Urinary Disorders Questions

An alkaline-ash diet is prescribed for a client with renal calculi. Which diet menu does the nurse advise the client to select?

Chicken, rice, and cranberries -> A spinach salad, milk, and a banana Peanut butter sandwich, milk, and prunes Pasta with shrimp, tossed salad, and a plum

Which conditions places the client at risk for developing acute postrenal failure?

Dehydration -> Hydronephrosis Rhabdomyolysis Glomerulonephritis

The nurse is collecting data on a newly admitted client with a diagnosis of bladder cancer. Which sign/symptom should be noted first?

Dysuria Urgency Frequency Hematuria

The nurse has a prescription to collect a 24-hour urine specimen from a client. The unlicensed assistive personnel (UAP) has been instructed on the collection technique. Which action by the UAP demonstrates the UAP needs further teaching?

Places the specimen on ice Discards a urine specimen collected at the start time -> Asks the client to void, save the specimen, and note the start time Asks the client to save a sample voided at the end of the collection time

The use of peritoneal dialysis for the treatment of chronic kidney disease would be contraindicated for which clients?

The client with cataracts The client with varicose veins The client with type 2 diabetes mellitus -> The client with chronic obstructive pulmonary disease (COPD)

The nurse is evaluating the data results of a client with sepsis and acute kidney injury with related azotemia and oliguria. Which are the primary features of azotemia and oliguria? Select all that apply.

Vasoconstriction Increase in cardiac output -> Increase in serum creatinine -> Increase in blood urea nitrogen (BUN) -> Urine output less than 0.5 mL/kg/hour Glomerular filtration rate (GFR) of 80 mL/min

A female client has a prescription for a clean-catch urine culture. After providing a sterile specimen cup to the client, the nurse should give which instruction so that the specimen is collected properly?

Void into the container, saving the full amount of urine. Cleanse the labia using cleansing towels, position the container, and begin to void. -> Cleanse the labia using cleansing towels, begin to void into toilet, and then collect the specimen. Wipe the labia front to back with toilet paper and void into the sterile specimen container.

The nurse is caring for a hospitalized client following cystoscopy and is monitoring for signs of complications associated with the procedure. Which result noted in the first few hours following the procedure indicates the need to notify the registered nurse?

Yellow urine Pink-tinged urine Pale yellow urine -> Bloody urine with clots

The nurse documents that the urine collected from a client diagnosed with early stage polycystic kidney disease is dilute with a low-specific gravity. Based on this documentation, which specific gravity result was likely present?

-> 1.000 1.010 1.020 1.030

Aluminum hydroxide is prescribed for the client with chronic kidney disease (CKD). When should the nurse instruct the client to take this medication?

-> With meals At bedtime On an empty stomach In the morning on arising

The nurse is reinforcing dietary instructions to a client with renal calculi who must learn to eat an alkaline-ash diet. The nurse determines that the client has properly understood the information presented if the client chooses which selection from a diet menu?

Chicken, potatoes, and cranberries -> A spinach salad, milk, and a banana Peanut butter sandwich, milk, and prunes Linguini with shrimp, tossed salad, and a plum

A client arrives at the ambulatory care clinic with low abdominal pain. A routine urine specimen reveals hematuria. The client does not have a fever. The nurse should next ask the client about a history of which condition?

Pyelonephritis Glomerulonephritis Renal cancer in the client's family -> Blow or trauma to the bladder or abdomen

A client newly diagnosed with renal failure will be receiving peritoneal dialysis. During the infusion of the dialysate, the client complains of abdominal pain. Which action by the nurse is appropriate?

Stop the dialysis. Slow the infusion. Decrease the amount to be infused. -> Explain that the pain will subside after the first few exchanges.

The nurse provides home care instructions to a client undergoing hemodialysis with regard to care of an arteriovenous (AV) fistula. Which statement by the client indicates an understanding of the instructions?

-> "I should check the fistula every day by feeling it for a vibration." "I am glad that the laboratory will be able to draw my blood from the fistula." "I should wear a shirt with tight arms to provide some compression on the fistula." "I should check my blood pressure in the arm where I have my fistula every week."

A client diagnosed with chronic kidney disease is being treated at home with continuous ambulatory peritoneal dialysis. The client notes that there is a decrease in the catheter outflow following the prescribed 6-hour dwell time and calls the nurse to report this occurrence. The nurse should reinforce instructing the client to take which action?

-> Ambulate in the home. Immediately notify the health care provider. Perform straight catheterization of the bladder. Flush the peritoneal catheter with a thrombolytic medication.

The nurse is working with a client newly diagnosed with chronic kidney disease (CKD) to set up a schedule for hemodialysis. The client states, "This is impossible! How can I even think about leading a normal life again if this is what I'm going to have to do?" The nurse determines that the client is exhibiting which reaction?

-> Anger Depression Withdrawal Projection

A male client has a history of urinary tract infections due to urinary retention. Which intervention should the nurse implement to decrease the risk of infection?

-> Assist the client to stand for voiding. Withhold oral fluids after 6:00 ᴘᴍ daily. Teach the client to wash his hands properly. Ask the client to take his temperature daily.

The nurse is caring for the client with epididymitis. Which treatment modalities should be implemented? Select all that apply.

-> Bed rest -> Sitz bath -> Antibiotics Heating pad -> Scrotal elevation Frequent ambulation

After a renal biopsy, the client complains of pain at the biopsy site, which radiates to the front of the abdomen. Which would this indicate?

-> Bleeding Infection Renal colic Normal, expected pain

The nurse must ambulate a client who has a nephrostomy tube attached to a drainage bag. The nurse plans to do this most safely and effectively by performing which action?

-> Changing the drainage bag to a leg collection bag Hanging the drainage bag from a walker while ambulating Tying the drainage bag to the client's waist while ambulating Asking the client to hold the drainage bag lower than the level of the bladder

The nurse is assisting a client with cystitis to select foods that are appropriate for an acid-ash diet. The nurse encourages the client to eat which food?

-> Cheese Ice cream Garden peas Strawberries

A client is seen in the health care clinic and acute pyelonephritis is suspected. The nurse reviews the client's record and should expect to note which associated signs and symptoms documented? Select all that apply.

-> Chills Low-grade fever Pale, dilute urine -> General weakness -> Nausea and vomiting Flank pain on the unaffected side

A client with acute glomerulonephritis had a urinalysis sent to the laboratory. The report reveals that there is hematuria and proteinuria in the urine. The nurse interprets that these results are which?

-> Consistent with glomerulonephritis Inconsistent with glomerulonephritis Indicative of impending renal failure Unclear and no conclusion can be drawn

The nurse notes that a client's urinalysis report contains a notation of positive red blood cells (RBCs). The nurse interprets that this finding is unrelated to which item that is part of the client's medical record?

-> Diabetes mellitus History of kidney stones Concurrent anticoagulant therapy History of recent blow to the right flank

The nurse is speaking with a client who underwent a minimally invasive procedure treatment for recurrent urolithiasis. Which instructions are appropriate to reinforce in the teaching plan? Select all that apply.

-> Drink at least 3000 mL of fluid each day. Expect some intermittent hematuria to occur. -> Complete the full course of prescribed antibiotics. Take acetaminophen (Tylenol) if chills and fever occur. -> Filter urine and collect any stones to take to the urological health care provider.

The nurse suspects the client has a urinary tract infection (UTI). Which signs/symptoms suggest a UTI? Select all that apply.

-> Dysuria -> Hematuria -> Frequency -> Flank pain Polydipsia -> Cloudy urine

The nurse is reviewing the client's record and notes that the health care provider has documented that the client has a renal disorder. Which laboratory results would indicate a decrease in renal function? Select all that apply.

-> Elevated serum creatinine level Elevated thrombocyte cell count -> Decreased red blood cell (RBC) count Decreased white blood cell (WBC) count -> Elevated blood urea nitrogen (BUN) level

The nurse is providing instructions to the client regarding the complications of peritoneal dialysis. The nurse instructs the client that which symptom is likely associated with the onset of peritonitis?

-> Fever Fatigue Clear dialysate output Leaking around the catheter site

The nurse is assigned to care for a client who has returned to the nursing unit following a left nephrectomy. The nurse places the highest priority on monitoring which data?

-> Hourly urine output Oxygen saturation levels Ability to turn side to side Tolerance for sips of clear liquids

The nurse is admitting a client with chronic kidney disease (CKD) to the nursing unit. The nurse monitors the client for which frequent cardiovascular sign that occurs in CKD?

-> Hypertension Hypotension Tachycardia Bradycardia

The nurse is reinforcing dietary instructions to a client diagnosed with acute glomerulonephritis. The nurse determines that the client understands the information presented if the client states the intention to do which action?

-> Limit protein intake. Increase intake of high-fiber foods. Limit intake of magnesium-rich foods. Increase intake of potassium-rich foods.

A client with end stage kidney disease (ESKD) undergoes a surgical procedure to create an arteriovenous fistula for hemodialysis in the upper extremity. The nurse should take which actions when the client returns from surgery? Select all that apply.

-> Monitor pain and administer analgesics. -> Monitor bleeding and swelling at the site. Monitor for circulation above the fistula site. Measure the blood pressure in the arm every hour. -> Check for audible bruit and palpable thrill at the fistula site.

A client with end stage kidney disease (ESKD) begins peritoneal dialysis. The nurse observes for which signs/symptoms indicating peritonitis? Select all that apply.

-> Nausea and vomiting Poor dialysate outflow -> Abdominal tenderness -> Cloudy peritoneal effluent -> Oral temperature of 38° C Clear fluid leakage at the catheter exit site

A client contacts the health care provider's office to report she is not feeling well, has burning with urination, and suspects she may have a urinary tract infection. The nurse instructs the client to collect a urine specimen for testing. Which urinalysis findings indicate the presence of a urinary tract infection? Select all that apply.

-> Nitrites, present Turbidity, clear Ketones, moderate -> White blood cells, 10 -> Leukoesterase, present Specific gravity, 1.025

The nurse is evaluating the assessment of a client's arteriovenous fistula being used for hemodialysis. Which findings would prompt the nurse to notify the health care provider immediately? Select all that apply.

-> No thrill palpated at fistula site -> No bruit auscultated at the fistula site Dialysis treatment lasting longer than 3 hours -> Absent pulse distal to the arteriovenous fistula Fistula site transparent dressing last changed 8 days ago

A client hospitalized with urolithiasis has a sudden significant decrease in urine output. The nurse should perform which action?

-> Notify the registered nurse. Obtain a urine-specific gravity. Tell the client to drink increased fluids. Replace the Foley catheter with a new one.

A client who underwent a kidney transplant 6 months earlier is seen in the clinic for a routine monthly appointment. The nurse reviews how the client has been doing and observes for signs/symptoms of acute rejection. Which signs/symptoms suggest acute rejection of the transplanted kidney? Select all that apply.

-> Oliguria Swelling of the lips Tachypnea with wheezing -> Elevation of blood pressure over baseline -> Abdominal tenderness on the side of the kidney transplant -> Elevation of serum blood urea nitrogen (BUN) and creatinine

The nurse is assessing the patency of an arteriovenous fistula in the left arm of a client who is receiving hemodialysis for the treatment of chronic kidney disease. Which finding indicates that the fistula is patent?

-> Palpation of a thrill over the fistula Presence of a radial pulse in the left wrist Absence of a bruit on auscultation of the fistula Capillary refill less than 3 seconds in the nail beds of the left hand

A client who had a prostatectomy has learned perineal exercises to gain control of the urinary sphincter. The nurse determines that the client needs further teaching if the client states that he will perform which action as part of these exercises?

-> Perform the Valsalva maneuver. Tighten the muscles as if trying to prevent urination. Contract the abdominal, gluteal, and perineal muscles. Tighten the rectal sphincter while relaxing abdominal muscles.

A client with acute kidney injury (AKI) has been treated with sodium polystyrene sulfonate (Kayexalate) by mouth. The nurse evaluates this therapy as effective if which value is noted on follow-up laboratory testing?

-> Potassium, 4.9 mEq/L Sodium, 142 mEq/L Calcium, 9.8 mg/dL Phosphorus, 3.9 mg/dL

A client tells the nurse she completed an educational program to manage her stress incontinence but is now discouraged. Which information from the client indicates the need for further teaching? Select all that apply

-> She performs the Kegel exercises every other day. -> She quit drinking coffee with cream but drinks diet cola. She has decreased her caloric and fat intake to lose weight. She maintains her fluid intake to 3000mL of fluid daily. -> She has begun an exercise program that includes lifting weights.

A client is diagnosed with polycystic kidney disease, and the nurse provides information to the client about the treatment plan. The nurse determines that the client needs further teaching if the client states that which component is part of the treatment plan?

-> Sodium restriction Genetic counseling Increased water intake Antihypertensive medications

The nurse is assisting in planning a teaching session with a client diagnosed with urethritis caused by infection with Chlamydia. The nurse should plan to include which point in the teaching session?

-> The most serious complication of this infection is sterility. Sexual partners during the last 12 months should be notified and treated. Medication therapy should be continued for 2 months without interruption. The infection can be prevented by using spermicide to alter the pH in the perineal area.

A client with a history of prostatic hypertrophy has purchased the over-the-counter medication, diphenhydramine (Benadryl), to treat symptoms of a runny nose. The nurse explains to the client that this medication combined with prostatic hypertrophy could cause exacerbation of which symptom?

-> Urinary retention Lowered heart rate Excessive sweating Excessive drooling

The nurse is assigned to care for a client who has just returned to the nursing unit after having hemodialysis for the first time. The nurse monitors the client carefully for which signs and symptoms of disequilibrium syndrome?

-> Vomiting and headaches Lethargy and hypertension Hypertension and sleepiness Abdominal pain and hypotension

A client with chronic kidney disease has been on dialysis for 3 years. The client is receiving the usual combination of medications for the disease, including aluminum hydroxide as a phosphate-binding agent. The client now has mental cloudiness, dementia, and complaints of bone pain. Which does this data indicate?

Advancing uremia Phosphate overdose Folic acid deficiency -> Aluminum intoxication

A client with acute glomerulonephritis is admitted to the nursing unit. The nurse should plan to do which action immediately on admission?

Ambulate the client frequently. Encourage a diet that is high in protein. Monitor the temperature every 2 hours. -> Remove the water pitcher from the bedside.

The nurse is caring for a 58-year-old client with renal failure who is on peritoneal dialysis. Which finding is considered most important by the nurse, requiring health care provider notification? Refer to chart.

BUN: 40mg/dL Heart rate: 96 beats per minute -> WBC 15,000 cells/mL ECG: First-degree heart block

The nurse is caring for a client who received a recent kidney transplant. Besides actual rejection of the transplant, which are some of the most important complications this client is at risk for? Select all that apply.

Colitis -> Malignancies Respiratory disease -> Cardiovascular disease -> Susceptibility to infection -> Corticosteroid-related complications

A client has undergone a transurethral resection of the prostate (TURP) a few hours ago to treat symptoms of benign prostatic hypertrophy. The nurse notes bright red blood and clots in the urinary catheter drainage bag. Which response should be the nurse's initial action?

Contact the client's surgeon to report the bleeding. Remove a small amount of fluid from the retention bulb. -> Increase the flow rate of the continuous bladder irrigation. Remove the indwelling catheter and encourage increased oral fluids.

The nurse monitoring a client receiving peritoneal dialysis notes that the client's outflow is less than the inflow. The nurse should take which actions? Select all that apply.

Contact the health care provider (HCP). -> Check the level of the drainage bag. -> Reposition the client to his or her side. -> Place the client in good body alignment. -> Check the peritoneal dialysis system for kinks. Increase the flow rate of the peritoneal dialysis solution.

A client has epididymitis as a complication of a urinary tract infection (UTI). The nurse is giving the client instructions to prevent a recurrence. The nurse determines that the client needs further teaching if the client states the intention to do which?

Drink increased amounts of fluids. Limit the force of the stream during voiding. -> Continue to take antibiotics until all symptoms are gone. Use condoms to eliminate risk from chlamydia and gonorrhea.

A hemodialysis client with a left arm fistula is at risk for arterial steal syndrome. The nurse monitors this client for which signs/symptoms of this disorder?

Edema and purpura of the left arm Warmth, redness, and pain in the left hand Aching pain, pallor, and edema of the left arm -> Pallor, diminished pulse, and pain in the left hand

A male client is diagnosed with urethritis caused by chlamydial infection. The unlicensed assistive personnel (UAP) assigned to the client asks the nurse what measures are necessary to prevent a contraction of the infection during care. Which instruction should the nurse give the UAP?

Enteric precautions should be instituted for the client. Gloves and mask should be used when in the client's room. Contact isolation should be initiated because the disease is highly contagious. -> Standard precautions are sufficient because the infection is transmitted sexually.

The nurse is assisting in planning a diet for a client with acute kidney injury (AKI). The nurse plans to restrict which dietary component from this client's diet?

Fats Vitamins -> Potassium Carbohydrates

The nurse is monitoring an older client suspected of having a urinary tract infection (UTI) for signs of the infection. Which sign/symptom should occur first?

Fever Urgency -> Confusion Frequency

A client, who had experienced significant blood loss in an automobile crash, was admitted to the hospital 2 days earlier. The nurse observes the client for which signs/symptoms that indicate acute kidney injury (AKI)? Select all that apply.

Hematuria -> Elevated urine specific gravity Severe spasmodic pain radiating to the groin area -> Rising serum blood urea nitrogen (BUN) and creatinine levels -> Urine output averaging 25 mL per hour while receiving an intravenous infusion at 150 mL/hour

A male client has a tentative diagnosis of urethritis. The nurse collects data from the client knowing that which are signs/symptoms of this disorder?

Hematuria and pyuria Dysuria and proteinuria -> Dysuria and penile discharge Hematuria and penile discharge

A client with new-onset renal failure is having a first hemodialysis treatment. The nurse is especially careful to monitor the client for which signs/symptoms after the dialysis treatment?

Hypertension, tachycardia, and fever Hypotension, bradycardia, and hypothermia Restlessness, irritability, and generalized weakness -> Headache, decreasing level of consciousness, and seizures

A client newly diagnosed with chronic kidney disease has recently begun hemodialysis. Which are signs/symptoms of disequilibrium syndrome?

Hypertension, tachycardia, and fever Hypotension, bradycardia, and hypothermia Restlessness, irritability, and generalized weakness -> Headache, deteriorating level of consciousness, and twitching

A client has been diagnosed with pyelonephritis. The nurse interprets that which health problem has placed the client at risk for this disorder?

Hypoglycemia -> Diabetes mellitus Coronary artery disease Orthostatic hypotension

The nurse is reviewing the medical record of a client with a diagnosis of pyelonephritis. Which disorder noted on the client's record should the nurse identify as a risk factor for this disorder?

Hypoglycemia -> Diabetes mellitus Coronary artery disease Orthostatic hypotension

Which observations by the nurse caring for clients on a hospital medical-surgical unit should be immediately reported to the health care provider? Select all that apply.

Pink-colored urine voided by a client admitted for urolithiasis Mucous shreds noted in the urine of a client who has an ileal conduit -> New confused mental state and pulse rate of 106 beats per minute in a 72-year-old client No urinary output for 24 hours in a client who has hemodialysis 3 times weekly -> A volume of 105 mL of urine over 4 hours in the collection bag of a 1-day postoperative client

The nurse is admitting a client to the nursing unit who has returned from the postanesthesia care unit following prostatectomy. The client has a three-way Foley catheter with continuous bladder irrigation. The nurse should maintain the flow rate of the continuous bladder infusion to maintain which urine output characteristic?

Red Colorless Yellow with small clots -> Pale yellow or slightly pink

A client is admitted to the surgical nursing unit following transurethral resection of the prostate (TURP) for benign prostatic hypertrophy. The client has a bladder irrigation infusing, and output is light cherry colored. The blood pressure is 134/82 mm Hg, the pulse is 84 beats per minute, and the client is afebrile with a respiratory rate of 18 breaths per minute. The licensed practical nurse (LPN) assisting in caring for the client collects assessment data 1 hour after admission to the nursing unit. The LPN notifies the registered nurse (RN) if which is noted on data collection?

Red urine Pain related to bladder spasms Urinary output of 200 mL greater than intake -> Blood pressure of 102/50 mm Hg, pulse 110 beats per minute

A client who suffered a crush injury to the leg has a highly positive urine myoglobin level. The nurse plans to monitor this particular client carefully for signs of which complication?

Respiratory failure Brain attack (stroke) Myocardial infarction -> Acute tubular necrosis

A client is scheduled for intravenous pyelography (IVP). Which priority nursing action should the nurse take?

Restrict fluids. Administer a sedative. -> Determine a history of allergies. Administer an oral preparation of radiopaque dye.

The nurse is caring for a client who had a renal biopsy. Which interventions should the nurse include in the plan of care for the client after this procedure? Select all that apply.

Restricting fluids during the first 24 hours -> Administering pain medication as prescribed -> Monitoring vital signs and the puncture site frequently -> Testing serial urine samples with dipsticks for occult blood Ambulating the client in the room and hall for short dist

The nurse is assisting a client who is new to a low-potassium diet to select food items from the menu. Which food item is lowest in potassium and should be recommended to the client on this dietary restriction?

Spinach -> Lima beans Cantaloupe Strawberries

A client with prostatitis resulting from kidney infection has received instructions on management of the condition at home and prevention of recurrence. Which statement indicates that the client understood the instructions?

Stop antibiotic therapy when pain subsides. Exercise as much as possible to stimulate circulation. -> Use warm sitz baths and analgesics to increase comfort. Keep fluid intake to a minimum to decrease the need to void.

The nurse is caring for a client undergoing peritoneal dialysis. The nurse checks the client and notes that the drainage from the outflow catheter is cloudy. The nurse notifies the registered nurse and plans to take which action?

Stop the peritoneal dialysis. Institute hemodialysis temporarily. -> Obtain a culture and sensitivity of the drainage. Add antibiotics to the next several dialysis bags.

A client with benign prostatic hypertrophy (BPH) undergoes a transurethral resection of the prostate (TURP) and is receiving continuous bladder irrigations postoperatively. Which are the signs/symptoms of transurethral resection (TUR) syndrome?

Tachycardia and diarrhea -> Bradycardia and confusion Increased urinary output and anemia Decreased urinary output and bladder spasms

A client has just undergone renal biopsy. In planning care for this client, the nurse should avoid which intervention?

Test urine for occult blood periodically. Administer opioid analgesics as needed. -> Ambulate in the room and hall for short distances. Encourage fluids to at least 3 L in the first 24 hours.

A client with acute pyelonephritis is scheduled for a voiding cystourethrogram. Which information about this procedure should the nurse give to the client?

The client must lie on an x-ray table in a cold, barren room. -> The client must void while the micturition process is filmed. Radioactive material is injected into the bladder with a syringe. Radiopaque contrast is injected into the bloodstream with a syringe.

The use of peritoneal dialysis for the treatment of chronic kidney disease would be contraindicated for which client?

The client with hypothyroidism -> The client with severe emphysema The client with type 2 diabetes mellitus The client with severe peripheral vascular disease

The nurse is inspecting the stoma of a client after creation of an ureterostomy. Which appearance should the nurse expect to note?

A dry stoma A pale stoma A dark-colored stoma -> A red and moist stoma

A client who is performing peritoneal dialysis at home calls the clinic and reports that the outflow from the dialysis catheter seems to be decreasing in amount. The nurse appropriately asks which question first?

"Have you had any abdominal discomfort?" "Have you had any recurring bouts of diarrhea?" -> "Have you experienced any constipation recently?" "Have you had an increased amount of flatulence?"

Which statements indicate an understanding of the necessary dietary modifications of a client diagnosed with chronic kidney disease? Select all that apply.

"I should avoid coffee, and tea is preferable." -> "I should avoid eggs, and a bagel is preferable." "I should avoid salt, and soy sauce is preferable." "I should avoid salt, and salt substitutes are preferable." -> "I should consume approximately 40 g of protein daily." "I should avoid carbonated sodas, and milk is preferable."

A client has received instructions on self-management of peritoneal dialysis. The nurse determines that the client needs further teaching if the client makes which statement?

"I will monitor my weight daily." "I will take my vital signs daily." "I will use meticulous aseptic technique for dialysate bag changes." -> "I will use a strong adhesive tape to anchor the catheter dressing."

The nurse has reinforced instructions to the client with a cystocele about Kegel exercises. The nurse determines that the client has not fully understood the directions if the client makes which statement?

"Stop and start the stream of urine several times during a voiding." "Tighten perineal muscles for up to 10 seconds several times a day." "Tighten perineal muscles for up to 5 minutes three or four times a day." -> "Begin voiding and then stop the stream, holding residual urine for an hour."

The nurse is urging a client to cough and deep breathe after a nephrectomy. The client tells the nurse, "That's easy for you to say! You don't have to do this." The nurse interprets that the client's statement is likely a result of which contributing factor?

A stress response to the ordeal of surgery A latent fear of needing dialysis if the surgery is unsuccessful -> Pain that is intensified because the location of the incision is near the diaphragm Effects of circulating metabolites that have not been excreted by the remaining kidney

A client, on the waiting list for a renal transplant, receives a hemodialysis treatment. Which findings indicate to the nurse that the treatment has been effective? Select all that apply.

A thrill is palpable in the arteriovenous fistula. The client states he is fatigued and wants to sleep. -> Serum potassium level is within the normal range. -> The client's weight is 2 kilograms less than predialysis weight. -> Serum blood urea nitrogen (BUN) and creatinine levels are lower than predialysis.

The nurse is preparing a client scheduled for an intravenous pyelogram (IVP). The nurse should take which important action before the test?

Administer a sedative. Encourage fluid intake. -> Ask about allergies to iodine or shellfish. Administer an oral preparation of radiopaque dye.

A client's kidneys are retaining greater amounts of sodium. The nurse anticipates that the kidneys are also retaining greater amounts of which other substances?

Calcium and chloride Potassium and chloride -> Chloride and bicarbonate Aluminum and magnesium

The nurse is collecting data from a client with epididymitis. The nurse should expect to note which signs and symptoms of this problem?

Diarrhea, groin pain, and scrotal edema Fever, diarrhea, groin pain, and ecchymosis -> Fever, nausea and vomiting, and painful scrotal edema Nausea and vomiting, and scrotal edema with ecchymosis

The nurse is caring for a client with epididymitis. The nurse anticipates noting which group of findings on data collection?

Diarrhea, groin pain, and scrotal edema Fever, diarrhea, groin pain, and ecchymosis -> Fever, nausea and vomiting, and painful scrotal edema Nausea, vomiting, and scrotal edema with widespread ecchymosis

A client who has a cold is seen in the emergency department with an inability to void. Because the client has a history of benign prostatic hyperplasia (BPH), the nurse questions the client about use of which medication?

Diuretics Antibiotics Antitussives -> Decongestants

The client with chronic kidney disease who is scheduled for hemodialysis this morning is due to receive a daily dose of enalapril (Vasotec). When should the nurse plan to administer this medication?

During dialysis Just before dialysis The day after dialysis -> On return from dialysis

A client with chlamydial infection has received instructions on self-care and prevention of further infection. The nurse determines that the client needs further teaching if the client states which?

I will use latex condoms to prevent disease transmission. I will return to the clinic as requested for follow-up culture in 1 week. -> I will use an antibiotic prophylactically to prevent symptoms of Chlamydia. I will reduce the chance of reinfection by limiting the number of sexual partners.

The nurse is providing dietary instructions to a client with renal calculi, and the laboratory analysis has revealed that the calculus is composed of uric acid. The nurse tells the client that it would be helpful to make which dietary changes?

Increase intake of seafood in the diet. -> Increase intake of legumes in the diet. Include organ meat type foods in the diet. Increase intake of cranberries and citrus fruits.

The client with diabetes mellitus receiving peritoneal dialysis asks the nurse why it is important to leave the dialysate infused only for a specific amount of time. The nurse responds that not adhering to the dwell time can increase the risk of the client experiencing which complication?

Infection Fluid overload -> Hyperglycemia Disequilibrium syndrome

The nurse is instructing a client with diabetes mellitus about peritoneal dialysis. The nurse tells the client that it is important to maintain the dwell time for the dialysis at the prescribed time because of risk for which complication?

Infection Fluid overload -> Hyperglycemia Disequilibrium syndrome

The nurse is reinforcing instructions to a client about the types of fluids that assist in prevention and treatment of urinary tract infections (UTIs). The nurse instructs the client to consume which fluids? Select all that apply.

Milk Soda -> Prune juice -> Apple juice -> Cranberry juice

The nurse is collecting data from a client who has had benign prostatic hyperplasia (BPH) in the past. To determine if the client is currently experiencing exacerbation of BPH, the nurse should ask the client about the presence of which early symptom?

Nocturia Urinary retention Urge incontinence -> Decreased force in the stream of urine

A client has an arteriovenous (AV) shunt in place for hemodialysis. The nurse should take which priority precaution, knowing that bleeding is a potential complication?

Observe the site once per shift. Check the shunt for the presence of a bruit and thrill. Check the results of blood tests as they are prescribed. -> Ensure that small clamps are attached to the AV shunt dressing.

The nurse is caring for a client who has been diagnosed as having a kidney mass. The client asks the nurse the reason for a renal biopsy, when other tests such as computed tomography (CT) and ultrasound are available. In formulating a response, the nurse incorporates the knowledge that a renal biopsy serves which purpose?

Provides an outline of the renal vascular system Determines if the mass is growing rapidly or slowly -> Gives specific cytological information about the lesion Helps differentiate between a solid mass and a fluid-filled cyst

The spouse of a client with acute kidney injury secondary to heart failure asks the nurse how this could happen. The nurse plans to base a response in part on the fact that which statement is true?

The kidneys get fatigued from having to filter too much fluid. The kidneys can react adversely to moderate doses of furosemide (Lasix). The kidneys will shut down easily if serum levels of digoxin (Lanoxin) are high. -> The kidneys generally require and receive about 20% to 25% of the resting cardiac output.

The nurse is caring for a hemodialysis client who has been receiving treatment for several years and is not a candidate for kidney transplant. The nurse knows that the majority of deaths of hemodialysis clients are related to which causes? Select all that apply.

Trauma -> Stroke Malignancies -> Infectious complications -> Myocardial infarction (MI) Peptic ulcer disease (PUD)

A client complains of leaking urine whenever she sneezes, coughs, or laughs. The nurse recognizes that this report is consistent with which type of incontinence?

Urge -> Stress Reflex Functional

A long-term care nurse notes that a female client has leakage of urine when sneezing, coughing, or laughing. The nurse reports that this client has which type of incontinence?

Urge incontinence -> Stress incontinence Reflex incontinence Functional incontinence

The nurse is assessing a client with suspected acute kidney injury. Which finding would support a diagnosis of acute intrarenal failure?

Urine output of 30 mL/hr for the past 24 hours -> Urine analysis positive for casts and cellular debris Renal ultrasound indicating the presence of ureteral calculi Blood urea nitrogen (BUN) level of 48 mg/dL and creatinine level of 1.2 mg/dL

A client is admitted to the emergency department following a fall from a horse. The health care provider (HCP) prescribes the insertion of an indwelling urinary catheter. The nurse notes blood at the urinary meatus while preparing for the procedure. Which action should the nurse take?

Use a smaller catheter. -? Notify the health care provider. Administer pain medication before inserting the catheter. Use extra povidone-iodine solution in cleansing the meatus.