NCLEX GU
A client who is performing peritoneal dialysis at home calls the clinic and reports that the outflow from the dialysis catheter seems to be decreasing in amount. The nurse appropriately asks which question first? 1."Have you had any abdominal discomfort?" 2."Have you had any recurring bouts of diarrhea?" 3."Have you experienced any constipation recently?" 4."Have you had an increased amount of flatulence?"
"Have you experienced any constipation recently?"
The nurse is caring for a hospitalized client following cystoscopy. Which discharge instructions are given to the client? Select all that apply. 1.Use antispasmodics for pain. 2.Restrict oral fluids for 1 to 2 days. 3.Expect pink-tinged urine for 1 week. 4.Take sitz baths for voiding discomfort. 5.Report severe pain to health care provider.
1, 4, 5
A client who suffered a crush injury to the leg has a highly positive urine myoglobin level. The nurse plans to monitor this particular client carefully for signs of which complication? 1.Respiratory failure 2.Brain attack (stroke) 3.Myocardial infarction 4.Acute tubular necrosis
Acute tubular necrosis
A client with chronic kidney disease has been on dialysis for 3 years. The client is receiving the usual combination of medications for the disease, including aluminum hydroxide as a phosphate-binding agent. The client now has mental cloudiness, dementia, and complaints of bone pain. Which does this data indicate? 1.Advancing uremia 2.Phosphate overdose 3.Folic acid deficiency 4.Aluminum intoxication
Aluminum intoxication
A client diagnosed with chronic kidney disease is being treated at home with continuous ambulatory peritoneal dialysis. The client notes that there is a decrease in the catheter outflow following the prescribed 6-hour dwell time and calls the nurse to report this occurrence. The nurse should reinforce instructing the client to take which action? 1.Ambulate in the home. 2.Perform straight catheterization of the bladder. 3.Immediately notify the primary health care provider. 4.Flush the peritoneal catheter with a thrombolytic medication.
Ambulate in the home.
A client has just undergone renal biopsy. In planning care for this client, the nurse should avoid which intervention? 1.Test urine for occult blood periodically. 2.Administer opioid analgesics as needed. 3.Ambulate in the room and hall for short distances. 4.Encourage fluids to at least 3 L in the first 24 hours.
Ambulate in the room and hall for short distances.
The nurse is preparing a client scheduled for an intravenous pyelogram (IVP). The nurse should take which important action before the test? 1.Administer a sedative. 2.Encourage fluid intake. 3.Ask about allergies to iodine or shellfish. 4.Administer an oral preparation of radiopaque dye.
Ask about allergies to iodine or shellfish.
A male client has a history of urinary tract infections due to urinary retention. Which intervention should the nurse implement to decrease the risk of infection? 1.Assist the client to stand for voiding. 2.Withhold oral fluids after 6:00 pm daily. 3.Ask the client to take his temperature daily. 4.Teach the client to wash his hands properly.
Assist the client to stand for voiding.
The nurse has reinforced instructions to the client with a cystocele about Kegel exercises. The nurse determines that the client has not fully understood the directions if the client makes which statement? 1."Stop and start the stream of urine several times during a voiding." 2."Tighten perineal muscles for up to 10 seconds several times a day." 3."Tighten perineal muscles for up to 5 minutes three or four times a day." 4."Begin voiding and then stop the stream, holding residual urine for an hour."
Begin voiding and then stop the stream, holding residual urine for an hour."
The nurse must ambulate a client who has a nephrostomy tube attached to a drainage bag. The nurse plans to do this most safely by performing which action? 1.Changing the drainage bag to a leg collection bag 2.Hanging the drainage bag from a walker while ambulating 3.Tying the drainage bag to the client's waist while ambulating 4.Asking the client to hold the drainage bag lower than the level of the bladder
Changing the drainage bag to a leg collection bag
The nurse is assisting a client with cystitis to select foods that are appropriate for an acid-ash diet. The nurse encourages the client to eat which food? 1.Cheese 2.Ice cream 3.Garden peas 4.Strawberries
Cheese
A client's kidneys are retaining larger than normal amounts of sodium. The nurse is reviewing the most recent laboratory data. The nurse should expect which laboratory value to be abnormal since the client is retaining sodium? 1.Calcium 8.8 mg/dL 2.Chloride 112 mEq/L 3.Potassium 4.1 mEq/L 4.Bicarbonate 23 mEq/L
Chloride 112 mEq/L
The nurse is monitoring an older client suspected of having a urinary tract infection (UTI) for signs of infection. Which sign/symptom is likely to present first? 1.Fever 2.Urgency 3.Confusion 4.Frequency
Confusion
A client who has a cold is seen in the emergency department with an inability to void. Because the client has a history of benign prostatic hyperplasia (BPH), the nurse questions the client about use of which medication? 1.Diuretics 2.Antibiotics 3.Antitussives 4.Decongestants
Decongestants
A client is scheduled for intravenous pyelography (IVP). Which priority nursing action should the nurse take? 1.Restrict fluids. 2.Administer a sedative. 3.Determine if there is a history of allergies. 4.Administer an oral preparation of radiopaque dye.
Determine if there is a history of allergies.
The nurse notes that a client's urinalysis report contains a notation of positive red blood cells (RBCs). The nurse interprets that this finding is unrelated to which information in the client's medical record? 1.Diabetes mellitus 2.History of kidney stones 3.Concurrent anticoagulant therapy 4.History of recent blow to the right flank
Diabetes mellitus
A male client has a tentative diagnosis of urethritis. The nurse should assess the client for which manifestation of the disorder? 1.Hematuria and pyuria 2.Dysuria and proteinuria 3.Hematuria and urgency 4.Dysuria and penile discharge
Dysuria and penile discharge
Which condition places the client at risk for developing acute postrenal failure? 1.Dehydration 2.Hydronephrosis 3.Rhabdomyolysis 4.Glomerulonephritis
Hydronephrosis
A client is admitted to the emergency department following a fall from a horse. The primary health care provider (PHCP) prescribes the insertion of an indwelling urinary catheter. The nurse notes blood at the urinary meatus while preparing for the procedure. Which action should the nurse take? 1.Use a smaller catheter. 2.Notify the primary health care provider. 3.Administer pain medication before inserting the catheter. 4.Use extra povidone-iodine solution in cleansing the meatus.
Notify the primary health care provider.
A client hospitalized with urolithiasis has a sudden significant decrease in urine output. The nurse should perform which action? 1.Notify the registered nurse. 2.Obtain a urine-specific gravity. 3.Tell the client to drink increased fluids. 4.Replace the Foley catheter with a new one.
Notify the registered nurse
The nurse is caring for a client undergoing peritoneal dialysis. The nurse checks the client and notes that the drainage from the outflow catheter is cloudy. The nurse notifies the registered nurse and plans to take which action? 1.Stop the peritoneal dialysis. 2.Institute hemodialysis temporarily. 3.Obtain a culture and sensitivity of the drainage. 4.Add antibiotics to the next several dialysis bags
Obtain a culture and sensitivity of the drainage.
The client with chronic kidney disease who is scheduled for hemodialysis this morning is due to receive a daily dose of enalapril. When should the nurse plan to administer this medication? 1.During dialysis 2.Just before dialysis 3.The day after dialysis 4.On return from dialysis
On return from dialysis
The nurse is reinforcing instructions to a client with renal calculi about how to change the urine pH to be more acidic. The nurse determines that the client needs further teaching if the client states which type of drink is acceptable? 1.Prune juice 2.Lemon juice 3.Orange juice 4.Cranberry juice
Orange juice
The nurse is urging a client to cough and deep breathe after a nephrectomy. The client tells the nurse, "That's easy for you to say! You don't have to do this." The nurse interprets that the client's statement is likely a result of which contributing factor? 1.A stress response to the ordeal of surgery 2.A latent fear of needing dialysis if the surgery is unsuccessful 3.Effects of circulating metabolites that have not been excreted by the remaining kidney 4.Pain that is intensified because the location of the incision is near the diaphragm
Pain that is intensified because the location of the incision is near the diaphragm
The nurse is admitting a client to the nursing unit who has returned from the postanesthesia care unit following prostatectomy. The client has a three-way Foley catheter with continuous bladder irrigation. The nurse should maintain the flow rate of the continuous bladder infusion to maintain which urine output characteristic? 1.Red 2.Colorless 3.Yellow with small clots 4.Pale yellow or slightly pink
Pale yellow or slightly pink
A client who had a prostatectomy has learned perineal exercises to gain control of the urinary sphincter. The nurse determines that the client needs further teaching if the client states that he will perform which action as part of these exercises? 1.Perform the Valsalva maneuver. 2.Tighten the muscles as if trying to prevent urination. 3.Contract the abdominal, gluteal, and perineal muscles. 4.Tighten the rectal sphincter while relaxing abdominal muscles.
Perform the Valsalva maneuver.
The nurse is assisting in planning a diet for a client with acute kidney injury (AKI). The nurse plans to restrict which dietary component from this client's diet? 1.Fats 2.Vitamins 3.Potassium 4.Carbohydrates
Potassium
A client with acute kidney injury (AKI) has been treated with sodium polystyrene sulfonate by mouth. The nurse evaluates this therapy as effective if which value is noted on follow-up laboratory testing? 1.Calcium, 9.8 mg/dL 2.Sodium, 142 mEq/L 3.Potassium, 4.9 mEq/L 4.Phosphorus, 3.9 mg/dL
Potassium, 4.9 mEq/L
A client with acute glomerulonephritis is admitted to the nursing unit. The nurse should plan to do which action immediately upon admission? 1.Ambulate the client frequently. 2.Encourage a diet that is high in protein. 3.Monitor the temperature every 2 hours. 4.Remove the water pitcher from the bedside.
Remove the water pitcher from the bedside.
A client is diagnosed with polycystic kidney disease, and the nurse provides information to the client about the treatment plan. The nurse determines that the client needs further teaching if the client states that which component is part of the treatment plan? 1.Sodium restriction 2.Genetic counseling 3.Increased water intake 4.Antihypertensive medications
Sodium restriction
A male client is diagnosed with urethritis caused by chlamydial infection. The unlicensed assistive personnel (UAP) assigned to the client asks the nurse what measures are necessary to prevent a contraction of the infection during care. Which instruction should the nurse give the UAP? 1.Enteric precautions should be instituted for the client. 2.Gloves and mask should be used when in the client's room. 3.Contact isolation should be initiated because the disease is highly contagious. 4.Standard precautions are sufficient because the infection is transmitted sexually.
Standard precautions are sufficient because the infection is transmitted sexually.
The use of peritoneal dialysis for the treatment of chronic kidney disease would be contraindicated for which clients? 1.The client with cataracts 2.The client with varicose veins 3.The client with type 2 diabetes mellitus 4.The client with chronic obstructive pulmonary disease (COPD)
The client with chronic obstructive pulmonary disease (COPD)
A client with a history of prostatic hypertrophy has purchased the over-the-counter medication, diphenhydramine, to treat symptoms of a runny nose. The nurse explains to the client that this medication combined with prostatic hypertrophy could cause exacerbation of which symptom? 1.Urinary retention 2.Lowered heart rate 3.Excessive drooling 4.Excessive sweating
Urinary retention
Aluminum hydroxide is prescribed for the client with chronic kidney disease (CKD). When should the nurse instruct the client to take this medication? 1. With meals 2. At bedtime 3. On an empty stomach 4. In the morning on arising
With meals
The nurse is caring for a client who had a renal biopsy. Which interventions should the nurse include in the plan of care for the client after this procedure? Select all that apply. 1.Restricting fluids during the first 24 hours 2.Administering pain medication as prescribed 3.Monitoring vital signs and the puncture site frequently 4.Testing serial urine samples with dipsticks for occult blood 5.Ambulating the client in the room and hall for short distances
2, 3, 4
The nurse monitoring a client receiving peritoneal dialysis notes that the client's outflow is less than the inflow. The nurse should take which actions? Select all that apply. 1.Contact the nephrologist. 2.Check the level of the drainage bag. 3.Reposition the client to his or her side. 4.Place the client in good body alignment. 5.Check the peritoneal dialysis system for kinks. 6.Increase the flow rate of the peritoneal dialysis solution.
2, 3, 4, 5
A client with acute kidney injury secondary to heart failure develops fluid volume excess. Which signs and symptoms should the nurse expect to see? Select all that apply. 1.Weak pulse 2.Weight gain 3.Decreased hematocrit 4.Distended jugular veins 5.Decreased breath sounds on auscultation 6.Decreased specific gravity with high volume
2, 3, 4, 6
The nurse is reviewing the laboratory results and physical examination of a client with acute glomerulonephritis. Which data should the nurse see? Select all that apply. 1.Polyuria 2.Hematuria 3.Proteinuria 4.Hypotension 5.Periorbital edema 6.Decreased specific gravity
2, 3, 5
A client, who had experienced significant blood loss in an automobile crash, was admitted to the hospital 2 days earlier. The nurse observes the client for which signs/symptoms that indicate acute kidney injury (AKI)? Select all that apply. 1.Hematuria 2.Elevated urine specific gravity 3.Severe spasmodic pain radiating to the groin area 4.Rising serum blood urea nitrogen (BUN) and creatinine levels 5.Urine output averaging 25 mL per hour while receiving an intravenous infusion at 150 mL/hour
2, 4, 5
The nurse is caring for a client who received a recent kidney transplant. Besides actual rejection of the transplant, which are some of the most important complications this client is at risk for? Select all that apply. 1.Colitis 2.Malignancies 3.Respiratory disease 4.Cardiovascular disease 5.Susceptibility to infection 6.Corticosteroid-related complications
2, 4, 5, 6
Which statements indicate an understanding of the necessary dietary modifications of a client diagnosed with chronic kidney disease? Select all that apply. 1."I should avoid coffee; tea is preferable." 2."I should avoid eggs; a bagel is preferable." 3."I should avoid salt; soy sauce is preferable." 4."I should avoid salt; salt substitutes are preferable." 5."I should consume approximately 40 g of protein daily." 6."I should avoid carbonated sodas; milk is preferable."
2, 5
A client, on the waiting list for a renal transplant, receives a hemodialysis treatment. Which findings indicate to the nurse that the hemodialysis treatment has been effective? Select all that apply. 1.A thrill is palpable in the arteriovenous fistula. 2.The client states he is fatigued and wants to sleep. 3.Serum potassium level is within the normal range. 4.The client's weight is 2 kilograms less than predialysis weight. 5.Serum blood urea nitrogen (BUN) and creatinine levels are lower than predialysis.
3, 4, 5
The nurse is reinforcing instructions to a client about the types of fluids that assist in prevention and treatment of urinary tract infections (UTIs). The nurse instructs the client to consume which fluids? Select all that apply. 1.Milk 2.Soda 3.Prune juice 4.Apple juice 5.Cranberry juice
3, 4, 5
The nurse is reviewing data on a client with sepsis and acute kidney injury with related azotemia and oliguria. Which are the primary features of azotemia and oliguria? Select all that apply. 1.Vasoconstriction 2.Increase in cardiac output 3.Increase in serum creatinine 4.Increase in blood urea nitrogen (BUN) 5.Urine output less than 0.5 mL/kg/hour 6.Glomerular filtration rate (GFR) of 80 mL/min
3, 4, 5
Which observations by the nurse caring for clients in a hospital medical-surgical unit should be immediately reported to the primary health care provider? Select all that apply. 1.Pink-colored urine voided by a client admitted for urolithiasis 2.Mucous shreds noted in the urine of a client who has an ileal conduit 3.New confused mental state and pulse rate of 106 beats per minute in a 72-year-old client 4.No urinary output for 24 hours in a client who has hemodialysis 3 times weekly 5.A volume of 105 mL of urine over 4 hours in the collection bag of a 1-day postoperative client
3, 5
An alkaline-ash diet is prescribed for a client with renal calculi. Which diet menu does the nurse advise the client to select? 1.Chicken, rice, and cranberries 2.A spinach salad, milk, and a banana 3.Peanut butter sandwich, milk, and prunes 4.Pasta with shrimp, tossed salad, and a plum
A spinach salad, milk, and a banana
The nurse has a prescription to collect a 24-hour urine specimen from a client. The unlicensed assistive personnel (UAP) has been instructed on the collection technique. Which action by the UAP demonstrates the UAP needs further teaching? 1.Places the specimen on ice 2.Discards a urine specimen collected at the start time 3.Asks the client to void, save the specimen, and note the start time 4.Asks the client to save a sample voided at the end of the collection time
Asks the client to void, save the specimen, and note the start time
After a renal biopsy, the client complains of pain at the biopsy site that radiates to the front of the abdomen. Which would this indicate? 1.Bleeding 2.Infection 3.Renal colic 4.Normal, expected pain
Bleeding
A client is admitted to the surgical nursing unit following transurethral resection of the prostate (TURP) for benign prostatic hypertrophy. The client has a bladder irrigation infusing, and output is light cherry colored. The blood pressure is 134/82 mm Hg, the pulse is 84 beats per minute, and the client is afebrile with a respiratory rate of 18 breaths per minute. The licensed practical nurse (LPN) assisting in caring for the client collects assessment data 1 hour after admission to the nursing unit. The LPN notifies the registered nurse (RN) if which is noted on data collection? 1.Red urine 2.Pain related to bladder spasms 3.Urinary output of 200 mL greater than intake 4.Blood pressure of 102/50 mm Hg, pulse 110 beats per minute
Blood pressure of 102/50 mm Hg, pulse 110 beats per minute
A client arrives at the ambulatory care clinic with low abdominal pain. A routine urine specimen reveals hematuria. The client does not have a fever. The nurse should next ask the client about a history of which condition? 1.Pyelonephritis 2.Glomerulonephritis 3.Renal cancer in the client's family 4.Blow or trauma to the bladder or abdomen
Blow or trauma to the bladder or abdomen
A client with benign prostatic hypertrophy (BPH) undergoes a transurethral resection of the prostate (TURP) and is receiving continuous bladder irrigations postoperatively. Which are the signs/symptoms of transurethral resection (TUR) syndrome? 1.Tachycardia and diarrhea 2.Bradycardia and confusion 3.Increased urinary output and anemia 4.Decreased urinary output and bladder spasms
Bradycardia and confusion
A female client has a prescription for a clean-catch urine culture. After providing a sterile specimen cup to the client, the nurse should give which instruction so that the specimen is collected properly? 1.Void into the container saving the full amount of urine. 2.Cleanse the labia using cleansing towels, position the container, and begin to void. 3.Wipe the labia front to back with toilet paper and void into the sterile specimen container. 4.Cleanse the labia using cleansing towels, begin to void into toilet, and then collect the specimen.
Cleanse the labia using cleansing towels, begin to void into toilet, and then collect the specimen.
A client has epididymitis as a complication of a urinary tract infection (UTI). The nurse is giving the client instructions to prevent recurrence. The nurse determines that the client needs further teaching if the client states the intention to do which action? 1.Drink an increased amount of fluids. 2.Limit the force of the stream during voiding. 3.Continue to take antibiotics until all symptoms are gone. 4.Use condoms to eliminate risk associated with chlamydia and gonorrhea.
Continue to take antibiotics until all symptoms are gone.
The nurse is collecting data from a client who has had benign prostatic hyperplasia (BPH) in the past. To determine whether the client is currently experiencing exacerbation of BPH, the nurse should ask the client about the presence of which early symptom? 1.Nocturia 2.Urinary retention 3.Urge incontinence 4.Decreased force in the stream of urine
Decreased force in the stream of urine
A client has been diagnosed with pyelonephritis. The nurse interprets that which health problem has placed the client at risk for this disorder? 1.Hypoglycemia 2.Diabetes mellitus 3.Coronary artery disease 4.Orthostatic hypotension
Diabetes mellitus
The nurse is reviewing the medical record of a client with a diagnosis of pyelonephritis. Which disorder noted on the client's record should the nurse identify as a risk factor for this diagnosis? 1.Hypoglycemia 2.Diabetes mellitus 3.Coronary artery disease 4.Orthostatic hypotension
Diabetes mellitus
A male client has a tentative diagnosis of urethritis. The nurse collects data from the client knowing that which are signs/symptoms of this disorder? 1.Hematuria and pyuria 2.Dysuria and proteinuria 3.Dysuria and penile discharge 4.Hematuria and penile discharge
Dysuria and penile discharge
A client has an arteriovenous (AV) shunt in place for hemodialysis. The nurse should take which priority precaution knowing that bleeding is a potential complication? 1.Observe the site once per shift. 2.Check the shunt for the presence of a bruit and thrill. 3.Check the results of blood tests as they are prescribed. 4.Ensure that small clamps are attached to the AV shunt dressing.
Ensure that small clamps are attached to the AV shunt dressing.
A client newly diagnosed with chronic kidney disease will be receiving peritoneal dialysis. During the infusion of the dialysate, the client complains of abdominal pain. Which action by the nurse is appropriate? 1.Stop the dialysis. 2.Slow the infusion. 3.Decrease the amount to be infused. 4.Explain that the pain will subside after the first few exchanges.
Explain that the pain will subside after the first few exchanges.
The nurse is caring for a client with epididymitis. The nurse anticipates noting which group of findings on data collection? 1.Diarrhea, groin pain, and scrotal edema 2.Fever, diarrhea, groin pain, and ecchymosis 3.Fever, nausea and vomiting, and painful scrotal edema 4.Nausea, vomiting, and scrotal edema with widespread ecchymosis
Fever, nausea and vomiting, and painful scrotal edema
The nurse is collecting data from a client with epididymitis. The nurse should expect to note which signs and symptoms of this problem? 1.Diarrhea, groin pain, and scrotal edema 2.Fever, diarrhea, groin pain, and ecchymosis 3.Fever, nausea and vomiting, and painful scrotal edema 4.Nausea and vomiting, and scrotal edema with ecchymosis
Fever, nausea and vomiting, and painful scrotal edema
The nurse is caring for a client who has been diagnosed as having a kidney mass. The client asks the nurse the reason for a renal biopsy when other tests such as computed tomography (CT) and ultrasound are available. In formulating a response, the nurse incorporates the knowledge that a renal biopsy serves which purpose? 1.Provides an outline of the renal vascular system 2.Determines if the mass is growing rapidly or slowly 3.Gives specific cytological information about the lesion 4.Helps differentiate between a solid mass and a fluid-filled cyst
Gives specific cytological information about the lesion
A client with new-onset renal failure is having a first hemodialysis treatment. The nurse is especially careful to monitor the client for which signs/symptoms after the dialysis treatment? 1.Hypertension, tachycardia, and fever 2.Hypotension, bradycardia, and hypothermia 3.Restlessness, irritability, and generalized weakness 4.Headache, decreasing level of consciousness, and seizures
Headache, decreasing level of consciousness, and seizures
The nurse is assigned to care for a client who has returned to the nursing unit following a left nephrectomy. The nurse places the highest priority on monitoring which data? 1.Hourly urine output 2.Oxygen saturation levels 3.Ability to turn side to side 4.Tolerance for sips of clear liquids
Hourly urine output
A client with diabetes mellitus is receiving peritoneal dialysis. The nurse should ensure maintenance of the dwell time for the dialysis at the prescribed time because of risk for which complication? 1.Infection 2.Hypoglycemia 3.Hyperglycemia 4.Peritoneal third spacing
Hyperglycemia
The client with diabetes mellitus receiving peritoneal dialysis asks the nurse why it is important to leave the dialysate infused only for a specific amount of time. The nurse responds that not adhering to the dwell time can increase the risk of the client experiencing which complication? 1.Infection 2.Fluid overload 3.Hyperglycemia 4.Disequilibrium syndrome
Hyperglycemia
The nurse is instructing a client with diabetes mellitus about peritoneal dialysis. The nurse tells the client that it is important to maintain the prescribed dwell time for the dialysis because of the risk of which complication? 1.Peritonitis 2.Hyperglycemia 3.Hyperphosphatemia 4.Disequilibrium syndrome
Hyperglycemia
The nurse is admitting a client with chronic kidney disease (CKD) to the nursing unit. The nurse monitors the client for which frequent cardiovascular sign that occurs in CKD? 1.Hypertension 2.Hypotension 3.Tachycardia 4.Bradycardia
Hypertension
A client with chlamydial infection has received instructions on self-care and prevention of further infection. The nurse determines that the client needs further teaching if the client states which? 1.I will use latex condoms to prevent disease transmission. 2.I will return to the clinic as requested for follow-up culture in 1 week. 3.I will use an antibiotic prophylactically to prevent symptoms of Chlamydia. 4.I will reduce the chance of reinfection by limiting the number of sexual partners.
I will use an antibiotic prophylactically to prevent symptoms of Chlamydia.
The nurse is providing dietary instructions to a client with renal calculi, and the laboratory analysis has revealed that the calculus is composed of uric acid. The nurse tells the client that it would be helpful to make which dietary changes? 1.Increase intake of seafood in the diet. 2.Increase intake of legumes in the diet. 3.Include organ meat type foods in the diet. 4.Increase intake of cranberries and citrus fruits.
Increase intake of legumes in the diet.
A client has undergone a transurethral resection of the prostate (TURP) a few hours ago to treat symptoms of benign prostatic hypertrophy. The nurse notes bright red blood and clots in the urinary catheter drainage bag. Which response should be the nurse's initial action? 1.Contact the client's surgeon to report the bleeding. 2.Remove a small amount of fluid from the retention bulb. 3.Increase the flow rate of the continuous bladder irrigation. 4.Remove the indwelling catheter and encourage increased oral fluids.
Increase the flow rate of the continuous bladder irrigation.
Which is an appropriate question to ask to determine the specific type of incontinence? 1."Do you feel pain when you urinate?" 2."Do you have any difficulty in starting your stream of urine?" 3."Have you needed to empty your bladder more frequently than usual?" 4."Have you been experiencing any urgency accompanied by dribbling or leaking urine?"
"Have you been experiencing any urgency accompanied by dribbling or leaking urine?"
The nurse is assisting a client who is new to a low-potassium diet to select food items from the menu. Which food item is lowest in potassium and should be recommended to the client on this dietary restriction? 1.Spinach 2.Lima beans 3.Cantaloupe 4.Strawberries
Lima beans
The nurse is reinforcing dietary instructions to a client diagnosed with acute glomerulonephritis. The nurse determines that the client understands the information presented if the client states the intention to do which action? 1.Limit protein intake. 2.Increase intake of high-fiber foods. 3.Limit intake of magnesium-rich foods. 4.Increase intake of potassium-rich foods.
Limit protein intake
The nurse provides home care instructions to a client undergoing hemodialysis with regard to care of an arteriovenous (AV) fistula. Which statement by the client indicates an understanding of the instructions? 1."I should check the fistula every day by feeling it for a vibration." 2."I am glad that the laboratory will be able to draw my blood from the fistula." 3."I should wear a shirt with tight arms to provide some compression on the fistula." 4."I should check my blood pressure in the arm where I have my fistula every week."
"I should check the fistula every day by feeling it for a vibration."
The nurse is talking with a client who has an arteriovenous fistula in the left arm. What statement by the client indicates a need for further teaching? 1."I check my fistula every day for pulsations." 2."I sleep on my left side with my arm tucked under my pillow." 3."I remind the lab personnel to take my blood from my right arm" 4."I will call the health care provider if I notice redness and swelling near the site"
"I sleep on my left side with my arm tucked under my pillow."
A client has received instructions on self-management of peritoneal dialysis. The nurse determines that the client needs further teaching if the client makes which statement? 1."I will monitor my weight daily." 2."I will take my vital signs daily." 3."I will use meticulous aseptic technique for dialysate bag changes." 4."I will use a strong adhesive tape to anchor the catheter dressing."
"I will use a strong adhesive tape to anchor the catheter dressing."
A client with acute pyelonephritis is scheduled for a voiding cystourethrogram. After the nurse provides information about this procedure, the client states, "I can't urinate in front of other people. I have a 'bashful' kidney." What is the nurse's best response? 1."Everyone feels that way." 2."The people there are all medical professionals." 3."You will be screened and given as much privacy as possible." 4."If you cannot urinate in front of others, the test will be cancelled."
"You will be screened and given as much privacy as possible."
The nurse suspects the client has a urinary tract infection (UTI). Which signs/symptoms suggest a UTI? Select all that apply. 1.Dysuria 2.Hematuria 3.Frequency 4.Flank pain 5.Polydipsia 6.Cloudy urine
1, 2, 3, 4, 6
The nurse is caring for the client with epididymitis. Which treatment modalities should be implemented? Select all that apply. 1.Bed rest 2.Sitz bath 3.Antibiotics 4.Heating pad 5.Scrotal elevation
1, 2, 3, 5
Which actions are included in the nursing care of the client undergoing peritoneal dialysis? Select all that apply. 1.Monitor vital signs including temperature. 2.Weigh the client before and after dialysis. 3.Check color and volume of dialysate solution. 4.Instruct the client to remain supine until the dialysate is drained. 5.Maintain aseptic technique when accessing the peritoneal catheter.
1, 2, 3, 5
The nurse is assessing a client's arteriovenous fistula being used for hemodialysis. Which findings would prompt the nurse to notify the primary health care provider immediately? Select all that apply. 1.No thrill palpated at fistula site 2.No bruit auscultated at the fistula site 3.Dialysis treatment lasting longer than 3 hours 4.Absent pulse distal to the arteriovenous fistula 5.Fistula site transparent dressing last changed 8 days ago
1, 2, 4
A client with end-stage kidney disease (ESKD) undergoes a surgical procedure to create an arteriovenous fistula for hemodialysis in the upper extremity. The nurse should take which actions when the client returns from surgery? Select all that apply. 1.Monitor pain and administer analgesics. 2.Monitor bleeding and swelling at the site. 3.Monitor for circulation above the fistula site. 4.Measure the blood pressure in the arm every hour. 5.Check for audible bruit and palpable thrill at the fistula site.
1, 2, 5
The nurse is reviewing the history and physical examination on a client diagnosed with polycystic kidney disease. Which data should the nurse expect to see? Select all that apply. 1.Hematuria 2.Flank or lumbar pain 3.Client age 20 years old 4.Palpable abdominal mass 5.History of urinary tract infections
1, 2, 5
A client with end-stage kidney disease (ESKD) begins peritoneal dialysis. The nurse observes for which signs/symptoms indicating peritonitis? Select all that apply. 1.Nausea and vomiting 2.Poor dialysate outflow 3.Abdominal tenderness 4.Cloudy peritoneal effluent 5.Oral temperature of 38° C 6.Clear fluid leakage at the catheter exit site
1, 3, 4, 5
A client tells the nurse she completed an educational program to manage her stress incontinence but is now discouraged. Which information from the client indicates the need for further teaching? Select all that apply. 1.She performs the Kegel exercises every other day. 2.She maintains her fluid intake to 3000 mL of fluid daily. 3.She quit drinking coffee with cream but drinks diet cola. 4.She has decreased her caloric and fat intake to lose weight. 5.She has begun an exercise program that includes lifting weights.
1, 3, 5
The nurse is reviewing the client's record and notes that the primary health care provider (PHCP) has documented that the client has a renal disorder. Which laboratory results would indicate a decrease in renal function? Select all that apply. 1.Elevated serum creatinine level 2.Elevated thrombocyte cell count 3.Decreased red blood cell (RBC) count 4.Decreased white blood cell (WBC) count 5.Elevated blood urea nitrogen (BUN) level
1, 3, 5
A client is seen in the health care clinic and acute pyelonephritis is suspected. The nurse reviews the client's record and should expect to note which associated signs and symptoms documented? Select all that apply. 1.Chills 2.Low-grade fever 3.Pale, dilute urine 4.General weakness 5.Nausea and vomiting 6.Flank pain on the unaffected side
1, 4, 5
The nurse is caring for a hemodialysis client who has been receiving treatment for several years and is not a candidate for kidney transplant. The nurse knows that the majority of deaths of hemodialysis clients are related to which causes? Select all that apply. 1.Stroke 2.Trauma 3.Malignancies 4.Infectious complications 5.Myocardial infarction (MI) 6.Peptic ulcer disease (PUD)
1, 4, 5
The nurse is speaking with a client who underwent a minimally invasive procedure treatment for recurrent urolithiasis. Which instructions are appropriate to reinforce in the teaching plan? Select all that apply. 1.Drink at least 3000 mL of fluid each day. 2.Expect some intermittent hematuria to occur. 3.Take acetaminophen if chills and fever occur. 4.Complete the full course of prescribed antibiotics. 5.Filter urine and collect any stones to take to the urological primary health care provider.
1, 4, 5
A client who underwent kidney transplant 6 months earlier is seen in the clinic for a routine monthly appointment. The nurse reviews how the client has been doing and observes for signs/symptoms of acute rejection. Which signs/symptoms suggest acute rejection of the transplanted kidney? Select all that apply. 1.Oliguria 2.Swelling of the lips 3.Tachypnea with wheezing 4.Elevation of blood pressure over baseline 5.Abdominal tenderness on the side of the kidney transplant 6.Elevation of serum blood urea nitrogen (BUN) and creatinine
1, 4, 5, 6
A client contacts the primary health care provider's office to report she is not feeling well, has burning with urination, and suspects she may have a urinary tract infection. The nurse instructs the client to collect a urine specimen for testing. Which urinalysis findings indicate the presence of a urinary tract infection? Select all that apply. 1.Nitrites, present 2.Turbidity, clear 3.Ketones, moderate 4.White blood cells, 10 5.Specific gravity, 1.025 6.Leukocyte esterase, present
1, 4, 6
A long-term care nurse notes that an older client who is normally alert has become progressively confused and irritable. What diagnostic tests should the nurse anticipate the health care provider to prescribe? Select all that apply. 1.Urinalysis 2.Lipid profile 3.Chemistry profile 4.Coagulation studies 5.Stool for occult blood 6.Complete blood count
1, 6
A hemodialysis client with a left arm fistula is at risk for arterial steal syndrome. The nurse monitors this client for which signs/symptoms of this disorder? 1.Edema and purpura of the left arm 2.Warmth, redness, and pain in the left hand 3.Aching pain, pallor, and edema of the left arm 4.Pallor, diminished pulse, and pain in the left hand
Pallor, diminished pulse, and pain in the left hand
The nurse is assessing the patency of an arteriovenous fistula in the left arm of a client who is receiving hemodialysis for the treatment of chronic kidney disease. Which finding indicates that the fistula is patent? 1.Palpation of a thrill over the fistula 2.Presence of a radial pulse in the left wrist 3.Absence of a bruit on auscultation of the fistula 4.Capillary refill less than 3 seconds in the nail beds of the left hand
Palpation of a thrill over the fistula
The use of peritoneal dialysis for the treatment of chronic kidney disease would be contraindicated for which client? 1.The client with hypothyroidism 2.The client with severe emphysema 3.The client with type 2 diabetes mellitus 4.The client with severe peripheral vascular disease
The client with severe emphysema
The nurse is assisting in planning a teaching session with a client diagnosed with urethritis caused by infection with Chlamydia. The nurse should plan to include which point in the teaching session? 1.The most serious complication of this infection is sterility. 2.Sexual partners during the last 12 months should be notified and treated. 3.Medication therapy should be continued for 2 months without interruption. 4.The infection can be prevented by using spermicide to alter the pH in the perineal area.
The most serious complication of this infection is sterility.
The nurse is assessing a client with suspected acute kidney injury. Which finding would support a diagnosis of acute intrarenal failure? 1.Urine output of 30 mL/hr for the past 24 hours 2.Urine analysis positive for casts and cellular debris 3.Renal ultrasound indicating the presence of ureteral calculi 4.Blood urea nitrogen (BUN) level of 48 mg/dL and creatinine level of 1.2 mg/dL
Urine analysis positive for casts and cellular debris
A client with prostatitis resulting from kidney infection has received instructions on management of the condition at home and prevention of recurrence. Which statement indicates that the client understood the instructions? 1.Stop antibiotic therapy when pain subsides. 2.Exercise as much as possible to stimulate circulation. 3.Use warm sitz baths and analgesics to increase comfort. 4.Keep fluid intake to a minimum to decrease the need to void.
Use warm sitz baths and analgesics to increase comfort.
The nurse is assigned to care for a client who has just returned to the nursing unit after having hemodialysis for the first time. The nurse monitors the client carefully for which signs and symptoms of disequilibrium syndrome? 1.Vomiting and headaches 2.Lethargy and hypertension 3.Hypertension and sleepiness 4.Abdominal pain and hypotension
Vomiting and headaches
The nurse is caring for a 58-year-old client with chronic kidney disease who is receiving peritoneal dialysis. Which finding is considered most important by the nurse, requiring primary health care provider notification? Refer to chart. 1.BUN: 40 mg/dL 2.WBC 15,000 mm3 3.ECG: First-degree heart block 4.Heart rate: 96 beats per minute
WBC 15,000 mm3