Urinary System Disorders Practice Quiz #3 (45 Questions)

4. A client receiving hemodialysis treatment arrives at the hospital with a blood pressure of 200/100, a heart rate of 110, and a respiratory rate of 36. Oxygen saturation on room air is 89%. He complains of shortness of breath, and +2 pedal edema is noted. His last hemodialysis treatment was yesterday. Which of the following interventions should be done first? 1. Administer oxygen 2. Elevate the foot of the bed 3. Restrict the client's fluids 4. Prepare the client for hemodialysis.

1. Administer oxygen

42. Which of the following is the most significant sign of peritoneal infection? 1. Cloudy dialysate fluid 2. Swelling in the legs 3. Poor drainage of the dialysate fluid 4. Redness at the catheter insertion site

1. Cloudy dialysate fluid

32. The dialysis solution is warmed before use in peritoneal dialysis primarily to: 1. Encourage the removal of serum urea. 2. Force potassium back into the cells. 3. Add extra warmth into the body. 4. Promote abdominal muscle relaxation.

1. Encourage the removal of serum urea.

28. The nurse is monitoring a client receiving peritoneal dialysis and nurse notes that a client's outflow is less than the inflow. Select actions that the nurse should take. 1. Place the client in good body alignment 2. Check the level of the drainage bag 3. Contact the physician 4. Check the peritoneal dialysis system for kinks 5. Reposition the client to his or her side.

1. Excess fluid volume related to the kidney's inability to maintain fluid balance.

37. The client with chronic renal failure tells the nurse he takes magnesium hydroxide (milk of magnesia) at home for constipation. The nurse suggests that the client switch to psyllium hydrophilic mucilloid (Metamucil) because: 1. MOM can cause magnesium toxicity 2. MOM is too harsh on the bowel 3. Metamucil is more palatable 4. MOM is high in sodium

1. MOM can cause magnesium toxicity

16. The nurse is performing an assessment on a client who has returned from the dialysis unit following hemodialysis. The client is complaining of a headache and nausea and is extremely restless. Which of the following is the most appropriate nursing action? 1. Notify the physician 2. Monitor the client 3. Elevate the head of the bed 4. Medicate the client for nausea

1. Notify the physician

1. Dialysis allows for the exchange of particles across a semipermeable membrane by which of the following actions? 1. Osmosis and diffusion 2. Passage of fluid toward a solution with a lower solute concentration 3. Allowing the passage of blood cells and protein molecules through it. 4. Passage of solute particles toward a solution with a higher concentration.

1. Osmosis and diffusion

14. A client is admitted to the hospital and has a diagnosis of early stage chronic renal failure. Which of the following would the nurse expect to note on assessment of the client? 1. Polyuria 2. Polydipsia 3. Oliguria 4. Anuria

1. Polyuria

40. A client with chronic renal failure has asked to be evaluated for a home continuous ambulatory peritoneal dialysis (CAPD) program. The nurse should explain that the major advantage of this approach is that it: 1. Is relatively low in cost 2. Allows the client to be more independent 3. Is faster and more efficient than standard peritoneal dialysis 4. Has fewer potential complications than standard peritoneal dialysis

2. Allows the client to be more independent

33. During the client's dialysis, the nurse observes that the solution draining from the abdomen is consistently blood tinged. The client has a permanent peritoneal catheter in place. Which interpretation of this observation would be correct? 1. Bleeding is expected with a permanent peritoneal catheter 2. Bleeding indicates abdominal blood vessel damage 3. Bleeding can indicate kidney damage. 4. Bleeding is caused by too-rapid infusion of the dialysate.

2. Bleeding indicates abdominal blood vessel damage

24. The client with chronic renal failure has an indwelling catheter for peritoneal dialysis in the abdomen. The client spills water on the catheter dressing while bathing. The nurse should immediately: 1. Reinforce the dressing 2. Change the dressing 3. Flush the peritoneal dialysis catheter 4. Scrub the catheter with povidone-iodine

2. Change the dressing

25. The client being hemodialyzed suddenly becomes short of breath and complains of chest pain. The client is tachycardic, pale, and anxious. The nurse suspects air embolism. The nurse should: 1. Continue the dialysis at a slower rate after checking the lines for air 2. Discontinue dialysis and notify the physician 3. Monitor vital signs every 15 minutes for the next hour 4. Bolus the client with 500 ml of normal saline to break up the air embolism.

2. Discontinue dialysis and notify the physician

21. 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: 1. Infection 2. Hyperglycemia 3. Fluid overload 4. Disequilibrium syndrome

2. Hyperglycemia

26. The nurse has completed client teaching with the hemodialysis client about self-monitoring between hemodialysis treatments. The nurse determines that the client best understands the information given if the client states to record the daily: 1. Pulse and respiratory rate 2. Intake, output, and weight 3. BUN and creatinine levels 4. Activity log

2. Intake, output, and weight

19. The nurse is preparing to care for a client receiving peritoneal dialysis. Which of the following would be included in the nursing plan of care to prevent the major complication associated with peritoneal dialysis? 1. Monitor the client's level of consciousness 2. Maintain strict aseptic technique 3. Add heparin to the dialysate solution 4. Change the catheter site dressing daily

2. Maintain strict aseptic technique

34. Which of the following nursing interventions should be included in the client's care plan during dialysis therapy? 1. Limit the client's visitors 2. Monitor the client's blood pressure 3. Pad the side rails of the bed 4. Keep the client NPO.

2. Monitor the client's blood pressure

13. The hemodialysis client with a left arm fistula is at risk for steal syndrome. The nurse assesses this client for which of the following clinical manifestations? 1. Warmth, redness, and pain in the left hand. 2. Pallor, diminished pulse, and pain in the left hand. 3. Edema and reddish discoloration of the left arm 4. Aching pain, pallor, and edema in the left arm.

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

9. 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. Absence of bruit on auscultation of the fistula. 2. Palpation of a thrill over the fistula 3. Presence of a radial pulse in the left wrist 4. Capillary refill time less than 3 seconds in the nail beds of the fingers on the left hand.

2. Palpation of a thrill over the fistula

2. A client is diagnosed with chronic renal failure and told she must start hemodialysis. Client teaching would include which of the following instructions? 1. Follow a high potassium diet 2. Strictly follow the hemodialysis schedule 3. There will be a few changes in your lifestyle. 4. Use alcohol on the skin and clean it due to integumentary changes.

2. Strictly follow the hemodialysis schedule

10. The client with chronic renal failure is at risk of developing dementia related to excessive absorption of aluminum. The nurse teaches that this is the reason that the client is being prescribed which of the following phosphate binding agents? 1. Alu-cap (aluminum hydroxide) 2. Tums (calcium carbonate) 3. Amphojel (aluminum hydroxide) 4. Basaljel (aluminum hydroxide)

2. Tums (calcium carbonate)

38. In planning teaching strategies for the client with chronic renal failure, the nurse must keep in mind the neurologic impact of uremia. Which teaching strategy would be most appropriate? 1. Providing all needed teaching in one extended session. 2. Validating frequently the client's understanding of the material. 3. Conducting a one-on-one session with the client. 4. Using videotapes to reinforce the material as needed.

2. Validating frequently the client's understanding of the material.

41. The client asks whether her diet would change on CAPD. Which of the following would be the nurse's best response? 1. "Diet restrictions are more rigid with CAPD because standard peritoneal dialysis is a more effective technique." 2. "Diet restrictions are the same for both CAPD and standard peritoneal dialysis." 3. "Diet restrictions with CAPD are fewer than with standard peritoneal dialysis because dialysis is constant." 4. "Diet restrictions with CAPD are fewer than with standard peritoneal dialysis because CAPD works more quickly."

3. "Diet restrictions with CAPD are fewer than with standard peritoneal dialysis because dialysis is constant."

3. A client is undergoing peritoneal dialysis. The dialysate dwell time is completed, and the dwell clamp is opened to allow the dialysate to drain. The nurse notes that the drainage has stopped and only 500 ml has drained; the amount the dialysate instilled was 1,500 ml. Which of the following interventions would be done first? 1. Change the client's position. 2. Call the physician. 3. Check the catheter for kinks or obstruction. 4. Clamp the catheter and instill more dialysate at the next exchange time.

3. Check the catheter for kinks or obstruction.

20. A client newly diagnosed with renal failure is receiving peritoneal dialysis. During the infusion of the dialysate the client complains of abdominal pain. Which action by the nurse is most appropriate? 1. Slow the infusion 2. Decrease the amount to be infused 3. Explain that the pain will subside after the first few exchanges 4. Stop the dialysis

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

44. To gain access to the vein and artery, an AV shunt was used for Mr. Roberto. The most serious problem with regards to the AV shunt is: 1. Septicemia 2. Clot formation 3. Exsanguination 4. Vessel sclerosis

3. Exsanguination

31. What is the primary disadvantage of using peritoneal dialysis for long-term management of chronic renal failure? 1. The danger of hemorrhage is high. 2. It cannot correct severe imbalances. 3. It is a time consuming method of treatment. 4. The risk of contracting hepatitis is high.

3. It is a time-consuming method of treatment.

17. The nurse is assisting a client on a low-potassium diet to select food items from the menu. Which of the following food items, if selected by the client, would indicate an understanding of this dietary restriction? 1. Cantaloupe 2. Spinach 3. Lima beans 4. Strawberries

3. Lima beans

39. The nurse helps the client with chronic renal failure develop a home diet plan with the goal of helping the client maintain adequate nutritional intake. Which of the following diets would be most appropriate for a client with chronic renal failure? 1. High carbohydrate, high protein 2. High calcium, high potassium, high protein 3. Low protein, low sodium, low potassium 4. Low protein, high potassium

3. Low protein, low sodium, low potassium

23. 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: 1. Just before dialysis 2. During dialysis 3. On return from dialysis 4. The day after dialysis

3. On return from dialysis

22. The client with acute renal failure has a serum potassium level of 5.8 mEq/L. The nurse would plan which of the following as a priority action? 1. Allow an extra 500 ml of fluid intake to dilute the electrolyte concentration. 2. Encourage increased vegetables in the diet 3. Place the client on a cardiac monitor 4. Check the sodium level

3. Place the client on a cardiac monitor

35. Aluminum hydroxide gel (Amphojel) is prescribed for the client with chronic renal failure to take at home. What is the purpose of giving this drug to a client with chronic renal failure? 1. To relieve the pain of gastric hyperacidity 2. To prevent Curling's stress ulcers 3. To bind phosphorus in the intestine 4. To reverse metabolic acidosis.

3. To bind phosphorus in the intestine

45. When caring for Mr. Roberto's AV shunt on his right arm, you should: 1. Cover the entire cannula with an elastic bandage 2. Notify the physician if a bruit and thrill are present 3. User surgical aseptic technique when giving shunt care 4. Take the blood pressure on the right arm instead

3. User surgical aseptic technique when giving shunt care

36. The nurse teaches the client with chronic renal failure when to take the aluminum hydroxide gel. Which of the following statements would indicate that the client understands the teaching? 1. "I'll take it every four (4) hours around the clock." 2. "I'll take it between meals and at bedtime." 3. "I'll take it when I have a sour stomach." 4. "I'll take it with meals and bedtime snacks."

4. "I'll take it with meals and bedtime snacks."

7. Which of the following clients is at greatest risk for developing acute renal failure? 1. A dialysis client who gets influenza 2. A teenager who has an appendectomy 3. A pregnant woman who has a fractured femur 4. A client with diabetes who has a heart catheterization

4. A client with diabetes who has a heart catheterization

6. Which of the following factors causes the nausea associated with renal failure? 1. Oliguria 2. Gastric ulcers 3. Electrolyte imbalances 4. Accumulation of waste products

4. Accumulation of waste products

5. A client has a history of chronic renal failure and received hemodialysis treatments three times per week through an arteriovenous (AV) fistula in the left arm. Which of the following interventions is included in this client's plan of care? 1. Keep the AV fistula site dry. 2. Keep the AV fistula wrapped in gauze. 3. Take the blood pressure in the left arm 4. Assess the AV fistula for a bruit and thrill

4. Assess the AV fistula for a bruit and thrill

15. The client with chronic renal failure returns to the nursing unit following a hemodialysis treatment. On assessment the nurse notes that the client's temperature is 100.2. Which of the following is the most appropriate nursing action? 1. Encourage fluids 2. Notify the physician 3. Monitor the site of the shunt for infection 4. Continue to monitor vital signs

4. Continue to monitor vital signs

8. In a client in renal failure, which assessment finding may indicate hypocalcemia? 1. Headache 2. Serum calcium level of 5 mEq/L 3. Increased blood coagulation 4. Diarrhea

4. Diarrhea

27. The client with an arteriovenous shunt in place for hemodialysis is at risk for bleeding. The nurse would do which of the following as a priority action to prevent this complication from occurring? 1. Check the results of the PT time as they are ordered. 2. Observe the site once per shift 3. Check the shunt for the presence of a bruit and thrill 4. Ensure that small clamps are attached to the AV shunt dressing.

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

11. The client newly diagnosed with chronic renal failure recently has begun hemodialysis. Knowing that the client is at risk for disequilibrium syndrome, the nurse assesses the client during dialysis for: 1. Hypertension, tachycardia, and fever 2. Hypotension, bradycardia, and hypothermia 3. restlessness, irritability, and generalized weakness 4. Headache, deteriorating level of consciousness, and twitching.

4. Headache, deteriorating level of consciousness and twitching.

43. The main indicator of the need for hemodialysis is: 1. Ascites 2. Acidosis 3. Hypertension 4. Hyperkalemia

4. Hyperkalemia

18. The nurse is reviewing a list of components contained in the peritoneal dialysis solution with the client. The client asks the nurse about the purpose of the glucose contained in the solution. The nurse bases the response knowing that the glucose: 1. Prevents excess glucose from being removed from the client. 2. Decreases risk of peritonitis. 3. Prevents disequilibrium syndrome 4. Increased osmotic pressure to produce ultrafiltration.

4. Increases osmotic pressure to produce ultrafiltration.

12. A client with chronic renal failure has completed a hemodialysis treatment. The nurse would use which of the following standard indicators to evaluate the client's status after dialysis? 1. Potassium level and weight 2. BUN and creatinine levels 3. VS and BUN 4. VS and weight.

4. VS and weight.