saunders ae

The nurse instructs a client about continuous ambulatory peritoneal dialysis (CAPD). Which statement by the client indicates an accurate understanding of CAPD? 1."No machinery is involved, and I can pursue my usual activities." 2."A cycling machine is used, so the risk for infection is minimized." 3."The drainage system can be used once during the day and a cycling machine for 3 cycles at night." 4."A portable hemodialysis machine is used so that I will be able to ambulate during the treatment."

1

A client with end-stage renal disease (ESRD) has the problem of ineffective coping. Which nursing interventions are appropriate in working with this client? Select all that apply. 1.Acknowledge the client's feelings. 2.Assess the client and family's coping patterns. 3.Explore the meaning of the illness with the client. 4.Set limits on mood swings and expressions of hostility. 5.Give the client information when the client is ready to listen.

1 2 3 5

The nurse is caring for a client just after ureterolithotomy and is monitoring the drainage from the ureteral catheter hourly. Suddenly, the catheter stops draining. The nurse assesses the client and determines that which could be the cause of the problem? Select all that apply 1.Blood clots 2.Mucous shreds 3.Ureteral edema 4.Chemical sediment 5.Catheter displacement

1 2 4 5

The nurse is reviewing the urinalysis results for a client with glomerulonephritis. Which findings should the nurse expect to note? Select all that apply. 1.Proteinuria 2.Hematuria 3.Positive ketones 4.A low specific gravity 5.A dark and smoky appearance of the urine

1 2 5 In the client with glomerulonephritis, characteristic findings in the urinalysis report are gross proteinuria and hematuria. The specific gravity is elevated, and the urine may appear dark and smoky. Positive ketones are not associated with this condition but may indicate a secondary problem.

A client had a new colostomy created 2 days earlier and is beginning to pass malodorous flatus from the stoma. What is the correct interpretation by the nurse? 1.This is a normal, expected event. 2.The client is experiencing early signs of ischemic bowel. 3.The client should not have the nasogastric tube removed. 4.This indicates inadequate preoperative bowel preparation.

1 As peristalsis returns following creation of a colostomy, the client begins to pass malodorous flatus. This indicates returning bowel function and is an expected event. Within 72 hours of surgery, the client should begin passing stool via the colostomy. Options 2, 3, and 4 are incorrect interpretations.

Diphenoxylate hydrochloride with atropine sulfate is prescribed for a client with ulcerative colitis. The nurse should monitor the client for which therapeutic effect of this medication? 1.Decreased diarrhea 2.Decreased cramping 3.Improved intestinal tone 4.Elimination of peristalsis

1 Diphenoxylate hydrochloride with atropine sulfate is an antidiarrheal product that decreases the frequency of defecation, usually by reducing the volume of liquid in the stools. The remaining options are not associated therapeutic effects of this medication.

A client is admitted to the nursing unit after undergoing radical prostatectomy for cancer. The nurse anticipates that which problem would be of most concern to the client in the immediate postoperative period? 1.Concern about the outcome of surgery 2.Continuous pain because of the effects of cancer 3.Appearance disturbance as a result of the presence of a suprapubic catheter 4.Concern about caring for self at home because of insufficient help after discharge

1 In the immediate postoperative period, the client who has had surgery for cancer may experience fear or concern related to the uncertain outcome of surgery. Postoperative pain is classified as acute, not continuous. The client may experience an alteration in appearance, but this is more likely to be related to the anticipated change in sexual function than the presence of the suprapubic catheter. The priority focus in the immediate postoperative period is not on concerns that apply to hospital discharge.

A client with chronic kidney disease (CKD) has been taking aluminum hydroxide gel. On the basis of this information, the nurse determines that the client is most at risk for which problem? 1.Constipation 2.Dehydration 3.Inability to tolerate activity 4.Impaired physical mobility

1 The client with CKD is almost certain to have a problem with constipation as a result of factors such as fluid restriction, fatigue that limits exercise, and dietary restrictions. In addition, phosphate-binding antacids such as aluminum hydroxide gel cause constipation as a side effect. The other problems listed are unrelated to the information in the question.

The nurse is preparing to teach a client with a new colostomy about how to perform a colostomy irrigation. Which information should the nurse include in the teaching plan? 1.Use 500 to 1000 mL of warm tap water. 2.Suspend the irrigant 36 inches above the stoma. 3.Insert the irrigation cone ½ inch into the stoma. 4.If cramping occurs, open the irrigation clamp farther.

1 The usual procedure for colostomy irrigation includes using 500 to 1000 mL of warm tap water. The solution is suspended 18 inches above the stoma. The cone is inserted 2 to 4 inches into the stoma but should never be forced. If cramping occurs, the client should decrease the flow rate of the irrigant as needed by closing the irrigation clamp. This practice is not common because of odor-proof pouches.

A client is about to begin hemodialysis. Which measures should the nurse employ in the care of the client? Select all that apply 1.Using sterile technique for needle insertion 2.Using standard precautions in the care of the client 3.Giving the client a mask to wear during connection to the machine 4.Wearing full protective clothing such as goggles, mask, gloves, and apron 5.Covering the connection site with a bath blanket to enhance extremity warmth

1,2,3,4

The nurse monitoring a client receiving peritoneal dialysis notes that the client's outflow is less than the inflow. Which actions should the nurse take? Select all that apply. 1.Check the level of the drainage bag. 2.Reposition the client to her or his side. 3.Place the client in good body alignment. 4.Check the peritoneal dialysis system for kinks. 5.Contact the primary health care provider (PHCP). 6.Increase the flow rate of the peritoneal dialysis solution.

1,2,3,4 If outflow drainage is inadequate, the nurse attempts to stimulate outflow by changing the client's position. Turning the client to the side or making sure that the client is in good body alignment may assist with outflow drainage. The drainage bag needs to be lower than the client's abdomen to enhance gravity drainage. The connecting tubing and peritoneal dialysis system are also checked for kinks or twisting, and the clamps on the system are checked to ensure that they are open. There is no reason to contact the PHCP. Increasing the flow rate should not be done and also is not associated with the amount of outflow solution.

The nurse monitoring a client receiving peritoneal dialysis notes that the client's outflow is less than the inflow. Which actions should the nurse take? Select all that apply. 1.Check the level of the drainage bag. 2.Reposition the client to his or her side. 3.Place the client in good body alignment. 4.Check the peritoneal dialysis system for kinks. 5.Contact the primary health care provider (PHCP). 6.Increase the flow rate of the peritoneal dialysis solution.

1,2,3,4 Peritoneal dialysis is a treatment that uses the peritoneum as a filter along with a dialysate solution to remove waste products. If outflow drainage is inadequate, the nurse attempts to stimulate outflow by changing the client's position. Turning the client to the side or making sure that the client is in good body alignment may assist with outflow drainage. The drainage bag needs to be lower than the client's abdomen to enhance gravity drainage. The connecting tubing and peritoneal dialysis system are also checked for kinks or twisting, and the clamps on the system are checked to ensure that they are open. There is no reason to contact the PHCP. Increasing the flow rate should not be done and also is not associated with the amount of outflow solution.

A client with cirrhosis has ascites and excess fluid volume. Which assessment findings does the nurse anticipate to note as a result of increased abdominal pressure? Select all that apply 1.Orthopnea and dyspnea 2.Petechiae and ecchymosis 3.Inguinal or umbilical hernia 4.Poor body posture and balance 5.Abdominal distention and tenderness

1,2,3,5 Excess fluid volume, related to the accumulation of fluid in the peritoneal cavity and dependent areas of the body, can occur in the client with cirrhosis. Ascites can cause physical problems because of the overdistended abdomen and resultant pressure on internal organs and vessels. These problems include respiratory difficulty, petechiae and ecchymosis, development of hernias, and abdominal distention and tenderness. Poor body posture and balance are unrelated to increased abdominal pressure.

The nurse discusses plans for future treatment options with a client with symptomatic polycystic kidney disease. Which treatment should be included in this discussion? Select all that apply. 1.Hemodialysis 2.Kidney transplant 3.Peritoneal dialysis 4.Bilateral nephrectomy 5.Intense immunosuppression therapy

1,2,4 Polycystic kidney disease is a genetic familial disease in which the kidneys enlarge with cysts that rupture and scar the kidney, eventually resulting in end-stage renal disease. Treatment options include hemodialysis or kidney transplant. Clients usually undergo bilateral nephrectomy to remove the large, painful, cyst-filled kidneys. Peritoneal dialysis is not a treatment option due to the infected cysts. The condition does not respond to immunosuppression.

A client with bladder cancer has undergone surgical removal of the bladder with creation of an ileal conduit. Which assessment findings indicate that the client is developing complications? Select all that apply. 1.Dusky appearance of the stoma 2.Stoma protrusion from the skin 3.Sharp abdominal pain with rigidity 4.Urine output greater than 30 mL/hour 5.Mucus shreds in the urine collection bag

1.Dusky appearance of the stoma 2.Stoma protrusion from the skin 3.Sharp abdominal pain

A client is admitted to the hospital with suspected bladder cancer. The nurse assesses the client for which early signs and symptoms of the disease? 1.Proteinuria and dysuria 2.Hematuria and absence of pain 3.Painful urination and hematuria 4.Pyuria and palpable abdominal mass

2

A client is diagnosed with viral hepatitis, complaining of "no appetite" and "losing my taste for food." What instruction should the nurse give the client to provide adequate nutrition? 1. Select foods high in fat. 2.Increase intake of fluids, including juices. 3.Eat a good supper when anorexia is not as severe. 4.Eat less often, preferably only 3 large meals daily.

2

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 clinic nurse should ask which question first? 1."Have you had any diarrhea?" 2."Have you been constipated recently?" 3."Have you had any abdominal discomfort?" 4."Have you had an increased amount of flatulence?"

2 Reduced outflow from the dialysis catheter may be caused by the catheter position, infection, or constipation. Constipation may contribute to a reduced outflow because peristalsis seems to aid in drainage.

A cystectomy is performed for a client with a diagnosis of bladder cancer, and a Kock pouch is created for urinary diversion. In creating a discharge teaching plan for the client, the nurse should include which instruction in the plan? 1.Dietary restrictions 2.Technique of catheterization 3.External pouch and application care 4.Proper administration of prophylactic antibiotics

2 A Kock pouch is a continent internal ileal reservoir. The nurse instructs the client about the technique of catheterization. Dietary restrictions are not required. There is no external pouch. Antibiotics are not required unless an infection is present; also, antibiotics are prescribed by the health care provider.

A client who has been receiving radiation therapy for bladder cancer tells the nurse that it feels as if she is voiding through the vagina. The nurse interprets that the client may be experiencing which condition? 1. Rupture of the bladder 2. The development of a vesicovaginal fistula 3. Extreme stress caused by the diagnosis of cancer 4. Altered perineal sensation as a side effect of radiation therapy

2 A vesicovaginal fistula is a genital fistula that occurs between the bladder and vagina. The fistula is an abnormal opening between these two body parts, and if this occurs, the client may experience drainage of urine through the vagina. The client's complaint is not associated with options 1, 3, or 4.

A client has developed acute kidney injury (AKI) as a complication of glomerulonephritis. Which should the nurse expect to observe in the client? 1.Bradycardia 2.Hypertension 3.Decreased cardiac output 4.Decreased central venous pressure

2 AKI caused by glomerulonephritis is classified as intrinsic or intrarenal failure. This form of AKI commonly manifests with hypertension, tachycardia, oliguria, lethargy, edema, and other signs of fluid overload. AKI from prerenal causes is characterized by decreased blood pressure or a recent history of the same, tachycardia, and decreased cardiac output and central venous pressure. Bradycardia is not part of the clinical picture for any form of renal failure.

The nurse is providing care for a client with a recent transverse colostomy. Which observation requires immediate notification of the primary health care provider? 1.Stoma is beefy red and shiny 2.Purple discoloration of the stoma 3.Skin excoriation around the stoma 4.Semiformed stool noted in the ostomy pouch

2 Ischemia of the stoma would be associated with a dusky or bluish or purple color. A beefy red and shiny stoma is normal and expected. Skin excoriation needs to be addressed and treated but does not require as immediate attention as purple discoloration of the stoma. Semiformed stool is a normal finding.

The nurse is reviewing the history of a client with bladder cancer. The nurse expects to note documentation of which most common sign or symptom of this type of cancer? 1.Dysuria 2.Hematuria 3.Urgency on urination 4.Frequency of urination

2 The most common sign in clients with cancer of the bladder is hematuria. The client also may experience irritative voiding symptoms such as frequency, urgency, and dysuria, and these symptoms often are associated with carcinoma in situ. Dysuria, urgency, and frequency of urination are also symptoms of a bladder infection.

The nurse is caring for a client with acute kidney injury (AKI). The nurse should test the client's urine for proteinuria to determine which type of AKI? 1.Prerenal 2.Intrinsic 3.Atypical 4.Postrenal

2 `

The nurse should incorporate which in the dietary plan to ensure optimal nutrition for the client during the acute phase of hepatitis? Select all that apply. 1.Select foods high in protein content. 2.Consume multiple small meals throughout the day. 3.Select foods low in carbohydrates to prevent nausea. 4.Allow the client to select foods that are most appealing. 5.Eliminate fatty foods from the meal trays until nausea subsides. 6.Eat a nutritious dinner because it is typically the best tolerated meal of the day.

2,4,5 Because the client with hepatitis experiences general malaise, small, more frequent meals are better tolerated than large meals, with breakfast being the best tolerated meal of the day. Self-selection of foods may enhance appetite over randomly selected foods. Fatty foods can exacerbate nausea and need to be avoided during the acute phase. The diseased liver may be unable to metabolize large amounts of protein at this time. The client should receive a diet high in carbohydrates to assist with meeting increased caloric needs. Anorexia typically increases as the day goes on.

A client arrives at the emergency department with complaints of low abdominal pain and hematuria. The client is afebrile. The nurse next assesses the client to determine a history of which condition? 1.Pyelonephritis 2.Glomerulonephritis 3.Trauma to the bladder or abdomen 4.Renal cancer in the client's family

3

The nurse is caring for a client with altered protein metabolism as a result of liver dysfunction. Which finding should the nurse expect to note when reviewing the client's laboratory results? 1.Increased lactase level 2.Decreased albumin level 3.Increased ammonia level 4.Decreased lactic acid level

3

The nurse is caring for a client with cancer of the prostate who has undergone a prostatectomy. Which action should the nurse include in discharge instructions? 1.Avoid driving the car for a few days. 2.Restrict fluid intake to prevent incontinence. 3.Avoid lifting objects heavier than 20 lb (9 kg) for at least 6 weeks. 4.Notify the primary health care provider if small blood clots are noticed during urination.

3 (small blood clots may be passed in urine for up to 2 weeks after surgery)

A client with chronic kidney disease returns to the nursing unit following a hemodialysis treatment. On assessment, the nurse notes that the client's temperature is 38.5° C (101.2° F). Which nursing action is most appropriate? 1.Encourage fluid intake. 2.Continue to monitor vital signs. 3.Notify the primary health care provider. 4.Monitor the site of the shunt for infection.

3 A temperature of 101.2° F (38.5° C) is significantly elevated and may indicate infection. The nurse should notify the primary health care provider (PHCP). Dialysis clients cannot have fluid intake encouraged. Vital signs and the shunt site should be monitored, but the PHCP should be notified first.

The nurse is reviewing the record of a client with a diagnosis of cirrhosis and notes that there is documentation of the presence of asterixis. How should the nurse assess for its presence? 1.Dorsiflex the client's foot. 2.Measure the abdominal girth. 3.Ask the client to extend the arms. 4.Instruct the client to lean forward.

3 Asterixis is irregular flapping movements of the fingers and wrists when the hands and arms are outstretched, with the palms down, wrists bent up, and fingers spread. Asterixis is the most common and reliable sign that hepatic encephalopathy is developing. Options 1, 2, and 4 are incorrect.

Which client is most at risk for developing a Candida urinary tract infection (UTI)?' 1.An obese woman 2.A man with diabetes insipidus 3.A young woman on antibiotic therapy 4.A male paraplegic on intermittent catheterization

3 Candida infections, which are fungal infections, develop in persons who are on long-term antibiotic therapy because an alteration of normal flora occurs.

The nurse is caring for a client experiencing an exacerbation of Crohn's disease. Which intervention should the nurse anticipate the primary health care provider prescribing? 1.Enteral feedings 2.Fluid restrictions 3.Oral corticosteroids 4.Activity restrictions

3 Oral corticosteroids are used to treat the inflammation of Crohn's disease,

The nurse is caring for a hospitalized client with a diagnosis of ulcerative colitis. Which finding, if noted on assessment of the client, should the nurse report to the primary health care provider (PHCP)? 1.Hypotension 2.Bloody diarrhea 3.Rebound tenderness 4.A hemoglobin level of 12 mg/dL (120 mmol/L)

3 Rebound tenderness may indicate peritonitis. Bloody diarrhea is expected to occur in ulcerative colitis. Because of the blood loss, the client may be hypotensive and the hemoglobin level may be lower than normal. Signs of peritonitis must be reported to the PHCP.

The nurse is assessing a client who has a new ureterostomy. Which statement by the client indicates the need for more education about urinary stoma care? 1."I change my pouch every week." 2."I change the appliance in the morning." 3."I empty the urinary collection bag when it is two-thirds full." 4."When I'm in the shower I direct the flow of water away from my stoma."

3 The urinary collection bag should be changed when it is one-third full to prevent pulling of the appliance and leakage. The remaining options identify correct statements about the care of a urinary stoma.

The registered nurse is instructing a new nursing graduate about hemodialysis. Which statement made by the new nursing graduate indicates an understanding of the procedure for hemodialysis? Select all that apply. 1."Sterile dialysate must be used." 2."Dialysate contains metabolic waste products." 3."Heparin sodium is administered during dialysis." 4."Dialysis cleanses the blood of accumulated waste products." 5."Warming the dialysate increases the efficiency of diffusion."

3,4,5

A client with viral hepatitis is having difficulty coping with the disorder. Which question by the nurse is the most appropriate in identifying the client's coping problem? 1."Do you have a fever?" 2."Are you losing weight?" 3."Have you enjoyed having visitors?" 4."Do you rest sometime during the day?"

3. Clients with hepatitis may experience anxiety because of an anticipated change in lifestyle or fear of prognosis. They also may have a disturbance in body image related to the stigma of having a communicable disease or a change in appearance because of jaundice. The correct option relates to the client's possible feelings of not wanting to be seen by others because of altered appearance. Remember that the client with hepatitis is jaundiced.

The home health nurse is planning to make a home visit to a client who has undergone surgical creation of an ileal conduit. The nurse should include which information on ostomy care in discussion with the client? 1.Plan to do appliance changes in the late evening hours. 2.Cut an opening that is slightly smaller than the stoma in the face plate of the appliance. 3.Appliance odor from urine breakdown to ammonia can be minimized by limiting fluids. 4.Cleanse the skin around the stoma, using gentle soap and water, and then rinse and dry well.

4

The nurse has provided instructions regarding home care measures for a client with acute pyelonephritis. Which statement by the client indicates a need for further teaching? 1."I should try to maintain an acid ash diet." 2."I should increase my fluid intake to 3 L per day." 3."I should take my daily dose of vitamin C to acidify the urine." 4."I need to avoid alcohol and highly spiced foods but may continue to drink my coffee every day."

4

The nurse is caring for a client with metastatic breast cancer. The client describes a new and sudden sharp pain in the back. Based on this assessment finding, which is the priority nursing intervention? 1.Document the findings. 2.Administer pain medication. 3.Place a heating pad on the client's back. 4.Notify the primary health care provider (PHCP)

4

A client with a bladder injury has had surgical repair of the injured area with placement of a suprapubic catheter. Which is the most appropriate nursing action to prevent complications of this procedure? 1.Monitor urine output once per shift. 2.Measure specific gravity once per shift. 3.Encourage an excessive intake of oral fluids. 4.Ensure that the catheter tubing is not kinked.

4 A complication after surgical repair of the bladder is disruption of sutures, caused by tension on them from urine buildup. The nurse prevents this from happening by ensuring that the catheter is able to drain freely. This involves basic catheter care, including keeping the tubing free from kinks, maintaining the tubing at a level below the bladder, and monitoring the flow of urine

A client has just had surgery to create an ileostomy. The nurse assesses the client in the immediate postoperative period for which mostfrequent complication of this type of surgery? 1.Folate deficiency 2.Malabsorption of fat 3.Intestinal obstruction 4.Fluid and electrolyte imbalance

4 A frequent complication that occurs following ileostomy is fluid and electrolyte imbalance. The client requires constant monitoring of intake and output to prevent this from occurring.

The nurse is caring for a client after abdominal surgery and creation of a colostomy. The nurse is assessing the client for a prolapsed stoma and should expect to note which observation if this is present? 1. A sunken and hidden stoma 2.A narrow and flattened stoma 3.A stoma that is dusky or bluish 4.A stoma that is elongated with a swollen appearance

4 A prolapsed stoma is one in which the bowel protrudes, causing an elongated and swollen appearance of the stoma. A retracted stoma is characterized by a sinking of the stoma. A stoma with a narrow opening is described as being stenosed. Ischemia of the stoma would be associated with a dusky or bluish color.

The client newly diagnosed with chronic kidney disease recently has begun hemodialysis. Knowing that the client is at risk for disequilibrium syndrome, the nurse should assess the client during dialysis for which associated manifestations? 1.Hypertension, tachycardia, and fever 2.Hypotension, bradycardia, and hypothermia 3.Restlessness, irritability, and generalized weakness 4.Headache, deteriorating level of consciousness, and twitching

4 Disequilibrium syndrome is characterized by headache, mental confusion, decreasing level of consciousness, nausea, vomiting, twitching, and possible seizure activity. Disequilibrium syndrome is caused by rapid removal of solutes from the body during hemodialysis. At the same time, the blood-brain barrier interferes with the efficient removal of wastes from brain tissue. As a result, water goes into cerebral cells because of the osmotic gradient, causing increased intracranial pressure and onset of symptoms. The syndrome most often occurs in clients who are new to dialysis and is prevented by dialyzing for shorter times or at reduced blood flow rates. Tachycardia and fever are associated with infection. Generalized weakness is associated with low blood pressure and anemia. Restlessness and irritability are not associated with disequilibrium syndrome.

The nurse is performing an assessment on a client who has returned from the dialysis unit following hemodialysis. The client is complaining of headache and nausea and is extremely restless. Which is the priority nursing action? 1.Monitor the client. 2.Elevate the head of the bed. 3.Assess the fistula site and dressing. 4.Notify the primary health care provider (PHCP).

4 Disequilibrium syndrome may be caused by rapid removal of solutes from the body during hemodialysis. These changes can cause cerebral edema that leads to increased intracranial pressure. The client is exhibiting early signs and symptoms of disequilibrium syndrome, and appropriate treatments with anticonvulsive medications and barbiturates may be necessary to prevent a life-threatening situation. The PHCP must be notified. Monitoring the client, elevating the head of the bed, and assessing the fistula site are correct actions, but the priority action is to notify the PHCP.

A client is admitted to the hospital with a diagnosis of benign prostatic hyperplasia, and a transurethral resection of the prostate is performed. Four hours after surgery, the nurse takes the client's vital signs and empties the urinary drainage bag. Which assessment finding indicates the need to notify the primary health care provider (PHCP)? 1.Red, bloody urine 2.Pain rated as 2 on a 0 to 10 pain scale 3.Urinary output of 200 mL higher than intake 4.Blood pressure, 100/50 mm Hg; pulse, 130 beats per minute

4 Frank bleeding (arterial or venous) may occur during the first day after surgery. Some hematuria is usual for several days after surgery. A urinary output of 200 mL more than intake is adequate. A client pain rating of 2 on a 0 to 10 scale indicates adequate pain control. A rapid pulse with a low blood pressure is a potential sign of excessive blood loss. The PHCP should be notified.

A client has just had a Foley catheter removed and is to be started on a bladder retraining program. Which intervention will provide the most useful information about the client's ability to empty the bladder? 1.Calculating total fluid intake for the shift 2.Recording the amount of the client's voidings 3.Assisting the client to the bathroom every 2 hours 4.Measuring postvoid residual using a bladder scan

4 Measuring postvoid residual gives specific information about the ability of the bladder to empty completely

The home care nurse visits a client who has just returned home from the hospital after a mastectomy with a suction drain in place. Which observed client behavior requires a need for further teaching? 1. Empties the drain to prevent infection 2. Elevates the arm when lying and sitting 3. Applies lotion to the area after the incision heals 4. Performs full range-of-motion exercises to the upper arm

4 The client should be instructed to limit upper arm range-of-motion exercises to the level of the shoulder only. Once the suction drain has been removed, the client can begin full range-of-motion exercises to the upper arm as prescribed. The client should elevate the arm while sitting down or lying, and the client will be able to apply lotion to the incision once it has healed. The drain is emptied as needed.

The nurse is caring for a client with ulcerative colitis. Which finding does the nurse determine is consistent with this diagnosis? 1.Hypercalcemia 2.Hypernatremia 3.Frothy, fatty stools 4.Decreased hemoglobin

4 Ulcerative colitis is an inflammatory disease of the large colon. Findings associated with ulcerative colitis include diarrhea with up to 10 to 20 liquid bloody stools per day, weight loss, anorexia, fatigue, increased white blood cell count, increased erythrocyte sedimentation rate, dehydration, hyponatremia, and hypokalemia (not hypercalcemia). Because of the loss of blood, clients with ulcerative colitis commonly have decreased hemoglobin and hematocrit levels. Clients with ulcerative colitis have bloody diarrhea, not steatorrhea (fatty, frothy, foul-smelling stools).

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.Hematuria and urgency 3.Dysuria and proteinuria 4.Dysuria and penile discharge

4 Urethritis in the male client often results from chlamydial infection and is characterized by dysuria, which is accompanied by a clear to mucopurulent discharge. Because this disorder often coexists with gonorrhea, diagnostic tests are done for both and include culture and rapid assays. Hematuria is not associated with urethritis. Pyuria is a condition where the urine contains white blood cells. Proteinuria is associated with kidney dysfunction.

A client undergoing hemodialysis begins to experience muscle cramping. What is the bestaction by the hemodialysis nurse in this situation? 1.Administer hypotonic saline. 2.Administer magnesium sulfate. 3.Increase the ultrafiltration rate. 4.Decrease the ultrafiltration rate.

4 muscle cramps during hemodialysis result from either too rapid removal of water and sodium or neuromuscular hypersensitivity

A client with severe back pain and hematuria is found to have hydronephrosis due to urolithiasis. The nurse anticipates which treatment will be done to relieve the obstruction? Select all that apply. 1.Peritoneal dialysis 2.Analysis of the urinary stone 3.Intravenous opioid analgesics 4.Insertion of a nephrostomy tube 5.Placement of a ureteral stent with ureteroscopy

4,5 Urolithiasis is the condition that occurs when a stone forms in the urinary system. Hydronephrosis develops when the stone has blocked the ureter and urine backs up and dilates and damages the kidney. Priority treatment is to allow the urine to drain and relieve the obstruction in the ureter. This is accomplished by placement of a percutaneous nephrostomy tube to drain urine from the kidney and placement of a ureteral stent to keep the ureter open. Peritoneal dialysis is not needed since the kidney is functioning. Stone analysis will be done later when the stone has been retrieved and analyzed. Opioid analgesics are necessary for pain relief but do not treat the obstruction.

A client with severe back pain and hematuria is found to have hydronephrosis due to urolithiasis. The nurse anticipates which treatment will be done to relieve the obstruction? Select all that apply. 1.Peritoneal dialysis 2.Analysis of the urinary stone 3.Intravenous opioid analgesics 4.Insertion of a nephrostomy tube 5.Placement of a ureteral stent with ureteroscopy

4,5 Urolithiasis is the condition that occurs when a stone forms in the urinary system. Hydronephrosis develops when the stone has blocked the ureter and urine backs up and dilates and damages the kidney. Priority treatment is to allow the urine to drain and relieve the obstruction in the ureter. This is accomplished by placement of a percutaneous nephrostomy tube to drain urine from the kidney and placement of a ureteral stent to keep the ureter open. Peritoneal dialysis is not needed, since the kidney is functioning. Stone analysis will be done later when the stone has been retrieved and analyzed. Opioid analgesics are necessary for pain relief but do not treat the obstruction.

A client with liver dysfunction has low serum levels of fibrinogen and a prolonged prothrombin time (PT). Based on these findings, which actions should the nurse plan to promote client safety? Select all that apply. 1.Monitor serum potassium levels. 2.Weigh client daily, and monitor trends. 3.Monitor for symptoms of fluid retention. 4.Provide the client with a soft toothbrush. 5.Instruct the client to use an electric razor. 6.Monitor all secretions for frank or occult blood.

4,5,6 Fibrinogen is produced by the liver and is necessary for normal clotting. A client who has insufficient levels is at risk for bleeding. The PT is prolonged when one or more of the clotting factors (II, V, VII, or X) is deficient, so the client's risk for bleeding is also increased. A soft toothbrush, an electric razor, and monitoring secretions for evidence of bleeding are measures that provide for client safety.

The nurse is teaching the client with viral hepatitis about the stages of the disease. The nurse should explain to the client that the second stage of this disease is characterized by which specific assessment findings? Select all that apply. 1.Jaundice 2.Flu-like symptoms 3.Clay-colored stools 4.Elevated bilirubin levels 5.Dark or tea-colored urine

EVERYTHING EXCEPT flu like

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, the nurse determines that the client should be questioned about the use of which medication? 1.Diuretics 2.Antibiotics 3.Antilipemics 4.Decongestants

In the client with benign prostatic hyperplasia, episodes of urinary retention can be triggered by certain medications, such as decongestants, anticholinergics, and antidepressants. These medications lessen the voluntary ability to contract the bladder. The client should be questioned about the use of these medications if he has urinary retention. Diuretics increase urine output. Antibiotics and antilipemics do not affect ability to urinate.