PCCII Exam 5 Practice Q's
What clinical finding in a postmenopausal patient with urethritis does the nurse attribute to low estrogen levels?
A pelvic examination shows tissue changes.
The nurse in the urology clinic is providing teaching for a female patient with cystitis. Which instructions does the nurse include in the teaching plan?
If urine remains cloudy, call the clinic. Try to take in 64 ounces of fluid each day. Be sure to complete the full course of antibiotics.
A patient has been prescribed trimethoprim-sulfamethoxazole (TMP-SMZ). The nurse realizes that this drug is most likely used to treat which condition?
Urinary tract infection
A nurse is preparing to obtain a daily weight from a client who has chronic kidney disease. Which of the following actions should the nurse implement?
Weigh the client after he has voided. The nurse should have the client void before obtaining a daily weight.
Which complication does the nurse monitor for in a pregnant patient who is diagnosed with cystitis?
Preterm labor
A nurse is teaching a client who has chronic kidney failure about planning a low-protein diet. The client states, "Why do I have to be concerned about protein?" Which of the following responses should the nurse make?
"A low-protein diet reduces the risk for uremia." Urea is a waste product of protein breakdown and can accumulate in clients who have kidney failure, causing uremia.
A male patient comes into the emergency department with a serum creatinine of 2.2 mg/dL and a blood urea nitrogen (BUN) of 24 mL/dL. What question would the nurse ask first when taking this patient's history?
"Have you been taking any aspirin, ibuprofen, or naproxen recently?"
The nurse is teaching a client with diabetes mellitus how to prevent or delay chronic kidney disease (CKD). Which client statement indicates an understanding of the teaching?
"I need to decrease the protein in my diet to preserve kidney function." Protein restriction early in the course of the disease prevents some of the problems of CKD and may preserve kidney function. Protein is restricted n the basis of the degree of kidney impairment (reduced GFR)
The nurse is instructing an older adult female patient about interventions to decrease the risk for cystitis. Which patient comment indicates that the teaching was effective?
"I should consume cranberry supplements 4x/week."
The nurse teaches a female patient about ways to prevent urinary tract infections. Which statements made by the patient indicate effective learning?
"I should wash the perineal area before intercourse." "I should urinate frequently thoughout the day." "I should drink 3 liters of fluid per day."
How many times a week do patients do peritoneal dialysis?
7 days a week
Creatinine
0.6-1.2 mg/dL
BUN
10-20 mg/dL
How do you stage someone's kidney disease?
24 hr creatinine
Phosphate
3.0-4.5 mg/dL
Potassium
3.5-5.0 mg/dL
A nurse is providing care to a group of patients on a urology unit. Which patient does the nurse identify as being at the greatest risk for developing urinary stones?
35-year-old female with quadriplegia from an auto accident
Calcium
9-10.5 mg/dL
A client has a long history of hypertension. Which category of medications would the nurse expect to be ordered to slow the progression of chronic kidney disease (CKD)?
Angiotensin-converting enzyme (ACE) inhibitor ACE inhibitors are the most effective drugs to slow the progression of the CKD in patients with HTN
A nurse is teaching a client who has chronic renal failure about the process of continuous ambulatory peritoneal dialysis (CAPD). Which of the following should the nurse include in the teaching?
CAPD requires the client to follow fewer dietary and fluid restrictions than with hemodialysis. Hemodialysis is the form of dialysis that uses a dialyzer to filter the client's blood. CAPD is contraindicated for clients who have a history of abdominal surgery or trauma to the abdomen. CAPD's advantages include fewer fluid and dietary restrictions as compared to hemodialysis. CAPD is recommended for clients who have end-stage renal disease.
The nurse is caring for several clients with chronic kidney disease. Which client should the nurse assess first?
Client with Kussmaul's respirations
A male client with chronic kidney disease (CKD) is refusing to take his medication and has missed two hemodialysis appointments. What is the best initial action for the nurse?
Discuss what the dialysis routine and drugs mean to him. CKD disrupts many aspects of life. Psychosocial support are the main part of a nurse's role.
When assessing the patient with benign prostatic hyperplasia (BPH), what assessment finding would the nurse expect as typical?
Distended bladder
The nurse is teaching a group of older adult women about the signs and symptoms of a urinary tract infection (UTI). Which concepts does the nurse explain in the presentation?
Dysuria Nocturia Urgency Frequency
A nurse is discussing renal transplant with a client who has end-stage renal disease (ESRD). Which of the following should the nurse identify as a contraindication for this treatment?
Having a chronic infection. Morbid obesity, a BMI of greater than 35, is a contraindication for renal transplantation. Having a pacemaker is not a contraindication for renal transplantation. If the client meets other criteria for renal transplantation then age is not a contraindication. An acute or chronic infection is a contraindication for renal transplantation
The nurse understands that the patient who has undergone a transurethral resection of the prostate (TURP) is at risk for developing which priority concern?
Hemorrhage
The patient has a prostate ultrasound and is diagnosed with BPH. To manage it, the provider prescribes drug therapy with finasteride (Proscar). What should the nurse teach the patient about this drug?
It will decrease the level of dihydrotesterone (DHT) and shrink the prostate. Proscar is a 5-alpha reductase inhibitor (5-ARI) that lowers DHT and shrinks the prostate as well as prevents further growth. It is important to remind patients that with 5-ARI drugs it may take up to 6 months before improvement occurs. Side effects include erectile dysfunction and decreased libido. Alpha blocking agents such as tamsulosin (Flomax) work by constricting the prostate gland and improving urine flow. Alpha blockers such as doxazosin (Cardura) and terazosin (Hytrin) may cause postural hypotension; they should also not be taken with drugs like Viagra.
A client is diagnosed with chronic kidney disease (CKD). What is an ideal goal of treatment set by the nurse in the care plan in preventing pulmonary edema?
Maintaining a balanced intake and output
When teaching a patient about trimethoprim-sulfamethoxazole (TMP-SMZ), the nurse gives highest priority to teaching the patient to
Patients on sulfonamide therapy need to increase their fluid intake.
The nurse is triaging a patient who presents to the urgent care clinic with symptoms of severe flank pain with spasms, nausea, vomiting, and oliguria. The patient states that the pain was initially intermittent and radiated from the lower back to the lower quadrants of the abdomen. Which action by the nurse is the most appropriate?
Perform a renal ultrasound
An adult with chronic renal failure is in the clinic for a routine check-up. Which result would give the nurse the most concern?
Phosphorus level of 6 mg/dL Calcium level of 9.0-10.5 g/dL; Phosphorus level of 3.0-4.5 mg/dL; Sodium level of 136-145 mmol/L; Potassium level of 3.5-5.1 mmol/L
A client is assessed by the nurse after a hemodialysis session. The nurse notes bleeding from the client's nose and around the hemodialysis catheter. What is the nurse's priority action?
Prepare protamine sulfate for administration.
The charge nurse of the medical-surgical unit is making staff assignments. Which staff member would be assigned to a patient with chronic kidney disease who is exhibiting a low-grade fever and a pericardial friction rub
Registered nurse who was assigned the same patient yesterday-
A nurse is reviewing laboratory values for a client who has systemic lupus erythematosus (SLE). Which of the following values should give the nurse the best indication of the client's renal function?
Serum creatinine A renal function disorder reduces the excretion of creatinine, resulting in increased levels of blood creatinine. Creatinine is a specific and sensitive indicator of renal function.
Which antibiotic for treating cystitis may cause side effects of sunburn and skin darkening?
Sulfamethoxazole
A client is having a peritoneal dialysis treatment. The nurse notes an opaque color to the effluent. What is the priority action by the nurse?
Take a sample of the effluent and send to the laboratory. Cloudy or opaque effluent is the earliest indication of peritonitis
A nurse is caring for a client who has chronic renal disease and is receiving therapy with epoetin alfa. Which of the following laboratory results should the nurse review for an indication of a therapeutic effect of the medication?
The hematocrit (Hct) Epoetin alfa is an antianemic medication that is indicated in the treatment of clients who have anemia due to reduced production of endogenous erythropoietin, which may occur in clients who have end-stage renal disease or myelosuppression from chemotherapy. The therapeutic effect of epoetin alfa is enhanced red blood cell production, which is reflected in an increased RBC, Hgb, and Hct.
How is urethritis different than a UTI?
Urethritis is often caused by sexually transmitted infections.
After taking a sulfonamide, a patient develops desquamation, scaling, and itching of skin. The nurse identifies this condition as
exfoliative dermatitis.
A nurse is reviewing the arterial blood gas values of a client who has chronic kidney disease. Which of the following sets of values should the nurse expect?
pH 7.25, PaCO2 30 mm Hg, HCO3- 19 mEq/L
The nurse will teach the patient with chronic bacterial prostatitis that
sexual intercourse and masturbation will relieve symptoms. Ejaculation helps drain the prostate and relieve pain. PSA elevation may be due to the prostatitis. NSAIDs are prescribed, but are often inadequate to control pain. Antibiotics should be continued for 4 to 16 weeks.
A patient is ordered to receive trimethoprim/sulfamethoxazole (Bactrim). This medication is a combination of two medications that are
synergistic
How many times a week do patients do Hemodialysis?
three times per week, for 3- to 5-hr sessions. Two needles are inserted, one into an artery and the other into a vein
A couple is seen at the infertility clinic because they have not been able to conceive. When performing a focused examination to determine any possible causes for infertility, the nurse will check the man for the presence of
varicocele
