NRSG 305 Practice Questions Exam 3
The nursing instructor who is teaching about incontinence in older adults recognizes a need for further instruction when a student makes which statement? "Many factors can contribute to incontinence." "A number of factors that contribute to incontinence can be altered." "Incontinence can increase social isolation in the elderly." "Frequency is not a major problem for the elderly."
"Frequency is not a major problem for the elderly."
A nurse's neighbor is experiencing some odd symptoms, and asks the nurse about them. The neighbor states having blood in the urine intermittently and thinks there is a lump in the back (where kidney is located). What advice is most appropriate for the nurse to relay to this neighbor? "Try drinking more water and see if the symptoms go away." "Do you think you might have a kidney infection?" "Make an appointment with your health care provider immediately." "See if your health care provider will prescribe some antibiotics for you."
"Make an appointment with your health care provider immediately."
Following a health promotion class, which statement by a participant demonstrates an accurate understanding of the risk factors for bladder cancer? "I suppose I should listen to my health care provider and drink more cranberry juice." "More than ever, I guess it would be worthwhile for me to quit smoking." "I can see that preventing bladder cancer is one more benefit of a healthy diet." "I think I should be okay because there's no history of bladder cancer in my family that I'm aware of."
"More than ever, I guess it would be worthwhile for me to quit smoking."
A client is having difficulty with a weight loss plan and asks the nurse, "What is wrong with me? Why can't I lose this weight?" Which rationale might the nurse offer to this client? "Obesity ultimately results from an energy imbalance of eating too many calories and not getting enough exercise." "Obesity ultimately results from a metabolic disorder causing a decrease in the metabolic rate." "Obesity ultimately results from a person's inability to control himself or herself when around food." "Obesity ultimately results from a psychological disorder that causes low self-esteem."
"Obesity ultimately results from an energy imbalance of eating too many calories and not getting enough exercise."
With the increased risk of drug toxicity among chronically ill older adults, which statement by the nurse explains why the older adult's kidney is vulnerable to toxic injury? "The kidney is rich in blood supply and can concentrate toxins in high levels in the medullary portion of the kidney." "Prescribed medications may not be monitored as closely as they should be since Medicare does not reimburse for routine laboratory testing." "The health care provider does not always monitor for toxicity at each follow-up appointment." "Every drug dosage should be determined by client weight but most clients refuse to get on the scale."
"The kidney is rich in blood supply and can concentrate toxins in high levels in the medullary portion of the kidney."
A client has a postvoid residual (PVR) volume of 250 mL. Which information would the nurse tell the client? "This is a normal value." "This value indicates you are having difficulty emptying your bladder." "This value indicates you are emptying your bladder too completely." "This test indicates you do not have adequate bladder control."
"This value indicates you are having difficulty emptying your bladder."
Accumulation of nitrogenous wastes such as urea in the circulatory system is an early sigh of chronic kidney disease (CKD). The nurse knows that normal levels of urea in blood are approximately: 20 mg/dL (7.14 mmol/L) 60 mg/dL (21.42 mmol/L) 80 mg/dL (28.56 mmol/L) 100 mg/dL (35.70 mmol/L)
20 mg/dL (7.14 mmol/L)
A nurse is assigned to care for a group of clients. Which client is most likely to be diagnosed with malabsorption syndrome? A 24-year-old with lactose intolerance A 36-year-old with acute pancreatitis A 40-year-old with severe inflammatory bowel disease A 5-year-old taking pancreatic enzymes for cystic fibrosis
A 40-year-old with severe inflammatory bowel disease
A geriatric nurse is caring for several clients. Which alterations in health should the nurse attribute to age-related physiologic changes? An 81-year-old man's serum creatinine level has increased sharply since his last blood work. A 78-year-old woman's GFR has been steadily declining over several years. A 90-year-old woman's blood urea nitrogen (BUN) is rising. A dipstick of an 80-year-old man's urine reveals protein is present.
A 78-year-old woman's GFR has been steadily declining over several years.
Which client likely faces the greatest risk of a gastrointestinal bleed? A client whose hypertension requires taking a diuretic, an ACE inhibitor, and a beta-adrenergic blocker A client who is taking a broad-spectrum antibiotic to treat a urinary tract infection A client with a history of anxiety who takes benzodiazepines several times daily A client who takes aspirin with each meal to control symptoms of osteoarthritis
A client who takes aspirin with each meal to control symptoms of osteoarthritis
A client with multiple pain-related injuries to the back, knees, and hips is admitted with acute liver failure. Upon procuring a medication list, the nurse notes that the client is taking several over-the-counter medications that contain a preparation known to be the drug that most commonly causes liver failure. Which drug is this? Aspirin Acetaminophen Ibuprofen Phenylephrine
Acetaminophen
A 34-year-old woman presents with an abrupt onset of shaking chills, moderate to high fever, and a constant ache in her lower back. She is also experiencing dysuria, urinary frequency, and a feeling of urgency. Her partner states that she has been very tired the last few days and that she looked like she may have the flu. What is the most likely diagnosis? Renal cell carcinoma Acute renal failure Renal calculi Acute pyelonephritis
Acute pyelonephritis
Given the fact that acute pancreatitis can result in severe, life-threatening complications, the nurse should be assessing the client for which complication? Cerebral hemorrhage Acute tubular necrosis Bilateral pneumothorax Complete heart block
Acute tubular necrosis
A client with history of alcohol abuse is brought to the emergency department after a weekend of heavy drinking, experiencing right upper quadrant pain, anorexia, nausea, jaundice and ascites. The nurse identifies these as manifestations of what disorder? Fatty liver Alcoholic hepatitis Cancer of the gallbladder Cholestasis
Alcoholic hepatitis
When assessing the client with acute pancreatitis, which of these diagnostic tests—consistent with the disease— does the nurse anticipate will be altered? The transaminases Creatine kinase Amylase and lipase Glucose values
Amylase and lipase
Chronic kidney disease impacts many systems in the body. What is the most common hematologic disorder caused by CKD? Polycythemia Erythrocythemia Anemia Leukocytosis
Anemia
A client has been diagnosed with chronic kidney disease (CKD). Which drug category is usually administered to treat coexisting conditions that manifest early in CKD? Antihypertensive medications Antiarrhythmic medications Opioid analgesics Nonsteroidal anti-inflammatory drugs (NSAIDs)
Antihypertensive medications
The nurse is assessing a client who is in the clinic for a routine physical. The client is female and has upper body obesity. Which of the following would the nurse describe as being the body type of this client? Pear shaped Apple shaped Rotund Gynecoid shaped
Apple shaped
Symptoms of gastric cancer include vague epigastric pain, which makes early detection difficult. The nurse would expect a client to undergo which diagnostic examination to determine the location of the gastric cancer? Blood test Chemotherapy Barium x-ray Occult blood
Barium x-ray
The nurse is caring for a client who has had acute blood loss from ruptured esophageal varices. What does the nurse recognize is an early sign of prerenal failure? Baseline blood pressure of 150/90 mm Hg that is now 130/80 mm Hg Baseline heart rate of 100 bpm that has increased to 120 bpm Baseline urine output of 50 mL/hr that is now 10 mL/hr Foul smelling, cloudy urine
Baseline urine output of 50 mL/hr that is now 10 mL/hr
The client has right upper quadrant pain caused by acute choledocholithiasis. The health care provider suspects the common bile duct is obstructed, based on which flowing lab value? Albumin 2.0 g/dL (20 g/L) (low) Amylase 150 units/L (2.50 µkat/L) (high) Bilirubin 15 mg/dL (256.56 µmol/L) (high) Serum calcium level 7 mg/dL (1.75 mmol/L) (low)
Bilirubin 15 mg/dL (256.56 µmol/L) (high)
The nursing instructor, while teaching about renal function and disorders, informs the students that the most frequent form of urinary tract cancer is: Kidney Bladder Uterine Testicular
Bladder
A client with a history of chronic kidney disease (CKD) is experiencing increasing fatigue, lethargy, and activity intolerance. The care team has established that the client's glomerular filtration rate (GFR) remains at a low, but stable, level. Which laboratory assessments will most likely be prescribed to help determine the cause of these new symptoms? Blood work for white cells and differential Cystoscopy and ureteroscopy Assessment of pancreatic exocrine and endocrine function Blood work for hemoglobin, red blood cells, and hematocrit
Blood work for hemoglobin, red blood cells, and hematocrit
How does the full-term newborn help to regulate its body temperature? Peripheral vascular constriction Decreased sweat Shivering Brown fat
Brown fat
A client is diagnosed with Zollinger-Ellison syndrome. Which clinical manifestations confirm this diagnosis? Select all that apply. Burning, gnawing pain when the stomach is empty Pain located near the midline close to the xiphoid process Excessive belching and burping following meals Continuous vomiting lasting many days at a time
Burning, gnawing pain when the stomach is empty Pain located near the midline close to the xiphoid process
Which response by the nurse best answers a client's question regarding the purpose of white fat? Energy storage Heat production Blood sugar regulation Gluconeogenesis
Energy storage
Hospitalized neonates are at greatest risk of developing septicemia related to which procedure? Catheter-associated bacteriuria Collection of urine for analysis Arterial blood gas measurement Suctioning of tracheostomy
Catheter-associated bacteriuria
A client with a body mass index of 32 would be classified as: Class I obesity Statistically healthy Extremely obese Underweight
Class I obesity
The nurse caring for four male clients recognizes which client is at highest risk for developing postrenal kidney failure? Client with prostatic hyperplasia Client with intratubular obstruction Client with severe hypovolemia Client with acute pyelonephritis
Client with prostatic hyperplasia
A nursing instructor who is teaching students about urinary incontinence in older adults suggests that an easy and effective way to remember the transient and treatable causes of urinary incontinence is to use which acronym? FACES SBAR DIAPPERS CBC
DIAPPERS
While studying about the process of urination, the nursing student learns that which muscle is known as the "muscle of micturition"? External sphincter muscle Internal sphincter muscle Detrusor muscle Trigone muscle
Detrusor muscle
The nurse is instructing a client with advanced kidney disease (AKD) about a dietary regimen. Which restriction should the nurse be sure to include in the treatment plan to decrease the progress of renal impairment in people with AKD? Fats Dietary protein Carbohydrates Foods high in calcium
Dietary protein
A client who has been taking acetaminophen 1000 mg every 4 hours presents to the Urgent Care Center with increased abdominal pain, elevated ALT, AST, and bilirubin levels. The nurse suspects the client is experiencing: Direct hepatotoxic reaction Idiosyncratic reaction Cholestatic reaction Chronic active hepatitis
Direct hepatotoxic reaction
Several urine tests can be useful in establishing a diagnosis of acute renal failure (ARF). The nurse must consider that fractional excretion of sodium can be particularly affected by administration of which type of drug? Sulfonylureas Calcium channel blockers Diuretics Beta-adrenergic blockers (beta-blockers)
Diuretics
A client newly diagnosed with pancreatic cancer is admitted to begin treatment. Which pain descriptors can be associated with adenocarcinomas of the pancreas? Sharp, stabbing pain with each deep breath. Dull epigastric pain accompanied by back pain, worse when lying flat and relieved by sitting forward. Abdominal pain following the ingestion of a large meal heavy with fat and protein. Severe, intractable headache caused by excess fluid in the CNS causing cerebral edema.
Dull epigastric pain accompanied by back pain, worse when lying flat and relieved by sitting forward.
An older male comes to the clinic with the chief report of having difficulty voiding. The physician diagnoses him with a lower urinary tract obstruction and stasis. What should the nurse suspect to be the most frequent cause of this client's problem? Kidney infection Enlargement of prostate gland Bladder tumor Gonorrhea
Enlargement of prostate gland
An newborn has been diagnosed with renal agenesis. Which characteristics should the nurse mention to the parents as it correlates to this diagnosis? Select all that apply. Eyes are situated very close together Epicanthic folds (skin of the upper eyelid) are present Low-set ears Long, narrow nose Receding chin
Epicanthic folds (skin of the upper eyelid) are present Low-set ears Receding chin
Pharmacologic treatment for peptic ulcers has changed over the past several decades. The nurse knows that the goal for pharmacologic treatment is focused on: Increasing acid production Neutralizing blood count Promoting special diet Eradicating Helicobacter pylori (H. pylori)
Eradicating Helicobacter pylori (H. pylori)
Most common uncomplicated urinary tract infections are caused by ____ that enter through the urethra. Pseudomonas Escherichia coli Staphylococcus aureus Group B Streptococcus
Escherichia coli
People with chronic kidney disease (CKD) have impaired immune responses due to high levels of urea and metabolic wastes in the blood. What is one thing missing in the immune response when a person with CKD is exposed to sick people? Failure to mount a fever with infection Failure of a phagocytic response with infection Decrease in granulocyte count Impaired humoral immunity response with infection
Failure to mount a fever with infection
A client diagnosed with flaccid neurogenic bladder is taught to apply pressure with the hand above the symphysis pubis while in the sitting position. What is the expected outcome of this technique? Fairly efficient emptying of the bladder Triggering of sacral micturition reflex Relaxing of the internal sphincter Activation of the micturition center
Fairly efficient emptying of the bladder
The nurse is teaching her client with hepatobiliary disease about her diet. She tells her that she may have steatorrhea, which is the malabsorption of which dietary component? Fat Starch Protein Calcium
Fat
The nurse is caring for a client with hepatitis and jaundice. The nurse recognizes that without sufficient circulating bile salts the client will have intolerance to which ingested substance? Protein Fats Carbohydrates Amino acids
Fats
Which assessment does the nurse recognize is consistent with signs and symptoms of acute pancreatitis? Groin pain Periumbilical pain Pulse of 58 beats per minute Hypertension
Periumbilical pain
Good hand-washing techniques are important in health care. The nurse knows that bacterial infections can be prevented by good hand washing techniques. Which route of transmission is most common for Clostridium difficile? Fecal-oral transmission Sexual transmission Vertical transmission Iatrogenic transmission
Fecal-oral transmission
A teenager who has a history of achalasia will likely complain of which clinical manifestation? Excessive heartburn following a high-fat meal of french fries Feeling like there is food stuck in the back of the throat Projectile vomiting across the room unrelated to meals Vomiting large amounts of bright red emesis
Feeling like there is food stuck in the back of the throat
In clients with acute diarrhea, many require no treatment. However, the nurse knows the priority assessment in all clients with diarrhea is: Fluid and electrolyte status Skin integrity Dietary intake Stool specimen
Fluid and electrolyte status
The body converts dietary carbohydrates into which substance? Glucose Fatty acids Enzymes Adipose
Glucose
In the balance of secretions in the gastric mucosa by the parietal cells, which ion is produced to buffer the production of hydrochloric acid? OH- HCO3- K+ H2O
HCO3-
In collecting assessment data on the school-aged population, which factor could be the most significant predictor of childhood obesity? Low socioeconomic status Low self-esteem Having parents who are obese Living in a rural neighborhood
Having parents who are obese
A health care provider suspects a client may have developed pancreatitis. Which laboratory value will confirm this diagnosis? High serum amylase and lipase Altered alkaline phosphatase and red blood cell count Chymotrypsin level and fibrinogen level Change in platelet count and prothrombin level
High serum amylase and lipase
When caring for the client with acute pancreatitis, which alterations does the nurse recognize is consistent with the disease? Hypertension Hyperglycemia Leukopenia Polyuria
Hyperglycemia
A nurse is assessing a client for early manifestations of chronic kidney disease (CKD). Which would the nurse expect the client to display? Hypertension Impotence Terry nails Asterixis
Hypertension
The nurse is caring for the client with hepatocellular carcinoma. What does the nurse recognize is a cause of this disease? Exposure to nonsteroidal anti-inflammatory medications Illness with hepatitis B or C Gallbladder disease Diabetes
Illness with hepatitis B or C
The nurse is assessing antibody levels for a client recovering from hepatitis B. Which antibody does the nurse anticipate will be present at this time? Immunoglobulin M (IgM) Anti Hepatitis C (anti HBc) Immunoglobulin G (IgG) Immunoglobulin A (IgA)
Immunoglobulin G (IgG)
The health care provider has completed the assessment on a client with jaundice. The provider determines that which pathophysiologic abnormality could cause the jaundice? Impaired uptake of bilirubin by the liver Increased conjugation of bilirubin Increased red blood cell development Decreased oxygen demands at birth
Impaired uptake of bilirubin by the liver
A client reports urinary incontinence, specifically not feeling the urge to urinate until the bladder voids uncontrollably. Client history shows type 1 diabetes of 40+ years and compliance with medication and diet. What is the most likely diagnosis? Incontinence caused by stress on the bladder Incontinence related to having large volumes stored in the bladder Incontinence caused by a physical block in the urethra Incontinence related to neuropathy causing overactive bladder
Incontinence related to neuropathy causing overactive bladder
The nurse is assessing a client who has a unilateral obstruction of the urinary tract. Which clinical finding by the nurse correlates to this diagnosis? Increase in blood pressure Excretion of dilute urine Increased urine output Inability to control urination
Increase in blood pressure
The nurse is reviewing laboratory results of a client who has liver failure. Which finding would place the client at increased risk for bleeding? Increased prothrombin time Increased levels of vitamin K Decreased number of red blood cells Increased platelet count
Increased prothrombin time
A client is to receive a radiocontrast media as part of a diagnostic scan. Which intervention is intended to reduce the nephrotoxic effects of the radiocontrast media? Having the client take nothing by mouth Increasing the normal saline intravenous infusion rate prior to the exam Administering one unit of packed red blood cells Administering ibuprofen 600 mg prior to the procedure
Increasing the normal saline intravenous infusion rate prior to the exam
A 20-year-old man who is addicted to methamphetamines has been admitted to the hospital with a diagnosis of protein-calorie malnutrition after many months of inadequate food intake. Which treatment plan would the care team most likely favor? Intravenous infusion of albumin coupled with vitamin supplementation Total parenteral nutrition Incremental feeding combined with vitamin and mineral supplementation Rapid administration of normal saline and carbohydrates
Incremental feeding combined with vitamin and mineral supplementation
A client presents for follow-up with ongoing treatment for peptic ulcer disease. What is the most likely goal of this client's pharmacologic treatment? Inhibiting gastric acid production Promoting hypertrophy of the gastric mucosa Increasing the rate of gastric emptying Increasing muscle tone of the cardiac sphincter
Inhibiting gastric acid production
A nurse is giving discharge instructions for a client who was diagnosed with acute pyelonephritis 3 days previously. Which instruction is important for the nurse to discuss when teaching the client? Restrict fluid intake to 1 L/day. The client will require bed rest at home for 7 days. Because the client received antibiotics in the hospital, there are no further medications required. It is important that the client take the prescribed antibiotic for the duration of the prescription.
It is important that the client take the prescribed antibiotic for the duration of the prescription.
The acute care unit has had an increase in Gram-negative septicemia over the last 6 months. Which of the following would the infection care nurse know might require clinical focus of the most common cause of these types of infections? Knowledge of aseptic technique when inserting urethral catheters Knowledge of starting IV fluids Knowledge of the administration of subcutaneous insulin Knowledge of performing activities of daily living
Knowledge of aseptic technique when inserting urethral catheters
The liver has many jobs. One of the most important functions of the liver is to cleanse the portal blood of old and defective blood cells, bacteria in the bloodstream, and any foreign material. Which cells in the liver are capable of removing bacteria and foreign material from the portal blood? Kupffer cells Langerhans cells Epstein cells Davidoff cells
Kupffer cells
While assessing a teenage girl suspected of having bulimia nervosa, the health care provider may find which clinical manifestation that would confirm the diagnosis? Select all that apply. Large number of teeth with dental caries Eroded tooth enamel leading to sensitive teeth Kyphosis Painless parotid gland enlargement Skin with lanugo
Large number of teeth with dental caries Eroded tooth enamel leading to sensitive teeth Painless parotid gland enlargement
An older adult presents to the primary health care provider's office with a report of bladder leakage. Which assessment correlates with a diagnosis of stress incontinence? Loss of small amounts of urine when laughing or sneezing Urinary retention followed by overflow and incomplete emptying Complete bladder emptying when the first sensation of fullness is felt Large amount of urine leakage during a hyperglycemic episode
Loss of small amounts of urine when laughing or sneezing
If a client is in the early phases of nephrotic syndrome, which area of the body will likely have the initial presence of edema? Lower extremities Abdomen Eyelids Hands
Lower extremities
Crohn disease not only affects adults but also can occur in children. The nurse assesses for which major manifestation in children with Crohn disease? Dental caries Halitosis Malnutrition Weight gain
Malnutrition
A nurse suspects a client may be experiencing flaccid bladder dysfunction based on 24-hour intake and output. Which diagnostic method is most likely to confirm or rule out whether the client is retaining urine? Blood test for creatinine, blood urea nitrogen, and glomerular filtration rate Urine test for culture and sensitivity Routine urinalysis Measurement of postvoid residual (PVR) by ultrasound
Measurement of postvoid residual (PVR) by ultrasound
The client with substance use disorder was found unconscious after overdosing on heroin 2 days prior. Because of prolonged pressure on the muscles the client has developed myoglobinuria, causing which complication? Obstruction of the renal tubules with myoglobin and damaged tubular cells Hypokalemia and metabolic acidosis Development of renal stones due to stasis Compartment syndrome in the lower extremities
Obstruction of the renal tubules with myoglobin and damaged tubular cells
A client asks the nurse what the most common sign/symptom of bladder cancer is. Which is the best response by the nurse? Painless hematuria Urinary frequency Intermittent urgency Continual dysuria
Painless hematuria
What is the most common sign of bladder cancer? Severe oliguria Hyperproteinuria Hyperphosphaturia Painless hematuria
Painless hematuria
The nurse is caring for a client with metastatic pancreatic cancer who is to undergo a surgical resection and radiation therapy. What does the nurse recognize is the goal of these interventions? Cure of the cancer Palliation of symptoms Removal of the tumor Diagnosis of the tumor
Palliation of symptoms
A nurse is caring for a client in spinal shock. Which intervention is appropriate in relation to the client's urinary status? Perform intermittent catheterization Assess bowel sounds Perform a urine culture Palpate the lower abdomen
Perform intermittent catheterization
Which condition/disorder would the nurse see as being likely to cause the most serious long-term problems? Horseshoe kidney Unilateral renal agenesis Simple renal cyst Polycystic kidney disease
Polycystic kidney disease
Which substance would not be found in glomerular filtrate? Water Potassium Sodium Protein
Protein
An adult client has been diagnosed with gastroesophageal reflux disease (GERD) after reporting ongoing "heartburn" unrelieved with antacids. Which medication should the nurse anticipate being prescribed for this client? Lactulose Proton pump inhibitor (PPI) Antibiotic Nonsteroidal anti-inflammatory drug (NSAID)
Proton pump inhibitor (PPI)
After several months of persistent heartburn, an adult client has been diagnosed with gastroesophageal reflux disease (GERD). Which treatment regimen is likely to be prescribed for this client's GERD? Surgical correction of the incompetent pylorus and limiting physical exercise Anti-inflammatory medications; avoiding positions that exacerbate reflux; a soft-textured diet Weight loss and administration of calcium channel blocking medications Proton pump inhibitors; avoiding large meals; remaining upright after meals
Proton pump inhibitors; avoiding large meals; remaining upright after meals
The nurse recognizes that acute renal injury is characterized by which of the following? Rapid decline in renal function Irreversible damage to nephrons Decreased blood urea nitrogen (BUN) Low incidence of mortality
Rapid decline in renal function
A nurse is completing an abdominal assessment on a client suspected to have appendicitis. When the nurse applies and then releases pressure in the client's right lower quadrant, the client experiences tenderness. The nurse is documenting the presence of: Rebound tenderness Referred tenderness Periumbilical tenderness Perforated appendix
Rebound tenderness
What is the most common cancer of the kidney? Wilms tumor Transitional cell carcinoma Renal cell carcinoma Lymphoma
Renal cell carcinoma
A nurse is caring for a client with hematuria. The nurse understands this may be a clinical manifestation of which renal conditions? Select all that apply. Renal cell carcinoma Renal calculi Unilateral hydronephrosis Acquired renal cyst
Renal cell carcinoma Renal calculi Acquired renal cyst
The GFR is considered to be the best measure of renal function. What is used to estimate the GFR? BUN Serum creatinine Albumin level Serum protein
Serum creatinine
Which assessment should be the priority when caring for a client with anorexia nervosa? Serum electrolyte levels Chest auscultation White blood cell count with differential Blood pressure monitoring
Serum electrolyte levels
An 86-year-old female client has been admitted to the hospital for the treatment of dehydration and hyponatremia after she curtailed her fluid intake to minimize urinary incontinence. The client's admitting laboratory results are suggestive of prerenal failure. The nurse should be assessing this client for which early sign of prerenal injury? Sharp decrease in urine output Excessive voiding of clear urine Acute hypertensive crisis Intermittent periods of confusion
Sharp decrease in urine output
A client with a peptic ulcer should be assessed by the nurse for which possible cause? Select all that apply. Smoking history Family history Alcohol usage Pain assessment Dietary history
Smoking history Family history Alcohol usage
Which clinical manifestation would lead the nurse to suspect the client has malabsorption syndrome with a deficiency in fat absorption? Steatorrhea Abdominal cramping Dry eyes Glossitis
Steatorrhea
A client is being treated for calcium oxalate kidney stones. The nurse will include which intervention in the client's care? Select all that apply. Straining urine Administering calcium carbonate Monitoring daily weight Administering loop diuretic Increasing fluid intake
Straining urine Administering calcium carbonate Increasing fluid intake
A nurse administering a client's medication tells the client that a proton pump inhibitor has been added. When the client asks the purpose of the medication, the nurse responds that it is to prevent: Stress ulcer Crohn disease Ulcerative colitis Malabsorption syndrome
Stress ulcer
The nurse caring for clients who have bladder cancer identifies which treatments to be acceptable for this cancer? Select all that apply. Surgical removal Radiation therapy Hypnosis Chemotherapy Herbal therapy
Surgical removal Radiation therapy Chemotherapy
x A client has experienced severe hemorrhage and is in prerenal acute kidney injury. The nurse anticipates the client's blood urea nitrogen (BUN) and serum creatinine laboratory results will be in which range? The BUN-to-creatinine ratio is 20:1. Creatinine level increase to 5 mg/dl (442 µmol/l) and BUN decreases to 4 mg/dl (1.4 mmol/l). BUN elevates above 60 mg/dl (21.4 mmol/l) and creatinine decreases to less than 0.3 mg/dl (less than 27 µmol/l). The BUN-to-creatinine ratio is 10:1.
The BUN-to-creatinine ratio is 20:1.
The nurse is providing nutritional support education to the family of an obese 10-year-old. The most important information to provide would be: The weight loss intervention should include all family members. Teach the child to skip the breakfast meal to decrease hunger through the day. Reward the child's cooperation by increased television or computer time. Focus on having the child achieve ideal body weight.
The weight loss intervention should include all family members.
An older adult client who recently started taking furosemide tells the nurse about now experiencing problems with urine incontinence. Which type of incontinence is this client likely experiencing? Stress Transient Overflow Neurogenic
Transient
The older adult client tells the health care provider about experiencing incontinence ever since starting diuretic therapy 2 weeks ago. What term should the provider document in the medical record related to the type of incontinence? Transient Chronic Neurogenic Stress
Transient
A client with chronic kidney disease (CKD) will be managed with peritoneal dialysis. Which description of this type of dialysis is most accurate? Vascular access is achieved through an internal arteriovenous fistula or an external arteriovenous shunt. Treatments typically occur three times each week for 3 to 4 hours. The dialyzer is usually a hollow cylinder composed of bundles of capillary tubes. Treatment involves the introduction into the peritoneum of a sterile dialyzing solution, which is drained after a specified time.
Treatment involves the introduction into the peritoneum of a sterile dialyzing solution, which is drained after a specified time.
The health care provider reviews the waist-hip ratio of a male client. The ratio is 1.0. Which interpretation is most accurate for this result? Upper body obesity Gluteal-femoral obesity Lower body obesity Peripheral obesity
Upper body obesity
The nurse understands that medications, although very beneficial to clients, can have harmful effects. When working with older adult clients the nurse should recognize that which outcome is a common result of potent, fast-acting diuretics? Increased potassium levels Urge incontinence Decreased urine output No untoward effects
Urge incontinence
An obese client with a history of gout and a sedentary lifestyle has been advised by the primary health care provider to avoid organ meats, certain fish, and other foods that are high in purines. This treatment would be advised for which type of kidney stones? Calcium stones Magnesium ammonium phosphate stones Uric acid stones Cystine stones
Uric acid stones
Which assessment findings would the nurse expect in a client with chronic urinary obstruction? Bladder spasms Urinary frequency High residual volume Overflow incontinence
Urinary frequency
Which is the most important factor in reducing hospital-acquired (nosocomial) urinary tract infections? Using urinary catheters only when necessary and their prompt removal when no longer needed Using prophylactic antibiotics in all surgical clients Using plastic rather than latex urinary catheters Irrigating urinary catheters with an antibiotic solution
Using urinary catheters only when necessary and their prompt removal when no longer
Two types of obesity are recognized: upper body obesity and lower body obesity. How is the type of obesity determined? Waist/hip circumference Chest circumference/weight Chest/hip circumference Waist circumference/weight
Waist/hip circumference
The poison control nurse is helping to calm a hysterical mother who called because her child ingested 10 tablets of B-complex vitamins. The mother keeps repeating over and over again, "Is my child is going to die?" What should the nurse convey to the mother? Take the child to the emergency department as these fat-soluble vitamins easily reach toxic levels quickly. Water-soluble vitamins are excreted into the urine, making toxicity less likely. This type of vitamin contains vitamin K; excess of vitamin K may cause blood clots. The child may retain fluid or develop edema for a few days after ingestion.
Water-soluble vitamins are excreted into the urine, making toxicity less likely.
Which clinical manifestations would tell a nurse that a client is having progressive decompensation related to obstruction of urinary outflow? Client complains of waking up several times in the night to void. When tested for residual urine volume, 1400 mL of urine is obtained when client is catheterized. Client states that he or she is incontinent. Client complains of urinary urgency.
When tested for residual urine volume, 1400 mL of urine is obtained when client is catheterized.
A rare condition caused by gastrin-secreting tumors most commonly found in the small intestine or pancreas is called: Zollinger-Ellison syndrome Creutzfeldt-Jakob disease Sickle cell anemia Stevens-Johnson syndrome
Zollinger-Ellison syndrome
A child has been brought to an urgent care clinic. The parents state that the child is "not making water." When taking a history, the nurse learns the child had a sore throat about 1 week ago but seems to have gotten over it. "We [parents] only had to give antibiotics for 3 days for the throat to be better." The nurse should suspect the child has developed: acute renal failure. kidney stones. acute postinfectious glomerulonephritis. nephrotic syndrome.
acute postinfectious glomerulonephritis.
The primary care provider for a newly admitted hospital client has added the glomerular filtration rate (GFR) to the blood work scheduled for this morning. The client's GFR results return as 50 mL/minute/1.73 m2. The nurse explains to the client that this result represents: a need to increase water intake. that the kidneys are functioning normally. a loss of over half the client's normal kidney function. concentrated urine.
a loss of over half the client's normal kidney function.
When explaining acute pancreatitis to a newly diagnosed client, the nurse will emphasize that the pathogenesis begins with an inflammatory process whereby: activated pancreatic enzymes escape into surrounding tissues, causing autodigestion of pancreatic tissue. the pancreas is irreversibly damaged and will not recover to normal functioning (chronic). the pancreas will hypertrophy (enlarge) to the point of causing bowel obstruction. stones will develop in the common bile duct, resulting in acute jaundice.
activated pancreatic enzymes escape into surrounding tissues, causing autodigestion of pancreatic tissue.
The nurse is reviewing the laboratory results for a client. Which laboratory findings would the nurse correlate with nephrotic syndrome? elevated urine protein level (>3.5 g/day) and hypoalbuminemia low triglycerides (<150 mg/dl; 1.69 mmol/l) and elevated sodium levels low platelet level (<20 ×103/µl; 20 ×109/l) and elevated blood pressure decreased high-density lipoproteins (HDL) and increased hemoglobin levels (Hgb >18 g/dl; 180 g/l).
elevated urine protein level (>3.5 g/day) and hypoalbuminemia
The nurse is assessing a client who has bulimia nervosa. The nurse would expect the assessment data to include that the client: engages in binge eating. weighs less than 85% of normal weight for height. reports constipation, cold intolerance, and bradycardia. engages in alcohol and substance abuse.
engages in binge eating.
Which measure would likely be rejected as part of a first-line weight loss plan for a client with a body mass index (BMI) of 30.2, type 2 diabetes, and hypertension? prescription drug therapy gastric bypass reducing caloric intake by at least 500 kcal/day 30 minutes or more of moderate-intensity activity at least 3 days per week
gastric bypass
A client tells the nurse that he is concerned about developing hepatitis after being exposed to contaminated feces, saliva, and food. The client is at risk for which infection? hepatitis A hepatitis B hepatitis C hepatitis D
hepatitis A
The nurse is evaluating the urinalysis results of a client presenting with polyuria and lower abdominal pain due to a suspected urinary tract infection (UTI). Which finding should the nurse report as evidence of a UTI? increased nitrites positive glucose specific gravity of 1.025 solid formations
increased nitrites
The nurse assesses a client in the emergency department with reports of abdominal pain. Which assessment finding will the nurse interpret as supporting appendicitis? increased pain when pressure to the lower right quadrant is released increased abdominal pain when the client passes urine client reports several days of intermittent nausea and vomiting severe, sharp pain in the upper quadrants of the abdomen
increased pain when pressure to the lower right quadrant is released
A client has been diagnosed with alcohol-induced liver disease. He admits to the nurse, "I know what the lungs do, and I know what the heart does, but honestly, I have no idea what the liver does in the body." The nurse should tell the client that the liver: is responsible for the absorption of most dietary nutrients, as well as the production of growth hormones. contributes to the metabolism of ingested food and provides the fluids that the GI tract requires. metabolizes most components of food and also cleans the blood of bacteria and drugs. maintains a balanced level of electrolytes and pH in the body and stores glucose, minerals, and vitamins.
metabolizes most components of food and also cleans the blood of bacteria and drugs.
Which client would be the least appropriate candidate for bariatric surgery? 22-year-old female client with a body mass index (BMI) of 42 morbidly obese client who does not wish to change the diet or perform exercise to lose weight very obese client with type 2 diabetes whose weight loss efforts have been unsuccessful 60-year-old male client who has had a body mass index (BMI) between 40 and 45 for the entire adult life
morbidly obese client who does not wish to change the diet or perform exercise to lose weight
A nurse is assessing a female client prior to educating about healthy lifestyle changes. The client has a body mass index (BMI) of 32.4. According to the BMI, the nurse would classify this client as: underweight. normal weight range. overweight. obese.
obese.
When educating students about the differences between brown fat versus white fat, the instructor will share that brown fat has iron in its mitochondria that will facilitate: production of a protein that releases the energy generated from metabolism as heat. the primary function of storing fat energy. insulation and cushioning of the body's vital organs. concentration of the fat tissue in the greater omentum and around the kidneys.
production of a protein that releases the energy generated from metabolism as heat.
A client is admitted to the hospital with a suspected diagnosis of strangulated bowel. The nurse anticipates the client will need: surgery to release the bowel. low fiber diet for 24 hours. insertion of a nasogastric tube. lower abdominal massage.
surgery to release the bowel.
Prior to undergoing diagnostic testing with contrast, it is recommended that older adult clients have their creatinine level checked. The rationale for this is to ensure the client: is not allergic to shell fish or iodine. will not undergo an acute kidney injury by decreasing renal blood flow. does not have a kidney stone obstructing the urethra. is in good enough health to withstand a walking on a treadmill.
will not undergo an acute kidney injury by decreasing renal blood flow.
