Test 4, part 2 bad day to be alive

The nurse is caring for a client who has just returned to the postsurgical unit following renal surgery. When assessing the client's output from surgical drains, the nurse should physically assess what parameter(s)? Select all that apply. A. Quantity of output B. Color of the output C. Visible characteristics of the output D. Specific gravity of the output E. Potential hydrogen (pH) of the output

A, B, C

A client with end-stage kidney disease is scheduled to begin hemodialysis. The nurse is working with the client to adapt the client's diet to maximize the therapeutic effect and minimize the risks of complications. The client's diet should include which of the following modifications? Select all that apply. A. Decreased protein intake B. Decreased sodium intake C. Increased potassium intake D. Fluid restriction E. Vitamin D supplementation

A, B, D

The nurse is planning client teaching for a client with end-stage kidney disease who is scheduled for the creation of a fistula. The nurse should teach the client what information about the fistula? A. "A vein and an artery in your arm will be attached surgically." B. "The arm should be immobilized for 4 to 6 days." C. "One needle will be inserted into the fistula for each dialysis treatment." D. "The fistula can be used 5 to 7 days after the surgery for dialysis treatment."

A. "A vein and an artery in your arm will be attached surgically."

A client with diabetic nephropathy has end-stage renal disease and is starting dialysis. What should the nurse teach the client about hemodialysis? A. "Hemodialysis is a treatment option that is usually required three times a week." B. "Hemodialysis is a program that will require you to commit to daily treatment." C. "This will require you to have surgery and a catheter will need to be inserted into your abdomen." D. "Hemodialysis is a treatment that is used for a few months until your kidney heals and starts to produce urine again."

A. "Hemodialysis is a treatment option that is usually required three times a week."

A client with cancer of the bladder has just returned to the unit from the PACU after surgery to create an ileal conduit. The client weighs 60 kg. The nurse is monitoring the client's urine output hourly and notifies the health care provider when the hourly output is less than what amount? A. 30 mL B. 50 mL C. 100 mL D. 125 mL

A. 30 mL

The nurse is caring for a client who has returned to the postsurgical suite after postanesthetic recovery from a nephrectomy. The nurse's most recent assessment reveals increased sedation, shortness of breath, hypotension, and low urine output over the last 2 hours. What is the nurse's best response? A. Assess the client for signs of bleeding and inform the primary provider. B. Perform a full neurological assessment and notify the primary care provider. C. Increase the frequency of taking vital signs, monitor urine output, and notify the provider. D. Palpate the client's torso bilaterally for flank pain and notify the primary care provider.

A. Assess the client for signs of bleeding and inform the primary provider.

The nurse is caring for a client postoperative day 4 following a kidney transplant. When assessing for potential signs and symptoms of rejection, what assessment should the nurse prioritize? A. Assessment of the quantity of the client's urine output B. Assessment of the client's incision C. Assessment of the client's abdominal girth D. Assessment for flank or abdominal pain

A. Assessment of the quantity of the client's urine output

A nurse is giving discharge instructions to a client following urodynamic testing. What are the priority topics to be addressed by the nurse? A. Beverage limitations, pain control, and urinary expectations B. Antibiotic adherence, carbohydrate restrictions, and urinary expectations C. Protein intake, mobility limitations, and urinary expectations D. Opioid usage, urinary expectations, fat and protein limitations

A. Beverage limitations, pain control, and urinary expectations

The nurse is caring for a client whose acute kidney injury (AKI) resulted from a prerenal cause. Which condition most likely caused this client's health problem? A. Burns B. Glomerulonephritis C. Ureterolithiasis D. Pregnancy

A. Burns

The nurse is assessing a client suspected of having developed acute glomerulonephritis. The nurse should expect to address what clinical manifestation that is characteristic of this health problem? A. Hematuria B. Precipitous decrease in serum creatinine levels C. Hypotension unresolved by fluid administration D. Glucosuria

A. Hematuria

A client is undergoing diagnostic testing for a suspected urinary obstruction. The nurse should know that incomplete emptying of the bladder due to bladder outlet obstruction can cause what issue? A. Hydronephrosis B. Nephritic syndrome C. Pyelonephritis D. Nephrotoxicity

A. Hydronephrosis

A nurse is working with a client who will undergo invasive urologic testing. The nurse has informed the client that slight hematuria may occur after the testing is complete. The nurse should recommend what action to help resolve hematuria? A. Increased fluid intake following the test B. Use of an over-the-counter (OTC) diuretic after the test C. Gentle massage of the lower abdomen

A. Increased fluid intake following the test

A client with end-stage renal disease receives continuous ambulatory peritoneal dialysis. The nurse observes that the dialysate drainage fluid is cloudy. What is the nurse's most appropriate action? A. Inform the health care provider and assess the client for signs of infection. B. Flush the peritoneal catheter with normal saline. C. Remove the catheter promptly and have the catheter tip cultured. D. Administer a bolus of IV normal saline as prescribed.

A. Inform the health care provider and assess the client for signs of infection.

The nurse and urologist have both been unsuccessful in catheterizing a client with a prostatic obstruction and a full bladder. What approach does the nurse anticipate the health care provider will use to drain the client's bladder? A. Insertion of a suprapubic catheter B. Scheduling the client immediately for a prostatectomy C. Application of warm compresses to the perineum to assist with relaxation D. Medication administration to relax the bladder muscles and reattempting catheterization in 6 hours

A. Insertion of a suprapubic catheter

The nurse has identified the nursing diagnosis of "Risk for Infection" in a client who undergoes peritoneal dialysis. What nursing action best addresses this risk? A. Maintain aseptic technique when administering dialysate. B. Wash the skin surrounding the catheter site with soap and water prior to each exchange. C. Add antibiotics to the dialysate as prescribed. D. Administer prophylactic antibiotics by mouth or IV as prescribed.

A. Maintain aseptic technique when administering dialysate.

A client with difficulty voiding and elevated BUN and creatinine values has been referred by the health care provider for further evaluation. The nurse should anticipate the use of what initial diagnostic test? A. Portable bladder ultrasound B. X-ray C. Computed tomography (CT) D. Nuclear scan

A. Portable bladder ultrasound

The nurse on a urology unit is working with a client who has been diagnosed with calcium oxalate renal calculi. When planning this client's health education, what nutritional guidelines should the nurse provide? A. Restrict protein intake as prescribed. B. Increase intake of potassium-rich foods. C. Follow a low-calcium diet. D. Encourage intake of food containing oxalates.

A. Restrict protein intake as prescribed.

The nurse who is leading a wellness workshop has been asked about actions to reduce the risk of bladder cancer. What health promotion action most directly addresses a major risk factor for bladder cancer? A. Smoking cessation B. Reduction of alcohol intake C. Maintenance of a diet high in vitamins and nutrients D. Vitamin D supplementation

A. Smoking cessation

A client with kidney stones is scheduled for extracorporeal shock wave lithotripsy (ESWL). What should the nurse include in the client's postprocedure care? A. Strain the client's urine following the procedure. B. Administer a bolus of 500 mL normal saline following the procedure. C. Monitor the client for fluid overload following the procedure. D. Insert a urinary catheter for 24 to 48 hours after the procedure.

A. Strain the client's urine following the procedure.

A 42-year-old woman comes to the clinic reporting occasional urinary incontinence when sneezing. The clinic nurse should recognize what type of incontinence? A. Stress incontinence B. Reflex incontinence C. Overflow incontinence D. Functional incontinence

A. Stress incontinence

The nurse is working with a client whose health history includes occasional episodes of urinary retention. What assessment finding would suggest that the client is currently retaining urine? A. The client's suprapubic region is dull on percussion. B. The client is uncharacteristically drowsy. C. The client claims to void large amounts of urine two to three times daily. D. The client takes a beta adrenergic blocker for the treatment of hypertension.

A. The client's suprapubic region is dull on percussion.

A client asks the nurse why kidney problems can cause gastrointestinal disturbances. What relationship should the nurse describe? A. The right kidney's proximity to the pancreas, liver, and gallbladder B. The indirect impact of digestive enzymes on renal function C. That the peritoneum encapsulates the GI system and the kidneys D. The left kidney's connection to the common bile duct

A. The right kidney's proximity to the pancreas, liver, and gallbladder

A female client has been prescribed a course of antibiotics for the treatment of a UTI. When providing health education for the client, the nurse should address what topic? A. The risk of developing a vaginal yeast infection as a consequence of antibiotic therapy B. The need to expect a heavy menstrual period following the course of antibiotics C. The risk of developing antibiotic resistance after the course of antibiotics D. The need to undergo a series of three urine cultures after the antibiotics have been completed

A. The risk of developing a vaginal yeast infection as a consequence of antibiotic therapy

Dipstick testing of an older adult client's urine indicates the presence of protein. Which statement is true of this assessment finding? A. This finding needs to be considered in light of other forms of testing. B. This finding is a risk factor for urinary incontinence. C. This finding is likely the result of an age-related physiologic change. D. This result confirms that the client has diabetes.

A. This finding needs to be considered in light of other forms of testing.

A nurse is caring for a 73-year-old client with a urethral obstruction related to prostatic enlargement. When planning this client's care, the nurse should be aware of the risk of what complication? A. Urinary tract infection B. Enuresis C. Polyuria D. Proteinuria

A. Urinary tract infection

The nurse is working on the renal transplant unit. To reduce the risk of infection in a client with a transplanted kidney, it is imperative for the nurse to take what action? A. Wash hands carefully and frequently. B. Ensure immediate function of the donated kidney. C. Instruct the client to wear a face mask. D. Bar visitors from the client's room.

A. Wash hands carefully and frequently.

A 52-year-old client is scheduled for diagnostic testing to address prolonged signs and symptoms of genitourinary dysfunction. What signs and symptoms are particularly suggestive of urinary tract disease? Select all that apply. A. Petechiae B. Pain C. Gastrointestinal symptoms D. Changes in voiding E. Jaundice

B, C, D

A client with gross hematuria has been admitted to a surgical floor in preparation for an upper cystoscopy in the morning. What post-procedure interventions would the nurse anticipate for this client? Select all that apply. A. Nothing by mouth (NPO) B. Intermittent straight catheterization C. Sedative agent administration D. Moist heat to abdomen E. Monitor for urinary retention

B, D, E

An inpatient client with acute kidney injury (AKI) has moderate edema to both legs. What resulting skin conditions would increase the client's likelihood of skin breakdown? Select all that apply. A. Atopic dermatitis B. Pruritus C. Psoriasis D. Urticaria E. Excoriation

B, E

A 76-year-old client with ESKD has been told by the health care provider that it is time to consider hemodialysis until a transplant can be found. The client tells the nurse about feeling unsure about undergoing a kidney transplant. What would be an appropriate response for the nurse to make? A. "The decision is certainly yours to make, but be sure not to make a mistake." B. "Kidney transplants in peoples your age are as successful as they are in younger clients." C. "I understand your hesitancy to commit to a transplant surgery. Success is relatively rare." D. "Have you talked this over with your family?"

B. "Kidney transplants in peoples your age are as successful as they are in younger clients."

The nurse is caring for a client recently diagnosed with renal calculi. The nurse should instruct the client to increase fluid intake to a level where the client produces at least how much urine each day? A. 1,250 mL B. 2,000 mL C. 2,750 mL D. 3,500 mL

B. 2,000 mL

A nurse on a busy medical unit provides care for many clients who require indwelling urinary catheters at some point during their hospital care. The nurse should recognize a heightened risk of injury associated with indwelling catheter use in which client? A. A client whose diagnosis of chronic kidney disease requires a fluid restriction B. A client who has Alzheimer disease and who is acutely agitated C. A client who is on bed rest following a recent episode of venous thromboembolism D. A client who has decreased mobility following a transmetatarsal amputation

B. A client who has Alzheimer disease and who is acutely agitated

The nurse coming on shift on the medical unit is taking a report on four clients. What client does the nurse know is at the greatest risk of developing ESKD? A. A client with a history of polycystic kidney disease B. A client with diabetes mellitus and poorly controlled hypertension C. A client who is morbidly obese with a history of vascular disorders D. A client with severe chronic obstructive pulmonary disease

B. A client with diabetes mellitus and poorly controlled hypertension

The critical care nurse is monitoring the client's urine output and drains following renal surgery. What should the nurse promptly report to the primary care provider? A. Increased pain on movement B. Absence of drain output C. Increased urine output D. Blood-tinged serosanguineous drain output

B. Absence of drain output

The nurse is caring for a client scheduled for renal angiography following a motor vehicle accident. What client preparation should the nurse most likely provide before this test? A. Administration of IV potassium chloride B. Administration of a laxative C. Administration of Gastrografin D. Administration of a 24-hour urine test

B. Administration of a laxative

The nurse has implemented a bladder retraining program for an older adult client. The nurse places the client on a timed voiding schedule and performs an ultrasonic bladder scan after each void. The nurse notes that the client typically has approximately 50 mL of urine remaining in the bladder after voiding. What would be the nurse's best response to this finding? A. Perform a straight catheterization on this client. B. Avoid further interventions at this time, as this is an acceptable finding. C. Place an indwelling urinary catheter. D. Press on the client's bladder in an attempt to encourage complete emptying.

B. Avoid further interventions at this time, as this is an acceptable finding.

The nurse is reviewing the electronic health record of a client with a history of incontinence. The nurse reads that the health care provider assessed the client's deep tendon reflexes. What condition of the urinary/renal system does this assessment address? A. Renal calculi B. Bladder dysfunction C. Benign prostatic hyperplasia (BPH) D. Recurrent urinary tract infections (UTIs)

B. Bladder dysfunction

A 52-year-old client is scheduled to undergo ileal conduit surgery. When planning this client's discharge education, what is the most plausible nursing diagnosis that the nurse should address? A. Impaired mobility related to limitations posed by the ileal conduit B. Deficient knowledge related to care of the ileal conduit C. Risk for deficient fluid volume related to urinary diversion D. Risk for autonomic dysreflexia related to disruption of the sacral plexus

B. Deficient knowledge related to care of the ileal conduit

A client being treated in the hospital has been experiencing occasional urinary retention. What voiding trigger technique would help this client? A. Using a bedpan instead of a commode B. Dipping the client's hands in warm water C. Performing a bladder scan after voiding D. Encouraging male clients to use a urinal in bed

B. Dipping the client's hands in warm water

A client has undergone the creation of an Indiana pouch for the treatment of bladder cancer. The nurse identified the nursing diagnosis of "disturbed body image." How can the nurse best address the effects of this urinary diversion on the client's body image? A. Emphasize that the diversion is an integral part of successful cancer treatment. B. Encourage the client to speak openly and frankly about the diversion. C. Allow the client to initiate the process of providing care for the diversion. D. Provide the client with detailed written materials about the diversion at the time of discharge.

B. Encourage the client to speak openly and frankly about the diversion.

A client is being treated for AKI and the client daily weights have been ordered. The nurse notes a weight gain of 3 pounds (1.4 kg) over the past 48 hours. What nursing diagnosis is suggested by this assessment finding? A. Imbalanced nutrition: More than body requirements B. Excess fluid volume C. Sedentary lifestyle D. Adult failure to thrive

B. Excess fluid volume

Resection of a client's bladder tumor has been incomplete and the client is preparing for the administration of the first ordered instillation of topical chemotherapy. When preparing the client, the nurse should emphasize the need to do which of the following? A. Remain NPO for 12 hours prior to the treatment. B. Hold the solution in the bladder for 2 hours before voiding. C. Drink the intravesical solution quickly and on an empty stomach. D. Avoid acidic foods and beverages until the full cycle of treatment is complete.

B. Hold the solution in the bladder for 2 hours before voiding.

A client has been successfully treated for kidney stones and is preparing for discharge. The nurse recognizes the risk of recurrence and has planned the client's discharge education accordingly. What preventive measure should the nurse encourage the client to adopt? A. Increasing intake of protein from plant sources B. Increasing fluid intake C. Adopting a high-calcium diet D. Eating several small meals each day

B. Increasing fluid intake

A nurse who provides care in a long-term care facility is aware of the high incidence and prevalence of urinary tract infections among older adults. What action has the greatest potential to prevent UTIs in this population? A. Administer prophylactic antibiotics as prescribed. B. Limit the use of indwelling urinary catheters. C. Encourage frequent mobility and repositioning. D. Toilet residents who are immobile on a scheduled basis.

B. Limit the use of indwelling urinary catheters.

A client is brought to the renal unit from the PACU status postresection of a renal tumor. Which of the following nursing actions should the nurse prioritize in the care of this client? A. Increasing oral intake B. Managing postoperative pain C. Managing dialysis D. Increasing mobility

B. Managing postoperative pain

A client is scheduled for a CT scan of the abdomen with contrast. The client has a baseline creatinine level of 2.3 mg/dL (203 mol/L). In preparing this client for the procedure, the nurse anticipates what orders? A. Monitor the client's electrolyte values every hour before the procedure. B. Provide adequate hydration before the procedure C. Start hemodialysis immediately prior to the CT scan D. Obtain a creatinine clearance by collecting a 24-hour urine specimen.

B. Provide adequate hydration before the procedure

A client with recurrent urinary tract infections has just undergone a cystoscopy and reports slight hematuria during the first void after the procedure. What is the nurse's most appropriate action? A. Administer a STAT dose of vitamin K, as prescribed. B. Reassure the client that this is not unexpected and then monitor the client for further bleeding. C. Promptly inform the health care provider of this assessment finding. D. Position the client supine and insert a Foley catheter, as prescribed.

B. Reassure the client that this is not unexpected and then monitor the client for further bleeding.

A client is scheduled for a diagnostic MRI of the lower urinary system. What preprocedure education should the nurse include? A. The need to be NPO for 12 hours prior to the test B. Relaxation techniques to use during the test C. The need for conscious sedation prior to the test D. The need to limit fluid intake to 1 liter in the 24 hours before the test

B. Relaxation techniques to use during the test

A client with chronic kidney disease is completing an exchange during peritoneal dialysis. The nurse observes that the peritoneal fluid is draining slowly and that the client's abdomen is increasing in girth. What is the nurse's most appropriate action? A. Advance the catheter 2 to 4 cm further into the peritoneal cavity. B. Reposition the client to facilitate drainage. C. Aspirate from the catheter using a 60-mL syringe. D. Infuse 50 mL of additional dialysate.

B. Reposition the client to facilitate drainage.

A client with a diagnosis of respiratory acidosis is experiencing renal compensation. What function does the kidney perform to assist in restoring acid-base balance? A. Sequestering free hydrogen ions in the nephrons B. Returning bicarbonate to the body's circulation C. Retaining ammonium chloride D. Excreting bicarbonate in the urine

B. Returning bicarbonate to the body's circulation

A client with a sacral pressure ulcer has had a urinary catheter inserted. As a result of this new intervention, the nurse should prioritize what nursing diagnosis in the client's plan of care? A. Impaired physical mobility related to presence of an indwelling urinary catheter B. Risk for infection related to presence of an indwelling urinary catheter C. Deficient knowledge regarding indwelling urinary catheter care D. Disturbed body image related to urinary catheterization

B. Risk for infection related to presence of an indwelling urinary catheter

The clinic nurse is preparing a plan of care for a client with a history of stress incontinence. What role will the nurse have in implementing a behavioral therapy approach? A. Provide medication teaching related to pseudoephedrine sulfate. B. Teach the client to perform pelvic floor muscle exercises. C. Prepare the client for an anterior vaginal repair procedure. D. Provide information on periurethral bulking.

B. Teach the client to perform pelvic floor muscle exercises.

A client on the medical unit has a documented history of polycystic kidney disease (PKD). What principle should guide the nurse's care of this client? A. The disease is self-limiting and cysts usually resolve spontaneously in the fifth or sixth decade of life. B. The client's disease is incurable and the nurse's interventions will be supportive. C. The client will eventually require surgical removal of his or her renal cysts. D. The client is likely to respond favorably to lithotripsy treatment of the cysts.

B. The client's disease is incurable and the nurse's interventions will be supportive.

The nurse is teaching a health class of older adults about urinary tract infections (UTI)s. What characteristic of UTIs should the nurse cite? A. Men over age 65 are equally prone to UTIs as women, but are more often asymptomatic. B. The prevalence of UTIs in older men approaches that of women in the same age group. C. Men of all ages are less prone to UTIs, but typically experience more severe symptoms. D. The prevalence of UTIs in men cannot be reliably measured, as men generally do not report UTIs.

B. The prevalence of UTIs in older men approaches that of women in the same age group.

A nurse is caring for a female client whose urinary retention has not responded to conservative treatment. When educating this client about self-catheterization, the nurse should encourage what practice? A. Assuming a supine position for self-catheterization B. Using clean technique at home to catheterize

B. Using clean technique at home to catheterize

A client has been admitted to the medical unit with a diagnosis of ureteral colic secondary to urolithiasis. When planning the client's admission assessment, the nurse should be aware that what signs and symptoms are characteristic of this diagnosis? Select all that apply. A. Diarrhea B. High fever C. Hematuria D. Urinary frequency E. Acute pain

C, D, E

An older adult client diagnosed with cancer is admitted to the oncology unit for surgical treatment. The client has been on chemotherapeutic agents to decrease tumor size prior to the planned surgery. The nurse caring for the client is aware that what precipitating factors in this client may contribute to acute kidney injury (AKI)? Select all that apply. A. Anxiety and agitation B. Low body mass index (BMI) C. Age-related physiologic changes D. Chronic systemic disease E. Nothing by mouth (NPO) status

C, D, E

A nurse is aware of the high incidence and prevalence of fluid volume deficit among older adults. What related health education should the nurse provide to an older adult? A. "If possible, try to drink at least 4 liters of fluid daily." B. "Ensure that you avoid replacing water with other beverages." C. "Remember to drink frequently, even if you don't feel thirsty." D. "Make sure you eat plenty of salt in order to stimulate thirst."

C. "Remember to drink frequently, even if you don't feel thirsty."

A client is reporting genitourinary pain shortly after returning to the unit from a scheduled cystoscopy. What intervention should the nurse perform? A. Encourage mobilization. B. Apply topical lidocaine to the client's meatus, as prescribed. C. Apply moist heat to the client's lower abdomen. D. Apply an ice pack to the client's perineum.

C. Apply moist heat to the client's lower abdomen.

A nurse is working with a female client who has developed stress urinary incontinence. Pelvic floor muscle exercises have been prescribed by the primary care provider. How can the nurse best promote successful treatment? A. Clearly explain the potential benefits of pelvic floor muscle exercises. B. Ensure the client knows that surgery will be required if the exercises are unsuccessful. C. Arrange for biofeedback when the client is learning to perform the exercises. D. Contact the client weekly to ensure that they are performing the exercises consistently.

C. Arrange for biofeedback when the client is learning to perform the exercises.

The nurse is caring for an acutely ill client. What assessment finding should prompt the nurse to inform the health care provider that the client may be exhibiting signs of acute kidney injury (AKI)? A. An inability to initiate voiding for 2 days. B. The urine is cloudy and has visible sediment with a foul odor. C. Average urine output has been 10 mL/hr for several hours. D. Client reports left-sided flank pain.

C. Average urine output has been 10 mL/hr for several hours.

A client is admitted to the ICU after a motor vehicle accident. On the second day of the hospital admission, the client develops acute kidney injury. The client is hemodynamically unstable, and renal replacement therapy is needed to manage the client's hypervolemia and hyperkalemia. Which of the following therapies will the client's hemodynamic status best tolerate? A. Hemodialysis B. Peritoneal dialysis C. Continuous venovenous hemodialysis (CVVHD) D. Plasmapheresis

C. Continuous venovenous hemodialysis (CVVHD)

A nurse is caring for a client who is in the diuresis phase of acute kidney injury. The nurse should closely monitor the client for what complication during this phase? A. Hypokalemia B. Hypocalcemia C. Dehydration D. Acute flank pain

C. Dehydration

A female client has been experiencing recurrent urinary tract infections. What health education should the nurse provide to this client? A. Bathe daily and keep the perineal region clean. B. Avoid voiding immediately after sexual intercourse. C. Drink liberal amounts of fluids. D. Void at least every 6 to 8 hours.

C. Drink liberal amounts of fluids.

The nurse is caring for a client with an indwelling urinary catheter. The nurse is aware that what nursing action helps prevent infection in a client with an indwelling catheter? A. Vigorously clean the meatus area daily. B. Apply powder to the perineal area twice daily. C. Empty the drainage bag at least every 8 hours. D. Irrigate the catheter every 8 hours with normal saline.

C. Empty the drainage bag at least every 8 hours.

The nurse is caring for a client in acute kidney injury (AKI). Which complication would most clearly warrant the administration of polystyrene sulfonate? A. Hypernatremia B. Hypomagnesemia C. Hyperkalemia D. Hypercalcemia

C. Hyperkalemia

A client has had a indwelling urinary catheter removed after having it in place for 10 days during recovery from an acute illness. Two hours after removal of the catheter, the client informs the nurse that the client is experiencing urinary urgency resulting in several small-volume voids. What is the nurse's best response? A. Inform the client that urgency and occasional incontinence are expected for the first few weeks post-removal. B. Obtain an order for a loop diuretic in order to enhance urine output and bladder function. C. Inform the client that this is not unexpected in the short term and scan the client's bladder following each void. D. Obtain an order to reinsert the client's urinary catheter and attempt removal in 24 to 48 hours.

C. Inform the client that this is not unexpected in the short term and scan the client's bladder following each void.

The nurse is caring for a client who has undergone creation of a urinary diversion. Forty-eight hours postoperatively, the nurse's assessment reveals that the stoma is a dark purplish color. What is the nurse's most appropriate response? A. Document the presence of a healthy stoma. B. Assess the client for further signs and symptoms of infection. C. Inform the primary care provider that the vascular supply may be compromised. D. Liaise with the wound-ostomy-continence (WOC) nurse because the ostomy appliance around the stoma may be too loose.

C. Inform the primary care provider that the vascular supply may be compromised.

The nurse is creating an education plan for a client who underwent a nephrectomy for the treatment of a renal tumor. What should the nurse include in the teaching plan? A. The importance of increased fluid intake B. Signs and symptoms of rejection C. Inspection and care of the incision D. Techniques for preventing metastasis

C. Inspection and care of the incision

The nurse is caring for a client after kidney surgery. When assessing for bleeding, what assessment parameter should the nurse evaluate? A. Oral intake B. Pain intensity C. Level of consciousness D. Radiation of pain

C. Level of consciousness

The nurse is caring for a client who underwent percutaneous (endourologic) lithotripsy earlier in the day. What instruction should the nurse give the client? A. Limit oral fluid intake for 1 to 2 days. B. Report the presence of fine, sand-like particles through the nephrostomy tube. C. Notify the health care provider about cloudy or foul-smelling urine. D. Report any pink-tinged urine within 24 hours after the procedure.

C. Notify the health care provider about cloudy or foul-smelling urine.

A client with a recent history of nephrolithiasis has presented to the ED. After determining that the client's cardiopulmonary status is stable, what aspect of care should the nurse prioritize? A. IV fluid administration B. Insertion of an indwelling urinary catheter C. Pain management D. Assisting with aspiration of the stone

C. Pain management

The nurse is providing a health education workshop to a group of adults focusing on cancer prevention. The nurse should emphasize what action in order to reduce participants' risks of renal carcinoma? A. Avoiding heavy alcohol use B. Control of sodium intake C. Smoking cessation D. Adherence to recommended immunization schedules

C. Smoking cessation

A client has a glomerular filtration rate (GFR) of 43 mL/min/1.73 m2. Based on this GFR, the nurse interprets that the client's chronic kidney disease is at what stage? A. Stage 1 B. Stage 2 C. Stage 3 D. Stage 4

C. Stage 3

The nurse is caring for a client receiving hemodialysis three times weekly. The client has had surgery to form an arteriovenous fistula. What is most important for the nurse to be aware of when providing care for this client? A. Using a stethoscope for auscultating the fistula is contraindicated B. The client feels best immediately after the dialysis treatment C. Taking a BP reading on the affected arm can damage the fistula D. The client should not feel pain during initiation of dialysis

C. Taking a BP reading on the affected arm can damage the fistula

The nurse is caring for a client who had a brush biopsy 12 hours ago. The presence of what assessment finding should prompt the nurse to notify the health care provider? A. Scant hematuria B. Renal colic C. Temperature 37.9°C (100.2°F) orally D. Infiltration of the client's intravenous catheter

C. Temperature 37.9°C (100.2°F) orally

Results of a client's 24-hour urine sample indicate osmolality of 510 mOsm/kg (510 mmol/kg), which is within reference range. What conclusion can the nurse draw from this assessment finding? A. The client's kidneys are capable of maintaining acid-base balance. B. The client's kidneys reabsorb most of the potassium that the client ingests. C. The client's kidneys can produce sufficiently concentrated urine. D. The client's kidneys are producing sufficient erythropoietin.

C. The client's kidneys can produce sufficiently concentrated urine.

A client has been admitted to the postsurgical unit following the creation of an ileal conduit. What should the nurse measure to determine the size of the appliance needed? A. The circumference of the stoma B. The length, then double it C. The widest part of the stoma D. Half the width of the stoma

C. The widest part of the stoma

A client admitted to the medical unit with impaired renal function reports severe, stabbing pain in the flank and lower abdomen. The client is being assessed for renal calculi. The nurse recognizes that the stone is most likely in what anatomic location? A. Meatus B. Bladder C. Ureter D. Urethra

C. Ureter

A gerontologic nurse is assessing a client who has numerous comorbid health problems. What assessment finding(s) should prompt the nurse to suspect a UTI? Select all that apply. A. Food cravings B. Upper abdominal pain C. Insatiable thirst D. Fever E. New onset of confusion

D, E

What nursing action should the nurse perform when caring for a client undergoing diagnostic testing of the renal-urologic system? A. Withhold medications until 12 hours post-testing. B. Ensure that the client knows the importance of temporary fluid restriction after testing. C. Inform the client of the medical diagnosis after reviewing the results. D. Assess the client's understanding of the test results after their completion.

D. Assess the client's understanding of the test results after their completion.

The nurse is collaborating with the wound-ostomy-continence (WOC) nurse to teach a client how to manage a new ileal conduit in the home setting. To prevent leakage or skin breakdown, the nurse should encourage which of the following practices? A. Empty the collection bag when it is between one-half and two-thirds full. B. Limit fluid intake to prevent production of large volumes of dilute urine. C. Reinforce the appliance with tape if small leaks are detected. D. Avoid using moisturizing soaps and body washes when cleaning the peristomal area.

D. Avoid using moisturizing soaps and body washes when cleaning the peristomal area.

A client has presented with signs and symptoms that are characteristic of acute kidney injury, but preliminary assessment reveals no obvious risk factors for this health problem. The nurse should recognize the need to interview the client about what priority topic? A. Typical diet B. Allergy status C. Psychosocial stressors D. Current medication use

D. Current medication use

A client has a flaccid bladder secondary to a spinal cord injury. The nurse recognizes this client's high risk for urinary retention and should implement what intervention in the client's plan of care? A. Relaxation techniques B. Sodium restriction C. Lower abdominal massage D. Double voiding

D. Double voiding

An adult client has been hospitalized with pyelonephritis. The nurse's review of the client's intake and output records reveals that the client has been consuming between 3 L and 3.5 L of oral fluid each day since admission. How should the nurse best respond to this finding? A. Supplement the client's fluid intake with a high-calorie diet. B. Emphasize the need to limit intake to 2 L of fluid daily. C. Obtain an order for a high-sodium diet to prevent dilutional hyponatremia. D. Encourage the client to continue this pattern of fluid intake.

D. Encourage the client to continue this pattern of fluid intake.

A client admitted with nephrotic syndrome is being cared for on the medical unit. When writing this client's care plan, based on the major clinical manifestation of nephrotic syndrome, what nursing diagnosis should the nurse include? A. Constipation related to immobility B. Risk for injury related to altered thought processes C. Hyperthermia related to the inflammatory process D. Excess fluid volume related to generalized edema

D. Excess fluid volume related to generalized edema

The nurse is caring for a client who is going to have an open renal biopsy. What nursing action should the nurse prioritize when preparing this client for the procedure? A. Discuss the client's diagnosis with the family. B. Bathe the client before the procedure with antiseptic skin wash. C. Administer antivirals before sending the client for the procedure. D. Keep the client NPO prior to the procedure.

D. Keep the client NPO prior to the procedure.

The nurse performing the health interview of a client with a new onset of periorbital edema has completed a genogram, noting the health history of the client's siblings, parents, and grandparents. This assessment addresses the client's risk of what kidney disorder? A. Nephritic syndrome B. Acute glomerulonephritis C. Nephrotic syndrome D. Polycystic kidney disease (PKD)

D. Polycystic kidney disease (PKD)

A client is postoperative day 3 following the creation of an ileal conduit for the treatment of invasive bladder cancer. The client is quickly learning to self-manage the urinary diversion, but expresses concern about the presence of mucus in the urine. What is the nurse's most appropriate response? A. Report this finding promptly to the primary care provider. B. Obtain a sterile urine sample and send it for culture. C. Obtain a urine sample and check it for pH. D. Reassure the client that this is an expected phenomenon.

D. Reassure the client that this is an expected phenomenon.

A client with end stage renal disease (ESKD) is being treated for a right ankle fracture unrelated to a fall. The client's lab values show high phosphate levels, low calcium levels, and low vitamin D levels. What is the most likely reason for this client's fracture? A. Osteoporosis B. Codman triangle C. Hypertrophic osteoarthropathy D. Renal osteodystrophy

D. Renal osteodystrophy

A client has experienced excessive losses of bicarbonate and has subsequently developed an acid-base imbalance. How will this lost bicarbonate be replaced? A. The kidneys will excrete increased quantities of acid. B. Bicarbonate will be released from the adrenal medulla. C. Alveoli in the lungs will synthesize new bicarbonate. D. Renal tubular cells will generate new bicarbonate.

D. Renal tubular cells will generate new bicarbonate.

An older adult has experienced a new onset of urinary incontinence, and family members identify this problem as being unprecedented. When assessing the client for factors that may have contributed to incontinence, the nurse should prioritize what assessment? A. Reviewing the client's 24-hour food recall for changes in diet B. Assessing for recent contact with individuals who have UTIs C. Assessing for changes in the client's level of psychosocial stress D. Reviewing the client's medication administration record for recent changes

D. Reviewing the client's medication administration record for recent changes

A 15-year-old is admitted to the renal unit with a diagnosis of postinfectious glomerular disease. The nurse should recognize that this form of kidney disease may have been precipitated by what event? A. Psychosocial stress B. Hypersensitivity to an immunization C. Menarche D. Streptococcal infection

D. Streptococcal infection

A client's most recent laboratory findings indicate a glomerular filtration rate (GFR) of 58 mL/min. The nurse should recognize what implication of this diagnostic finding? A. The client is likely to have a decreased level of blood urea nitrogen (BUN). B. The client is at risk for hypokalemia. C. The client is likely to have irregular voiding patterns. D. The client is likely to have increased serum creatinine levels.

D. The client is likely to have increased serum creatinine levels.

A nurse's colleague has applied an incontinence pad to an older adult client who has experienced occasional episodes of functional incontinence. What principle should guide the nurse's management of urinary incontinence in older adults? A. Diuretics should be promptly discontinued when an older adult experiences incontinence. B. Restricting fluid intake is recommended for older adults experiencing incontinence. C. Urinary catheterization is a first-line treatment for incontinence in older adults with incontinence. D. Urinary incontinence is not considered a normal consequence of aging.

D. Urinary incontinence is not considered a normal consequence of aging.

A female client's most recent urinalysis results are suggestive of bacteriuria. When assessing this client, the nurse's data analysis should be informed by what principle? A. Most UTIs in female clients are caused by viruses and do not cause obvious symptoms. B. A diagnosis of bacteriuria requires three consecutive positive results. C. Urine contains varying levels of healthy bacterial flora. D. Urine samples are frequently contaminated by bacteria normally present in the urethral area.

D. Urine samples are frequently contaminated by bacteria normally present in the urethral area.

The nurse is caring for a client with a history of systemic lupus erythematosus who has been recently diagnosed with end-stage kidney disease (ESKD). The client has an elevated phosphorus level and has been prescribed calcium acetate to bind the phosphorus. The nurse should teach the client to take the prescribed medication at what time? A. Only when needed B. Daily at bedtime C. First thing in the morning D. With each meal

D. With each meal