Elimination Prep-U
A client who has been treated for chronic renal failure (CRF) is ready for discharge. The nurse should reinforce which dietary instruction?
"Increase your carbohydrate intake."
A client the nurse is caring for has developed a bladder infection while in the hospital. The client has had a Foley catheter for two weeks. The client's family asks you how the client got this infection. What would be the nurse's best response?
"People in hospitals are often more susceptible to infections because they are already ill and they are exposed to germs while they are in the hospital."
A client presents at the clinic with reports of urinary retention. What question should the nurse ask to obtain additional information about the client's report?
"When did you last urinate?"
A client is scheduled for a renal ultrasound. Which of the following would the nurse include when explaining this procedure to the client?
"You don't need to do any fasting before this noninvasive test."
The nurse has been asked to provide health information to a female patient diagnosed with a urinary tract infection. What appropriate instructions will the nurse provide? Select all that apply.
-Cleanse around the perineum and urethral meatus after each bowel movement to reduce pathogens. -Drink liberal amounts of fluid to flush out bacteria. -Void every 2-3 hours to prevent over-distention of the bladder
When fluid intake is normal, the specific gravity of urine should be:
1.010 to 1.025
A nurse is preparing a presentation for a local community group of older adults about colon cancer. What would the nurse include as the primary characteristic associated with this disorder?
A change in bowel habits
The nurse is caring for a client with renal failure. Which factor indicates a compromised immune system?
A deficiency of circulating lymphocytes
The nurse is completing a full exam of the renal system. Which assessment finding best documents the need to offer the use of the bathroom?
A dull sound when percussing over the bladder
The nurse is planning the care of a patient with a major thermal burn. What outcome will the nurse understand will be optimal during fluid replacement?
A urinary output of 30 mL/hr
In an industrial accident, a client who weighs 155 lb (70 kg) sustained full-thickness burns over 40% of his body. He's in the burn unit receiving fluid resuscitation. Which finding shows that the fluid resuscitation is benefiting the client?
A urine output consistently above 40 ml/hour
A nurse caring for a client with small-bowel obstruction should plan to implement which nursing intervention first?
Administering I.V. fluids
A 24-hour urine collection is scheduled to begin at 8:00 am. When should the nurse initiate the procedure?
After discarding the 8:00 am specimen
Which of the following digestive enzymes aids in the digesting of starch?
Amylase
The nurse is able to identify which condition as uremia?
An excess of urea in the blood
The patient has been diagnosed with urge incontinence. What classification of medication does the nurse expect the patient will be placed on to help alleviate the symptoms?
Anticholinergic agents
A client receiving antiretroviral therapy reports "not urinating enough." What is the nurse's best action?
Assess blood urea nitrogen and creatinine.
A client reports constipation. Which nursing measure would be most effective in helping the client reduce constipation?
Assist client to increase dietary fiber.
A client has undergone a total abdominal hysterectomy and bilateral salpingo-oophorectomy as treatment for endometrial cancer. When providing postoperative care to this client the nurse would be alert for signs and symptoms of which of the following?
Bladder dysfunction
A client is admitted with hyperosmolar hyperglycemic nonketotic syndrome (HHNS). Which laboratory finding should the nurse expect in this client?
Blood glucose level 1,100 mg/dl
The nurse is performing an abdominal assessment for a patient with diarrhea and auscultates a loud rumbling sound in the left lower quadrant. What will the nurse document this sound as on the nurse's notes?
Borborygmus
a rumbling noise caused by the movement of gas through the intestines, often associated with diarrhea.
Borborygmus
The client with chronic renal failure complains of intense itching. Which assessment finding would indicate the need for further nursing education?
Brief, hot daily showers
A client who underwent an anterior colporrhaphy 6 hours ago has not voided. She reports some discomfort in her suprapubic area. Which of the following would the nurse expect to do?
Catheterize the client.
The nurse working with a client after an ileal conduit notices that the pouching system is leaking small amounts of urine. What is the appropriate nursing intervention?
Change the wafer and pouch.
A 24-year-old patient was admitted to the emergency room after a water skiing accident. The X-rays revealed two fractured vertebrae, T-12 and L1. Based on this information, the nurse would know to perform which of the following actions?
Check the patient's urine for hematuria.
A patient has been diagnosed with a UTI and is prescribed an antibiotic. What first-line fluoroquinolone antibacterial agent for UTIs has been found to be significantly effective?
Cipro
The nurse is irrigating a client's colostomy when the client begins to report cramping. What is the appropriate action by the nurse?
Clamp the tubing and allow client to rest.
When assessing a client with obstructive jaundice, which of the following stool characteristics is the client likely to report?
Clay-colored or whitish
Which is a clinical manifestation of cholelithiasis?
Clay-colored stools
A patient with end-stage kidney disease (ESKD) has developed anemia. What laboratory finding does the nurse understand to be significant in this stage of anemia?
Creatinine level of 6 mg/100 mL
The nurse is completing a routine urinalysis using a dipstick. The test reveals an increased specific gravity. The nurse should suspect which condition?
Decreased fluid intake
A nurse who works in a clinic sees many patients with a variety of medical conditions. The nurse understands that a risk factor for UTIs is which of the following?
Diabetes mellitus
The client with a diagnosis of heart failure reports frequently awakening during the night with the need to urinate. What explanation will the nurse offer to explain the urination?
Edema is collected in dependent extremities during the day; at night when the client lays down, it is reabsorbed into the circulation and excreted by the kidneys
A side-effect of chemotherapy is renal damage. To prevent this, the nurse should:
Encourage fluid intake, if possible, to dilute the urine.
A client who comes to the clinic complaining of perineal pain, dysuria and fever is diagnosed with prostatitis. The nurse understands that which of the following organisms would be the most likely cause?
Escherichia coli
A client is ordered continuous bladder irrigation at a rate of 60 gtt/minute. The nurse hangs a 2 L bag of sterile solution with tubing on a three-legged IV pole. She then attaches the tubing to the client's three-way urinary catheter, adjusts the flow rate, and leaves the room. Which important procedural step did the nurse fail to follow?
Evaluating patency of the drainage lumen
A client with chronic renal failure complains of generalized bone pain and tenderness. Which assessment finding would alert the nurse to an increased potential for the development of spontaneous bone fractures?
Hyperphosphatemia
A 65-year-old man complains to his health care provider that, when he urinates, he has to start and stop several times over a period of minutes in order to fully empty his bladder. The nurse is aware that this is not uncommon in men over the age of 60. This "double voiding" is directly related to which of the following?
Hyperplasia of the prostate gland
An elderly client diagnosed with diarrhea is taking digoxin. Which electrolyte imbalance should the nurse be alert to?
Hypokalemia
The nurse is caring for a patient after kidney surgery. What major danger should the nurse closely monitor for?
Hypovolemic shock caused by hemorrhage
When assessing a client with benign prostatic hyperplasia, which of the following would the nurse expect the client to report as the initial complaint?
Increased effort to void
Gastrin has which of the following effects on gastrointestinal (GI) motility?
Increased motility of the stomach
For a client with hyperglycemia, which assessment finding best supports a nursing diagnosis of Deficient fluid volume?
Increased urine osmolarity
A client is receiving an IV infusion of mannitol (Osmitrol) after undergoing intracranial surgery to remove a brain tumor. To confirm that this drug is producing its therapeutic effect, the nurse should consider which finding most significant?
Increased urine output
Crohn's disease is a condition of malabsorption caused by which pathophysiological process?
Inflammation of all layers of intestinal mucosa
A client who is post op from bariatric surgery reports constipation. What is the most likely cause of the client's symptoms?
Insufficient water intake
The nurse helps a client to correctly perform peritoneal dialysis at home. The nurse must educate the client about the procedure. Which educational information should the nurse provide to the client?
Keep the dialysis supplies in a clean area, away from children and pets
Examination of a client's bladder stones reveals that they are primarily composed of uric acid. The nurse would expect to provide the client with which type of diet?
Low purine
Diet modifications for patient diagnosed with chronic inflammatory bowel disease include which of the following?
Low residue
Celiac disease (celiac sprue) is an example of which category of malabsorption?
Mucosal disorders causing generalized malabsorption
A client with suspected renal dysfunction is scheduled for excretory urography. The nurse reviews his history for conditions that may warrant changes in client preparation. Normally, the client should be mildly hypovolemic (fluid depleted) before excretory urography. Which history finding calls for the client to be well hydrated?
Multiple myeloma
A client with decreased urine output refractory to fluid challenges is evaluated for renal failure. Which condition may cause the intrinsic (intrarenal) form of acute renal failure?
Nephrotoxic injury secondary to use of contrast media
Which assessment would a nurse perform on a client with Cushing's syndrome who is at high risk of developing a peptic ulcer?
Observe stool color
A group of students are reviewing the phases of acute renal failure. The students demonstrate understanding of the material when they identify which of the following as occurring during the second phase?
Oliguria
The pre-nursing class is learning about the nervous system in their anatomy class. What part of the nervous system would the students learn is responsible for digesting food and eliminating body waste?
Parasympathetic
If an indwelling catheter is necessary, which nursing intervention should be implemented to prevent infection?
Perform meticulous perineal care daily with soap and water
Which medication may be ordered to relieve discomfort associated with a urinary tract infection?
Phenazopyridine
The nurse is conducting a history and assessment related to a client's incontinence. Which element should the nurse include in the assessment before beginning a bladder training program?
Physical and environmental conditions
A client is scheduled for a renal arteriogram. When the nurse checks the chart for allergies to shellfish or iodine, she finds no allergies recorded. The client is unable to provide the information. During the procedure, the nurse should be alert for which finding that may indicate an allergic reaction to the dye used during the arteriogram?
Pruritus
A patient with a UTI is having burning and pain when urinating. What urinary analgesic is prescribed for relief of these symptoms?
Pyridium
A client who is postoperative from bariatric surgery reports foul-smelling, fatty stools. What is the nurse's understanding of the primary reason for this finding?
Rapid gastric dumping
Following percutaneous nephrolithotomy, the client is at greatest risk for which nursing diagnosis?
Risk for infection
A client with AIDS is admitted to the hospital with severe diarrhea and dehydration. The physician suspects an infection with Cryptosporidium. What type of specimen should be collected to confirm this diagnosis?
Stool specimen for ova and parasites
Which type of incontinence is associated with weakened perineal muscles that permit the leakage of urine when intra-abdominal pressure is increased?
Stress incontinence
Dilutional hyponatremia occurs in which disorder?
Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
A patient is having a DRE in the physician's office and the nurse is to assist in the examination. What can the nurse instruct the client to do to decrease the discomfort from the exam?
Take a deep breath and exhale when the physician inserts a gloved finger into the rectum.
A client has undergone a renal transplant and returns to the health care agency for a follow-up evaluation. Which finding would lead to the suspicion that the client is experiencing rejection?
Tenderness over transplant site
A nurse is required to monitor the effectiveness of fluid resuscitation in a client who is being treated for burns. Which of the following assessments would indicate the success of the fluid resuscitation?
The client's urinary output is 0.5 mL/kg/hour.
The nurse is caring for a client who has presented to the walk-in clinic. The client verbalizes pain on urination, feelings of fatigue, and diffuse back pain. When completing a head-to-toe assessment, at which specific location would the nurse assess the client's kidneys for tenderness?
The costovertebral angle
The nurse is providing supportive care to a client receiving hemodialysis in the management of acute renal failure. Which statement from the nurse best reflects the ability of the kidneys to recover from acute renal failure?
The kidneys can improve over a period of months.
Which is the most common type of prostate surgery?
Trans-urethral resection of the prostate
A client presents to the emergency department with complaints of acute GI distress, bloody diarrhea, weight loss, and fever. Which condition in the family history is most pertinent to the client's current health problem?
Ulcerative colitis
Which clinical finding should a nurse look for in a client with chronic renal failure?
Uremia
A client comes to the emergency department complaining of a sudden onset of sharp, severe flank pain. During the physical examination, the client indicates that the pain, which comes in waves, travels to the suprapubic region. He states, "I can even feel the pain at the tip of my penis." Which of the following would the nurse suspect?
Urinary calculi
A nurse assesses a client shortly after living donor kidney transplant surgery. Which postoperative finding must the nurse report to the physician immediately?
Urine output of 20 ml/hour
The nurse is assessing a client for constipation. Which review should the nurse conduct first to identify the cause of constipation?
Usual pattern of elimination
Which of the following assessment findings would be most important for indicating dumping syndrome in a postgastrectomy client?
Weakness, diaphoresis, diarrhea 90 minutes after eating
The nurse is assigned to care for a patient in the oliguric phase of kidney failure. When does the nurse understand that oliguria is said to be present?
When the urine output is less than 30 mL/h
Because of difficulties with hemodialysis, peritoneal dialysis is initiated to treat a client's uremia. Which finding during this procedure signals a significant problem?
White blood cell (WBC) count of 20,000/mm3
A nurse is caring for a client with a brain tumor and increased intracranial pressure (ICP). Which intervention should the nurse include in the care plan to reduce ICP?
administer stool softeners
A nurse is caring for a diabetic patient with a diagnosis of nephropathy. What would the nurse expect the urinalysis report to indicate?
albumin
A longitudinal tear or ulceration in the lining of the anal canal is termed a(n):
anal fissure
Which of the following diagnostic tests would the nurse expect to be ordered to determine the details of the arterial supply to the kidneys?
angiography
The nurse is helping a client who experiences frequent constipation select meal choices for the day. Which food should the nurse encourage the client to order?
bran cereal
A woman in her late 30's has been having unusually heavy menstrual periods combined with occasional urine and stool leakage over the past few weeks. Upon further inquiry, she reveals that she also has post-coital pain and bleeding. To which diagnosis will the investigation most likely lead?
cervical cancer
A patient has been diagnosed with syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which of the following manifestations would be expected in this patient?
concentrated urine
The nurse recognizes that the older adult is at risk for surgical complications due to:
decreased renal function
A client who can't tolerate oral feedings begins receiving intermittent enteral feedings. When monitoring for evidence of intolerance to these feedings, what must the nurse remain alert for?
diaphoresis, vomiting, and diarrhea.
A client with chronic renal failure (CRF) has developed faulty red blood cell (RBC) production. The nurse should monitor this client for:
fatigue and weakness
A client is experiencing some secretion abnormalities, for which diagnostics are being performed. Which substance is typically reabsorbed and not secreted in urine?
glucose
A client is having a blood urea nitrogen (BUN) test. BUN level is:
increased in renal disease and urinary obstruction.
A nurse is reviewing the laboratory test results of a client with renal disease. Which of the following would the nurse expect to find?
increased serum creatinine
A client is prescribed methadone 10 mg three times a day for neuralgia following chemotherapy treatment. The client reports that he is experiencing constipation and asks the nurse for information about preventing constipation. The nurse recommends
increasing the amount of bran and fresh fruits and vegetables
Bladder retraining following removal of an indwelling catheter begins with
instructing the client to follow a 2- to 3-hour timed voiding schedule.
The nurse is creating a bowel evacuation program for a paraplegic client. When should the nurse plan to administer a suppository?
just before breakfast
A client comes to the emergency department complaining of sudden onset of sharp, severe pain in the lumbar region that radiates around the side and toward the bladder. The client also reports nausea and vomiting and appears pale, diaphoretic, and anxious. The physician tentatively diagnoses renal calculi and orders flat-plate abdominal X-rays. Renal calculi can form anywhere in the urinary tract. What is their most common formation site?
kidney
With which condition should the nurse expect that a decrease in serum osmolality will occur?
kidney failure
The nurse knows to advise the patient with hyperparathyroidism that he or she should be aware of signs of the common complication of:
kidney stones
A client admitted to the hospital with abdominal pain, anemia, and bloody stools reports feeling weak and dizzy. The client has rectal pressure and needs to urinate and move their bowels. The nurse should help them:
onto the bedpan
What is a hallmark of the diagnosis of nephrotic syndrome?
proteinuria
A client tells the nurse that the stool was colored yellow. The nurse assesses the client for
recent foods ingested.
A nurse is reviewing the history of a client who is suspected of having glomerulonephritis. Which of the following would the nurse consider significant?
recent history of streptococcal infection
When the nurse places the patient in the stirrups for a pelvic exam she observes a bulge caused by rectal cavity protrusion. What does the nurse know this protrusion is called?
rectocele
A client with spinal cord injury has no awareness of the need to void. This type of incontinence is termed
reflex (neurogenic) incontinence.
The nurse is aware, when caring for patients with renal disease, that which substance made in the glomeruli directly controls blood pressure?
renin
Which of the following hormones is secreted by the juxtaglomerular apparatus?
renin
One of the roles of the nurse in caring for clients with chronic renal failure is to help them learn to minimize and manage potential complications. This would include:
restricting potassium
Which type of incontinence is the involuntary loss of urine through an intact urethra as a result of coughing?
stress
The nurse knows that which of the following body parts explains why cystitis is more common in women?
the urethra
A client with urinary retention needs to undergo a procedure to insert an indwelling catheter. What should the nurse discuss with the health care provider before catheterization?
type and size of the catheter to be used
