NURS 321 Practice Questions for Renal/GU Quiz

A nurse is planning care for a client who has cystitis. Which of the following interventions should the nurse include in the plan? a. Instruct the client to take antibiotics until dysuria is not longer present b. Instruct the client to avoid drinking carbonated beverages c. Instruct the client to drink 240mL of tomato juice each day d. Instruct the client to drink 1 of fluid each day

B rationale: carbonated beverages can irritate the bladder; D: people with cystitis should drink 2-3L of fluid everyday to flush and dilute the urine unless contraindicated

A nurse is assessing a client who has end-stage kidney disease and is receiving hemodialysis. Which of the following findings should the nurse identify as an indication the client is experiencing fluid overload? a. The client has a 5lb weight gain since yesterday b. Flattened neck veins c. Oxygen saturation 93% d. Return of skin to previous position when the client's shin is palpated

A rationale: a gain of more than 2lbs per day or 5lb per week is an indication of fluid overload

A nurse is caring for a client who has polycystic kidney disease (PKD). Which of the following findings should the nurse expect? a. Flank pain b. Hypotension c. Confusion d. Urinary retention

A rationale: flank pain, hypertension and polyuria are associated with PKD; confusion is with ESKD

A nurse is discussing indications for urinary catherization with a newly licensed nurse. Which of the following indications should the nurse include? (Select all that apply) a. Relief of urinary stream b. Convenience for the nursing staff or the client's family c. Measurement of residual urine after urination d. Routine acquisition of a urine specimen e. An open perineal wound

A (?) It asks for a select all that apply but only puts one answer that applies

A nurse is caring for a client who has an indwelling urinary catheter. Which of the following actions should the nurse take to prevent infection? a. Replace the catheter every 3 days b. Check the catheter tubing for kinks or twisting c. Irrigate the catheter once each shift d. Clean the perineal area with an antiseptic solution daily

B rationale: These obstructions can affect the flow of urine causing pooling in the tubing that could backflow into the bladder; C: nurse should avoid irrigation of the catheter unless there is an obstruction

A nurse is caring for a client who has a new diagnosis of urolithiasis. Which of the following should the nurse identify as an associated risk factor? a. Hypocalcemia b. BMI less than 25 c. Family history d. Diuretic use

C

A nurse is teaching a client who has acute kidney injury about the oliguric phase. Which of the following information should the nurse include in the teaching? a. Renal function is reestablished b. BUN and creatinine levels decrease c. Urine output is less than 400mL per 24hr d. The glomerular filtration rate (GFR) recovers

C

A nurse is ready to insert an indwelling urinary catheter for a female client. Which of the following instructions should the nurse give the client as the catheter is inserted? a. Contract the pelvic muscles b. Take a sip of water c. Exhale slowly d. Bear down

D

A nurse is reviewing the laboratory data of a client following a hemodialysis treatment. The nurse should expect to find a decrease in which of the following laboratory values? a. RBC count b. Protein c. Calcium d. Potassium

D rationale: Ca levels increases through the process of diffusion during dialysis and K levels decrease. RBC and protein molecules are too big to be removed through dialysis

A nurse is assessing a client who has chronic kidney disease for fluid volume increase. Which of the following provides a reliable measure of fluid retention a. Daily weight b. Sodium level c. Tissue turgor d. Intake and output

A

A nurse is reviewing the laboaratory test results from a client who has prerenal acute kidney injury (AKI). Which of the following electrolyte imbalance should the nurse expect? a. Hyperkalemia b. Hypernatremia c. Hypercalcemia d. Hypophosphatemia

A rationale: AKI is a loss of renal function that results in a failure to maintain homeostasis. Fluid and electrolyte balance, as well as acid-base balance, are disrupted. The nurse should expect the client to haver hyperkalemia due to the protein breakdown and the subsequent release of intracellular K into the circulation. The kidneys' inability to filter and excrete K results in hyperkalemia

A nurse is planning care for a client who has acute glomerulonephritis. Which of the following interventions should the nurse include in the plan? a. Administer antibiotics b. Encourage increased fluid intake c. Obtain weight weekly d. Encourage frequent ambulation

A rationale: Acute glomerulonephritis related to streptococcal infection is treated with antibiotic therapy, including penicillins and erythromycin

A nurse is reviewing the arterial blood gas values of a client who has chronic kidney disease. Which of the following sets of values should the nurse expect? a. pH 7.25, HCO3- 19mEq/L, PaCO2 30mmHg b. pH 7.30, HCO3- 26mEq/L, PaCO2 50mmHg c. pH 7.50, HCO3- 20mEq/L, PaCO2 32mmHg d. pH 7.55, HCO3- 30mEq/L, PaCO2 31mmHg

A rationale: Should be metabolic acidosis, so low everything. Normal range: pH 7.35-7.45, HCO3 21-28, PaCO2 35-45

A nurse is caring for a client who will have blood sampling for a serum creatinine level and asks what this test shows. Which of the following responses should the nurse make? a. "This test will tell your doctor how your kidneys are functioning" b. "You'll have to ask your doctor" c. "This test will tell if you have severe renal impairment or a disease" d. "We'll find out if any medications, such as steroids, are interfering with your kidney function"

A rationale: The response answers the client's question simply rather than avoiding it; C: focuses unnecessarily on negative outcomes

A nurse is caring for a client 4 hr postoperative following a kidney biopsy. Which of the following interventions should the nurse take? (Select all that apply) a. Monitor for hematuria b. Check for flank pain c. Monitor for extravasion of tissue surrounding the biopsy site d. Encourage ambulation e. Administer aspirin PRN for pain

A,B rationale: A&B: detect bleeding, C: infiltration of dye or med around an IV site and not for biopsy, D: should be on strict bedrest, E: ASA can cause increased risk of bleeding

A nurse is developing a plan of care for a client who has a new ileal conduit. The nurse should include that the client is at risk for which of the following? (Select all that apply) a. Anxiety b. Disturbed body image c. Impaired skin integrity d. Infection e. Fluid volume deficit

A,B,C,D rationale: A: due to the effects of ileal conduit has on lifestyle and relationship, anxiety is appropriate for the nurse to include as a risk

A nurse is caring for a client who has end-stage renal disease (ESRD). Which of the following are expected findings? (Select all that apply) a. Slurred speech b. Bone pain c. Bradypnea d. Pruritus e. Hypotension

A,B,D rationale: Tachypnea and hypertension are expected findings

A nurse is planning care for a client who is scheduled to have a kidney biopsy. Which of the following information should the nurse include in the plan? (Select all that apply) a. Obtain a urine specimen prior to the procedure b. Obtain written, informed consent c. Administer diphenhydramine (Benadryl) prior to the procedure d. Maintain NPO status prior to the procedure e. Obtain coagulation studies

A,B,D,E rationale: A: a urine specimen should be obtained to allow for post-procedure comparison

A nurse is teaching a client who has chronic kidney disease about limiting foods that are high in potassium. Which of the following foods should the nurse instruct the client to avoid? (Select all that apply) a. Green Beans b. Tomatoes c. Bananas d. Asparagus e. Raisins

B,C,E

A nurse is caring for a client who has chronic renal disease and is receiving therapy with epoetin alfa. Which of the following laboratory results should the nurse review for an indication of a therapeutic effect of the medication? a. The leukocyte count b. The platelet count c. The hematocrit (Hct) d. The erythrocyte sedimentation rate (ESR)

C rationale: Epoetin alfa is an antianemic medication that is indicated in the treatment of clients who have anemia due to reduced production of endogenous erythropoietin, which may occur in clients who have ESRD or myelosuppression from chemotherapy. The therapeutic effect of epoetin alfa is enhanced red blood cell production, which is reflected in an increased RBC, Hgb, and Hct

A nurse is providing dietary teaching to a client who has frequent kidney stones. Which of the following instructions should the nurse include in the teaching? a. "Limit your intake of dairy products" b. "Increase the amount of protein in your diet" c. "Avoid eating tree nuts, such as almonds" d. "Take a vitamin C supplement twice daily"

C rationale: High-oxalate foods like peanuts ad tree nuts should be avoided However, in class, prof said A should be the better answer

A nurse is reviewing the laboratory values of a client who has chronic glomerulonephritis. Which of the following is an expected finding for this client? a. Serum creatinine 0.8mg/dL b. RBC 4.9mm3 c. BUN 100mg/dL d. Serum potassium 4.0mEq/L

C rationale: The kidneys normally eliminate urea by the process of filtration and tubular secretion. Therefore, BUN is a measure of kidney function. The client's BUN level is above the expected reference range and is an indication of poor kidney function

A nurse is caring for a client who has a new arteriovenous (AV) graft in his left forearm. Which of the following techniques should the nurse use to assess the patency of this graft? a. Measure the client's blood pressure to ensure it is higher in the left arm than the right b. Check the brachial and radial pulses of the left arm simultaneously c. Auscultate the site for a bruit d. Auscultate the antecubital fossa using a Doppler stethoscope

C rationale: The nurse should auscultate for the presence of a bruit or palpate the site for a thrill every 4hr to assess for blood flow

A nurse is caring for a client who reports recurrent flank pain, nausea, and vomiting for 24hr. Which of the following actions is the nurse's priority? a. Monitor intake and output b. strain the urine c. Administer pain medication d. Administer an antiemetic

C rationale: Using Maslow's hierarchy of needs, the nurse's priority is to meet the client's physiological need for comfort. Therefore, the first action the nurse should take is to administer pain medication to relieve the client's flank pain

A nurse is caring for a client who has an indwelling urinary catheter and notes blood-tinged urine in the catheter bag. The nurse recognizes this finding can be a manifestation of which of the following urinary alterations? a. Pernicious anemia b. Dehydration c. Prostate enlargement d. Bladder infection

D rationale: A: is from lack of intrinsic factor which is needed to absorb B12 which is used for formation of RBC. Hematuria is not a manifestations of pernicious anemia; B: is for oliguria; C: is for urinary hesitancy of difficulty initiating a stream of urine

A nurse is assessing a client who has a urine output of 250mL in a 24-hr period. Which of the following descriptive terms should the nurse place in the client's electronic record? a. Enuresis b. Anuria c. Nocturia d. Oliguria

D rationale: Oliguria is where the total output is 100-400mL of urine in 24hr. Anuria is where the total output <100L in 24hr

A nurse is planning care for a client who has urolithiasis. Which of the following actions should the nurse take? a. Apply cold compress to the client's flank area b. Restrict protein intake to 2 servings per day c. Discourage ambulation d. Encourage intake of at least 3L of fluids per day

D rationale: The client should drink at least 3,000mL of fluids/ day to dilute urine, increase hydrostatic pressure behind the stone, and move the calculi down the urinary tract

A nurse is caring for an older adult client who has a urinary tract infection( (UTI). Which of the following manifestations should the nurse identify as a finding specifically associated with this client? a. Urinary retention b. Low back pain c. Incontinence d. Confusion

D rationale: Urinary retention, low back pain and incontinence are findings in all ages, only confusion is specifically associated with elder clients

A nurse is reviewing the BUN and creatinine levels of an older adult client who has chronic kidney disease. The nurse should expect which of the following findings? a. BUN 10g/dL and creatinine 0.3mg/dL b. BUN 23g/dL and creatinine 1.0mg/dL c. BUN 8g/dL and creatinine 0.7mg/dL d. BUN 45g/dL and creatinine 8mg/dL

D rationale: an elevation of both BUN and creatinine is an expected finding of CKD

A nurse is caring for a client who is two days postoperative following creation of an ileal conduit. Which of the following is an unexpected finding associated with this procedure? a. Edema of the stoma b. Urine in the drainage appliance c. Redness of the stoma d. Feces in the drainage appliance

D rationale: the ileal conduit procedure incorporates implantation of the ureters into a portion of the ileum that has been resected from its anatomical position and now functions as a reservoir or conduit for urine. Feces should not be draining from the conduit