Module 7 Assignment 1 NCLEX-PN Custom EAQ: Urinary Disorders

A client with chronic kidney disease is admitted to the hospital with a severe infection and anemia. The client reports depression and irritablility. The client' s spouse asks about the anticipated plan of care. Which response would the nurse give

"A dietary restriction of meat, eggs, and cheese so the kidneys can clear the waste products."

A client is scheduled for a transurethral resection of the prostate (TURP). Which statement made by the client most indicates the need for further preoperative teaching?

"My incision will probably be painful."

When explaining a renal clearance test to a client, the nurse reports the test measures the kidneys ' ability to remove a substance from the plasma within which amount of time?

1 min

Having received hemodialysis over two years for chronic kidney disease, the client reports to the dialysis unit for treatment displaying angry and critical behaviors. The nurse notes the client is frequently noncompliant with medications and diet. Which explanation would the nurse associate with the client' s behavior before intervening?

A defense against underlying depression and fear

For a client with end-stage renal disease, which manifestation would the nurse monitor development? Select all that apply. One, some, or all responses may be correct.

Anemia Dyspnea Anasarca

Which finding on the laboratory report of an adolescent child with nephrotic syndrome does the nurse expect the child' s urine to reveal?

High protein level

Which indicator would the nurse expect to associate with a client with end-stage renal disease? Select all that apply. One, some, or all responses may be correct.

Azotemia Hypertension

When prescribed for a client reporting urinary problems, cholinergic medications prevent which physiological response?

Bladder flaccidity

Which manifestation would a nurse expect a client with renal calculi to report? Select all that apply. One, some, or all responses may be correct.

Blood in the urine Frequency and urgency of urination

Which dietary need would the nurse discuss with a client being treated with continuous ambulatory peritoneal dialysis (CAPD) for chronic glomerulonephritis?

High-quality protein

For which client finding would the nurse conclude that the anemia accompaning chronic kidney disease should be treated?

Chronic fatigue

When a client asks about the cause of urinary incontinence, which potential cause would the nurse discuss with the client? Select all that apply. One, some, or all responses may be correct.

Confusion Medication Dehydration Fecal impaction Restricted mobility

For a client with renal insufficiency and fluid volume overload, which action would the nurse take to safely administer the drug, torsemide? Select all that apply. One, some, or all responses may be correct

Do not administer later than midafternoon.

For a client with a history of chronic kidney disease, the nurse would monitor development of which sign?

Edema and pruritus

For a client who received a renal transplant, which sign of organ rejection would the nurse include in the client' s teachings?

Elevated blood pressure

Which disease increases the risk for hyperkalemia?

End-stage renal disease

The nurse is caring for a client who has a prescription for a diuretic, a 2-g sodium diet, and an oral fluid restriction of 1200 mL daily. The most recent laboratory results are blood urea nitrogen (BUN) level of 42 mg/dL and a creatinine of 1.1 mg/dL. Which action would the nurse take considering the assessment findings?

Expecting an increase in the oral fluid intake

When noting a client' s medication history includes a cholinergic medication, the nurse recalls the medication treats which type of urinary condition?

Flaccid bladder

Which factor would contribute to hyponatremia in a client who is admitted with a fractured hip, kidney failure, and dehydration and has received 1500 mL of intravenous (IV) fluid in the past 24 hours?

Fluid intake

During the early postoperative period after a radical nephrectomy, for which acute life-threatening complication would the nurse monitor the client?

Hemorrhage

For which finding would a nurse assess during the oliguric phase of kidney injury or disease?

Hyperkalemia

Which manifestation of chronic kidney disease indicates the need for hemodialysis?

Hyperkalemia

A nurse anticipates that dialysis will be necessary for a 12- year-old child with chronic kidney disease when the child begins to exhibit which symptom?

Hypervolemia

Which compensatory mechanism within the body is activated to counteract the effects of the child' s acid-base imbalance due to severe dehydration?

Increased respiratory rate

Which advice would be most beneficial for a client who has diabetes and renal disease? Select all that apply. One, some, or all responses may be correct.

Instruct the client to check blood pressure regularly. Contact the primary health care provider before taking ibuprofen. Encourage the client to undergo a microalbuminuria test yearly.

To prevent future development of renal calculi for a client with ureteral colic, which action would the nurse include in the plan of care?

Instructing the client to drink 8 to 10 glasses of water daily

Within which area of the urinary tract are renal calculi most commonly formed?

Kidney

Which factor influences a client' s ability to perform deep breathing and coughing therapy after a nephrectomy for cancer of the kidney?

Location of the surgical incision

The nurse recalls furosemide, prescribed for a client with hypervolemia, acts on which part of the renal system?

Loop of Henle

Which action is important for the nurse to take while providing care for a client with a ureteral calculus? Select all that apply. One, some, or all responses may be correct

Monitor intake and output Strain the urine at each voiding Administer the prescribed analgesic

For the client who had percutaneous lithotripsy for renal calculi, the nurse would provide which important instruction?

Notify health care provider of cloudy or foul-smelling urin

Which adverse reaction will the nurse monitor for in a client receiving sulfa-type loop diuretics who is also on an aminoglycoside antibiotic? Select all that apply. One, some, or all responses may be correct

Ototoxicity

A child with a diagnosis of glomerulonephritis has a decrease in urine output to less than 100 mL/24 hr, a creatinine clearance of 60 mL/min, and an irregular apical pulse. A diagnosis of acute renal failure is made. Which serum level would require immediate intervention?

Potassium 6.1 mEq/L

When reviewing the laboratory reports for a client with end-stage renal disease, which test result would the nurse anticipate?

Potassium of 6.3 mEq/L

A client who has had a transurethral resection of the prostate asks why it is necessary to maintain the retention catheter taut secured to the leg. Which reason would the nurse include in the response to this question?

Prevents bleeding

Which condition would the nurse suspect for a client reporting dysuria, hesitancy, urinary urgency, and leaking; and whose laboratory reports reveal a serum prostate-specific antigen (PSA) level of 5 ng/mL with an elevated prostatic acid phosphatase (PAP) levels?

Prostate cancer

Which individual on the health care team may be responsible for the complication of pneumonia in a client who underwent a nephrectomy and was cared for by a registered nurse (RN) with some duties delegated to a cross-trained technician? Select all that apply. One, some, or all responses may be correct.

RN Cross-trained technician

Which type of acid-base imbalance may most likely be found in the client with heart failure and a blood pH greater than 7.45?

Respiratory alkalosis

For a client with prostate cancer, which factor would the nurse associate with urinal requests at frequent intervals followed by either non-voiding or voiding only in very small amounts?

Retention

Which assessment would the nurse associate with the function of a newly transplanted kidney?

Serum creatinine

For a client scheduled for a transurethral ureterolithotomy for a left ureteral calculus, which type of pain would the client report during the preoperative assessment?

Spasmodic, left side pain which radiates to the suprapubic area

Which potential complication is the most serious for a client with acute kidney injury?

infection

When a client with acute kidney disease questions the need for a protein-restricted diet, which response would the nurse make?

This diet supplies only essential amino acids and reduces the amount of metabolic waste products, which decreases stress on kidney

Which intervention would the nurse implement as directed when finding poor skin turgor and scanty urine output on assessment of a client experiencing a psychotic episode? Select all that apply. One, some, or all responses may be correct.

Turn at least every two hours (q 2 h). Initiate input and output (I&O) recording. Watch urine output closely. Perform neurologic assessment every four hours (q 4 h). Encourage oral fluids in small amounts. Give intravenous (IV) solution at 125 mL per hour as prescribed.

To confirm a diagnosis of a urinary tract infection for a client who develops chills, fever, flank pain, and malaise while recovering from deep partial-thickness burns, which prescribed diagnostic tests would the nurse anticipate?

Urinalysis and urine culture and sensitivity

For the older adult population, which genitourinary factor contributes to urinary incontinence?

Urinary tract infection

When teaching a client about health practices to help decrease future urinary tract infections, which information would the nurse include?

Wear cotton underpant

Of which finding would the nurse monitor potential development when providing care for a client with complications associated with peritoneal dialysis? Select all that apply. One, some, or all responses may be correct.

achycardia Cloudy outflow Abdominal pain

For a client with chronic kidney disease who has fluid restrictions, which intervention would the nurse offer for reports of thirst?

hard candy

When providing care for a client with chronic renal disease, which post-hemodialysis manifestation would the nurse expect?

weight loss