Test 2 PrepU (Ch 4,8-11, 26-28, 32-34), Resp., renal, reprod., A/B

Patients with advanced COPD experience progressive inactivity, exercise intolerance, and disability. The nurse must carefully monitor the exercise tolerance of patients taking:

Corticosteroids are associated with myopathy, especially in leg muscles.

You are performing pulmonary function studies on clients in the clinic. What position do you know a client should be in to have maximum lung capacities and volumes?

In the standing position or sitting upright

Which of the following is as integumentary manifestation of chronic renal failure?

Integumentary manifestations of chronic renal failure include a gray-bronze skin color and ecchymosis. Asterixis, tremors, and seizures are neurological manifestations of chronic renal failure.

A patient who wears contact lenses is to be placed on rifampin for tuberculosis therapy. What should the nurse tell the patient?

"You should switch to wearing your glasses while taking this medication." The nurse informs the patient that rifampin may discolor contact lenses and that the patient may want to wear eyeglasses during treatment.

A creatinine clearance test has been ordered. The nurse prepares to:

A creatinine clearance test is a 24-hour urine test and is useful in evaluating renal disease.

Wound drains, inserted during the laryngectomy, stay in place until what criteria are met?

Drains are removed when secretions are minimal, which usually is less than 30 mL for 48 straight hours.

A female client who is diagnosed with calcium oxalate stones is instructed to limit calcium intake. The client is informed that she should consume ____________ mg/ day, or less, of calcium as part of her dietary treatment.

1000: The pH of the urine needs to be adjusted so that urinary salts remain in a solution form and thereby, prevent the formation of stones. Therefore, in the case of clients who suffer from calcium oxalate stones, it is important to limit calcium intake to 1000mg/day or less.

Assessment of a client reveals evidence of a cystocele. The nurse interprets this as which of the following?

A cystocele is the bulging of the bladder into the vagina. A rectocele is a herniation of the rectum into the vagina. An enterocele is a protrusion of the intestinal wall into the vagina. An uterovaginal prolapse is the downward displacement of the cervix anywhere from low in the vagina to outside the vagina.

Emphysema is described by?

A disease of the airways characterized by destruction of the walls of overly distended alveoli. Emphysema is a category of COPD. Asthma has a clinical outcome of airflow obstruction. Bronchitis includes the presence of cough and sputum production for at least a combined total of 2 to 3 months in each of two consecutive years. Bronchiectasis is a condition of chronic dilatation of a bronchus or bronchi.

A patient presented to a clinic with a cough suggestive of pneumonia. Which of the following describes the expected characteristic of the cough?

A hacking cough may be suggestive of pneumonia. A dry and irritating cough can accompany an upper respiratory infection. Laryngotracheitis is associated with an irritative, high-pitched cough; a brassy cough is found with tracheal lesions.

A nurse practitioner examines a 23-year-old woman from the Middle East. She documents that the patient has type I female genital mutilation (FGM) and examines her for signs of vaginal cellulitis and infection. Type I FGM refers to which of the following?

A partial or total removal of the clitoris is a type 1 FGM that results in short-term or long-term complications.

A 32-year-old flight attendant is undergoing diagnostics due to a significant drop in renal output. The physician has scheduled an angiography and you are in the midst of completing client education about the procedure. The client asks what the angiography will reveal. What is your response, as her nurse?

A renal angiogram (renal arteriogram) provides details of the arterial supply to the kidneys, specifically the location and number of renal arteries (multiple vessels to the kidney are not unusual) and the patency of each renal artery.

Which of the following is used to identify vesicoureteral reflux?

A voiding cystourethrography is used as a diagnostic tool to identify vesicoureteral reflux. An IV urography may be used as the initial assessment of various suspected urologic problems, especially lesions in the kidneys and ureters, and it provides an approximate estimate of renal function. Renal angiography is used to evaluate renal blood flow, to differentiate renal cysts from tumors, to evaluate hypertension, and preoperatively for renal transplantation.

A history of infection specifically caused by group A beta-hemolytic streptococci is associated with which of the following disorders?

Acute glomerulonephritis is also associated with varicella zoster virus, hepatitis B, and Epstein-Barr virus. Acute renal failure is associated with hypoperfusion to the kidney, parenchymal damage to the glomeruli or tubules, and obstruction at a point distal to the kidney. Chronic renal failure may be caused by systemic disease, hereditary lesions, medications, toxic agents, infections, and medications. Nephrotic syndrome is caused by disorders such as chronic glomerulonephritis, systemic lupus erythematosus, multiple myeloma, and renal vein thrombosis.

A 64-year-old man is seeing his urologist for an annual check-up, post prostatectomy. The health care provider is concerned with the symptom he finds because it is considered diagnostic for bladder cancer. Which of the following signs/symptoms is diagnostic for bladder cancer?

Although flank pain may occur, the painless, gross hematuria is characteristic of bladder cancer.

A patient has an increase in blood osmolality when the nurse reviews the laboratory work. What can this increase indicate for the patient?

Antidiuretic hormone (ADH), also known as vasopressin, is a hormone that is secreted by the posterior portion of the pituitary gland in response to changes in osmolality of the blood. With decreased water intake, blood osmolality tends to increase, stimulating ADH release.

A client comes into the Emergency Department with epistaxis. What intervention should you perform when caring for a client with epistaxis?

Apply direct continuous pressure. The severity and location of bleeding determine the treatment of a client with epistaxis. To manage this condition, the nurse should apply direct continuous pressure to the nares for 5 to 10 minutes with the client's head tilted slightly forward. Application of a moustache dressing or a drip pad to absorb drainage, application of a nasal splint, and placement of the client in a semi-Fowler's position are interventions related to the management of a client with a nasal obstruction.

The nurse assigned to a patient with possible pulmonary edema assesses the patient's lungs. Using auscultation, she identifies a characteristic breath sound diagnostic of pulmonary edema. Which of the following describes that breath sound?

Auscultation reveals crackles in the lung bases (especially in the dependent lung areas) that rapidly progress toward the apices of the lungs. These crackles are caused by the movement of air through the alveolar fluid. The chest X-ray reveals increased interstitial markings, with or without cardiomegaly. The patient may have tachycardia. Pulse oximetry values begin to fall, and arterial blood gas analysis demonstrates worsening hypoxemia.

The nurse inspects the thorax of a patient with advanced emphysema. What does the nurse expect the chest configuration to be for this patient?

Barrel chest occurs as a result of overinflation of the lungs, which increases the anteroposterior diameter of the thorax. It occurs with aging and is a hallmark sign of emphysema and COPD. In a patient with emphysema, the ribs are more widely spaced and the intercostal spaces tend to bulge on expiration. Funnel chest occurs when there is a depression in the lower portion of the sternum. This may compress the heart and great vessels, resulting in murmurs. Funnel chest may occur with rickets or Marfan's syndrome. A pigeon chest occurs as a result of the anterior displacement of the sternum, which also increases the anteroposterior diameter. This may occur with rickets, Marfan syndrome, or severe kyphoscoliosis. Kyphoscoliosis is characterized by elevation of the scapula and a corresponding S-shaped spine. This deformity limits lung expansion within the thorax. It may occur with osteoporosis and other skeletal disorders that affect the thorax

A patient with urinary retention needs to undergo a procedure to insert an indwelling catheter. Which information should the nurse discuss with the physician before catheterization?

Before catheterization, the nurse should inquire about the type and size of the catheter to be used and if the catheter should be removed or retained in place after the bladder is empty. Inserting the nasogastric tube, administering enemas, and placing IV lines are measures that are taken during preoperative and postoperative preparation in the case of surgery.

Hyperkalemia is a serious side effect of acute renal failure. Identify the electrocardiogram (ECG) tracing that is diagnostic for hyperkalemia.

Characteristic ECG signs of hyperkalemia are tall, tented, or peaked T waves, absent P waves, and a widened QRS complex.

A patient has been diagnosed with a UTI and is prescribed an antibiotic. What first-line fluoroquinolone antibacterial agent for UTIs has been found to be significantly effective?

Ciprofloxacin (Cipro) is a fluoroquinolone used to treat UTIs. Co-trimoxazole (Bactrim, Septra) is a trimethoprim-sulfamethoxazole combination medication. Nitrofurantoin (Macrodantin, Furadantin) is an anti-infective urinary tract medication.

A client who has had a right orchiectomy is scheduled to undergo a retroperitoneal lymph node dissection. The client states, "I'm afraid I will have problems with impotency afterwards." Which of the following responses would be most appropriate?

Clients with nonseminomas usually undergo a radical, nerve-sparing, procedure known as retroperitoneal lymph node dissection (RPLND) within 6 weeks of an orchiectomy as well. RPLND decreases potential metastasis from the testis and the need for chemotherapy. If only one testis is removed, sexual activity, libido, and fertility usually are unaffected. After a radical lymph node dissection, libido and erections are preserved. Sperm banking is an option that needs to be addressed before medical or surgical treatment occurs. The client's ability to achieve an erection should be preserved. As a result, there shouldn't be a need for medications to help him achieve an erection.

The nurse expects that emergency medical treatment for epistaxis may include insertion of a cotton pledget moistened with:

Cotton applicators soaked in a vasoconstricting solution (ie, epinephrine, ephedrine, cocaine) may be inserted into the nose to reduce the blood flow.

The nurse is caring for a patient with a pulmonary disorder. What observation by the nurse is indicative of a very late symptom of hypoxia?

Cyanosis, a bluish coloring of the skin, is a very late indicator of hypoxia. The presence or absence of cyanosis is determined by the amount of unoxygenated hemoglobin in the blood. Cyanosis appears when there is at least 5 g/dL of unoxygenated hemoglobin.

A client with acute renal failure is undergoing dialysis for the first time. The nurse monitors the client closely for dialysis equilibrium syndrome, a complication that's most common during the first few dialysis sessions. Typically, dialysis equilibrium syndrome causes:

Dialysis equilibrium syndrome causes confusion, a decreasing level of consciousness, headache, and seizures. These findings, which may last several days, probably result from a relative excess of interstitial or intracellular solutes caused by rapid solute removal from the blood. The resultant organ swelling interferes with normal physiological functions. To prevent this syndrome, many dialysis centers keep first-time sessions short and use a reduced blood flow rate. Acute bone pain and confusion are associated with aluminum intoxication, another potential complication of dialysis. Weakness, tingling, and cardiac arrhythmias suggest hyperkalemia, which is associated with renal failure. Hypotension, tachycardia, and tachypnea signal hemorrhage, another dialysis complication.

A client has a full bladder. Which sound would the nurse expect to hear on percussion?

Dullness on percussion indicates a full bladder; tympany indicates an empty bladder. Resonance is heard over areas that are part air and part solid, such as the lungs. Flatness is heard over very dense tissue, such as the bone or muscle.

The nurse is preparing a patient for a gynecologic examination when the patient says, "I hope the exam doesn't hurt as much as intercourse with my husband does." What should the nurse document this finding as?

Dyspareunia (difficult or painful intercourse) can be superficial, deep, primary, or secondary and may occur at the beginning of, during, or after intercourse.

You are caring for a client who has been diagnosed with viral pneumonia. You are making a plan of care for this client. What nursing interventions would you put into the plan of care for a client with pneumonia?

Encourage increased fluid intake. The nurse places the client in semi-Fowler's position to aid breathing and increase the amount of air taken with each breath. Increased fluid intake is important to encourage because it helps to loosen secretions and replace fluids lost through fever and increased respiratory rate. The nurse monitors fluid intake and output, skin turgor, vital signs, and serum electrolytes. He or she administers antipyretics as indicated and ordered. Antibiotics are not given for viral pneumonia. The client's activity level is ordered by the physician, not decided by the nurse.

A nurse is caring for a client who had a stroke. Which nursing intervention promotes urinary continence?

Encouraging a daily fluid intake of at least 2 L helps fill the client's bladder, thereby promoting bladder retraining by stimulating the urge to void. The nurse shouldn't give the client soda before bedtime; soda acts as a diuretic and may make the client incontinent. The nurse should take the client to the bathroom or offer the bedpan at least every 2 hours throughout the day; twice per day is insufficient. Consultation with a dietitian won't address the problem of urinary incontinence.

After teaching a group of students about malignant bladder tumors, the instructor determines that the teaching was successful when the students identify which of the following clients as having the greatest risk for developing a malignant bladder tumor?

Environmental and occupational health hazards are associated with bladder tumors. Therefore, the client who smokes is at the greatest risk for a malignant tumor. The client with a history of untreated gonorrhea is most vulnerable to urethral strictures, while the client with a history of bladder inflammation may be vulnerable to interstitial cystitis. Finally, the client with sexually transmitted disease may be vulnerable to acquiring urethritis.

A physician stated to the nurse that the patient has fluid noted in the pleural space and will need a thoracentesis. The nurse would expect that the physician will document this fluid as which of the following?

Fluid accumulating within the pleural space is called a pleural effusion. A pneumothorax is air in the pleural space. A hemothorax is blood within the pleural space. Consolidation is lung tissue that has become more solid in nature due to collapse of alveoli or infectious process.

Patients with urolithiasis need to be encouraged to:

Fluids need to be increased up to 4 L/day to help prevent additional stone formation.

A patient expresses concerns about future reproduction after a surgery to correct the cancer of the testes and for whom treatment has proceeded without collecting and storing sperm. Which of the following alternatives should a nurse suggest to the patient?

For a patient after a surgery to correct the cancer of the testes and for whom treatment has proceeded without collecting and storing sperm, the nurse explains other pregnancy options, such as donor insemination or adoption. There is no reversal of surgery possible for cancer of the testes

A client reports urinary frequency, urgency, and dysuria. Which of the following would the nurse most likely suspect?

Frequency, urgency, and dysuria are commonly associated with urinary tract infection. Hesitancy and enuresis may indicate an obstruction. Oliguria or anuria and proteinuria might suggest acute renal failure. Nocturia is associated with nephrotic syndrome.

According to Healthy People 2010, which of the following is a major cause of chronic renal failure

Healthy People 2010 identifies diabetes (36%) and hypertension (24%) as the two major causes. Other causes include pyelonephritis, obstruction of the urinary tract, and infections.

A nurse takes the initial history of a patient who is being examined for cancer of the larynx. Select the sign that is considered an early clinical indicator.

Hoarseness of more than 2 weeks' duration occurs in the patient with cancer in the glottic area, because the tumor impedes the action of the vocal cords during speech. The voice may sound harsh, raspy, and lower in pitch. Later symptoms include dysphasia, dyspnea (difficulty breathing), unilateral nasal obstruction or discharge, persistent hoarseness, persistent ulceration, and foul breath. Cervical lymph adenopathy, unintentional weight loss, a general debilitated state, and pain radiating to the ear may occur with metastasis

A nurse is caring for a client who has a history of sleep apnea. The client understands the disease process when he says:

I should become involved in a weight loss program. Obesity and decreased pharyngeal muscle tone commonly contribute to sleep apnea; the client may need to become involved in a weight loss program. Using an inhaler won't alleviate sleep apnea, and the physician probably wouldn't order an inhaler unless the client had other respiratory complications. A high-protein diet and sleeping on the side aren't treatment factors associated with sleep apnea.

A nurse administers albuterol (Proventil), as ordered, to a client with emphysema. Which finding indicates that the drug is producing a therapeutic effect?

In a client with emphysema, albuterol is used as a bronchodilator. A respiratory rate of 22 breaths/minute indicates that the drug has achieved its therapeutic effect because fewer respirations are required to achieve oxygenation. Albuterol has no effect on pupil reaction or urine output. It may cause a change in the heart rate, but this is an adverse, not therapeutic, effect.

The client you are caring for has just been told they have advanced laryngeal cancer. What is the treatment of choice?

In more advanced cases, total laryngectomy may be the treatment of choice. Partial laryngectomy, laser surgery, and radiation therapy are not the treatment of choice for advanced cases of laryngeal cancer.

Which of the following causes should the nurse suspect in a client is diagnosed with intrarenal failure?

Intrarenal causes of renal failure include prolonged renal ischemia, nephrotoxic agents, and infectious processes such as acute glomerulonephritis.

A physician orders cystoscopy and random biopsies of the bladder for a client who reports painless hematuria. Test results reveal carcinoma in situ in several bladder regions. To treat bladder cancer, the client will have a series of intravesical instillations of bacillus Calmette-Guérin (BCG), administered 1 week apart. When teaching the client about BCG, the nurse should mention that this drug commonly causes:

Intravesical instillation of BCG commonly causes hematuria. Other common adverse effects of BCG include urinary frequency and dysuria. Less commonly, BCG causes cystitis, urinary urgency, urinary incontinence, urinary tract infection, abdominal cramps or pain, decreased bladder capacity, tissue in urine, local infection, renal toxicity, and genital pain. BCG isn't associated with renal calculi, delayed ejaculation, or impotence.

A male patient, who is 82 years of age, suffers from urinary incontinence. Which of the following factors should the nurse assess before beginning a bladder training program for the patient?

It is essential to assess the patient's physical and environmental conditions before beginning a bladder training program, because the patient may not be able to reach the bathroom in time. During the bladder training program, a change in environment may be an effective suggestion for the patient. It is not so essential to assess the patient's history of allergy, occupation, and smoking habits before beginning a bladder training program.

Your client has a history of hoarseness lasting longer than 2 weeks. The client is now complaining of feeling a lump in their throat. What would you suspect this client has?

Laryngeal cancer: Later, the client notes a sensation of swelling or a lump in the throat, followed by dysphagia and pain when talking. Hoarseness is not indicative of pharyngeal cancer; laryngeal polyps; or cancer of the tonsils.

Which of the following is a term used to describe excessive menstrual bleeding?

Menorrhagia is excessive menstrual bleeding. Amenorrhea is the absence of menses. Dysmenorrhea is painful menses; It is characterized by crampy pain that begins before or shortly after the onset of menstrual flow and continues for 48 to 72 hours. Metrorrhagia is excessive and prolonged menstrual bleeding.

When assessing the impact of medications on the etiology of ARF, the nurse recognizes which of the following as the drug that is not nephrotoxic?

Penicillin: The three nephrotoxic drugs are aminoglycerides.

A patient comes to the emergency department complaining of a knifelike pain when taking a deep breath. What does this type of pain likely indicate to the nurse?

Pleurisy. Pleuritic pain from irritation of the parietal pleura is sharp and seems to "catch" on inspiration; patients often describe it as being "like the stabbing of a knife." In carcinoma, the pain may be dull and persistent because the cancer has invaded the chest wall, mediastinum, or spine.

Which of the following is the hallmark of the diagnosis of nephrotic syndrome?

Proteinuria (predominantly albumin) exceeding 3.5 g per day is the hallmark of the diagnosis of nephrotic syndrome. Hypoalbuminemia, hypernatremia, and hyperkalemia may occur.

A patient with asthma is prescribed a short acting beta-adrenergic (SABA) for quick relief. Which of the following is the most likely drug to be prescribed?

Proventil, a SABA, is given to asthmatic patients for quick relief of symptoms. Atrovent is an anticholinergic. Combivent is a combination SABA/anticholinergic, and Flovent is a corticosteroid.

A client presents to the emergency department complaining of a dull, constant ache along the right costovertebral angle along with nausea and vomiting. The most likely cause of the client's symptoms is:

Renal calculi usually presents as a dull, constant ache at the costovertebral angle. The client may also present with nausea and vomiting, diaphoresis, and pallor. The client with an overdistended bladder and interstitial cystitis presents with dull, continuous pain at the suprapubic area that's intense with voiding. The client also complains of urinary urgency and straining to void. The client with acute prostatitis presents with a feeling of fullness in the perineum and vague back pain, along with frequency, urgency, and dysuria.

The nurse is participating in a bladder retraining program for a patient who had an indwelling catheter for 2 weeks. The nurse knows that, during this process, straight catheterization, after catheter-free intervals, can be discontinued when residual urine is:

Residual urine greater than 100 mL is considered diagnostic of urinary retention. Refer to Box 28-9 in the text.

A child is having an asthma attack and the parent can't remember which inhaler to use for quick relief. The nurse accesses the child's medication information and tells the parent to use which inhalant?

Short-acting beta2-adrenergic agonists (albuterol [AccuNeb, Proventil, Ventolin], levalbuterol [Xopenex HFA], and pirbuterol [Maxair]) are the medications of choice for relief of acute symptoms and prevention of exercise-induced asthma. Cromolyn sodium (Crolom, NasalCrom) and nedocromil (Alocril, Tilade) are mild to moderate anti-inflammatory agents and are considered alternative medications for treatment. These medications stabilize mast cells. These medications are contraindicated in acute asthma exacerbations. Long-acting beta2-adrenergic agonists are not indicated for immediate relief of symptoms. These include theophylline (Slo-Bid, Theo- Dur) and salmeterol (Serevent Diskus).

A patient has stage 3 chronic kidney failure. What would the nurse expect the patient's glomerular filtration rate (GFR) to be?

Stage 3 of chronic kidney disease is defined as having a GFR of 30-59 mL/min/1.73 m2

In which stage of COPD is the forced expiratory volume (FEV) less than 30%?

Stage III patients demonstrate an FEV less than 30% with respiratory failure or clinical signs of right heart failure. Stage II patients demonstrate an FEV of 30% to 80%. Stage I is mild COPD with an FEV less than 70%. Stage 0 is characterized by normal spirometry

The health care provider diagnosed a patient with subacute rhinosinusitis. The nurse knows that the inflammatory process had existed for:

Subacute rhinosinusitis is classified by the duration of the inflammatory process, which is normally for 4 to 12 weeks. Acute is less than 4 weeks and chronic is more than 12 weeks.

Which client would the nurse identify as being at highest risk for the development of testicular cancer?

Testicular cancer is most common in between 15 and 34 years of age and is the leading cause of cancer deaths in men between 25 to 34 years of age. Its incidence is higher in Caucasians and men with a history of cryptorchidism. Other clients at risk are those with a family history of the disease, those who are HIV-positive or have developed AIDS, and those who already have had cancer in one testicle.

A nurse is assigned to care for a patient with COPD. The doctor has ordered oxygen at 6 L/min. Which of the following does the nurse need to obtain to give the O2?

The Venturi mask is the most reliable and accurate method for delivering precise concentrations of oxygen through noninvasive means. It is used primarily for patients with COPD because it can accurately provide appropriate levels of supplemental oxygen, thus avoiding the risk of suppressing the hypoxic drive.

When a patient has undergone a laryngectomy and there is evidence of wound breakdown, the nurse monitors the patient very carefully because he or she is at high risk for

The carotid artery lies close to the stoma and may rupture from erosion if the wound does not heal properly. Pulmonary embolism is associated with immobility. Dehydration may lead to poor wound healing and breakdown. Pneumonia is a risk for any postoperative patient.

A nurse is teaching a female client with a history of multiple urinary tract infections (UTIs). Which statement indicates the client understands the teaching about preventing UTIs?

The client demonstrates understanding of teaching when she states that she should take vitamin C each day. Increasing vitamin C intake to at least 1,000 mg per day helps acidify the urine, decreasing the amount of bacteria that can grow. The client should wipe from front to back to avoid introducing bacteria from the anal area into the urethra. The client should shower, not bathe, to minimize the amount of bacteria that can enter the urethra. The client should increase her fluid intake, and void every 2 to 3 hours and completely empty her bladder. Holding urine in the bladder can cause the bladder to become distended, which places the client at further risk for UTI.

A client diagnosed with tuberculosis (TB) is taking medication for the treatment of TB. The nurse should instruct the client that he will be safe from infecting others approximately how long after initiation of the chemotherapy regimen?

The client needs to take the prescribed medications for approximately 2 to 3 weeks before discontinuing precautions against infecting others. Effectiveness of the drug therapy is determined by negative sputum smears obtained on three consecutive days. Although results can vary among clients, the majority respond to therapy within 2 to 3 weeks.

A group of students is reviewing the process of urine elimination. The students demonstrate understanding of the process when they identify which amount of urine as triggering the reflex?

The desire to urinate comes from the feeling of bladder fullness. A nerve reflex is triggered when approximately 150 to 200 mL of urine accumulates.

After teaching a group of students about how to perform peritoneal dialysis, which statement would indicate to the instructor that the students need additional teaching?

The dialysate should be warmed in a commercial warmer and never in a microwave oven. Strict aseptic technique is essential. The infusion clamp is opened during the infusion and clamped after the infusion. When the dwell time is done, the drain clamp is opened and the fluid is allowed to drain by gravity into the drainage bag.

A pneumothorax is a possible complication of COPD. Symptoms will depend on the suddenness of the attack and the size of the air leak. The most common, immediate symptom that should be assessed is:

The initial symptom is usually chest pain of sudden onset that leads to feelings of chest pressure, dyspnea, and tachycardia. A cough may be present.

The nurse notes that a patient who is retaining fluid had a 1-kg weight gain. The nurse knows that this is equivalent to about how many mL?

The most accurate indicator of fluid loss or gain in an acutely ill patient is weight. An accurate daily weight must be obtained and recorded. A 1-kg weight gain is equal to 1,000 mL of retained fluid.

A patient undergoes surgery for removing a malignant tumor, followed by a urinary diversion procedure. Which of the following postoperative procedures should the nurse perform?

The most important postoperative nursing management is to maintain skin and stomal integrity to avoid further complications, such as skin infections and urinary odor. Determining the patient's ability to manage stoma care, showing photographs, and suggesting a visit to a local ostomy group would be a part of the preoperative procedure.

A routine serum glucose analysis indicated the presence of renal glycosuria. The nurse knew that the serum glucose level was:

The normal serum glucose level ranges from about 80 to 110 mg/dL. Renal glycosuria occurs if the amount of glucose in the blood and the glomerular filtrate exceeds the amount that the tubules are able to reabsorb. Glycosuria is seen when the serum glucose level exceeds 180 mg/dL

A client is administered dialysate solution through an abdominal catheter. The nurse notices that the return flow rate is slow, so the nurse advises the client to move to the other side. However, even after changing the client's position, the nurse does not observe an increase in return flow. Which of the following actions should the nurse perform to help accelerate the return flow rate?

The nurse instills dialysate solution and clamps the tubing. If the return flow rate is slow, the nurse asks the client to move from side to side. If this maneuver is unsuccessful, the physician may need to reposition the catheter. The nurse should not tamper with the catheter settings, as this may worsen the client's condition or damage the apparatus. Also, stopping the process and resuming it after 5 minutes will not help increase the return flow of the dialysate.

The nurse assessed a 28-year-old woman who was experiencing dyspnea severe enough to make her seek medical attention. The history revealed no prior cardiac problems and the presence of symptoms for 6 months' duration. On assessment, the nurse noted the presence of both inspiratory and expiratory wheezing. Based on this data, which of the following diagnoses is likely?

The presence of both inspiratory and expiratory wheezing usually signifies asthma if the individual does not have heart failure.

Which of the following is a term used to describe excessive nitrogenous waster in the blood, as seen in acute glomerulonephritis?

The primary presenting features of acute glomerulonephritis are hematuria, edema, azotemia (excessive nitrogenous wastes in the blood), and proteinuria (>3 to 5 g/day).

When preparing a chest drainage system, the nurse would fill the water seal chamber to which mark?

The water seal chamber is filled with water to the 2 cm level. All other levels would be inappropriate to maintain adequate chest drainage.

A patient is having an MAG3 renogram and is informed that radioactive material will be injected to determine kidney function. What should the nurse instruct the patient to do during the procedure?

This relatively new scan is used to further evaluate kidney function in some centers. The patient is given an injection containing a small amount of radioactive material, which will show how the kidneys are functioning. The patient needs to lie still for about 35 minutes while special cameras take images.

A recent immigrant is diagnosed with pulmonary tuberculosis (TB). Which intervention is the most important for the nurse to implement with this client?

To lessen the spread of TB, everyone who had contact with the client must undergo a chest X-ray and TB skin test. Testing will help determine if the client infected anyone else. Teaching about the cause of TB, reviewing the risk factors, and the importance of testing are important areas to address when educating high-risk populations about TB before its development.

A client comes to the emergency department complaining of severe pain in the right flank, nausea, and vomiting. The physician tentatively diagnoses right ureterolithiasis (renal calculi). When planning this client's care, the nurse should assign the highest priority to which nursing diagnosis?

Ureterolithiasis typically causes such acute, severe pain that the client can't rest and becomes increasingly anxious. Therefore, the nursing diagnosis of Acute pain takes highest priority. Diagnoses of Risk for infection and Impaired urinary elimination are appropriate when the client's pain is controlled. A diagnosis of Imbalanced nutrition: Less than body requirements isn't pertinent at this time.

Which vitamin is usually administered with isoniazid (INH) to prevent INH-associated peripheral neuropathy?

Vitamin B6 (pyridoxine) is usually administered with INH to prevent INH-associated peripheral neuropathy. Vitamins C, D, and E are not appropriate.

A female patient undergoes dialysis as a part of treatment for kidney failure. The patient is administered heparin during dialysis to achieve therapeutic levels. Which of the following steps should the nurse take to allow heparin to be metabolized and excreted in the patient?

When heparin is administered to a patient during dialysis, it is very important not to administer injections for the next 2 to 4 hours. This restriction allows heparin to be metabolized and excreted. While caring for patients with chronic glomerulonephritis, the nurse should provide periods of rest throughout the day, with uninterrupted sleep at night. When obtaining vascular access, the nurse should avoid puncturing the same site used previously. Using dialysate solutions after 2 hours of dialysis will not allow heparin to be metabolized and excreted.

The nurse working in the radiology clinic is assisting with a pulmonary angiography. The nurse knows that when monitoring clients after a pulmonary angiography, what should the physician be notified about?

When monitoring clients after a pulmonary angiography, nurses must notify the physician about diminished or absent distal pulses, cool skin temperature in the affected limb, and poor capillary refill. When the contrast medium is infused, the client will sense a warm, flushed feeling.

When preparing a client for hemodialysis, which of the following would be most important for the nurse to do?

When preparing a client for hemodialysis, the nurse would need to check for a thrill or bruit over the vascular access site to ensure patency. Inspecting the catheter insertion site for infection, adding the prescribed drug to the dialysate, and warming the solution to body temperature would be necessary when preparing a client for peritoneal dialysis.

he nurse is assigned to care for a patient in the oliguric phase of kidney failure. When does the nurse understand that oliguria is said to be present?

When the urine output is less than 30 mL/h Oliguria is defined as urine output <0.5 mL/kg/h

A client regularly recognizes the sensation of needing to void but cannot control voiding in time to reach a toilet. How would the nurse document this type of incontinence?

With urge incontinence, the client experiences the urge to void but cannot control voiding in time to reach a toilet.

nurse is assisting with a subclavian vein central line insertion when the client's oxygen saturation drops rapidly. He complains of shortness of breath and becomes tachypneic. The nurse suspects the client has developed a pneumothorax. Further assessment findings supporting the presence of a pneumothorax include

diminished or absent breath sounds on the affected side. In the case of a pneumothorax, auscultating for breath sounds will reveal absent or diminished breath sounds on the affected side. Paradoxical chest wall movements occur in flail chest conditions. Tracheal deviation occurs in a tension pneumothorax. Muffled or distant heart sounds occur in cardiac tamponade.