URINARY SET NCLEX

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:

2. Acute tubular necrosis

nurse is monitoring an older client suspected of having a urinary tract infection (UTI) for signs of the infection. The nurse would be alert to the presence of:

3. Confusion

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

4. Decongestants

A client diagnosed with chronic renal failure 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 instruct the client to take which action?

1. Ambulate in the home.

A nurse is working with a client newly diagnosed with chronic renal failure (CRF) 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:

1. Anger

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?

1. Assist the client to stand for voiding.

A nurse has given 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 states to:

1. Begin voiding and then stop the stream, holding residual urine for an hour.

After a renal biopsy, the client complains of pain at the biopsy site, which radiates to the front of the abdomen. Based on this complaint, the nurse further monitors the client for:

1. Bleeding

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

3. Continue to take antibiotics until all symptoms are gone.

A client is scheduled for intravenous pyelography (IVP). Before the test, the priority nursing action would be to:

3. Determine a history of allergies.

A male client has a tentative diagnosis of urethritis. The nurse collects data from the client, knowing that which of the following are manifestations of the disorder?

3. Dysuria and penile discharge

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

3. Fever, nausea and vomiting, and painful scrotal edema

A nurse has a prescription to collect a 24-hour urine specimen from a client. The nurse should avoid which of the following errors in technique while completing this procedure?

4. Ask the client to void, save the specimen, and note the start time.

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

4. Bloody urine with clots

A nurse is assisting in planning a teaching session with a female client diagnosed with urethritis caused by infection with chlamydia. The nurse would plan to include which of the following points in the teaching session?

. The most serious complication of this infection is sterility.

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) immediately if which of the following is noted on data collection?

1. Blood pressure of 102/50 mm Hg, pulse 110 beats per minute

A nurse is encouraging a client, who is incontinent, to participate in recreational therapy. What nursing intervention would the nurse consider performing first?

1. Change the client's soiled disposable brief.

Which of the following statements indicates an understanding of the necessary dietary modifications of a client diagnosed with chronic renal failure? Select all that apply.

2. "I should avoid eggs, and a bagel is preferable." 5. "I should consume approximately 40 g of protein daily.

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

2. Administering pain medication as prescribed 3. Monitoring vital signs and the puncture site frequently 4. Testing serial urine samples with dipsticks for occult blood

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

2. Ambulate in the room and hall for short distances.

A client with benign prostatic hypertrophy (BPH) undergoes a transurethral resection of the prostate (TURP) and is receiving continuous bladder irrigations postoperatively. The nurse monitors the client for signs of transurethral resection (TUR) syndrome, including:

2. Bradycardia and confusion

A 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:

2. Changing the drainage bag to a leg collection bag

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.

2. Check the level of the drainage bag. 3. Reposition the client to his or her side. 4. Place the client in good body alignment. 5. Check the peritoneal dialysis system for kinks.

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

2. Cleanse the labia using cleansing towels, begin to void into toilet, and then collect the specimen.

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

2. Diabetes mellitus

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 of the following questions first?

3. "Have you experienced any constipation recently?"

A nurse has provided 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 of the following selections from a diet menu?

3. A spinach salad, milk, and a banana

A client's kidneys are retaining greater amounts of sodium. The nurse anticipates that the kidneys are also retaining greater amounts of:

3. Chloride and bicarbonate

A 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:

3. Gives specific cytological information about the lesion

A nurse is caring for the client with epididymitis. The nurse understands that which treatment modality could increase swelling in the affected area?

3. Heating pad

A nurse is collecting data on a newly admitted client with a diagnosis of bladder cancer. While collecting data on this client the nurse would most likely expect to note:

3. Hematuria

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 the risk of:

3. Hyperglycemia

A 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

3. Increase intake of legumes in the diet.

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

3. Nausea and vomiting

A 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:

3. Pain that is intensified because the location of the incision is near the diaphragm

A nurse is teaching a client regarding types of fluids that assist in prevention and treatment of urinary tract infections (UTIs). The nurse tells the client to consume which of the following fluids? Select all that apply.

3. Prune juice 4. Tomato juice 5. Cranberry juice

A nurse is assigned to care for a client who has just returned to the nursing unit following a renal biopsy. The nurse plans to do which of the following to properly care for this client for the remainder of the shift?

3. Test the urine for occult blood.

A client with chlamydial infection has received instructions on self-care and prevention of further infection. The nurse determines that the client needs additional instructions if the client states that he or she will:

3. Use doxycycline prophylactically to prevent symptoms of chlamydia.

The client who has a cold is seen in the emergency department with an inability to void. Because the client has a history of benign prostatic hyperplasia, the nurse determines that the client should be questioned about the use of which of the following medications?

4. Decongestants

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 asks the client about the presence of which early symptom?

4. Decreased force in the stream of urine

A nurse is reviewing the client's record and notes that the health care provider has documented that the client has a renal disorder. On review of the laboratory results, the nurse would most likely expect to note which of the following?

4. Elevated blood urea nitrogen (BUN) level

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?

4. Explain that the pain will subside after the first few exchanges.

A nurse is collecting data from a male client with epididymitis. The nurse would expect to note which of the following signs and symptoms of this problem?

4. Fever, nausea and vomiting, and painful scrotal edema

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. What is the nurse's initial action?

Increase the flow rate of the continuous bladder irrigation.

A nurse is told by an older woman that she has begun to be incontinent of urine at night and now drinks no fluids after 6:00 ᴘᴍ. The nurse's response should be guided by the knowledge that:

ncontinence at any age deserves urological attention.

A 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 of the following?

1. Hourly urine output

A nurse is admitting a client with chronic renal failure (CRF) to the nursing unit. The nurse monitors the client for which frequent cardiovascular sign that occurs in CRF?

1. Hypertension

A nurse is assisting in planning a diet for a client with acute renal failure (ARF). The nurse plans to restrict which of the following dietary components from this client's diet?

4. Potassium

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

4. Remove the water pitcher from the bedside.

The spouse of a client with acute renal failure secondary to heart failure asks the nurse how this could happen. The nurse plans to base a response in part on the fact that the kidneys:

1. Generally require and receive about 20% to 25% of the resting cardiac output

A 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?

1. "I should check the fistula every day by feeling it for a vibration."

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

1. 1.000

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

1. A spinach salad, milk, and a banana

A 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 of the following foods?

1. Cheese

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:

1. Consistent with glomerulonephritis

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

1. Diabetes mellitus

A 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 of the following items that is part of the client's medical record?

1. Diabetes mellitus

A nurse is monitoring an older client suspected of having a urinary tract infection (UTI) for signs of the infection. The nurse would be alert to the presence of:

1. Fever

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

1. Fever

A client is scheduled for a myelogram, and the nurse provides a list of instructions to the client regarding preparation for the procedure. Which instructions should the nurse place on the list? Select all that apply.

1. Jewelry will need to be removed. 2. An informed consent will need to be signed. 4. The procedure will take approximately 45 minutes.

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

1. Lima beans

A client hospitalized with urolithiasis has a sudden significant decrease in urine output. The nurse would immediately:

1. Notify the registered nurse.

A 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 renal failure. Which finding indicates that the fistula is patent?

1. Palpation of a thrill over the fistula

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 instruction if the client states that he or she will perform which of the following as part of these exercises?

1. Perform the Valsalva maneuver.

A client with acute renal failure (ARF) has been treated with sodium polystyrene sulfonate (Kayexalate) by mouth. The nurse evaluates this therapy as effective if which of the following values is noted on follow-up laboratory testing?

1. Potassium, 4.9 mEq/L

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 additional information if the client states that which of the following is a component of the treatment plan?

1. Sodium restriction

The use of peritoneal dialysis for the treatment of chronic renal failure would be contraindicated for which of the following clients?

1. The client with chronic obstructive pulmonary disease (COPD)

A client has received instructions on self-management of peritoneal dialysis. The nurse determines that the client needs further instruction if the client states to:

1. Use a strong adhesive tape to anchor the catheter dressing

A 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?

1. Vomiting and headaches

A nurse is admitting a client to the nursing unit who has returned from the post-anesthesia care unit following prostatectomy. The client has a three-way Foley catheter with continuous bladder irrigation. The nurse would maintain the flow rate of the continuous bladder infusion to maintain a urine output that is:

4. Pale yellow or slightly pink

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

2. Ensure that small clamps are attached to the AV shunt dressing.

A client with new-onset renal failure is having a first hemodialysis treatment. The nurse is especially careful to monitor the client for which of the following on return from the dialysis treatment?

2. Headache, decreasing level of consciousness, and seizures

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

2. Hydronephrosis

A nurse is inserting an indwelling urinary catheter into a male client. As the catheter is inserted into the urethra, urine begins to flow into the tubing. At this point, the nurse:

2. Inserts the catheter 2.5 to 5 cm and inflates the balloon

female 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. The nurse should:

2. Notify the health care provider.

A 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?

2. Obtain a culture and sensitivity of the drainage.

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

2. Stress incontinence

The use of peritoneal dialysis for the treatment of chronic renal failure would be contraindicated for which of the following clients?

2. The client with severe emphysema

A nurse is assessing a client with suspected acute renal failure. Which of the following findings would support a diagnosis of acute intrarenal failure?

2. Urine analysis positive for casts and cellular debris

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

4. Pallor, diminished pulse, and pain in the left hand

A client with prostatitis resulting from kidney infection has received instructions on management of the condition at home and prevention of recurrence. The nurse determines that the client understood the instructions if the client has verbalized that he will:

3. Use warm sitz baths and analgesics to increase comfort.

A client with chronic renal failure 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. The nurse interprets that these data are compatible with:

4. Aluminum intoxication

A nurse is preparing the client who is scheduled for an intravenous pyelogram (IVP). The nurse would take which most important action before the test?

4. Ask about allergies to iodine or shellfish.

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 of the following?

4. Blow or trauma to the bladder or abdomen

A client newly diagnosed with chronic renal failure has recently begun hemodialysis. Knowing that the client is at risk for disequilibrium syndrome, the nurse monitors the client during dialysis for:

4. Headache, deteriorating level of consciousness, and twitching

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:

4. Hyperglycemia

The nurse has given 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 of the following?

4. Limit protein intake.

Which of the following would the nurse include in the plan of care for a client following a renal scan?

4. No special precautions, except to wear gloves if coming into contact with the client's urine.

The client with chronic renal failure who is scheduled for hemodialysis this morning is due to receive a daily dose of enalapril (Vasotec). The nurse should plan to administer this medication:

4. On return from dialysis

A male client who is hospitalized is diagnosed with urethritis caused by chlamydial infection. The nursing assistant assigned to the client asks the nurse what measures are necessary to prevent a contraction of the infection during care. The nurse tells the assistant that:

4. Standard precautions are sufficient, because the infection is transmitted sexually.

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?

4. Stress

A young female client with acute pyelonephritis is scheduled for a voiding cystourethrogram. The nurse determines that this client would likely benefit from increased support and teaching about the procedure because:

4. The client must void while the micturition process is filmed.