Term 2 Cumulative Review

Which conditions can contribute to the formation of renal calculi? 1. protein in the urine 2. dehydration 3. iron deficiency 4. obesity

Dehydration; inadequate fluid intake and urinary stasis can promote the formation of renal calculi.

Which of the following is a risk factor for UTI? 1. COPD 2. diabetes mellitus 3. anemia 4. osteoporosis

Diabetes mellitus; there is an increased amount of glucose in the urine.

A nurse is reinforcing teaching with a client who is to perform manual peritoneal dialysis at home. The nurse should include which of the following instruction? 1. use clean technique when caring for the catheter 2. expect outflow solution to be cloudy after dwell time 3. sit in a chair when instilling the dialysate solution 4. instill the dialysate solution over 1 hour

Sit in a chair when instilling the dialysate solution; client should sit or be in fowlers position to facilitate inflow by gravity. Strict aseptic technique should be used. Cloudy, odorous outflow indicates infection (report immediately). Instill solution over approx. 10 minutes.

A nurse is caring for a client who is receiving treatment for a potassium level of 3.1. The nurse should identify a decrease in which of the following factors as a therapeutic response to therapy? 1. deep-tendon reflexes 2. appetite 3. bowel motility 4. urinary output

Urinary output; hypokalemia can cause polyuria, so decrease in urinary output is sign of effective treatment. Hypokalemia causes decreased in reflexes, bowel motility, and nausea and vomiting.

A nurse is collecting data from a client who has a sodium level of 128. Which of the following manifestations should the nurse expect? 1. hyporeflexia 2. headache 3. constipation 4. increased appetite

Headache; manifestations of hyponatremia are hyperreflexia, muscle twitching, tremors, neurologic manifestations such as headache, diarrhea, anorexia, nausea, vomiting.

Which of the following is an early manifestation of renal impairment? 1. diluted urine 2. yellowish-gray skin 3. muscle cramps 4. weight gain

Diluted urine; the kidneys are unable to concentrate urine

Which foods should be avoided when phosphorus is restricted for a chronic kidney disease client? (SATA) - Milk - Sunflower seeds - Orange juice - Frozen kale - Poultry

Milk, sunflower seeds, poultry. All animal products are high in phosphorus.

A nurse is assisting with the plan of care for a client who has a three-way urethral catheter connected to continuous bladder irrigation following a suprapubic and transurethral resection of the prostate. Which intervention should the nurse include in the plan of care?

Adjust the flow rate of irrigation fluid so that the urine is light pink; the purpose of a three-way catheter with irrigation is to promote hemostasis and urinary drainage.

A nurse is caring for a client who has cholelithiasis with bile duct obstruction. The nurse should expect which of the following findings when obtaining the client's urine specimen? 1. pale yellow 2. bright orange 3. red 4. amber

Amber; bilary obstruction will cause a backward flow of bile, which must be filtered out of the body by the kidneys.

A nurse is reviewing lab reports for a client who has chronic kidney disease. Which of the following should the nurse expect to find? 1. BUN 10, serum creatinine 0.3 2. BUN 45, serum creatinine 1.0 3. BUN 11, serum creatinine 10 4. BUN, serum creatinine 8

BUN 35, serum creatinine 8; the goal for the patient is the keep the BUN below 100 and creatinine below 8

A nurse is collecting data from a client who has a calcium level of 12. Which of the following manifestations should the nurse expect? 1. hypotension 2. decreased deep tendon reflexes 3. diarrhea 4. increased appetite

Decreased deep tendon reflexes; manifestations of hypercalcemia are hypertension, decreased deep tendon reflexes, constipation, anorexia, nausea, and vomiting

A nurse is collecting data from a client who has a sodium level of 155. Which of the following manifestations should the nurse expect? 1. cool, clammy skin 2. hypertension 3. increased salivation 4. decreased level of consciousness

Decreased level of consciousness; manifestations of hypernatremia are hot, dry skin, hypotension, increased thirst, decreased LOC from dehydration of brain cells.

A nurse is assisting with discharge of a client who is postoperative from a kidney transplant. The nurse should instruct the client that which of the following is an indication of rejection? 1. BUN 15 2. serum creatinine 0.9 3. decreased urine output 4. purulent drainage from the incision

Decreased urine output; indications of transplant rejection are elevated BUN, elevated creatinine, and decrease in urine output.

A nurse is caring for a client who has benign prostatic hyperplasia (BPH). Which of the following finding should the nurse expect? 1. urge incontinence 2. critically elevated prostate-specific antigen level 3. difficulty starting the flow or urine 4. painful urination

Difficulty starting the flow of urine; will experience hesitancy due to the enlargement of the prostate pressing on the urethra.

A nurse is reinforcing discharge teaching with a client about how to care for a newly created ileal conduit. Which of the following instructions should the nurse include in the teaching? 1. Change the ostomy pouch daily. 2. empty the ostomy pouch when it is 2/3 full 3. trim the opening of the ostomy seal to be 1/2 inch wider than the stoma. 4. apply lotion to the peristomal skin when changing the ostomy pouch.

Empty the ostomy pouch when it is 2/3 full; will prevent leakage, skin irritation, and infection. Ostomy pouch is changed every 3-7 days.

A nurse is collecting data for a middle aged client who has pyelonephritis. Which of the following finding should the nurse expect? 1. flank pain 2. hypotension 3. confusion 4. weight gain

Flank pain; due to inflammation in the kidney pelvis.

A nurse is monitoring a client following a hemodialysis treatment through an arteriovenous (AV) fistula. Which of the following findings should the nurse report to the provider? 1. BP 134/82 2. headache, restlessness 3. palpable thrill at the AV fistula access site 4. heart rate 65

Headache, restlessness; manifestations of disequilibrium syndrome, which occurs during or after hemodialysis due to rapid shifts of fluids, pH, and osmolarity. This can lead to seizures and coma and should be reported.

A nurse is reviewing lab test result from a client who has acute kidney injury. Which of the following findings should the nurse identify as expected for this condition? 1. hypokalemia 2. hypermagnesemia 3. hypercalcemia 4. hypophosphatemia

Hypermagnesemia; due to inability of the kidneys to filter waste products from the blood.

A nurse is collecting data from a client who has alcohol use disorder and is experiencing metabolic acidosis. Which of the following manifestations should the nurse expect? 1. cool, clammy skin 2. hyperventilation 3. increased blood pressure 4. bradycardia

Hyperventilation; the system attempts to compensate or return the pH to normal by increasing the rate and depth of respirations. Other manifestations are warm, flushed skin, hypotension, and tachycardia.

A nurse is assisting with the care of a client following a transurethral resection of the prostate and has an indwelling urinary catheter. Which of the following actions should the nurse take? 1. weigh the client weekly 2. irrigate the catheter as prescribed 3. instruct client to report an urge to urinate 4. instruct client to bear down as if to have a bowel movement every hour

Irrigate the catheter as prescribed; removes blood clots and maintain catheter patency.

A nurse is reinforcing teaching for a client who has chronic kidney disease about the process of continuous ambulatory peritoneal dialysis. Which of the following should the nurse include in the teaching? 1. the solution infuses using an infusion pump 2. it is the treatment of choice for those with a hx of abdominal trauma 3. it is continuous 24 hour a day, 7 days a week 4. it is suspended at the level of the umbilicus during the infusion

It is continuous 24 hours a day, 7 days a week; it has a swelling time of 4-8 hours before the fluid is drained.

A nurse assisting in the post-dialysis plan of care for a client who is receiving hemodialysis fro chronic kidney disease. Which of the following interventions should the nurse include in the plan of care? 1. Monitor client for HTN. 2. check client's temperature for hypothermia 3. Monitor client for bleeding 4. check the client for increased urine output

Monitor for bleeding; monitor for at least 1 hour after the procedure because heparin is administered during the hemodialysis treatment.

A nurse is caring for a client who is in the oliguric phase of acute kidney injury. Which of the following actions should the nurse take? 1. provide diet high in protein 2. provide ibuprofen for retroperitoneal discmfort 3. monitor intake and output hourly 4. encourage client to consume at least 2L of fluid daily

Monitor intake and output hourly; monitor for signs of fluid imbalance which includes I&O and daily weights. Notify provider if output is below 30mL/hour

A nurse is caring for a client who is receiving peritoneal dialysis. The nurse should monitor the client for which of the following manifestations of peritonitis? 1. hyperactive bowel sounds 2. nausea and vomiting 3. decreased heart rate 4. increased urinary output

Nausea and vomiting; manifestations are abdominal tenderness or pain, anorexia, nausea, vomiting, restlessness, and confusion.

Which foods should be avoided to limit potassium? (SATA) - orange juice - watermelon - corn flakes cereal - white rice

Orange juice, Bananas

A nurse is caring for a client who had a cholecystectomy and has a T-tube drain. Which of the following actions should the nurse take? 1. secure the tubing to the client's gown 2. place the client into Fowler's position 3. clamp the tubing when the client ambulates 4. apply a transparent dressing to the drain site

Place the client into Fowler's position; T-tube drains by gravity. Collection bag should be placed lower than the insertion site.

A nurse is collecting data on a client who has end-stage kidney disease. Which of the following is an expected finding? 1. hypokalemia 2. hypotension 3. euphoria 4. pruritus

Pruritus; uremic syndrome from the kidneys' poor ability to excrete waste.

The nurse should expect to find a decrease in which of the following serum lab values when caring for a client who has chronic glomerulonephritis? 1. potassium 2. phosphate 3. creatinine 4. RBC

RBC; there is a decreased production of erythropoietin

A nurse is reviewing the medical record of a client who has acute kidney injury. Which of the following should the nurse recognize as a potential causative factor? 1. Hx of chronic alcohol abuse 2. recent CT scan with contrast dye 3. Hx of HTN 4. recent hospital stay for DVT

Recent CT scan with contrast dye; contrast dye is a nephrotoxin and can result in acute tubular necrosis

A nurse is reinforcing dietary instructions with a client who has chronic kidney disease. Which of the following information should the nurse include? 1. maintain low carb diet 2. eliminate ingestion of foods high in protein 3. reduce intake of foods high in potassium 4. increase intake of sodium-containing food.

Reduce intake of foods high in potassium; potassium levels increase dangerously with impaired kidney function.

A nurse is preparing a client for a kidney biopsy. Which of the following actions should the nurse take? 1. instruct the client to remain NPO 8 hour before the procedure. 2. inform the client that the biopsy is performed while lying supine 3. administer a cleansing enema before the procedure 4. review coagulation studies before the procedure.

Review coagulation studies before the procedure; patient should be NPO 4-6 hr before procedure because of mild sedation. Procedure is performed while patient is prone. Coagulation studies are done because there is a risk of bleeding.

A nurse is reviewing admissio prescriptions for a client who has benign prostatic hyperplasia. Which of the following medications should the nurse expect to administer? 1. Doxepin 2. Oseltamivir 3. Silodosin 4. Ceftriaxone

Silodosin; silodosin is an alpha-adrenergic blocker medication used to treat BPH by relaxing smooth muscle to improve urine flow.

A nurse is reporting a client's serum potassium of 6.2. Which of the following medications should the nurse expect the provider to prescribe? 1. Acetylcysteine 2. potassium iodide 3. sodium polystyrene sulfonate 4. lactulose

Sodium polystyrene sulfonate (Kayexalate); absorbs potassium from within the large intestine.

A nurse is caring for a client who has paraplegia and is on an intermittent urinary catheterization program. Which of the following findings indicates to the nurse the need to catheterize the client? 1. urge incontinence 2. suprapubic discomfort 3. reflex incontinence 4. nocturnal enuresis

Suprapubic discomfort; indicator of bladder distention.

A nurse is collecting data from a client who has cystitis. Which of the following findings should the nurse expect? 1. suprapubic tenderness 2. oliguria 3. generalized edema 4. proteinuria

Suprapubic tenderness; there should be tenderness upon palpation of the bladder. Urinary urgency and frequency should be expected.

A nurse is reinforcing teaching to a client who is scheduled for an intravenous pyelogram. Which of the following should the nurse include in the teaching? 1. Omit daily dose of aspirin 2. take a laxative the evening before the procedure 3. expect to be drowsy for 24 hours following the procedure 4. you will feel cold chills after the dye has been injected

Take a laxative the evening before; stool or gas in bowel make it difficult to visualize the renal system during an IVP

A nurse is collecting data from a client who has a calcium level of 8. Which of the following manifestations should the nurse expect? 1. hypertension 2. tetany 3. constipation 4. negative chvostek sign

Tetany; manifestations of hypocalcemia are tetany, hypotension, diarrhea, and positive chvostek and trousseau signs.

A nurse is collecting data from an older adults client who reports a sudden onset or urinary incontinence. The nurse should collect additional data to determine if the client has which of the following conditions? 1. urolithiasis 2. uremia 3. diabetic nephropathy 4. UTI

UTI

A nurse is monitoring a client who is 12 hours postop following a colectomy. Which of the following should the nurse report to the provider? 1. Bowel sounds 10/min 2. potassium 3.7 3. urine output 48mL/2hour 4. Heart rate 90/min

Urine output 48mL/2hour; indicates hypovolemia and urinary retention. Bowel sounds might be reduced following the administration of general anesthesia.

A nurse is reinforcing teaching with a client about the oliguric phase of acute kidney injury. What should the nurse include in the teaching? 1. oliguric phase lasts for 2 days 2. begins within 1 month of the injury 3. urine output is less than 400mL per 24 hours 4. BUN and creatinine decreases during this phase

Urine output is less than 400mL per 24 hours; the phase lasts 10-14 days, occurs within 1 week, and will have an elevation in BUN and creatinine levels.

A nurse is reviewing lab findings for a client who had a urinalysis. Which finding should the nurse report to the provider? 1. dark amber color 2. pH 5.0 3. occasional casts 4. WBC 10

WBC 10; expected range is from 0 to 4.

A nurse in a provider's office is reinforcing teaching with a client who is to undergo a cystoscopy. Which of the following information should the nurse include in the teaching? 1. you can take a warm sitz bath after the procedure 2. you shouled expect to have dark red urine after the procedure 3. you can drink clear liquids up until the start of the procedure. 4. you will receive an intravenous dye before the procedure

You can take a warm sitz bath after the procedure; after the procedure there may be voiding discomfort. This will help alleviate the pain.