from the arm with the fistula, but not the one with the shunt. c) Administer IV fluids in the arm with the shunt, but not the one with the fistula. d) Cover the fistula with a light dressing, and cover the shunt thoroughly with a heavy dressing.
a) The graft has a higher risk of hemorrhage, clotting, and infection than the fistula does.
Which is the etiological factor of nephrogenic DI? a) Meningitis b) Lithium therapy c) Grave's disease d) Sulfonamide therapy
b) Lithium therapy
On the third postop day after a subtotal thyroidectomy for a tumor, a client C/O a "funny, jittery feeling." Which intervention is appropriate for the nurse to take? a) Explain that this reaction is expected and not a concern. b) Take the vital signs and place the client in a high-Fowler's position. c) Request stat serum calcium and phosphorus levels and chart the results. d) Test for Chvostek and Trousseau signs and notify the HCP of the complaints.
d) Test for Chvostek and Trousseau signs and notify the HCP of the complaints.
Which clinical manifestations would the nurse expect the client to report when experiencing renal calculi? SATA. a) Blood in the urine b) Irritability and twitching c) Dry, itchy skin and pyuria d) Frequency and urgency of urination e) Pain radiating from the kidney to a shoulder
a) Blood in the urine d) Frequency and urgency of urination
Four days after a client had a cystectomy and formation of an ileal conduit, the nurse observes mucus threads in the client's urine. Which action would the nurse take? a) Recognize that this is an expected response. b) Obtain a specimen for culture and sensitivity. c) Notify the HCP immediately. d) Increase the client's fluid intake for the next 12 hours.
a) Recognize that this is an expected response. Rationale: This reponse is expected after a diversion because mucus is secreted continually by the intestional mucosa.
A client with end-stage renal disease has an internal arteriovenous fistula in one arm and an external arteriovenous shunt in the other arm. Which difference between the two methods of access will the nurse consider in planning care? a) The graft is more subject to hemorrhage, clotting, and infection than the fistula is. b) Blood pressure readings can be taken in the arm with the fistula but not in the one with the shunt. c) IV fluids will be administered in the arm with the shunt. d) The fistula should have a light dressing, and the shunt should be covered thoroughly with a heavy dressing.
a) The graft is more subject to hemorrhage, clotting, and infection than the fistula is.
The nurse reviews the medical record of an older client admitted with chronic kidney disease. Which clinical finding is the priority requiring collaboration with the HCP? a) Sodium level of 135 b) Potassium level of 6 c) Creatinine clearance of 20 mL/min d) Blood pressure of 150/100
b) Potassium level of 6 Rationale: The client has an increased potassium level outside the expected range for an adult, placing the client at risk for a cardiac dysrhythmia. A creatinine clearance is low (normal range 95 mL/min in women and 120 mL/min in men); however, the client has chronic renal disease and this value reflects the disease process.
Which discharge instruction would the nurse emphasize when preparing a client with Addison disease for discharge? a) "Limit physical activity." b) "Restrict sodium in your diet." c) "Continue steroid replacement therapy." d) "Schedule frequent healthcare appointments."
c) "Continue steroid replacement therapy."
Which are neurological manifestations of hyperthyroidism? SATA. a) Fatigue b) Diaphoresis c) Blurred vision d) Exophthalmos e) Shallow respirations
c) Blurred vision d) Exophthalmos
Which information about BPH is important for the nurse to consider when caring for a client with that condition? a) It is a congenital abnormality b) A malignancy usually results c) It predisposes to hydronephrosis d) Prostate-specific antigen decreases
c) It predisposes to hydronephrosis Rationale: Inability to empty the bladder as a result of pressure exerted by the enlarging prostate on the urethra causes a backup of urine into the ureters and finally the kidneys (hydronephrosis).
The RN is caring for a client with renal calculi. To which healthcare professional with the RN delegate the task of administering oral medications to this client? a) Certified technician b) Patient care technician c) Licensed practical nurse d) Unlicensed assistive personnel
c) Licensed practical nurse
Which term would the nurse document in the client's medical record after observing reduced urinary output? a) Anuria b) Dysuria c) Oliguria d) Nocturia
c) Oliguria Rationale: A reduced urinary output of less than 400 mL in a 24 hour period is called oliguria.
A client, admitted with Addison disease, is emaciated and reports muscular weakness and fatigue. Which disturbed body process would the nurse determine is the root cause of the client's clinical manifestations? a) Fluid balance b) Electrolyte levels c) Protein catabolism d) Masculinizing hormones
c) Protein catabolism
Which outcome is the main focus of treatment for a client with Addison disease? a) Decrease in eosinophils b) Increase in lymphoid tissue c) Restoration of electrolyte balance d) Improvement of carbohydrate metabolism
c) Restoration of electrolyte balance
A client with Cushing syndrome asks why a low-sodium, high-potassium diet has been prescribed. Which response by the nurse is accurate? a) "The client will gain excessive weight if sodium is limited." b) "An adequate intake of potassium contributed to the disease." c) "This type of diet increases emotional stability." d) "Excessive aldosterone and cortisone cause the retention of sodium and loss of potassium."
d) "Excessive aldosterone and cortisone cause the retention of sodium and loss of potassium."
A child in renal failure who has undergone creation of an arteriovenous fistula access begins hemodialysis three times a week. The nurse teaches the mother the specific care for her child's needs. Which statement indicates that further teaching is necessary? a) "I'll offer more drinks in warm weather." b) "I should call the clinic if he vomits or has diarrhea." c) "I'll check his pulse at the wrist on each arm every day." d) "It's OK to take his BP on the arm with the fistula."
d) "It's OK to take his BP on the arm with the fistula."
Which findings would the nurse expect when assessing a client who has a ureteral calculus? a) Foul odor and dark urine b) Urgency and mild aching pain c) Frequency with small amounts of urine d) Hematuria with sharp pain when voiding
d) Hematuria with sharp pain when voiding
A pathology report states a client's urinary calculus is composed of uric acid. Which food item would the nurse instruct the client to avoid? a) Milk b) Liver c) Cheese d) Vegetables
b) Liver
Which classic sign will a nurse find in a client with Addison disease? a) Ecchymosis b) Hyperreflexia c) Exophthalmos d) Hyperpigmentation
d) Hyperpigmentation
Which food would the nurse teach a client who has urinary phosphate calculi to include in the diet? a) Pear b) Beef c) Salmon d) Cheese
a) Pear Rationale: All fresh fruits are low in phosphate, which should be limited in a client with urinary phosphate calculi. Beef and fish contain phosphate; all protein foods are high in phosphate. Dairy products are high in phosphorus.
Which findings in the older adult client are associated with a UTI? SATA. a) Fever b) Urgency c) Confusion d) Incontinence e) Slight rise in temperature
c) Confusion d) Incontinence e) Slight rise in temperature
Which integumentary manifestations can be noticed in a client with a serum creatinine value of 7 mg/dL and a BUN value of 240 mg/dL? Select all that apply. One, some, or all responses may be correct. a) Pruritus b) Clubbing c) Cyanosis d) Ecchymosis e) Uremic frost
a) Pruritus d) Ecchymosis e) Uremic frost
Which body mechanism related to infectious processes is impaired as a result of Addison disease? a) Stress response b) Electrolyte imbalance c) Metabolic processes d) Respiratory function
a) Stress response
The nurse is caring for a client who underwent a total thyroidectomy. Which assessment finding would lead the nurse to notify the rapid response team? a) Stridor b) Hoarseness c) Bradycardia d) Hypocalcemia
a) Stridor
A client is diagnosed with Cushing syndrome. The nurse would monitor the client for which cardiovascular complication? a) Chest pain b) Tachycardia c) Hypertension d) Atrial fibrillation
c) Hypertension
Which client responses to insulin are indicative of a hypoglycemic reaction? SATA. a) Tremors b) Anorexia c) Confusion d) Glycosuria e) Diaphoresis
a) Tremors c) Confusion e) Diaphoresis
A client who is 5'8 and weighs 220 lbs has ureteral colic, blood in the urine, and a BP of 150/90. Which objective is the highest priority? a) Decrease pain b) Decrease weight c) Decrease hematuria d) Decrease hypertension
a) Decrease pain Rationale: Ureteral colic clinical manifestations include sharp, severe pain radiating toward the genitalia and thigh. It is associated with ureteral distention and must be relieved.
Which SxS will a client admitted to the hospital with a diagnosis of Cushing syndrome exhibit? a) Hyperkalemia and edema b) Hypotension and sodium loss c) Muscle wasting and hypoglycemia d) Muscle weakness and frequent urination
d) Muscle weakness and frequent urination
The nurse shares the discharge instructions with a client who has prostate cancer. The client asks, "How much more blood will they need? Don't they have enough?" Which laboratory test would the nurse discuss the need to monitor throughout the course of the disease? a) Albumin b) Creatinine c) BUN d) PSA
d) PSA
Which SxS would be concerning for fluid volume excess in a child with a diagnosis of acute post-streptococcal glomerulonephritis? a) Dysuria, rash, pruitus b) Diarrhea, polyuria, weight loss c) Hypotension, tachycardia, proteinuria d) Periorbital edema, smoky urine, headaches
d) Periorbital edema, smoky urine, headaches
Which clinical manifestations would the nurse expect to identify in a client with a diagnosis of Cushing syndrome? SATA. a) Polyuria b) Truncal obesity c) Hypotension d) Sleep disturbance e) Thin arms and legs
b) Truncal obesity d) Sleep disturbance e) Thin arms and legs
Hyperthyroidism SxS (SATA) a) Lethargy b) Tachycardia c) Weight gain d) Constipation e) Exophthalmos
b) Tachycardia e) Exophthalmos
A client with Addison disease is receiving cortisone therapy. Which complications would the nurse expect if the client abruptly stops the medication? SATA. a) Hypokalemia b) Generalized edema c) Shock d) Alkalosis e) Circulatory collapse
c) Shock e) Circulatory collapse
A client with kidney dysfunction is about to undergo renal testing using a contrast medium. Which interventions would be in the client's plan of care? SATA. a) Assessing the client for a history of cirrhosis b) Asking the client about known shellfish allergies c) Assessing for a history of lactic acidosis d) Evaluating the client's hydration status by checking blood pressure and respiratory rate e) Discontinuing metformin for 24 hours from the time of contrast medium administration
a) Assessing the client for a history of cirrhosis b) Asking the client about known shellfish allergies d) Evaluating the client's hydration status by checking blood pressure and respiratory rate
A client with end-stage renal disease has a mature arteriovenous (AV) fistula. Which interventions would the nurse include in the client's plan of care? SATA. a) Auscultate the fistula for the presence of a bruit. b) Palpate the site to identify the presence of a thrill. c) Irrigate the fistula with saline to maintain patency. d) Avoid drawing blood from the affected extremity. e) Keep the fistula clamped until ready to perform dialysis.
a) Auscultate the fistula for the presence of a bruit. b) Palpate the site to identify the presence of a thrill. d) Avoid drawing blood from the affected extremity.
Which symptom might the nurse identify when assessing a client with hyperthyroidism? a) Fatigue b) Dry skin c) Anorexia d) Bradycardia
a) Fatigue Rationale: Excessive metabolic activity associated with hyperthyroidism causes fatigue.
A client is diagnosed with hyperthyroidism and is treated with l-131. Before discharge the nurse teaches the client to observe for SxS of therapy-induced hypothyroidism. Which SxS would be included in the teaching? SATA. a) Fatigue b) Dry skin c) Insomnia d) Intolerance to heat e) Progressive weight gain
a) Fatigue b) Dry skin e) Progressive weight gain
Which clinical findings would the nurse expect of a child with a diagnosis of acute post-streptococcal glomerulonephritis? SATA. a) Hematuria b) Proteinuria c) Periorbital edema d) Decreased specific gravity e) Mildly elevated BP
a) Hematuria b) Proteinuria c) Periorbital edema e) Mildly elevated BP
Which SxS would the nurse expect a client to exhibit with Cushing syndrome? SATA. a) Hirsutism b) Round face c) Pitting edema d) Buffalo hump e) Hypoglycemia
a) Hirsutism b) Round face d) Buffalo hump
Which symptom would the nurse expect a client diagnosed with Cushing syndrome to exhibit? a) Lability of mood b) Postural hypotension c) Increased skin thickness d) Ectomorphism with a moon face
a) Lability of mood Rationale: Excess adrenocorticoids can cause emotional lability, euphoria, and psychosis. Increased secretion of androgens results in hirsutism, HTN, and hyperglycemia.
Which signs and symptoms might the nurse identify when assessing a client with hyperthyroidism? SATA. a) Menstrual irregularities b) Hypotension c) Facial edema d) Flushed appearance e) Short attention span
a) Menstrual irregularities d) Flushed appearance e) Short attention span
The nurse is caring for an adult client with acromegaly. Which clinical manifestation would the nurse expect to assess in a client with acromegaly? a) Prominent jaw b) Decreased pulse c) Increased height d) Increased sodium
a) Prominent jaw Rationale: Acromegaly is caused by increased secretion of growth hormone in adults after a full growth and epiphyseal closure; it causes enlargement of bones and soft tissue of the lower jaw, cheeks, hands, and feet.
Hydrocortisone is prescribed for a client with Addison's disease. Which response is a therapeutic effect of this medication? a) Supports a better response to stress b) Promotes a decrease in BP c) Decreases episodes of SOB d) Controls an excessive loss of potassium
a) Supports a better response to stress
A client has been taking levothyroxine for hypothyroidism for 3 months. The nurse suspects that a decrease in dosage is needed when the client exhibits with clinical manifestations? SATA. a) Tremors b) Bradycardia c) Somnolence d) Heat intolerance e) Decreased blood pressure
a) Tremors d) Heat intolerance Rationale: Excessive levothyroxine produces adaptations similar to hyperthyroidism, including tremors, tachycardia, hypertension, heat intolerance, and insomnia. These adaptations are related to the increase in the metabolic rate associated with hyperthyroidism.
A client presents with chief complaints of unexplained weight gain and back pain from a compression fracture of the vertebrae. On assessment, there is truncal obesity with excessively thin extremities, a moon-shaped face, a buffalo hump, thin hair, and adult acne. The symptoms described are suggestive of which disease? a) Addison disease b) Cushing disease c) Multiple sclerosis d) Kaposi sarcoma
b) Cushing disease
A client with hyperthyroidism asks the nurse about the tests that will be ordered. Which diagnostic tests would the nurse include in a discussion with this client? a) T4 and x-ray films b) TSH assay and T3 c) Thyroglobulin level and PO2 D) Protein-bound iodine and SMA
b) TSH assay and T3
Which foods would then nurse teach a client to avoid when diagnosed with calcium oxalate renal calculi? SATA. a) Milk b) Tea c) Liver d) Spinach e) Rhubarb
b) Tea d) Spinach e) Rhubarb Rationale: Tea, rhubarb, and spinach are high in calcium oxalate. Milk is an acceptable calcium-rich protein and is avoided with calcium stones, but not with oxalate stones. Liver is a purine-rich food and avoided with uric acid renal calculi or gout.
The laboratory values of a client with renal calculi reveal a serum calcium within expected limits and an elevated serum purine. Which type of stone composition is consistent with these laboratory values? a) Cystine b) Uric acid c) Calcium oxalate d) Magnesium ammonium phosphate
b) Uric acid
The laboratory values of a client with renal calculi reveal a serum calcium within expected limits and an elevated serum purine. Which type of stone composition is consistent with these lab values? a) Cystine b) Uric acid c) Calcium oxalate d) Magnesium ammonium phosphate
b) Uric acid Rationale: Purines are precursors of uric acid, which crystallizes.
A client with advanced cancer of the bladder is scheduled for a cystectomy and ileal conduit. Which intervention would the nurse anticipate the HCP with prescribe to prepare the client for surgery? a) Intravesical chemotherapy b) Instillation of urinary antiseptic c) Administration of an antibiotic d) Placement of an indwelling catheter
c) Administration of an antibiotic
Which sign and symptom is an associated complication of chronic kidney disease while undergoing peritoneal dialysis? a) Petechiae b) Abdominal bruit c) Cloudy return dialysate d) Increased blood glucose level
c) Cloudy return dialysate Rationale: The return dialysate should be clear; cloudy solution is indicative of infection.
The nurse is reviewing the EHR of a client admitted with SIADH. Which medication order would the nurse question? a) Furosemide (Lasix) b) Tolvaptan (Aquaretic) c) IV 0.9 NaCl d) Demeclocycline (Declomycin)
c) IV 0.9 NaCl Rationale: IV 0.9% NaCl would be administered cautiously in patients with SIADH, as it can further potentiate fluid volume overload.
The nurse on the pediatric unit is admitting an adolescent child with acute glomerulonephritis (AGN). Which is the priority nursing intervention? a) Assessing the child for dysuria b) Inspecting the child for jaundice c) Monitoring the child for HTN d) Testing the child's vomitus for occult blood
c) Monitoring the child for HTN
A client diagnoses with invasive cancer of the bladder has brachytherapy as scheduled. Which successful therapy outcome would the nurse expect with this client? a) Decrease in urine output b) Increase in pulse strength c) Shrinkage of tumor when scanned d) Increase in the quantity of WBCs
c) Shrinkage of tumor when scanned
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? a) "The staff will provide total care, because the infection causes severe fatigue." b) "Mood elevators will be prescribed to improve the depression and irritability." c) "Vitamin B12 will be prescribed for the anemia, and the stools will be dark." d) "Protein foods will be restricted so the kidneys can clear waste products."
d) "Protein foods will be restricted so the kidneys can clear waste products." Rationale: Restriction of protein intake decreases the workload of the damaged kidneys. Medications are avoided because they may mask symptoms.
The nurse writes a goal of preventing renal calculi in a care plan for a client who has paraplegia. Which information provides the rationale for selecting this goal? a) High fluid volume intake b) Increased calcium intake c) Inadequate kidney function d) Accelerated bone demineralization
d) Accelerated bone demineralization Rationale: Calcium that has left the bones as a response to prolonged inactivity enters the blood and may precipitate in the kidneys, forming calculi.
A client who has a ureteral calculus is admitted to the hospital with severe flank pain, nausea, and hematuria. Which intervention would the nurse implement first? a) Strain all urine output b) Increase oral fluid intake c) Obtain a urine specimen for culture d) Administer a prescribed analgesic
d) Administer a prescribed analgesic
Which preoperative plan would the nurse make for a client who will have a cystectomy and creation of an ileal conduit? a) Limit oral fluid intake for 36 hours. b) Teach range-of-motion and Kegel exercises. c) Explain the procedure for irrigating an ileal conduit. d) Administer cleansing enemas and laxatives as prescribed.
d) Administer cleansing enemas and laxatives as prescribed. Rationale: Preoperative cleansing of the bowel is necessary before surgical resection and formation of a urinary conduit.
Which clinical manifestation would the nurse associate with benign prostatic hyperplasia? a) Perineal edema b) Urethral discharge c) Flank pain radiating to the groin d) Distention of the lower abdomen
d) Distention of the lower abdomen Rationale: Distention of the suprapubic area indicates the bladder is distended with urine and palpable.
After an unsuccessful lithotripsy to break up renal calculi, a nephrolithotomy was successful in removing the client's renal calculi. Which clinical indicator would the nurse monitor during the postop period and report immediately to the HCP? a) Continuous passage of pink-tinged urine b) Pink drainage on the client's surgical dressing c) Total intake volume of 2,000mL in 24 hours d) Urinary output of 20-30 mL/h
d) Urinary output of 20-30 mL/h
After an unsuccessful lithotripsy to break up the renal calculi, a nephrolithotomy was successful in removing the client's stones. Which clinical indicator would the nurse monitor during the postop period and report immediately to the HCP? a) Continuous passage of pink-tinged urine b) Pink drainage on the client's surgical dressing c) Total intake volume of 2000 mL in 24 hours d) Urinary output of 20-30 mL/hr
d) Urinary output of 20-30 mL/hr
Which statement is accurate regarding erythropoietin? a) Erythropoietin is released by the pancreas. b) An erythropoietin deficiency causes diabetes. c) An erythropoietin deficiency is associated with renal failure. d) Erythropoietin is released only when there is adequate blood flow.
c) An erythropoietin deficiency is associated with renal failure. Rationale: Erythropoietin is produced by the kidneys; its deficiency occurs in renal failure.
A client has returned from surgery with a nephrostomy tube. Which actions would the nurse take? SATA. a) Ensure free drainage of urine. b) Milk the tube every 2 hours. c) Keep an accurate record of intake and output. d) Instill 12 mL of normal saline every 8 hours. e) Observe and document urine characteristics.
a) Ensure free drainage of urine. c) Keep an accurate record of intake and output. e) Observe and document urine characteristics.
Which clinical findings would the nurse expect to find during the assessment of a child with AGN? SATA. a) Flank pain b) Periorbital edema c) Intermittent fever d) Increased urine volume e) Decreased joint mobility
a) Flank pain b) Periorbital edema c) Intermittent fever
A client with cholelithiasis is schedules for a lithotripsy. Which could the nurse include in the client's teaching plan? a) Opioids will be available for post-procedural pain. b) Fever is a common response after this procedure. c) Heart palpitations often occur after this procedure. d) Anesthetics are not necessary during the procedure.
a) Opioids will be available for post-procedural pain.
Which action would be appropriate to implement when collecting a 24 hour urine test? a) Start the time of the test after discarding the first void b) Discard the last void c) Insert a urinary retention catheter to promote the collection of urine d) Strain the urine after each void before adding the urine to the container
a) Start the time of the test after discarding the first void
A child with nephrotic syndrome has been receiving prednisone for 1 week. Which information in the child's record indicates to the nurse that the medication has been effective? SATA. a) Weight loss b) Lower blood pH c) Decreased lethargy d) Increased urine output e) Decreased blood pressure
a) Weight loss c) Decreased lethargy d) Increased urine output
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? a) "I must touch the shunt several times a day to feel for the bruit." b) "I have to take his blood pressure every day in the arm with the fistula." c) "He will have to be careful at night not to lie on the arm with the fistula." d) "We really should check the fistula every day for signs of redness and swelling."
b) "I have to take his blood pressure every day in the arm with the fistula."
A client who had a TURP experiences dribbling after removal of the indwelling catheter. Which response to the client would the nurse use? a) "I know you're worried, but the dribbling will go away in a few days." b) "Increase your fluid intake and urinate at regular intervals." c) "Limit your fluid intake and urinate when you first feel the urge." d) "The catheter will have to be reinserted until your bladder regains its tone."
b) "Increase your fluid intake and urinate at regular intervals." This will improve bladder tone, which should alleviate dribbling.
Which instruction would the nurse use when preparing a client who successfully passed their renal calculus for discharge home? a) "Continue to strain all urine." b) "Increase your fluid intake." c) "Limit dietary potassium." d) "Maintain bed rest for 24 hours."
b) "Increase your fluid intake."
Which condition can be prevented when a client with chronic kidney disease receives medication to manage anemia? a) Uremic frost b) Chronic fatigue c) Tubular necrosis d) Dependent edema
b) Chronic fatigue Rationale: Kidney failure results in impaired erythropoietin production, which causes anemia and chronic fatigue; treating the anemia will help in managing the fatigue.
Which clinical finding would the nurse expect when assessing a 4-year-old child admitted with nephrotic syndrome? a) Severe lethargy b) Dark, frothy urine c) Chronic hypertension d) Flushed, ruddy complexion
b) Dark, frothy urine Rationale: Dark, frothy urine is a characteristic of a child with nephrotic syndrome; large amounts of protein in the urine cause it to take on this appearance.
A client who has renal failure asks the nurse why anemia keeps recurring. Which reason would the nurse explain to the client? a) Increase in blood pressure b) Decrease in erythropoietin c) Increase in serum phosphate levels d) Decrease in sodium concentration
b) Decrease in erythropoietin Rationale: The hormone Erythropoietin, produced by the kidneys, stimulates the bone marrow to produce RBCs. In renal failure, there is a deficiency of Erythropoietin that often results in the client developing anemia.
A client with history of chronic kidney disease is hospitalized. Which assessment findings would alert the nurse to suspect kidney insufficiency? a) Facial flushing b) Edema and pruritus c) Dribbling after voiding d) Diminished force of urination
b) Edema and pruritus Rationale: The accumulation of metabolic wastes in the blood (uremia) can cause pruritus; edema results from fluid overload caused by impaired urine production.
Which laboratory test provides evidence consistent with a client having renal impairment? SATA. a) Serum albumin: 4.7 b) Serum creatinine: 2.0 c) Serum potassium: 5.9 d) Serum cholesterol: 120 e) BUN: 32
b) Serum creatinine: 2.0 c) Serum potassium: 5.9 e) BUN: 32
Which is the most appropriate assessment to detect the development of complications associated with AGN in a child? a) Assess the joints for stiffness daily b) Measure the pH of each urine specimen c) Check the blood pressure Q4H d) Test the urine from each voiding for glucose
c) Check the blood pressure Q4H
Which symptom is indicative of the need for dialysis in the child with chronic kidney disease (CKD)? a) Hypotension b) Hypokalemia c) Hypervolemia d) Hypercalcemia
c) Hypervolemia Rationale: Hypervolemia results when the kidneys have failed and are no longer able to maintain homeostasis, the blood pressure is high, and cardiac overload is imminent.
A child is admitted to the pediatric unit with a tentative diagnosis of AGN. Which would the nurse expect the laboratory report to reveal? a) Low sedimentation rate b) Increased serum complement c) Increased antistreptolysin O (ASO) titer d) Decreased BUN level
c) Increased antistreptolysin O (ASO) titer
A child is admitted to the pediatric unit with nephrotic syndrome. Which measures would the nurse expect to include in the plan of care for this child? SATA. a) Maintaining bed rest b) Administering antibiotics c) Providing symptomatic care d) Eliminating high-sodium foods e) Monitoring response to steroids
c) Providing symptomatic care d) Eliminating high-sodium foods e) Monitoring response to steroids
Which activities would the nurse include when teaching adults about activities that increase the risk of developing bladder cancer? SATA. a) Jogging 3 miles a day b) Drinking 3 cans of pop a day c) Smoking two packs of cigarettes a day d) Working with dyes used in rubber every day e) Using a jackhammer and chainsaw every day
c) Smoking two packs of cigarettes a day d) Working with dyes used in rubber every day Rationale: The occurrence of bladder cancer is related to smoking. Dyes in rubber and hair dyes are environmental carcinogens; working with them daily increases the individual's risk of bladder cancer.
Which type of cytokine is used to treat anemia secondary to chronic kidney disease? a) a-Interferon b) Interleukin-2 c) Interleukin-11 d) Erythropoietin
d) Erythropoietin Rationale: Erythropoietin is used to treat anemia related to chronic kidney disease. The failing kidneys are not able to produce erythropoietin to signal the bone marrow to produce red blood cells, resulting in anemia.
A client's clinical manifestations include dysuria, hesitancy, urinary urgency, and urinary leakage. The client's serum PSA level is 5 ng/mL, and the client has an elevated prostatic acid phosphatase (PAP) level. Which disorder would the nurse suspect? a) Orchitis b) Hydrocele c) Prostatitis d) Prostate cancer
d) Prostate cancer
Which description of pain would the nurse expect a client with a ureteral calculus to report? a) Boring-type pain that is located in the flank b) Dull and constant at the costovertebral angle c) Located at the level of the kidneys and occurring with each urination d) Spasmodic and radiating from the side to the suprapubic area
d) Spasmodic and radiating from the side to the suprapubic area Rationale: Pain with ureteral stones is caused by spasm (renal colic) and is excruciating and intermittent; it follows the path of the ureter to the bladder down to the groin.
