EXAM 5
A female client presents to the health clinic for a routine physical examination. The nurse observes that the client's urine is bright yellow. Which question is most appropriate for the nurse to ask the client?
"Do you take multiple vitamin preparations?"
A client with end-stage renal disease is scheduled to undergo a kidney transplant using a sibling donated kidney. The client asks if immunosuppressive drugs can be avoided. Which is the best response by the nurse?
"Even a perfect match does not guarantee organ success."
Which of the following is a term used to describe excessive nitrogenous waste in the blood, as seen in acute glomerulonephritis?
Azotemia
Behavioral interventions for urinary incontinence can be coordinated by a nurse. A comprehensive program that incorporates timed voiding and urinary urge inhibition is referred to as what?
Bladder retraining
A client with chronic renal failure (CRF) is admitted to the urology unit. Which diagnostic test results are consistent with CRF?
Blood urea nitrogen (BUN) 100 mg/dL and serum creatinine 6.5 mg/dL
What is the most common presenting objective symptom of a urinary tract infection in older adults, especially in those with dementia?
Change in cognitive functioning
The nurse is educating a client who is required to restrict potassium intake. What foods would the nurse suggest the client eliminate that are rich in potassium?
Citrus fruits
Which is a clinical manifestation of cholelithiasis?
Clay-colored stools
The client is admitted to the hospital with a diagnosis of acute glomerulonephritis. Which clinical manifestation would the nurse expect to find?
Cola-colored urine
Which value does the nurse recognize as the best clinical measure of renal function?
Creatinine clearance
Which term refers to a failure of one or both or both of the testes to descend into the scrotum?
Cryptorchidism
A client has undergone diagnostic testing that involved the insertion of a lighted tube with a telescopic lens. The nurse identifies this test as which of the following?
Cystoscopy
A client who suffered hypovolemic shock during a cardiac incident has developed acute renal failure. Which is the best nursing rationale for this complication?
Decrease in the blood flow through the kidneys
Which age-related change affects the male reproductive system?
Decreased plasma testosterone levels
A client is admitted with nephrolithiasis. What symptoms does the nurse expect the client to experience? Select all that apply.
Difficulty starting a urine stream Suprapubic pain Elevated temperature Hematuria
A patient experiences hypotension, lethargy, and muscle spasms while receiving bladder irrigations after a transurethral resection of the prostate (TURP). What is the first action the nurse should take?
Discontinue the irrigations.
Which of the following is a cause of a calcium renal stone?
Excessive intake of vitamin D
Which condition in a client with pancreatitis makes it necessary for the nurse to check fluid intake and output, check hourly urine output, and monitor electrolyte levels?
Frequent vomiting, leading to loss of fluid volume
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
Which type of incontinence refers to the involuntary loss of urine due to extrinsic medical factors, particularly medications?
Iatrogenic
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 teaching a male client to perform monthly testicular self-examinations. Which point is appropriate to make?
Testicular cancer is a highly curable type of cancer.
Which nursing assessment finding indicates the client has not met expected outcomes?
The client voids 75 cc four hours post cystoscopy.
The nurse is caring for a client who is brought to the emergency department after being found unconscious outside in hot weather. Dehydration is suspected. Baseline lab work including a urine specific gravity is ordered. Which relation between the client's symptoms and urine specific gravity is anticipated?
The specific gravity will be high.
The nurse knows that which of the following body parts explains why cystitis is more common in women?
The urethra
Which is the most common type of prostate surgery?
Transurethral resection of the prostate
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
Which is a reversible cause of urinary incontinence in the older adult?
constipation
An appropriate nursing intervention for the client following a nuclear scan of the kidney is to:
encourage high fluid intake
Which nursing assessment finding indicates that the client who has undergone renal transplant has not met expected outcomes?
fever
When the bladder contains 400 to 500 mL of urine, this is referred to as
functional capacity.
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 has been diagnosed with acute glomerulonephritis. This condition causes:
proteinuria.
A client with cholelithiasis has a gallstone lodged in the common bile duct. When assessing this client, the nurse expects to note:
yellow sclerae.
A patient has undergone a renal biopsy. After the test, while the patient is resting, the patient complains of severe pain in the back, arms, and shoulders. Which of the following appropriate nursing interventions should be offered by the nurse?
Asses the patient's back and shoulder areas for signs of internal bleeding.
Which of the following is an age-related change associated with the renal system?
Renal arteries thicken
A nurse should monitor blood glucose levels for a patient diagnosed with hyperinsulinism. What blood value does the nurse recognize as inadequate to sustain normal brain function?
30 mg/dL
A client reports urinary frequency, urgency, and dysuria. Which of the following would the nurse most likely suspect?
Infection
A client with erectile dysfunction is prescribed sildenafil (Viagra). Which of the following would the nurse include in the teaching plan for this client?
"You may experience headache and some flushing with this drug."
A patient has stage 3 chronic kidney failure. What would the nurse expect the patient's glomerular filtration rate (GFR) to be?
A GFR of 30-59 mL/min/1.73 m
A patient has stage 3 chronic kidney failure. What would the nurse expect the patient's glomerular filtration rate (GFR) to be?
A GFR of 30-59 mL/min/1.73 m2
You have an order to infuse Ranitidine HCL (Zantac) to your patient who is on mechanical ventilation prevent gastric ulcers. Ranitidine 50 mg. is diluted in 100 mL D5W. To infuse this over 20 minutes as recommended, you will set the infusion pump to deliver______________ mL/hour?
300
Following a renal biopsy, a client reports severe pain in the back, the arms, and the shoulders. Which intervention should be offered by the nurse?
Assess the patient's back and shoulder areas for signs of internal bleeding.
A client is frustrated and embarrassed by urinary incontinence. Which measure should the nurse include in a bladder retraining program?
Assessing present voiding patterns
The nurse is providing an education program for the nursing assistants in a long-term care facility in order to decrease the number of UTIs in the female population. What interventions should the nurse introduce in the program? Select all that apply.
Assist the patients with frequent toileting. Provide careful perineal care. Perform hand hygiene prior to patient care.
Following a cystoscopy, the client has a nursing diagnosis of acute pain related to the trauma of the procedure to the urinary tract. An appropriate nursing intervention is to:
Assist with warm sitz baths.
A patient is having a problem with retention of urine in the bladder. Which of the following diagnostic tests measures the amount of residual urine in the bladder?
Bladder ultrasonography
The nurse is providing care to a client who has had a kidney biopsy. The nurse would need to be alert for signs and symptoms of which of the following?
Bleeding
Which of the following patient populations have the highest risk for developing testicular cancer?
Caucasian American
The nurse is assessing a client at the diagnostic imaging center. For which diagnostic test would the client assess for an allergy to shellfish?
Computed tomography with contrast
When describing the functions of the kidney to a client, which of the following would the nurse include?
Control of water balance
A client is admitted to the healthcare facility suspected of having acute pancreatitis and undergoes laboratory testing. Which of the following would the nurse expect to find?
Elevated urine amylase levels
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
After teaching a group of students about the types of urinary incontinence and possible causes, the instructor determines that the students have understood the material when they identify which of the following as a cause of stress incontinence?
Decreased pelvic muscle tone due to multiple pregnancies
One of the potential problems for a client with a urinary diversion is disturbed body image related to change in appearance and function. The expected outcome is that the client will accept the altered appearance and perform self-care. Which activities would help in achieving that expected outcome? Select all that apply.
Reassure the client that nursing staff will provide care until he or she is ready. Discuss the change in function and let the client know what to expect when recovery from surgery is complete. Help the client gain independence by reinforcing that self-care is quite manageable and providing time for practice.
A woman comes to her health care provider's office with signs and symptoms of kidney stones. Which of the following should be the primary medical management goal?
Relieve the pain.
Increased appetite and thirst may indicate that a client with chronic pancreatitis has developed diabetes mellitus. Which of the following explains the cause of this secondary diabetes?
Relieving abdominal pain
A nurse is describing the renal system to a client with a kidney disorder. Which structure would the nurse identify as emptying into the ureters?
Renal Pelvis
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
The nurse is preparing a discharge teaching plan for a client who has had a prostatectomy. Which of the following would be appropriate to include?
Performing perineal exercises frequently throughout the day
The following catheterization procedures are used to treat clients with urinary retention. Which procedure would the nurse identify as carrying the greatest risk to the client?
Permanent drainage with a urethral catheter
During a physical examination, the nurse inspects the external genitalia of a male client. Which of the following would the nurse identify as an abnormality?
Skin lesions
Which is an effect of aging on upper and lower urinary tract function?
Susceptibility to develop hypernatremia
A group of students is reviewing for a test on the urinary and renal system. The students demonstrate understanding of the information when they identify which of the following as part of the upper urinary tract?
Ureters
A client comes to the clinic for a follow-up visit. During the interview, the client states, "Sometimes when I have to urinate I can't control it, and do not reach the bathroom in time." The nurse suspects that the client is experiencing which type of incontinence?
Urge
Which assessment finding would create the greatest risk to a client ordered a phosphodiesterase inhibitor such as sildenafil?
Use of nitrates
A client is admitted for treatment of chronic renal failure (CRF). The nurse knows that this disorder increases the client's risk of:
water and sodium retention secondary to a severe decrease in the glomerular filtration rate.
A patient has acute kidney injury (AKI) with a negative nitrogen balance. How much weight does the nurse expect the patient to lose?
0.5 kg/day
The nurse is caring for a patient that has developed oliguria. Oliguria is defined as urine output less than ___________mL/kg/hr.
0.5 mL/kg/hr.
The nurse notes that a patient who is retaining fluid had a 1-kg weight gain. The nurse knows that this is equivalent to about how many mL?
1,000 mL
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
A history of infection specifically caused by group A beta-hemolytic streptococci is associated with which disorder?
Acute glomerulonephritis
A nurse is teaching a client and the client's family about chronic pancreatitis. Which are the major causes of chronic pancreatitis?
Alcohol consumption and smoking
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.
Which of the following is a major cause of relapsing urinary tract infections in men?
Chronic bacterial prostatitis
Diet modifications are part of nutritional therapy for the management of ARF. Select the high-potassium food that should be restricted.
Citrus fruits
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 overdistention of the bladder
After teaching a group of students about malignant bladder tumors, the instructor determines that the teaching was successful when the students identify which of the following clients as having the greatest risk for developing a malignant bladder tumor?
Client with a history of cigarette smoking
A patient comes to the clinic suspecting a possible UTI. What symptoms of a UTI would the nurse recognize from the assessment data gathered?
Cloudy urine
A 70-year-old client is admitted with acute pancreatitis. The nurse understands that the mortality rate associated with acute pancreatitis increases with advanced age and attributes this to which gerontologic consideration associated with the pancreas?
Decreases in the physiologic function of major organs
Which nursing diagnosis is appropriate for the client with a new ileal conduit? Select all that apply.
Deficient knowledge: management of urinary diversion Disturbed body image Risk for impaired skin integrity
Which of the following may result if prostate cancer invades the urethra or bladder?
Hematuria
Which factor contributes to UTI in older adults?
Immunocompromise
A nurse is providing preoperative teaching to a client undergoing a cholecystectomy. Which topic should the nurse include in her teaching plan?
Increase respiratory effectiveness.
Patients with urolithiasis need to be encouraged to:
Increase their fluid intake so that they can excrete 2.5 to 4 liters every day.
What is a characteristic of the intrarenal category of acute kidney injury (AKI)?
Increased BUN
The nurse reviews a client's history and notes that the client has a history of hyperparathyroidism. The nurse would identify that this client most likely would be at risk for which of the following?
Kidney stones
A client diagnosed with acute kidney injury (AKI) has developed congestive heart failure. The client has received 40 mg of intravenous push (IVP) Lasix and 2 hours later, the nurse notes that there are 50 mL of urine in the Foley catheter bag. The client's vital signs are stable. Which health care order should the nurse anticipate?
Lasix 80 mg IVP
A patient who has been treated for uric acid stones is being discharged from the hospital. What type of diet does the nurse discuss with the patient?
Low-purine diet
A nurse is teaching a client about the cause of acute pancreatitis. The nurse evaluates the teaching as effective when the client correctly identifies which condition as a cause of acute pancreatitis?
Maintaining normal respiratory function
A client with acute pancreatitis has been started on total parenteral nutrition (TPN). Which action should the nurse perform after administration of the TPN?
Measure blood glucose concentration every 4 to 6 hours
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 nurse has been asked to speak to a local women's group about preventing cystitis. Which of the following would the nurse include in the presentation?
Need to urinate after engaging in sexual intercourse
A 64-year-old man is seeing his urologist for an annual check-up, post prostatectomy. The health care provider is concerned with the symptom he finds because it is considered diagnostic for bladder cancer. Which of the following signs/symptoms is diagnostic for bladder cancer?
Painless, gross hematuria
Nursing assessment for the patient receiving peritoneal dialysis would include which of the following to detect the most serious complication of this procedure?
Palpate the abdominal wall for rebound tenderness.
A client undergoes renal angiography. The nurse prepares the client for the test and provides postprocedure care. Which intervention should the nurse provide to the client after renal angiography?
Palpate the pulses in the legs and feet
Which medication may be ordered to relieve discomfort associated with a UTI?
Phenazopyridine
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
The nurse is reviewing a patient's laboratory results. What findings does the nurse assess that are consistent with acute glomerulonephritis? Select all that apply.
Red blood cells in the urine Proteinuria White cell casts in the urine
Sympathomimetics have which of the following effects on the body?
Relaxation of bladder wall
A patient comes to the emergency department and tells the nurse, "I took a pill to help me perform and then passed out." The nurse is assessing the patient and finds a nitroglycerin patch on his back. What is the first intervention the nurse must perform?
Take the patient's blood pressure.
The client presents with nausea and vomiting, absent bowel sounds, and colicky flank pain. The nurse interprets these findings as consistent with:
The client presents with nausea and vomiting, absent bowel sounds, and colicky flank pain. The nurse interprets these findings as consistent with:
After having transurethral resection of the prostate (TURP), a client returns to the unit with a three-way indwelling urinary catheter and continuous closed bladder irrigation. Which finding suggests that the client's catheter is occluded?
The client reports bladder spasms and the urge to void.
A patient has a suprapubic catheter inserted postoperatively. What would be the advantages of the suprapubic catheter versus a urethral catheter? Select all that apply.
The patient can void sooner than with a urethral catheter. The suprapubic catheter allows for more mobility. The suprapubic catheter permits measurement of residual urine without urethral instrumentation.
A group of students are reviewing information about disorders of the bladder and urethra. The students demonstrate understanding of the material when they identify which of the following as a voiding dysfunction?
Urinary retention
Which of the following is the most common site of a nosocomial infection?
Urinary tract
The nurse recognizes that urinalysis results that most likely indicate a urinary tract infection include:
WBC 50
A male client has doubts about performing peritoneal dialysis at home. He informs the nurse about his existing upper respiratory infection. Which of the following suggestions can the nurse offer to the client while performing an at-home peritoneal dialysis?
Wear a mask when performing exchanges.
A nurse is obtaining a male client's health history before performing a physical examination. Which information would most likely not be obtained?
age of first ejaculate
The digestion of carbohydrates is aided by
amylase
A client in a short-procedure unit is recovering from renal angiography in which a femoral puncture site was used. When providing postprocedure care, the nurse should:
check the client's pedal pulses frequently.
A triple-lumen indwelling urinary catheter is inserted for continuous bladder irrigation following a transurethral resection of the prostate. In addition to balloon inflation, the functions of the three lumens include:
continuous inflow and outflow of irrigation solution.
A client is undergoing a diagnostic workup for suspected testicular cancer. When obtaining the client's history, the nurse checks for known risk factors for this type of cancer. Testicular cancer has been linked to:
cryptorchidism.
The nurse is obtaining a health history from a client describing urinary complications. Which assessment finding is most suggestive of a malignant tumor of the bladder?
hematuria
Which cancer ranks second as the cause of death in American men?
prostate
An client with a history of hypertension is being seen by the urologist due to erectile dysfunction. Results from the client's nocturnal penile tumescence test measured several spontaneous erections while the client slept. What does this indicate?
psychological etiology
A client presents to the emergency department complaining of a dull, constant ache along the right costovertebral angle along with nausea and vomiting. The most likely cause of the client's symptoms is:
renal calculi
A client is scheduled for a transurethral resection of the prostate (TURP). Which statement demonstrates that the expected outcome of "client demonstrates understanding of the surgical procedure and aftercare" has been met?
"The surgeon is going to insert a scope through my urethra to remove a portion of the gland."
A client with urinary tract infection is prescribed phenazopyridine (Pyridium). Which of the following instructions would the nurse give the client?
"This medication will relieve your pain."
A client comes to the clinic reporting urinary symptoms. Which statement would most likely alert the nurse to suspect benign prostatic hyperplasia (BPH)?
"I've had trouble getting started when I urinate, often straining to do so."
After teaching a group of students about how to perform peritoneal dialysis, which statement would indicate to the instructor that the students need additional teaching?
"It is appropriate to warm the dialysate in a microwave."
A client with chronic renal failure comes to the clinic for a visit. During the visit, he complains of pruritus. Which suggestion by the nurse would be most appropriate?
"Keep your showers brief, patting your skin dry after showering."
A client with urinary incontinence asks the nurse for suggestions about managing this condition. Which suggestion would be most appropriate?
"Make sure to eat enough fiber to prevent constipation."
The nurse is caring for a client who is scheduled for the creation of an ileal conduit. Which statement by the client provides evidence that client teaching was effective?
"My urine will be eliminated through a stoma."
Which of the following recommendations would a nurse advocate during infancy and childhood to help reduce potential adult complications such as orchitis?
Ensure immunizations against infectious diseases such as mumps.
The nurse is instructing a 3-year-old's mother regarding abnormal findings within the urinary system. Which assessment finding would the nurse document as a normal finding for this age group?
Enuresis
After teaching a group of students about erectile dysfunction, the instructor determines that the teaching was successful when the students identify which of the following as true?
Erectile dysfunction may be due to testosterone insufficiency.
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
Which of the following causes should the nurse suspect in a client diagnosed with intrarenal failure?
Glomerulonephritis
Which of the following is an immediate danger after a prostate surgery?
Hemorrhagic shock
The nurse is preparing a presentation for a local community group about prostate cancer and possible dietary risk factors. Which of the following would the nurse most likely include?
High-fat diet
The diagnosis of prostate cancer is confirmed by which of the following?
Histologic exam of tissue
Upon receiving the dinner tray for a client admitted with acute gallbladder inflammation, the nurse will question which of the following foods on the tray?
Hot roast beef sandwich with gravy
The nurse is obtaining a health history from a 58-year-old client stating that he is having difficulty obtaining an erection during sexual activity. The client asks how an "erectile medication" works and if there are any side effects to the medication. The nurse explains the action of the medication and directions for use and warns of which side effect related to the client's history?
Hypotension with nitrate use
The nurse is caring for a client diagnosed with bladder cancer and requiring a cystectomy. The nurse overhears the physician instructing the client on the presence of a stoma with a temporary pouch. In gathering information for the client, which urinary diversion would the nurse select?
Ileal conduit
The nurse is conducting a community education program on UTIs. The nurse determines that the participants understand the teaching when they identify which factor as contributing to UTIs in older adults?
Immunocompromise
A client has end-stage renal failure. Which of the following should the nurse include when teaching the client about nutrition to limit the effects of azotemia?
Increase carbohydrates and limit protein intake.
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
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 patient with an indwelling catheter after a radical prostatectomy is having bladder spasms. What medication prescribed by the physician can the nurse administer to help alleviate the discomfort?
Oxybutynin (Ditropan)
Which of the following is the most common symptom of bladder cancer?
Painless gross hematuria
If an indwelling catheter is necessary, which nursing intervention should be implemented to prevent infection?
Perform meticulous perineal care daily with soap and water
The nurse is caring for a postoperative client who has a Kock pouch. Nursing assessment findings reveal abdominal pain, absence of bowel sounds, fever, tachycardia, and tachypnea. The nurse suspects which of the following?
Peritonitis
Nursing students are reviewing information about the male reproductive system and normal age-related changes. They demonstrate understanding of the topic when they identify which of the following as occurring?
Plasma testosterone levels decrease.
Which is an age-related change affecting the male reproductive system?
Plasma testosterone levels decrease.
When caring for a client with acute pancreatitis, the nurse should use which comfort measure?
Positioning the client on the side with the knees flexed
Retention of which electrolyte is the most life-threatening effect of renal failure?
Potassium
A client comes to the emergency department complaining of sudden, sharp testicular pain. Further examination reveals torsion of the spermatic cord. Which of the following would the nurse expect to do next?
Prepare the client for surgery
A nurse is teaching a client about a circumcision. Which external reproductive structure is removed by circumcision?
Prepuce
A patient is suspected to have prostate cancer related to observed clinical symptoms. What definitive test can the nurse assist with to confirm a diagnosis of prostate cancer?
Prostate biopsy
What is a hallmark of the diagnosis of nephrotic syndrome?
Proteinuria
Which term refers to inflammation of the renal pelvis?
Pyelonephritis
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 is admitted to the health care facility with abdominal pain, a low-grade fever, abdominal distention, and weight loss. The physician diagnoses acute pancreatitis. What is the primary goal of nursing care for this client?
Relieving abdominal pain
A client being treated for pancreatitis faces the risk of atelectasis. Which of the following interventions would be important to implement to minimize this risk?
Reposition the client every 2 hours.
A client with pancreatitis is admitted to the medical intensive care unit. Which nursing intervention is most appropriate?
Reserving an antecubital site for a peripherally inserted central catheter (PICC)
A client with renal failure is undergoing continuous ambulatory peritoneal dialysis. Which nursing diagnosis is the most appropriate for this client?
Risk for infection
The laboratory results for a patient with renal failure, accompanied by decreased glomerular filtration, would be evaluated frequently. Which of the following is the most sensitive indicator of renal function?
Serum creatinine of 1.5 mg/dL
The nurse is admitting a patient to the intensive care unit with a diagnosis of acute pancreatitis. What does the nurse expect was the reason the patient came to the hospital?
Severe abdominal pain
What is used to decrease potassium level seen in acute renal failure?
Sodium polystyrene sulfonate
Following a nephrectomy, which assessment finding is most important in determining nursing care for the client?
SpO2 at 90% with fine crackles in the lung bases
A client comes to the clinic for a follow-up visit. During the interview, the client states, "Sometimes when I have to urinate, I can't control it and do not reach the bathroom in time." The nurse suspects that the client is experiencing which type of incontinence?
Urge
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
The most frequent reason for admission to skilled care facilities includes which of the following?
Urinary incontinence
A client admitted with a gunshot wound to the abdomen is transferred to the intensive care unit after an exploratory laparotomy. IV fluid is being infused at 150 mL/hour. Which assessment finding suggests that the client is experiencing acute renal failure (ARF)?
Urine output of 250 ml/24 hours
Following a vasectomy, which is the most important instruction to provide to the client?
Use another form of birth control until further notice.
A client underwent a transurethral resection of the prostate gland 24 hours ago and is on continuous bladder irrigation. Which nursing intervention is appropriate?
Use sterile technique when irrigating the catheter.
The nurse is providing care to a client who has had a renal biopsy. The nurse would need to be alert for signs and symptoms of which of the following?
bleeding
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 evaluating the effectiveness of discharge teaching for a client with an oxalate urinary stone. Which statement by the client indicates the need for further teaching by the nurse? Select all that apply
"I will never have another urinary stone again." "I need to take allopurinol." "Tylenol is best to control my pain." "I'm so glad I don't have to make any changes in my diet."
The client with polycystic kidney disease asks the nurse, "Will my kidneys ever function normally again?" The best response by the nurse is:
"As the disease progresses, you will most likely require renal replacement therapy."
Based on the nurse's knowledge of the probable first indicator of prostate cancer, which of the following questions should be included in the history and physical examination?
"Do you have any perineal discomfort?"
The nurse is preparing the client for magnetic resonance imaging (MRI) of the kidney. Which statement by the client requires action by the nurse?
"I took my blood pressure medication with my morning coffee an hour ago."
The nurse is admitting a client who is to undergo an open renal biopsy. About which of the following comments by the client should the nurse be most concerned?
"I took my usual dose of Coumadin last night."
An investment banker with chronic renal failure informs the nurse of the choice for continuous cyclic peritoneal dialysis. Which is the best response by the nurse?
"This type of dialysis will provide more independence."
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."
A nurse is caring for a client with a fluid and electrolyte balance. What urine specific gravity would the nurse expect to measure?
1.018
One hour after administration of a test dose of 0.5 mL of Iron Dextran Injection (INFeD), you are administer the remainder to total 100mg. If the pharmacy has delivered a vial of INFeD 100mg elemental iron/2 mL for both doses, how many mLs will you draw up in the syringe to administer? _____________ mLs.
1.5
A nurse is assisting the physician conducting a cystogram. The client has an intravenous (IV) infusion of D5W at 40 ml/hr. The physician inserts a urinary catheter into the bladder and instills a total of 350 ml of a contrast agent. The nurse empties 500 ml from the urinary catheter drainage bag at the conclusion of the procedure. How many milliliters does the nurse record as urine?
150
A male client has undergone a semen analysis for evaluation of fertility. The nurse understands that a sperm count of which of the following would suggest infertility?
18 million/mL
The nurse is caring for a client with chronic kidney disease. The patient has gained 4 kg in the past 3 days. In milliliters, how much fluid retention does this equal? Enter your response as a whole number.
4,000 mL
A client is having prostate-specific antigen (PSA) testing done. Which result would the nurse identify as abnormal?
4.6 nanograms/milliliter
Sevelamer hydrochloride (Renagel) has been prescribed for a client with chronic renal failure. The physician has prescribed Renagel 800 mg orally three times per day with meals to treat the client's hyperphosphatemia. The medication is available in 400 mg tablets. How many tablets per day will the nurse administer to the client?
6
As treatment of erectile dysfunction, Viagra is taken how many minutes before intercourse to be effective?
60
Which client is most likely to develop prostate cancer according to a nurse working at a health screening at the local mall?
A 56-year-old African American man
A client comes to the emergency department complaining of severe pain in the right flank, nausea, and vomiting. The physician tentatively diagnoses right ureterolithiasis (renal calculi). When planning this client's care, the nurse should assign the highest priority to which nursing diagnosis?
Acute pain
A client is evaluated for severe pain in the right upper abdominal quadrant, which is accompanied by nausea and vomiting. The physician diagnoses acute cholecystitis and cholelithiasis. For this client, which nursing diagnosis takes top priority?
Acute pain related to biliary spasms
A client with a history of alcohol abuse comes to the emergency department and complains of abdominal pain. Laboratory studies help confirm a diagnosis of acute pancreatitis. The client's vital signs are stable, but the client's pain is worsening and radiating to his back. Which intervention takes priority for this client?
Administering morphine I.V. as ordered
The nurse is reviewing the potassium level of a patient with kidney disease. The results of the test are 6.5 mEq/L, and the nurse observes peaked T waves on the ECG. What priority intervention does the nurse anticipate the physician will order to reduce the potassium level?
Administration of sodium polystyrene sulfonate [Kayexalate])
A patient with chronic kidney failure experiences decreased levels of erythropoietin. What serious complication related to those levels should the nurse assess for when caring for this client?
Anemia
The nurse is employed in a urologist's office. Which classification of medication is anticipated for clients having difficulty with urinary incontinence?
Anticholinergic
An ileal conduit is created for a client after a radical cystectomy. Which of the following would the nurse expect to include in the client's plan of care?
Application of an ostomy pouch
The presence of prerenal azotemia is a probable indicator for hospitalization for CAP. Which of the following is an initial laboratory result that would alert a nurse to this condition?
Blood urea nitrogen (BUN)-to-creatinine ratio (BUN:Cr) >20.
Which treatment involves implantation of interstitial radioactive seeds under anesthesia to treat prostate cancer?
Brachytherapy
A client with Stage IV prostate cancer is to receive hormone therapy. The nurse would inform the client about possible adverse effects including which of the following?
Breast tenderness
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 patient admitted with electrolyte imbalance has carpopedal spasm, ECG changes, and a positive Chvostek sign. What deficit does the nurse suspect the patient has?
Calcium
Which objective symptom of a UTI is most common in older adults, especially those with dementia?
Change in cognitive functioning
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.
The nurse is encouraging the client with recurrent urinary tract infections to increase his fluid intake to 8 large glasses of fluids daily. The client states he frequently drinks water and all of the following. Which of the following would the nurse discourage for this client?
Coffee in the morning
A creatinine clearance test is ordered for a client with possible renal insufficiency. The nurse must collect which serum concentration midway through the 24-hour urine collection?
Creatinine
The nurse expects which of the following assessment findings in the client in the diuretic phase of acute renal failure?
Dehydration
An older adult client is being evaluated for suspected pyelonephritis and is ordered kidney, ureter, and bladder (KUB) x-ray. The nurse understands the significance of this order is related to which rationale?
Detects calculi, cysts, or tumors
A patient is planning to use a negative-pressure (vacuum) device to maintain and sustain an erection. What should the nurse caution the patient about with the use of this device?
Do not leave the constricting band in place for longer than 1 hour to avoid penile injury.
The nurse notes that the client's urine is blood-tinged following cystoscopy. Which nursing action should the nurse take next?
Document the finding in the health record.
A client is in end-stage chronic renal failure and is being added to the transplant list. The nurse explains to the client how donors are found for clients needing kidneys. Which statement is accurate?
Donors are selected from compatible living or deceased donors.
Which instruction would be included in a teaching plan for a client diagnosed with a urinary tract infection?
Drink liberal amount of fluids.
A client has a full bladder. Which sound would the nurse expect to hear on percussion?
Dullness
A nurse is planning care for a client with acute pancreatitis. Which client outcome does the nurse assign as the highest priority?
Dysfunction of the pancreatic islet cells
A patient is diagnosed with mild acute pancreatitis. What does the nurse understand is characteristic of this disorder?
Edema and inflammation
A major goal when caring for a catheterized patient is to prevent infection. Select all the nursing actions that apply.
Empty the collection bag at least every 8 hours to reduce bacterial growth. Suspend the drainage bag off the floor. Wash the perineal area with soap and water at least twice daily.
A nurse is caring for a client who had a stroke. Which nursing intervention promotes urinary continence?
Encouraging intake of at least 2 L of fluid daily
A client is prescribed amitriptyline, an antidepressant for incontinence. The nurse understands that this drug is an effective treatment for which reason? Select all that apply.
Increases bladder neck resistance Decreases involuntary bladder contractions
A nurse caring for a patient with a neurogenic bladder knows to assess for the major complication of:
Infection
A client is scheduled for a cholecystogram for later in the day. What is the nurse's understanding on the diagnostic use of this exam?
It visualizes the gallbladder and bile duct.
After a radical prostatectomy for prostate cancer, a client has an indwelling catheter removed. The client then begins to have periods of incontinence. During the postoperative period, which intervention should be implemented first?
Kegel exercises
The nurse is caring for a patient in the oliguric phase of acute kidney injury (AKI). What does the nurse know would be the daily urine output?
Less than 400 mL
A patient is having an MAG3 renogram and is informed that radioactive material will be injected to determine kidney function. What should the nurse instruct the patient to do during the procedure?
Lie still on the table for approximately 35 minutes.
Clinical manifestations of common bile duct obstruction include all of the following except:
Light-colored urine
When the nurse is caring for a patient with acute pancreatitis, what intervention can be provided in order to prevent atelectasis and prevent pooling of respiratory secretions?
Light-colored urine
A nurse who is taking care of a patient with a spinal cord injury documents the frequency of reflex incontinence. The nurse understands that this is most likely due to:
Loss of motor control of the detrusor muscle.
Examination of a client's bladder stones reveal that they are primarily composed of uric acid. The nurse would expect to provide the client with which type of diet?
Low purine
A client undergoes surgery to remove a malignant tumor, followed by a urinary diversion procedure. Which postoperative procedure should the nurse perform?
Maintain skin and stoma integrity
The nurse is preparing a presentation for an older adult group of males at a senior center. Which of the following would the nurse expect to include when describing the effects of aging on the male reproductive system?
Men retain the ability to fertilize ova irrespective of age.
The nurse is preparing a presentation for a men's community group about health promotion. Which of the following would the nurse include as a current recommendation for screening?
Monthly testicular self-examination (TSE)
Urine specific gravity is a measurement of the kidney's ability to concentrate and excrete urine. The specific gravity measures urine concentration by measuring the density of urine and comparing it with the density of distilled water. Which is an example of how urine concentration is affected?
On a hot day, a person who is perspiring profusely and taking little fluid has low urine output with a high specific gravity.
A client is admitted with nausea, vomiting, and diarrhea. His blood pressure on admission is 74/30 mm Hg. The client is oliguric and his blood urea nitrogen (BUN) and creatinine levels are elevated. The physician will most likely write an order for which treatment?
Start IV fluids with a normal saline solution bolus followed by a maintenance dose.
Which type of incontinence refers to involuntary loss of urine through an intact urethra as a result of a sudden increase in intra-abdominal pressure?
Stress
Which should be included as part of the home care instructions for a client with epididymitis and orchitis?
Take prescribed antibiotics.
The nurse is educating a female patient with a UTI on the pharmacologic regimen for treatment. What is important for the nurse to instruct the patient to do?
Take the antibiotic for 3 days as prescribed.
Hyperkalemia is a serious side effect of acute renal failure. Identify the electrocardiogram (ECG) tracing that is diagnostic for hyperkalemia.
Tall, peaked T waves
When caring for the patient with acute glomerulonephritis, which of the following assessment findings should the nurse anticipate?
Tea-colored urine
Which nursing intervention should the nurse caring for the client with pyelonephritis implement?
Teach client to increase fluid intake up to 3 liters per day.
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.
When developing an educational program for a group of adolescents about sexually transmitted infections (STIs), what should the nurse inform the group about the single greatest risk factor for contracting an STI?
The number of sexual partners
The nurse is assisting in the transport of a client with an indwelling catheter to the diagnostic studies unit. Which action made by the nursing assistant would require instruction?
The nursing assistant places the drainage bag on the client's abdomen for transport.
A patient with acute pancreatitis puts the call bell on to tell the nurse about an increase in pain. The nurse observes the patient guarding; the abdomen is board-like and no bowel sounds are detected. What is the major concern for this patient?
The patient has developed peritonitis.
The client states to the nurse that he is very anxious about having prostate cancer ever since his prostate-specific antigen (PSA) test came back elevated. The client asks, "Which diagnostic test produces definitive results if cancer is present?" The nurse is most correct to state which of the following?
Tissue biopsy
The physician has written the following orders for a new client admitted with pancreatitis: bed rest, nothing by mouth (NPO), and administration of total parenteral nutrition (TPN) . Which does the nurse attribute as the reason for NPO status?
To avoid inflammation of the pancreas
The nurse is caring for a patient with acute pancreatitis. The patient has an order for an anticholinergic medication. The nurse explains that the patient will be receiving that medication for what reason?
To reduce gastric and pancreatic secretions
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.
Rejection of a transplanted kidney within 24 hours after transplant is termed
hyperacute rejection.
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
Which enzyme aids in the digestion of fats?
lipase
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
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?
medication usage
A client with a history of bladder retention hasn't voided for 8 hours. A nurse concerned that the client is retaining urine notifies the physician. He orders a bladder ultrasonic scan and placement of an indwelling catheter if the residual urine is greater than 350 mL. The nurse knows that using the bladder ultrasonic scan to measure residual urine instead of placing a straight catheter reduces the risk of:
microorganism transfer.
A nurse is providing postprocedure care for a client who underwent percutaneous lithotripsy. In this procedure, an ultrasonic probe inserted through a nephrostomy tube into the renal pelvis generates ultra-high-frequency sound waves to shatter renal calculi. The nurse should instruct the client to:
notify the physician about cloudy or foul-smelling urine.
The term used to describe total urine output less than 0.5 mL/kg/hour is
oliguria.
The nurse cares for a client with end-stage kidney disease (ESKD). Which acid-base imbalance is associated with this disorder?
pH 7.20, PaCO2 36, HCO3 14-
Following morning hygiene of an elderly client, the nurse is unable to replace the retracted foreskin of the penis. Which is the most likely outcome?
painful swelling
A client has a suspected bladder tumor. What is the most common first symptom of a malignant tumor of the bladder?
painless hematuria
A nurse is reviewing the history and physical examination of a client with a suspected malignant tumor of the bladder. Which finding would the nurse identify as the most common initial symptom?
painless hematuria
The nurse is caring for a client who reports orange urine. The nurse suspects which factor as the cause of the urine discoloration?
phenazopyridine hydrochloride-orange pee
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 sources of potassium usually found in fresh fruits and vegetables.
Following percutaneous nephrolithotomy, the client is at greatest risk for which nursing diagnosis?
risk for infection
Testicular cancer risk is highest for adolescents and men younger than age 35. To specifically address testicular cancer risk, a nurse should modify client teaching for male clients to include:
testicular self-examination
