Med/Surg Exam 2 Practice Question
A client with urinary retention needs to undergo a procedure to insert an indwelling catheter. Before catheterization, the nurse would discuss with the physician information about: a. insertion of a nasogastric tube b. administering cleansing enemas c. placement of IV and central venous pressure lines d. the type and size of the catheter to be used
d. the type and size of the catheter to be used
The nurse instructs a client to perform continuous ambulatory peritoneal dialysis correctly at home. Which educational information should the nurse provide to the client? a. wear a mask while handling any dialysate solutions b. clean the catheter insertion site daily with soap c. keep the catheter stabilized to the abdomen, below the belt line d. use an aseptic technique during the procedure
d. use an aseptic technique during the procedure
A client presents to the ED reporting left flank pain and lower abdominal pain. The pain is severe, sharp, stabbing and colicky in nature. The client has also experienced nausea and emesis. The nurse suspects the client is experiencing: a. ureteral stones b. pyelonephritis c. urethral infection d. cystitis
a. urethral stones
The most accurate indicator of fluid loss or gain in an acutely ill client is: a. weight b. edema c. blood pressure d. pulse rate
a. weight
Below which serum sodium concentration might convulsions or coma occur? a. 145 mEq/L b. 135 mEq/L c. 140 mEq/L d. 142 mEq/L
b. 135 mEq/L
The normal serum value for potassium is: a. 8.5-10.5 mg/dL b. 3.5-5.0 mEq/L c. 96-106 mEq/L d. 135-145 mEq/L
b. 3.5-5.0 mEq/L
Which electrolyte is a major anion in body fluid? a. Calcium b. Chloride c. Sodium d. Potassium
b. Chloride
The nurse is assigned to care for a client with a serum phosphorus concentration of 5.0 mg/dL. The nurse anticipates that the client will also experience which electrolyte imbalance? a. Hypermangesemia b. Hypocalcemia c. Hyperchloremia d. Hyponatremia
b. Hypocalcemia
Which electrolyte is a major cation in body fluid? a. Bicarbonate b. Potassium c. Phosphate d. Chloride
b. Potassium
A history of infection specifically caused by group A beta-hemolytic streptococci is associated with which disorder? a. acute renal failure b. acute glomerulonephritis c. nephrotic syndrome d. chronic renal failure
b. acute glomerulonephritis
The nurse is completing a routine urinalysis using a dipstick. The test reveals an increased specific gravity. The nurse should suspect which condition? a. increased fluid intake b. decreased fluid intake c. glomerulonephritits d. diabetes insipidus
b. decreased fluid intake
The nurse passes out medications while a client prepares for hemodialysis. The client is ordered to receive numerous medications including antihypertensives. What is the best action for the nurse to take? a. ask if the client wants to take the medications b. hold the medications until after dialysis c. administer the medications as ordered d. check with the dialysis nurse about the medications
b. hold the medications until after dialysis
Which factor contributes to UTI in older adults? a. sporadic use of antimicrobial agents b. immunocompromise c. active lifestyle d. low incidence of chronic illness
b. immunocompromise
Which type of incontinency refers to the involuntary loss of urine due to extrinsic medial factors, particularly medications? a. incomplete bladder empyting b. incontinence c. urgency d. urinary retention
b. incontinence
Early signs of hypervolemia include: a. thirst b. increased breathing effort and weight gain c. decrease in blood pressure d. moist breath sounds
b. increased breathing effort and weight gain
Oncotic pressure refers to the: a. excretion of substances such as glucose through increased urine output b. osmotic pressure exerted by proteins c. amount of pressure needed to stop the flow of water by osmosis d. number of dissolved particles contained in a unit of fluid
b. osmotic pressure exerted by proteins
What is a hallmark of the diagnosis of nephrotic syndrome? a. hypokalemia b. proteinuria c. hypnatremia d. hypoalbuminemia
b. proteinuria
A nurse is caring for a client with acute renal failure and hypernatremia. In this case, which action can be delegated to the nursing assistant? a. Monitor for signs and symptoms of dehydration b. Provide oral care every 2-3 hours c. assess the client's weight daily for trends d. teach the client about increased fluid intake
b. provide oral care every 2-3 hours
The nurse is caring for a client with a serum sodium concentration of 113 mEq/L. The nurse should monitor the client for the development of which condition? a. Nausea b. Headache c. Confusion d. Hallucinations
c. Confusion
Which term describes painful or difficult urination? a. anuria b. dysuria c. oliguria d. nocturia
b. dysuria
Hypokalemia can cause which symptom to occur? a. production of concentrated urine b. excessive thirst c. increased release of insulin d. decreased sensitivity to digitalis
b. excessive thirst
The nurse is assessing a client for local complication of intravenous therapy. Which are local complications? Select all that apply. a. air embolism b. hematoma c. extravasation d. infection e. phlebitis
b. hematoma c. extravasation e. phlebitis
Which risk factors predispose a client to the development of kidney stones? Select all that apply. a. hypoparathyroidism b. immobilization c. gout d. hyperparathyroidism
b. immobilization
When fluid intake is normal, the specific gravity of urine should be: a. less than 1.010 b. 1.000 c. 1.010 to 1.025 d. great than 1.025
c. 1.010 to 1.025
The nurse is care for a client with a serum potassium concentration of 6.0 mEq/L. The client is ordered to receive oral sodium polystyrene sulfonate and furosemide. What other order should the nurse anticipate giving? a. Change the lactated ringer solution to 3% saline b. Increase the rate of the intravenous lactated ringer solution c. Discontinue the IV lactated ringer solution d. Change the lactated ringer solution to 2.5% dextrose
c. Discontinue the IV lactated ringer solution
Which condition might occur with respiratory acidosis? a. decreased pulse b. decreased blood pressure c. increased intracranial pressure d. mental alertness
c. increased intracranial pessure
Approximately what percentage of blood passing through the glomeruli is filtered into the nephron? a. 40 b. 10 c. 30 d. 20
d. 20
The nurse monitors the client for potential complication during dialysis but recognizes NOT to monitor for: a. muscle cramping b. air embolism c. dyrhythmias d. hypertension
d. hypertension
What is a characteristic of the intrarenal category of acute kidney injury (AKI)? a. high specific gravity b. decreased creatinine c. decreased urine sodium d. increased BUN
d. increased BUN
What is a characteristic of the intrarenal category of acute renal failure? a. decreased urine sodium b. decreased creatinine c. high specific gravity d. increased BUN
d. increased BUN
Which term best describes a total urine output less than 500 mL in 24 hours? a. dysuria b. polyuria c. nocturia d. oliguria
d. oliguria
Which hormone causes the kidneys to reabsorb sodium? a. aldosterone b. growth hormone c. prostaglandins d. antidiuretic hormone
a. aldosterone
Which type of medication may be used to inhibit bladder contraction in a client with incontinence? a. anticholinergic agent b. tricylic antidepressants c. estrogen hormone d. over-the-counter decongestant
a. anticholinergic agent
What is an insensible mechanism of fluid loss? a. breathing b. nausea c. urination d. bowel elimination
a. breathing
An 82-year-old client experiences urinary incontinence. Which factor should the nurse assess before beginning a bladder training program for this client? a. Physical and environmental conditions b. history of allergies c. occupational history d. smoking habits
a. physical and environmental conditions
Retention of which electrolyte is the most life-threatening effect of renal failure? a. potassium b. calcium c. sodium d. phosphorous
a. potassium
The calcium concentration in the blood is regulated by which mechanism? a. Parathyroid hormone (PTH) b. Thyroid hormone (TH) c. Adrenal gland d. Androgens
a. Parathyroid Hormone (PTH)
The nurse is caring for a client diagnosed with bulimia. The client is being treated for a serum potassium concentration of 2.9 mEq/L. Which statement made by the client indicates the need for further teaching? a. "I can use laxatives and enemas but only once a week" b. "I will take a potassium supplement daily as prescribed" c. "I will be sure to buy frozen vegetables when I grocery shop" d. "A good breakfast for me will include milk and a couple bananas"
a. "I can use laxatives and enemas but only once a week"
The nurse is instructing a client with recurrent hyperkalemia about following a potassium-restricted diet. Which statement by the client indicated the need for additional instruction? a. "I will not salt my food; instead I'll use salt substitute" b. "Bananas have a lot of potassium in them; I'll stop buying them" c. "I need to check to see whether my cola beverage has potassium in it" d. "I 'll drink cranberry juice with my breakfast instead of coffee"
a. "I will not salt my food; instead I'll use salt substitute"
The nurse is caring for a client scheduled for urodynamic testing. Following the procedure, which information does the nurse provide to the client? a. "Contact the primary provider if you experience fever, chills, or lower back pain" b. "You can stop taking the prescribed antibiotic" c. "You will be sent home with a urinary catheter" d. "You may resume consuming caffeinated, carbonated, and alcoholic beverages"
a. "contact the primary provider if you experience fever, chills or lower back pain"
The nurse is caring for a client in the ICU following a new-drowning event in saltwater. The client is restless, lethargic and demonstrating tremors. Additional assessment findings include swollen and dry tongue, flushed skin, and peripheral edema. The nurse anticipates that the client's serum sodium value would be: a. 155 mEq/L b. 135 mEq/L c. 125 mEq/L d. 145 mEq/L
a. 155 mEq/L
Which is a reversible cause of urinary incontinence in the older adult? a. decreased progesterone levels in menopausal women b. age c. constipation d. increased fluid
c. constipation
When the bladder contains 400 to 500 mL of urine, this is referred to as: a. anuria b. renal clearance c. functional capacity d. specific gravity
c. functional capacity
The nurse recognizes which condition as an integumentary manifestation of chronic renal failure? a. seizures b. tremors c. gray-bronze skin color d. asterixis
c. gray-bronze skin
The nurse cares for a client after extensive abdominal surgery. The client develops an infection that is treated with IV gentamicin. After 4 days of treatment, the client develop oliguria, and lab results indicate azotemia. the client is diagnosed with acute tubular necrosis and transferred to the ICU. The client is hemodynamically stable. Which dialysis method would be most apprpriate for the client? a. continuous arteriovenous hemofiltraiton (CAVH) b. continuous venvenous hemofiltration (CVVH) c hemodialysis d. peritoneal dialysis
c. hemodialysis
A client diagnosed with chronic renal failure receives continuous peritoneal dialysis. The nurse instructs the client about which diet plan? a. low-sodium diet b. high-calorie diet c. high-protein diet d. low-protein diet
c. high-protein diet
The nurse performs acute intermittent peritoneal dialysis (PD) on a client who is experiencing uremic signs and symptoms The peritoneal fluid is not draining as expected. What is the best response by the nurse? a. push the catheter further into the abdomen b. notify the healthcare provider c. turn the client from side to side d. lower the head of the bed
c. turn the client form side to side
The nurse is caring for a client diagnosed with hyperchloremia. Which are signs and symptoms of hyperchloremia? Select all that apply. a. hypotension b. dehydration c. weakness d. lethargy e. tachypnea
c. weakness d. lethargy e. tachypnea
A client with a magnesium concentration of 2.6 mEq/L is being treated on a medical-surgial unit. Which treatment should the nurse anticipate will be used? a. fluid restriction b. oral magnesium oxide c. dialysis d. intravenous furosemide
d. Intravenous furosemide
The nurse is caring for a client undergoing alcohol withdrawal. Which serum laboratory value should the nurse monitor most closely? a. Calcium b. Potassium c. Phosphorus d. Magnesium
d. Magnesium
Which is a correct route of administration for potassium? a. IM b. IV push c. SQ d. Oral
d. Oral
The nurse treats a client with end-stage kidney disease (ESKD). The nurse is concerned that the client is developing renal osteodystrophy. Upon review of the client's lab values, it is noted that the client has had calcium level of 11mg/dL for the past 3 days and the phosphate level is 5.5 mg/dL. The nurse anticipates the administration of which medication? a. Mylanta b. Os-Cal (calcium carbonate) c. Phos-Lo (calcium carbonate) d. Renagel (sevelamer)
d. Renagel (sevelamer)
The nurse cares for a client diagnosed with chronic glomerulonephritis. The nurse will observe the client for the development of: a. hypophosphatemia b. hypokalemia c. metabolic alkalosis d. anemia
d. anemia
Which value does the nurse recognize as the best clinical measure of renal function? a. volume of urine output b. circulating ADH concentration c. urine-specific gravity d. creatinine clearance
d. creatinine clearance
Which factor increases blood urea nitrogen (BUN)? a. decreased protein intake b. hypothermia c. overhydration d. gastrointestinal bleeding
d. gastrointestinal bleeding
What percentage of potassium excreted daily leaves the body by way of the kidneys? a. 80 b. 60 c. 20 d. 40
a. 80
Which is the most common cause of symptomatic hypomagnesemia? a. Alcoholism b. Burns c. Sedentary lifestyle d. IV drug use
a. Alcoholism
Which could be a potential cause of respiratory acidosis? a. Hypoventilation b. Diarrhea c. Hyperventilation d. Vomiting
a. Hypoventilation
A client diagnosed with acute kidney injury (AKI) has a serum potassium level of 6.5 mEq/L. The nurse anticipates administering: a. Kayexalate b. IV dextrose 50% c. calcium supplements d. sorbitol
a. Kayexalate
What is used to decrease potassium level seen in an acute renal failure? a. Kayexalate b. sorbitol c. calcium supplements d. IV dextrose 50%
a. Kayexalate
While reviewing a client's chart, the nurse notes the client has been experiencing enuresis. To assess whether this remains an ongoing problem for the client, the nurse asks which question? a. "Do you urinate while sleeping?" b. "Is it painful when you urinate?" c. "Does it burn when you urinate?" d. "Do you have a strong desire to void?"
a. "Do you urinate while sleeping?"
Approximately what percentage of blood passing through the glomeruli is filtered into the nephron? a. 20% b. 40% c. 30% d. 10%
a. 20%
Renal function results may be within normal limits until the GFR is reduced to less than which percentage of normal? a. 50 b. 40 c. 30 d. 20
a. 50
The nurse is caring for a client who was admitted with fluid volume excess (FVE). Which nursing assessments should the nurse include in the ongoing monitoring of the client? Select all that apply a. blood pressure, heart rate, and rhythm b. nutritional status and diet c. skin assessment for edema and turgor d. strength testing for muscle wasting e. intake and output, urine volume and color
a. blood pressure, heart rate, and rhythm c. skin assessment for edema and turgor e. intake and output, urine volume and color
A creatinine clearance test is ordered for a client with a possible renal insufficiency. The nurse must collect which serum concentration midway through the 24-hour urine collection? a. creatinine b. osmolality c. hemoglobin d. blood urea nitrogen
a. creatinine
During the diuresis period of acute kidney injury (AKI), the nurse should observe the client closely for what complication? a. dehydration b. hypokalemia c. renal calculi d. oliguria
a. dehydration
A 30-year old client presents to the clinic for an employment physical. The nurse notes protein in the client's urine. The nurse understands that transient proteiunuria can be caused by which factor(s)? Select all that apply a. fever b. strenuous exercise c. NSAIDs d. prolonged standing e. diabetes mellitus
a. fever b. strenuous exercise d. prolonged standing
To assess circulating oxygen concentration, the 2001 Kidney Disease Outcomes Quality Initiative: Management of Anemia Guidelines recommends the use of which diagnostic test? a. hemoglobin b. hematocrit c. arterial blood gases d. serum iron concentration
a. hemoglobin
Acute dialysis is indicated during which situation? a. impending pulmonary edema b. hypokalemia c. metabolic alkalosis d. dehydration
a. impending pulmonary edema
Clients diagnosed with hypervolemia should avoid sweet or dry food because it: a. increases the client's desire to consume fluid b. obstructs water elimination c. can lead to weight gain d. can cause dehydration
a. increases the client's desire to consume fluid
The nurse is caring for a client with severe diarrhea. The nurse recognizes that the client is at risk for developing which acid-base imbalance? a. metabolic acidosis b. respiratory acidosis c. metabolic alkalosis d. respiratory alkalosis
a. metabolic acidosis
During a routine assessment, the client states; "I wake up all night long to go to the bathroom." The nurse documents this finding as which condition? a. nocturia b. polyuria c. oliguria d. dysuria
a. nocturia
The nurse cares for a client with a right-arm arteriovenous fistula (AVF) for hemodialysis treatments. Which nursing action is contraindicated? a. obtaining a blood pressure reading from the right arm b. palpating the fistula for a "thrill" c placing the client's watch on the left wrist d. obtaining blood samples from the left arm
a. obtaining a blood pressure reading from the right arm
The nurse cares for a client with acute kidney injury (AKI). The client is experiencing an increase in the serum concentration of urea and creatinine. The nurse determines the client is experiencing which phase of AKI? a. oliguria b. diuresis c. initiation d. recovery
a. oliguria
The nurse cares for a client with end-stage kidney disease (ESKD). Which acid-base imbalance is associated with this disorder? a. pH 7.20 PaCO2 36 HCO3 14 b. pH 7.47 PaCO2 45 HCO3 33 c. pH 7.31 paCO2 48 HCO3 24 d. pH 7.50 PaCO2 29 HCO3 22
a. pH 7.20 PaCO2 36 HCO3 14
when evaluating arterial blood gases (ABGs), which value is consistent with metabolic alkalosis? a. pH 7.48 b. O saturation 95% c. HCO 21 mEq/L d. PaCO 36
a. pH 7.48
The nurse is analyzing the arterial blood gas (ABG) results of a client diagnosed with severe pneumonia. Which of the following ABG results indicates respiratory acidosis? a. pH: 7.20, PaCO2: 65mmHG, HCO3: 26 mEq/L b. pH: 7.32, PaCO2: 40 mmHG, HCO3: 18 mEq/L c. pH: 7.50, PaCO2: 30mmHG, HCO3: 24 mEq/L d. pH: 7.42, PaCO2: 45mmHG, HCO3: 22 mEq/L
a. pH: 7.20, PCO2: 65mmHg, HCO3: 26 mEq/L
Which is an effect of aging on upper and lower urinary tract function? a. susceptibility to develop hypernatremia b. increased glomerular filtration rate c. acid-base balance d. increased blood flow to the kidney
a. susceptibility to develop hypernatremia
When caring for a client with an uncomplicated mild UTI, the nurse knows that recent studies have shown which drug to be a good choice for short-course (e.g., 3 day) therapy? a. Ciprofloxacin b. Levofloxacin c. Trimethoprim-sulfamethoxazole d. Nitrofurantoin
b Levofloxacin
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? a. "Have you noticed any vaginal bleeding?" b. "Do you take multiple vitamin preparations?" c. "Do you take phenytoin daily?" d. "Have you had a recent urinary tract infection?"
b. "Do you take multiple vitamin preparations?"
The nurse is caring for a client who underwent a kidney transplant. The client appears anxious and tearful and states, "My body is going to reject the new kidney; I know I'm going to die." What is the best response by the nurse? a. "Don't think like that; I'm certain you will be fine" b. "I understand your concerns, let's talk about them." c. "You've waited years for this transplant, you need to think positively" d. "If your body rejects the kidney, you can go back on dialysis; you are not going to die"
b. "I understand your concerns, let's talk about them"
Which solution is hypotonic? a. 0.9% NaCl b. 0.45% NaCl c. Lactated Ringer Solution d. 5% NaCl
b. 0.45% NaCl
which value represents a normal BUN-to-creatinine ratio? a. 4:1 b. 10:1 c. 6:1 d. 8:1
b. 10:1
The nurse is caring for a patient with a metabolic acidosis (pH 7.25). Which of the following values is useful to the nurse in determining whether the cause of the acidosis is due to acid gain or to bicarbonate loss? a. PaCO2 b. Anion gap c. Bicarbonate level d. Serum sodium level
b. anion gap
The nurse is caring for a client after a cystoscopic examination. Following the procedure, the nurse informs the client that which effect may occur? a. diarrhea b. blood-tinged urine c. severe abdominal pain d. nausea and emesis
b. blood-tinged urine
The nurse is caring for a patient with a medical history of untreated CKD that has progressed to ESKD. Which of the following serum values and associated signs and symptoms will the nurse expect the patient to exhibit? Select all that apply. a. Chloride 90 mEq/L; irritability and seizures b. calcium 7.5 mg/dL; hypotension and irritability c. Potassium 6.4 mEq/L; dysrhythmias and abdominal distention d. Magnesium 1.5 mg/dL; mood changes and insomnia e. phosphate 5.0 mg/dL; tachycardia and nausea and emesisi
b. calcium 7.5 mg/dL; hypotension and irritability c. Potassium 6.4 mEq/L; dysrhythmias and abdominal distention e. Phosphate 5.0 mg/dL; tachycardia and nausea and emesis
Which information is important when teaching a client how to perform self-catheterization? a. The nurse uses nonsterile technique in the hospital setting b. catheterization should occur every 4 to 6 hours and before bedtime c. the catheter is rinsed with sterile normal saline after being soaked in a cleaning solution d. peroxide is recommended for cleaning the urinary catheter
b. catheterization should occur every 4 to 6 hours and before bedtime
The nurse is caring for a client with a history of sickle cell anemia. The nurse understands that this predisposes the client to which renal or urologic disorder? a. neurogenic bladder b. chronic kidney disease c. kidney stone formation d. proteinuria
b. chronic kidney disease
Which term refers to casts in the urine? a. bacteriuria b. cylindruria c. pyruria d. crystalluria
b. cylindruria
Which instruction would be included in a teaching plan for a client diagnosed with a UTI? a. drink coffee or tea to increase diuresis b. drink liberal amount of fluids c. use tub baths as opposed to showers d. void every 4 to 6 hours
b. drink liberal amounts of fluids
To obtain information about the chief report and medical history of an older adult client, the nurse asks the client about any medication history. Why is obtaining a medication history important? a. it may indicate the client's general health b. it may indicate multiple medications taken by the client c. it may reflect the client's childhood and family illnesses d. it may indicate drugs that should not be prescribed to the client
b. it may indicate multiple medications taken by the client
A client is treated for renal calculi and suspected hydronephrosis. Therefore, the nurse should maintain a record of the kidney's function. Which measure can the nurse take to help achieve the objective? a. palpate for a thrill over the vascular access b. monitor the patient's intake and output c. inspect the skin over the fistula or graft for signs of infection d. note the nail beds and mobility of the fingers
b. monitor the patient's intake and output
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? a. assess for signs of electrolyte and water imbalance b. palpate the pulses in the legs and feet c. encourage the client to void d. monitor the client for signs and symptoms of pyelonephritis
b. palpate the pulses in the legs and feet
The nurse is caring for a client who reports orange urine. The nurse suspects which factor as the cause of urine discoloration? a. phenytoin b. phenazopyridium hydrochloride c. infection d. metronidazole
b. phenazopyrdidium hydrochloride
A client with a history of chronic renal infections is to undergo CT with contrast. Before the procedure, the nurse should complete which action? a. keep the client NPO for 1 hour before the scan b. place emergency medical equipment in the procedure room c. hold the client's iron supplement until after the diagnostic test d. instruct the client to maintain a full bladder for the diagnostic test
b. place emergency medical equipment in the procedure room
The nurse is analyzing the ECG rhythm tracing of a client experiencing hypercalcemia. Which ECG change is typically associated with this electrolyte imbalance? a. prolonged QT intervals b. prolonged PR intervals c. elevated ST segments d. peaked T waves
b. prolongs PR intervals
Which is the correct term for the ability of the kidneys to clear solutes from the plasma? a. GFR b. renal clearance c. specific gravity d. tubular secretion
b. renal clearance
A nurse cares for an acutely ill client. The nurse understands that the most accurate indicator of fluid loss or gain in an acutely ill client is: a. blood pressure b. weight c. edema d. pulse rate
b. weight
A client diagnosed with acute kidney injury (AKI) has developed congestive heart failure. The client has received 40mg of IV push Lasix and 2 hours later, the nurse notes that there are 50 mL of urine in the foley catheter bay. The client's vital signs are stable. Which health care order should the nurse anticipate? a. Mannitol 12.5 g IVP b. Normal saline bolus of 500 mL c. Lasix 80mg IVP d. chest x-ray
c. Lasix 80mg IVP
A client is being treated in the ICU 24 hours after having radical neck dissection completed. The client's serum calcium concentration is 7.6 mg/dL. Which physical examination finding is consistent with this electrolyte imbalance? a. Slurred speech b. Negative Chvostek sign c. Presence of trousseau sign d. Muscle weakness
c. Presence of Trousseau sign
A change that occurs during chronic glomerulonephritis is termed: a. hypophosphatemia b. hypokalemia c. anemia d. metabolic alkalosis
c. anemia
What is the most common presenting objective symptom of a UTI in older adults, especially those with dementia? a. back pain b. incontinence c. change in cognitive functioning d. hematuria
c. change in cognitive function
Bladder retraining following removal of an indwelling catheter begins with: a. advising the client to avoid urinating for at least 6 hours b. encouraging the client to void immediately c. instructing the client to follow a 2 to 3 hours timed voiding schedule d. performing straight catheterization after 4 hours
c. instructing the client to follow a 2 to 3 hours timed voiding schedule
The nurse observes that the client's urine is orange. Which additional assessment would be important for this client? a. intake of multiple vitamin preparations b. bleeding c. intake of medications such as phenytoin d. infection
c. intake of medications such as phenytoin
When caring for a client who has risk factors for fluid and electrolyte imbalances, which assessment finding is the highest priority for the nurse to follow up? a. blood pressure 96/53 mmHg b. weight loss of 4lb c. irregular heart rate d. mild confusion
c. irregular heart rate
Which is an effect of aging on upper and lower urinary tract function? a. acid-base balance b. increased blood flow to the kidneys c. increased GFR d. more prone to develop hypernatremia
d. more prone to develop hypernatremia
A client with cancer is being treated on the oncology unit for bilateral breast cancer. The client is undergoing chemotherapy. The nurse notes the client's serum calcium concentration is 12.3 mg/dL. Given this laboratory finding, the nurse should suspect that the: a. client may be developing hyperaldosteronism b. client has a history of alcohol abuse c. malignancy is causing the electrolyte imbalance d. client's diet is lacking in calcium-rich food products
c. malignancy is causing the electrolyte imbalance
Which statement accurately reflects a rule of thumb on which the nurse may rely in assessing a client's fluid balance? a. minimal intake of 2 L/day b. Minimal urine output of 50 mL/hour c. Minimal intake of 1.5 L/day d. Minimal urine output of 10 mL/hour
c. minimal intake of 1.5 L/day
The term used to describe total urine output less than 0.5 mL/kg/hr is a. anuria b. nocturia c. oliguria d. dysuria
c. oliguria
Which period of acute renal failure is accompanied by an increase in the serum concentration of substances usually excreted by the kidneys? a. recovery b. initiation c. oliguria d. diuresis
c. oliguria
Which type of incontinence is the involuntary loss of urine through an intact urethra as a result of coughing? a. urge b. overflow c. stress d. reflex
c. stress
Which condition leads to chronic respiratory acidosis in older adults? a. overuse of sodium bicarbonate b. erratic meal patterns c. thoracic skeletal change d. decreased renal function
c. thoracic skeletal changes
What is the term for a concentration of urea and other nitrogenous wastes in the blood? a. proteinuria b. uremia c. hematuria d. azotemia
d azotemia
A client is to receive hypotonic IV solution in order to provide free water replacement. Which solution does the nurse anticipate administering? a. 0.9% NaCl b. 5% NaCl c. Lactated Ringer solution d. 0.45% NaCl
d. 0.45% NaCl
Which is considered an isotonic solution? a. 0.45% normal saline b. Dextran in normal saline c. 3% NaCl d. 0.9% normal saline
d. 0.9% normal saline
In assessing the appropriateness of removing a suprapubic catheter, the nurse recognizes that the client's residual urine must be less than which amount on two separate occasions (morning and evening)? a. 30 mL b. 50 mL c. 400 mL d. 100 mL
d. 100 mL
A client is experiencing a severe anxiety attack and hyperventilating presents to the emergency department. The nurse would expect the client's pH value to be: a. 7.35 b. 7.45 c. 7.30 d. 7.50
d. 7.50
The nurse has been assigned to care for various clients. Which client is at the highest risk for a fluid and electrolyte imbalance? a. A 66-year old client who had an open cholecystectomy with a T-tube placed that is draining 125 mL of bile per shift b. A 45-year old client who had a laparoscopic appendectomy 24 hours ago and is being advanced to a regular diet c. A 79 year-old client admitted with a diagnosis of pneumonia d. An 82-year old client who receives all nutrition via tube feedings and whose medication include carvedilol and torsemide
d. An 82-year old client who receives all nutrition via tube feedings and whose medications include carvedilol and torsemide
The nurse is preparing a client for a nuclear scan of the kidneys. Following the procedure, the nurse instructs the client to: a. notify the health care team if bloody urine is noted b. maintain bed rest for 2 hours c. carefully handle urine because it is radioactive d. drink liberal amounts of fluids
d. drink liberal amounts of fluids
Rejection of a transplanted kidney within 24 hours after transplant is termed: a. chronic rejection b. acute rejection c. simple rejection d. hyperacute rejection
d. hyperacute rejection
The nurse cares for a client who underwent a kidney transplant. The nurse understands that rejection of a transplanted kidney within 24 hours after transplant is termed: a. simple rejection b. chronic rejection c. acute rejection d. hyperacute rejection
d. hyperacute rejection
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? a. clean the catheter insertion site daily with soap b. keep the catheter stabilized to the abdomen, below the belt line c. wear a mask while handling any dialysate solutions d. keep the dialysis supplies in a clean area, away from children and pets
d. keep the dialysis supplies in a clean area, away from children and pets
A client undergoes surgery to remove a malignant tumor, followed by a urinary diversion procedure. Which postoperative procedure should the nurse perform? a. show photographs and drawings of the placement of the stoma b. determine the client's ability to manage stoma care c. suggest a visit to a local ostomy group d. maintain skin and stoma integrity
d. maintain skin and stoma integrity
Which arterial blood gas (ABG) result would the nurse anticipate for a client with a 3-day history of vomiting? a. pH: 7.28, PaCO2: 25 mmHg, HCO3: 15 b. pH: 7.34, paCO2: 60 mmHg, HCO3: 34 c. pH: 7.45, PCO2: 32 mmHg, HCO3: 21 d. pH: 7.55, PaCO2: 60 mm Hg, HCO3: 28
d. pH: 7.55, PaCO2: 60 mmHg, HCO3: 28
If an indwelling catheter is necessary, which nursing intervention should be implemented to prevent infection? a. use a clean technique during insertion b. place the catheter bag on the client's abdomen when moving the client c. use a sterile technique to disconnect the catheter from the tubing to obtain urine specimens d. perform meticulous perineal care daily with soap and water
d. perform meticulous perineal care daily with soap and water
Which term refers to inflammation of the renal pelvis? a. interstitial nephritis b. urethritis c. cystitis d. pyelonephritis
d. pyelonephritis
The nurse is participating in the care of a client who had a peripherally inserted central catheter (PICC) placed in the right arm. After catheter placement, the nurse should complete which action? a. assess the client's blood pressure on the right arm b. administer the prescribed IV fluids c. obtain written consent for the procedure d. send the client for a chest x-ray
d. send the client for a chest x-ray
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? a. overflow b. urge c. reflex d. stress
d. stress
The nurse who teaches a client about preventing recurrent UTIs would include which statement? a. take tub baths instead of showers b. increase intake of coffee, tea and colas c. void every 5 hours during the day d. void immediately after sexual intercourse
d. void immediately after sexual intercourse
