GU Renal quiz

A nurse is preparing to remove a client's urinary catheter. After performing hand hygiene, which of the following actions should the nurse take?

Position the client supine.

A nurse is caring for an older adult client who has a new prescription for spironolactone. Which of the following laboratory values should the nurse monitor for this client?

Potassium Spironolactone is a potassium-sparing diuretic that can cause hyperkalemia. The nurse should plan to monitor potassium levels while the client takes this medication. Spironolactone may be discontinued if the serum potassium level is above 5 mEq/L.

A nurse is collecting data from a client about pitting edema and notes an indentation of 6 mm (0.25 in) at the point of pressure. Which of the following numbers should the nurse document to indicate the intensity of the client's edema?

​3+ The nurse should document pitting edema of 5 to 7 mm as 3+.

The nurse is reinforcing discharge teaching with a client about a new prescription for furosemide. Which of the following client statements indicates an understanding of the teaching?

" I need to limit my sun exposure and wear sunscreen while on this medication." The client should limit sun exposure and wear sunscreen while taking furosemide due to the adverse effect of photosensitivity.

A nurse is caring for a client who has dyspnea, crackles, and 3+ bilateral pitting pedal edema. Which of the following serum sodium levels should the nurse identify as an indication of fluid volume excess?

116 mEq/L A 116 mEq/L serum sodium level is below the expected reference range. A client who has dyspnea, crackles, and 3+ pitting pedal edema most likely has increased free body water excess without concurrent sodium retention. This can lead to hyponatremia.

A nurse is caring for a client who has impaired renal function. The nurse should notify the provider if the client's hourly urine output falls below what amount? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

30 ml/hr

A nurse is collecting data from a client who has a sodium level of 128 mEq/L. Which of the following manifestations should the nurse expect?

A client who has a sodium level of 128 mEq/L is experiencing hyponatremia. The nurse should expect this client to have neurologic manifestations such as a headache due to swelling of brain cells.

A nurse is reviewing the medicals records of a group of clients. The nurse should identify that hemodialysis is appropriate for which of the following clients?

A client who has minimal urine output following a drug overdose The nurse should recognize that hemodialysis therapy is appropriate for clients who have end-stage kidney disease, drug overdose, hyperkalemia, fluid overload, or metabolic acidosis.

A nurse is assisting with the plan of care for a client who has a three-way urethral catheter connected to continuous bladder irrigation following a suprapubic and transurethral resection of the prostate. Which intervention should the nurse include in the plan of care?

Adjust the flow rate of the irrigation fluid so that the urine is light pink. The purpose of the three-way catheter with irrigation is to promote hemostasis and urinary drainage. The nurse should adjust the flow rate so that the urine is pink- tinged.

A nurse is reinforcing discharge teaching to a client who will be performing intermittent self-catheterizations. Which of the following statements should the nurse include in the teaching?

Advance the catheter 5 cm (2 in) after urine begins to flow. MY ANSWER The nurse should instruct the client to advance the catheter 5 cm (2 in) farther after urine begins to flow to ensure it is completely in the bladder.

A nurse is caring for a client who has cholelithiasis with bile duct obstruction. The nurse should expect which of the following findings when obtaining the client's urine specimen?

Amber The nurse should expect this client to have dark or amber-colored urine. The client who has biliary obstruction will experience a backward flow of bile, which must be filtered out of the body by the kidneys.

A nurse is reviewing the laboratory reports for a client who has chronic kidney disease. Which of the following laboratory reports should the nurse expect to find?

BUN 35 mg/dL, serum creatinine 8 mg/dL A client who has chronic kidney disease will have an elevation of both the BUN and serum creatinine. The goal for a client who has chronic kidney disease is to keep the BUN below 100 mg/dL and the creatinine below 8 mg/dL.

A nurse is caring for a client who has a diagnosis of acute glomerulonephritis. Which of the following should be reported immediately to the provider? ​

Blood pressure 162/90 mm Hg When using the urgent vs non-urgent approach to client care, the nurse determines that the priority finding to report to the provider is a blood pressure of 162/90 mm Hg . Acute glomerular nephritis is classified as an immunologic kidney disorder. Fluid retention due to injury to the glomeruli leads to hypertension. To prevent complications, the nurse should monitor the blood pressure and report elevated blood pressure to the provider immediately as antihypertensive therapy may be needed.

A nurse is reviewing data for a client who has chronic kidney disease. Which of the following data should the nurse identify as the best indicator of fluid volume status?

Daily weight According to evidence-based practice, the nurse should identify that the best indicator of fluid volume status is daily weight. Weight provides the most accurate indicator of fluid volume status.

A nurse is collecting data from a client who has a sodium level of 155 mEq/L. Which of the following manifestations should the nurse expect?

Decreased level of consciousness A client who has a sodium level of 155 mEq/L is experiencing hypernatremia. The nurse should expect this client to have a decreased level of consciousness from the dehydration of brain cells.

A nurse is reinforcing teaching with a client who is scheduled for lithotripsy about conditions that can contribute to the formation of renal calculi. Which of the following conditions should the nurse include?

Dehydration MY ANSWER Inadequate fluid intake and urinary stasis can promote the formation of renal calculi.

A nurse in a provider's office is reinforcing teaching with a client who is to start taking colchicine orally for gout. The nurse should tell the client that which of the following findings is an adverse effect of colchicine?

Diarrhea The nurse should instruct the client that he should discontinue the medication immediately if gastrointestinal effects occur, such as nausea, vomiting, and abdominal pain.

A nurse is caring for a client who has benign prostatic hyperplasia (BPH). Which of the following finding should the nurse expect? ​

Difficulty starting the flow of urine The client who has BPH will experience hesitancy, or difficulty starting the flow of urine due to the enlargement of the prostate pressing on the urethra.

A nurse is collecting data for a client who has early manifestations of renal impairment. Which of the following findings should the nurse expect?

Diluted urine The nurse should expect the client to have diluted urine as an early manifestation of renal impairment because the kidneys are unable to concentrate urine.

A nurse is reinforcing teaching with a female client about preventing urinary tract infections (UTIs). Which of the following instructions should the nurse include?

Drink 16 oz of cranberry juice each day. The nurse should instruct the client to drink fluids that acidify the urine, such as cranberry juice.

A nurse is collecting data for a middle aged client who has pyelonephritis. Which of the following finding should the nurse expect? ​

Flank pain MY ANSWER The nurse should expect the client to have flank pain due to inflammation and infection in the kidney pelvis.

A nurse is caring for a client who has a new diagnosis of urolithiasis. Which of the following risk factors should the nurse identify as contributing to this diagnosis?

High-purine diet Excessive intake of purines is a risk factor for uric acid stones.

A nurse is reviewing the laboratory test results from a client who has acute kidney injury. Which of the following findings should the nurse identify as expected for this condition?

Hypermagnesemia The nurse should expect the client to have hypermagnesemia due to the inability of the kidneys to filter waste products from the blood.

A nurse is reinforcing discharge teaching with a client who has undergone a transurethral resection of the prostate (TURP). Which of the following statements should the nurse include in the teaching?

Increase fluid intake if urine becomes blood tinged."

A nurse is implementing a bladder-training program for a client. For which of the following actions by the assistive personnel (AP) who is helping with the client's care should the nurse intervene?

Instructs the client to urinate whenever the urge occurs MY ANSWER The goal of bladder training is to increase bladder control. The primary objective is to have the client resist the urge to urinate and thus increase time between urination. The nurse should instruct the AP to encourage the client to take deep breaths when she feels the urge to urinate.

A nurse is evaluating the 24-hr I&O records of several clients. Which of the following client findings indicates an acceptable fluid balance?

Intake 2,400 mL, output 2,500 mL Output should be fairly closely equivalent to intake. This is an acceptable fluid balance.

A nurse is assisting with the care of a client following a transurethral resection of the prostate (TURP) and has an indwelling urinary catheter. Which of the following actions should the nurse take?

Irrigate the catheter as prescribed. The nurse should irrigate the catheter to remove blood clots and maintain catheter patency.

A nurse is planning to insert an indwelling urinary catheter for an adult female client. Which of the following actions should the nurse plan to take?

Lubricate the catheter 2.5 to 5 cm (1 to 2 in). The nurse should lubricate the catheter 2.5 to 5 cm (1 to 2 in) for a female client prior to inserting the catheter to prevent discomfort and facilitate advancing the catheter. The nurse should lubricate the catheter 15 to 17.5 cm (6 to 7 in) for a male client.

A charge nurse is assisting a newly-licensed nurse to insert an indwelling urinary catheter for a male client. Which of the following actions requires the charge nurse to intervene

Lubricates the first 2.5 to 5 cm (1 to 2 in) of the catheter tubing The nurse should lubricate the first 2.5 to 5 cm (1 to 2 in) of the catheter tubing when inserting a catheter for a female client. The nurse should lubricate the first 15 to 17.5 cm (6 to 7 in) of tubing when inserting a catheter for a male client to ensure the catheter enters the bladder.

A nurse is reviewing the chart of a client who is scheduled to have radiological studies of the kidneys performed with the use of IV contrast dye. Which of the following client medications should the nurse withhold prior to the examination?

Metformin MY ANSWER The nurse should recognize that metformin is used to treat type 2 diabetes and can cause lactic acidosis and renal failure when given along with IV contrast dye. It should be held for 24 hr prior to and 48 hr following the procedure.

A nurse is reviewing the urinalysis results of a client who reports urinary frequency and burning. Which of the following findings should the nurse report to the provider?

Microscopic hematuria Hematuria indicates the presence of blood in the urine, which is a finding associated with urinary tract infection. The nurse should report this finding to the provider so the client can receive appropriate treatment.

A nurse is reinforcing nutrition teaching to a client who has chronic kidney disease about limiting foods high in phosphorus. Which of the following foods should the nurse instruct the client to avoid? (Select all that apply).

Milk and sunflower seeds and poultry

A nurse is caring for a client following a renal biopsy. Which of the following actions should the nurse take? (Select all that apply).

Monitor for hematuria is correct. The nurse should monitor the client for bleeding, such as hematuria, tachycardia, hypotension, or bleeding at the biopsy site. Check for flank pain is correct. Flank pain is a manifestation of internal bleeding from the renal biopsy.

A nurse is caring for a client who is in the oliguric phase of acute kidney injury. Which of the following actions should the nurse take?

Monitor intake and output hourly

A nurse is assisting in the post-dialysis plan of care for a client who is receiving hemodialysis treatment for chronic kidney disease. Which of the following interventions should the nurse include in the plan of care?

Monitor the client for bleeding. The nurse should monitor for bleeding at least for 1 hr after the procedure because heparin is administered during the hemodialysis treatment and places the client at risk for bleeding.

A nurse is reviewing the laboratory values for a client who takes spironolactone and notes that the client's serum potassium level is 6.8 mEq/L. The nurse notifies the provider and anticipates that the provider will provide which of the following instructions?

Obtain a 12-lead ECG. This client's potassium level is above the expected reference range. Because hyperkalemia can cause ECG changes, including ventricular dysrhythmias and cardiac arrest, it is essential to obtain a 12-lead ECG and to monitor for such changes.

A nurse is collecting data from a client who has a urine output of 250 mL in a 24-hr period. Which of the following terms should the nurse use to document this finding in the electronic record?

Oliguria MY ANSWER The nurse should document that the client has oliguria, which is urine output less than 500 mL in 24 hr or less than 30 mL per hr.

A nurse is collecting data from a child who has nephrotic syndrome. Which of the following manifestations should the nurse expect?

Periorbital edema The glomerular membrane is permeable to albumin, which is excreted and changes the colloidal osmotic pressure. Therefore, periorbital edema is a clinical manifestation of nephrotic syndrome.

A nurse is reinforcing teaching with a client who has a new prescription for phenazopyridine. The nurse should reinforce to the client to expect which of the following while taking this medication?

Reddish-orange urine The nurse should instruct the client that taking phenazopyridine can change the urine color to red or orange and that the finding is harmless. However, the discolored urine can stain cloth

A nurse is reinforcing dietary instructions with a client who has chronic kidney disease. Which of the following information should the nurse include?

Reduce intake of foods high in potassium. The nurse should include information for the client to reduce foods high in potassium, because potassium levels can increase dangerously high with impaired kidney function.

A nurse is collecting data from a client. Which of the following findings should the nurse report to the charge nurse as an indicator of dehydration?

Skin tenting A client who has dehydration has poor skin turgor, with skin tenting, which the nurse should observe for over the sternum or the back of the forearm.

A nurse is reviewing laboratory findings for a client who has acute kidney disease. Which of the following findings should the nurse expect?

Serum creatinine 6 mg/dL Serum creatinine 6 mg/dL is above the expected reference range. A client who has acute kidney disease will have an elevated serum creatinine level, and glomerular filtration rate decreases with decreased renal function.

A nurse is reviewing the admission prescriptions for a client who has benign prostatic hyperplasia. Which of the following medications should the nurse expect to administer?

Silodosin The nurse should recognize that silodosin is an alpha-adrenergic blocker medication used to treat BPH by relaxing smooth muscle to improve urine flow.

A nurse is phoning a provider to report a client's serum potassium of 6.2 mEq/L. Which of the following medications should the nurse expect the provider to prescribe?

Sodium polystyrene sulfonate MY ANSWER This potassium level is above the expected reference range. Therefore, the nurse should expect to administer sodium polystyrene sulfonate, which absorbs potassium from within the large intestine.

A nurse is caring for a client who has paraplegia and is on an intermittent urinary catheterization program. Which of the following findings indicates to the nurse the need to catheterize the client?

Suprapubic discomfort Suprapubic discomfort is an indicator of bladder distention. The nurse should perform intermittent catheterization when bladder distention is present to prevent bladder trauma.

A nurse is reinforcing teaching to a client who is scheduled for an intravenous pyelogram. Which of the following should the nurse include in the teaching?

Take a laxative the evening before the procedure. MY ANSWER Stool or gas in the bowel may make it difficult to visualize the renal system during an intravenous pyelogram, so typically the bowel is cleansed the day before.

A nurse is reinforcing teaching with a client about the oliguric phase of acute kidney injury. Which of the following information should the nurse include in the teaching?

The client's urine output is less than 400 mL per 24 hours. The client who has acute kidney injury will have urine output of 100 to 400 mL per 24 hours.

A nurse is caring for a client who is receiving treatment for a potassium level of 3.1 mEq/L. The nurse should identify a decrease in which of the following factors as a therapeutic response to therapy?

Urinary output Hypokalemia can cause polyuria. Therefore, the nurse should identify a decrease in the client's urinary output as a sign of effectiveness of treatment

A nurse is emptying a client's urinal when she notices the urine is dark amber, cloudy, and has an unpleasant odor. The nurse should identify that these findings are likely to be the result of which of the following?

Urinary tract infection With a urinary tract infection, the urine appears cloudy and concentrated because of the presence of WBCs and bacteria. Pus and bacteria can cause the unpleasant smell.

A nurse is collecting data from a client who has dehydration. Which of the following findings should the nurse expect?

Urine output 20 mL/hr MY ANSWER A client who has dehydration can have decreased urine output, usually less than 30 mL/hr.

A nurse is monitoring a client who has dehydration and is receiving IV fluid replacement. Which of the following findings should the nurse identify as effectiveness of the treatment?

Urine output 200 mL/4 hr This finding indicates a urine output 50 mL/hr. The nurse should identify a urine output of at least 30 mL/hr as indicating adequate circulating fluid volume and kidney function.

A charge nurse overhears a newly licensed nurse providing instructions to a female client on the proper steps to collect a midstream urine specimen. Which of the following statements made by the newly licensed nurse requires the charge nurse to intervene?

Use the provided towelette to cleanse the area by moving in a back-and-forth motion." MY ANSWER The client should use a new towelette each time to cleanse from an area of least contamination (front) to an area of greater contamination (back).

A nurse is reviewing the medication record of a client who has chronic renal disease. Which of the following medications should the nurse identify as having the potential to cause nephrotoxicity?

Vancomycin Vancomycin, an anti-infective, can cause nephrotoxicity.

A nurse is reinforcing teaching with a client who has received treatment for kidney stones. The nurse should remind the client to increase intake of which of the following?

Water Clients who are prone to kidney stones should drink 3 to 4 L of fluid, with most of it water, through the course of each day. This helps keep urine dilute to prevent the concentration and precipitation of substances that form kidney stones.

A nurse is reinforcing teaching to a female client who has acute cystitis and is to start therapy with phenazopyridine. Which of the following information should the nurse give to the client?

Wear a protective pad under clothing to prevent staining." MY ANSWER The nurse should reinforce that this medication will cause the urine to change to an orange or red color that can stain clothing.

A nurse is reinforcing teaching about monitoring weight with a client who has chronic kidney disease. Which of the following instructions should the nurse include in the teaching? .

Weigh at the same time each day. The nurse should instruct the client to weigh at the same time each day for a more accurate reading.

A nurse is reinforcing teaching with the mother of a toddler who has acute nephrotic syndrome. The nurse should emphasize the need to report which of the following manifestations to the provider? ​

Yellow nasal discharge Yellow or green nasal discharge is a sign of an upper respiratory infection. Children who have nephrotic syndrome are at constant risk for infection, so the mother should report this manifestation to the provider who can prescribe appropriate and prompt treatment.

A nurse in a provider's office is reinforcing teaching with a client who is to undergo a cystoscopy. Which of the following information should the nurse include in the teaching?

You can take a warm sitz bath after the procedure."

A nurse is reinforcing teaching with a client who is to undergo a creatinine clearance test. Which of the following information should the nurse include in the teaching?

You will need to avoid rigorous exercise during the test time." MY ANSWER Exercise can cause an increase in the creatinine values. The nurse should inform the client that he should avoid exercising during the testing time.

A nurse is preparing a sterile field for the insertion of a urinary catheter. Identify the sequence of actions the nurse should follow. (Move the steps into the box on the right, placing them in the selected order of performance. Use all the steps.)

body. The first action the nurse should take is to perform hand hygiene. Hand hygiene reduces the number of micro-organisms on the skin and prevents the spread of micro-organisms to the sterile field. Next, the nurse should place the sterile package on the work surface The sterile package contains items that should be placed on a flat, clean, and dry work surface above waist level. When opening the sterile package, the nurse should lift the outermost flap away from the body by grasping the tip of the flap. After the outermost flap is open, the nurse should open the side flaps, pulling each to the side so that they lie flat on the work surface. The innermost flap should be opened toward body. At this point, the nurse can use the inner surface of the package as a sterile field, keeping in mind that the 2.5 cm (1 in) border around the edges of the inner surface is not sterile