Renal & Urinary - Adult Health - NCLEX

The nurse has a prescription to obtain a urinalysis specimen from a client with an indwelling urinary catheter. Which actions should the nurse include in performing this procedure? Select all that apply.

Explaining the procedure to the client 2. Clamping the tubing of the drainage bag 3. Aspirating a sample from the port on the drainage tubing Wiping the port with an alcohol swab before inserting the syringe

A client has developed acute kidney injury (AKI) as a complication of glomerulonephritis. Which should the nurse expect to observe in the client?

Hypertension

The nurse is performing assessment on a client with acute kidney injury who is in the oliguric phase. Which should the nurse expect to note? Select all that apply.

Increased serum creatinine level 2. A low and fixed specific gravity 3. Increased blood urea nitrogen (BUN) level Urine osmolarity of approximately 300 mOsm/kg (300 mmol/kg)

The nurse is admitting a client who has an arteriovenous (AV) fistula in the right arm for hemodialysis. Which nursing intervention is the best way to prevent injury to the AV site?

Placing a sign at the bedside that reads "No blood pressure measurements or venipunctures in the right arm"

The spouse of a client with acute kidney injury secondary to heart failure asks the nurse how a heart problem can affect the kidneys. The nurse should formulate a response using what fact about the kidneys?

The kidneys generally require and receive about 20% to 25% of the resting cardiac output.

A client tells the nurse about a pattern of a strong urge to void, followed by incontinence before the client can get to the bathroom. Based on the data provided, which condition should the nurse suspect?

Urge incontinence

A client is about to begin hemodialysis. Which measures should the nurse employ in the care of the client? Select all that apply.

Using sterile technique for needle insertion 2. Using standard precautions in the care of the client 3. Giving the client a mask to wear during connection to the machine 4. Wearing full protective clothing such as goggles, mask, gloves, and apron

The nurse is teaching a client with nephrotic syndrome about managing the disorder. What should the nurse instruct the client to adjust according to the amount of edema present?

Activity level

The client with a crush injury to the leg has a highly positive urine myoglobin level. The nurse should assess this client carefully for signs and symptoms of which problem?

Acute tubular necrosis

The client with chronic kidney disease has an indwelling abdominal catheter for peritoneal dialysis. The client spills water on the catheter dressing while bathing. Which action should the nurse immediately take?

Change the dressing.

The nurse monitoring a client receiving peritoneal dialysis notes that the client's outflow is less than the inflow. Which actions should the nurse take? Select all that apply.

Check the level of the drainage bag. 2. Reposition the client to his or her side. Place the client in good body alignment. 5. Check the peritoneal dialysis system for kinks.

The nurse is collecting data from a client. Which symptom described by the client is characteristic of an early symptom of benign prostatic hyperplasia?

Decreased force in the stream of urine

The nurse is reviewing the assessment findings for a client with a diagnosis of nephrotic syndrome. Which should the nurse expect to note in this client?

Decreased serum albumin levels

The nurse is reviewing the medical record of a client with a diagnosis of pyelonephritis. Which disorder, if noted on the client's record, should the nurse identify as a risk factor for this disorder?

Diabetes mellitus

The nurse discusses plans for future treatment options with a client with symptomatic polycystic kidney disease. Which treatment should be included in this discussion? Select all that apply.

Hemodialysis Kidney transplant 4. Bilateral nephrectomy

The nurse is reviewing the list of components contained in the peritoneal dialysis solution with the client. The client asks the nurse about the purpose of the glucose contained in the solution. The nurse should base the response on knowing that which is the action of the glucose in the solution?

Increases osmotic pressure to produce ultrafiltration

The nurse is creating a plan of care for a client with chronic kidney disease and uremia. The nurse is developing interventions to assist in promoting an increased dietary intake while at the same time maintaining necessary dietary restrictions. Which action should the nurse include in the plan of care?

Maintain a diet high in calories with frequent snacks.

The nurse is urging a client to cough and deep breathe after nephrectomy. The client tells the nurse, "That's easy for you to say! You don't have to do this." The nurse interprets that the client's statement is most likely to be a result of which factor?

Pain that is intensified because of the location of the incision near the diaphragm

The nurse is assessing a client who has returned from the postanesthesia care unit after transurethral resection of the prostate (TURP). The nurse should assess for which color in the urinary drainage tubing that indicates proper irrigation and adequate functioning of the device?

Pale pink

A hemodialysis client with a left arm fistula is at risk for arterial steal syndrome. The nurse should assess for which manifestations of this complication?

Pallor, diminished pulse, and pain in the left hand

A client with nephrolithiasis arrives at the clinic for a follow-up visit. Laboratory analysis of the stone that the client passed 1 week earlier indicates that the stone is composed of calcium oxalate. Based on these data, what food item does the nurse instruct the client to avoid?

Spinach

The nurse is preparing to teach ostomy care to a client who has just had a urinary diversion; the client expresses concern about body appearance. Which client action indicates that the best initial positive adaptation is being made?

Agrees to look at the ostomy

A client with epididymitis is upset about the extent of scrotal edema. Attempts to reassure the client that this condition is temporary have not been effective. The nurse should plan to address which client problem?

Altered body appearance related to change in the appearance of the scrotum

A home care nurse is making home visits to an older client with urinary incontinence who is very concerned about the incontinent episodes. Which finding by the nurse indicates that the client has an environmental barrier to normal voiding?

Bathroom located on the second floor, bedroom on the first floor

A client with chronic kidney disease has completed a hemodialysis treatment. The nurse should use which standard indicators to evaluate the client's status after dialysis?

Vital signs and weight

The nurse is providing instructions regarding the complications of peritoneal dialysis. The nurse emphasizes that onset of peritonitis, a serious complication, is most likely to be associated with which clinical manifestation?

Fever

A client with glomerulonephritis has developed acute kidney injury (AKI) as a complication. The nurse should expect to note which abnormal finding documented on the client's medical record?

Hypertension

The nurse is performing an assessment on a client who has returned from the dialysis unit following hemodialysis. The client is complaining of headache and nausea and is extremely restless. Which is the priority nursing action?

Notify the health care provider (HCP).

The nurse is planning a teaching session with a client who has chronic kidney disease (CKD) about managing the condition between dialysis treatments. The nurse should plan to include the instruction that weight gain between dialysis treatments should be ideally what value?

2 to 3 lbs (1 to 1.5 kg)

A client with chronic kidney disease (CKD) has been taking aluminum hydroxide gel. On the basis of this information, the nurse determines that the client is most at risk for which problem?

Constipation

The nurse is performing an assessment on a client after a cystoscopy. Which assessment finding indicates a need to notify the health care provider (HCP)?

Grossly bloody urine with clots

The nurse is preparing to care for a client receiving peritoneal dialysis. Which should be included in the nursing plan of care to prevent the major complication associated with peritoneal dialysis?

Maintain strict aseptic technique.

A client with chronic kidney disease returns to the nursing unit following a hemodialysis treatment. On assessment, the nurse notes that the client's temperature is 38.5°C (101.2°F). Which nursing action is most appropriate?

Notify the health care provider.

A client arrives at the emergency department with complaints of low abdominal pain and hematuria. The client is afebrile. The nurse next assesses the client to determine a history of which condition?

Trauma to the bladder or abdomen

A client who is to have a cystectomy with creation of an ileal conduit asks the nurse why the bowel needs to be cleansed before surgery if the bladder is being removed. Which response by the nurse is the most appropriate?

"A portion of the bowel will be used to create the conduit for urinary diversion."

A client who is performing peritoneal dialysis at home calls the clinic and reports that the outflow from the dialysis catheter seems to be decreasing in amount. The clinic nurse should ask which question first?

"Have you been constipated recently?"

The nurse measures the cardiac output of a client and finds it to be 6 L/min. Which amount of kidney perfusion should the nurse anticipate?

1200 to 1500 mL/min

The nurse is preparing to perform a discharge teaching with a client who is started on hemodialysis. Which information should the nurse provide regarding the hemodialysis schedule?

3 to 4 hours of treatment 3 days per week

The nurse is working on a medical-surgical nursing unit and is caring for several clients with chronic kidney disease. The nurse interprets that which client is best suited for peritoneal dialysis as a treatment option?

A client with severe heart failure

A client with chronic kidney disease (CKD) has been on dialysis for 3 years. The client is receiving the usual combination of medications for the disease, including aluminum hydroxide as a phosphate-binding agent. The client now presents with mental cloudiness, dementia, and complaints of bone pain. The nurse determines that these assessment data are compatible with which condition?

Aluminum intoxication

A client is being evaluated as a potential kidney donor for a family member. The client asks the nurse why separate teams are evaluating donor and recipient. What is the most appropriate response by the nurse?

Avoids a conflict of interest between the team evaluating the recipient and the team evaluating the donor

A client who has had a prostatectomy has been instructed in perineal exercises to gain control of the urinary sphincter. The nurse determines that the client demonstrates a need for further teaching when he states that he will perform which movement as part of these exercises?

Bearing down as if having a bowel movement

A client who is undergoing peritoneal dialysis calls the nurse at the renal unit and reports the presence of severe abdominal pain and diarrhea. The client also informs the nurse that the peritoneal dialysis returns are brown-tinged in color. Which would the nurse suspect?

Bowel perforation

A client with benign prostatic hyperplasia undergoes a transurethral resection of the prostate. Postoperatively the client is receiving continuous bladder irrigations. The nurse assesses the client for manifestations of transurethral resection syndrome. Which assessment data would indicate the onset of this syndrome?

Bradycardia and confusion

Which finding noted in the client on continuous ambulatory peritoneal dialysis (CAPD) should be reported to the health care provider (HCP)?

Cloudy yellow dialysate output

A client with an external arteriovenous shunt in place for hemodialysis is at risk for bleeding. Which is the priority nursing intervention?

Ensure that small clamps are attached to the arteriovenous shunt dressing.

A client has been diagnosed with pyelonephritis. The nurse interprets that which health problem has placed the client at risk for this disorder?

Diabetes mellitus

A client with severe back pain and hematuria is found to have hydronephrosis due to urolithiasis. The nurse anticipates which treatment will be done to relieve the obstruction? Select all that apply.

Insertion of a nephrostomy tube 5. Placement of a ureteral stent with ureteroscopy

The nurse has completed teaching with the hemodialysis client about self-monitoring between hemodialysis treatments. The nurse should determine that education was effective if the client states to record which parameters daily?

Intake and output (I&O) and weight

The nurse checks the serum myoglobin level for a client with a crush injury to the right lower leg because the client is at risk for developing which type of acute kidney injury?

Intrarenal

The nurse is providing instructions to a client who is scheduled for cystoscopy and possible biopsy under general anesthesia. Which information should the nurse include?

Intravenous fluids may be started on the day of the procedure.

The nurse is caring for a client with acute kidney injury (AKI). The nurse should test the client's urine for proteinuria to determine which type of AKI?

Intrinsic

The nurse is caring for a client with acute kidney injury (AKI) experiencing metabolic acidosis. When performing an assessment, the nurse should expect to note which breathing pattern?

Kussmaul respirations

The nurse is caring for a client who was prescribed furosemide. The nurse should monitor the client for damage of which kidney structure?

Nephron

A client with chronic kidney disease who is scheduled for hemodialysis this morning is due to receive a daily dose of enalapril. When should the nurse plan to administer this medication?

On return from dialysis

The nurse is monitoring a client who has just returned from surgery after a transurethral resection of the prostate (TURP). The client has a 3-way Foley catheter in place for ongoing bladder irrigation. The nurse is observing the color of the client's urine and should expect which urine color during the immediate postoperative period?

Pale pink urine

A client is being discharged to home while recovering from acute kidney injury (AKI). Reduced dietary intake of which substance indicates to the nurse that the client understands the dietary teaching?

Potassium

The nurse is reviewing the urinalysis results for a client with glomerulonephritis. Which findings should the nurse expect to note? Select all that apply.

Proteinuria 2. Hematuria A dark and smoky appearance of the urine

The health care provider writes prescriptions for a client with chronic kidney disease (CKD). Which prescription should the nurse question?

Provide a high-protein diet.

The nurse assessing the ureterostomy of a postoperative client interprets that the stoma has normal characteristics if which is observed?

Red and moist

The nurse is analyzing the posthemodialysis laboratory test results for a client with chronic kidney disease. The nurse interprets that the dialysis is having an expected but nontherapeutic effect if which value is decreased?

Red blood cell (RBC) count

The nurse is caring for a client whose urine output was 25 mL per hour for 2 consecutive hours. The nurse reviews the health care provider's prescriptions and plans care, knowing that which client-related factor would increase the amount of blood flow to the kidneys?

Release of low levels of dopamine

Before providing care for a client in the late stages of chronic kidney disease (CKD), the nurse should review the results of which most relevant laboratory studies?

Serum potassium, serum calcium

A client is diagnosed with epididymitis. The nurse checks the health care provider's prescriptions and expects that which measures will be prescribed? Select all that apply.

Sitz bath 2. Antibiotics 3. Scrotal elevation Bed rest with bathroom privileges

A client diagnosed with polycystic kidney disease has been taught about the treatment plan for this disease. The nurse should determine that the client needs further teaching if the client states that which is included in the treatment plan?

Sodium restriction

A cystectomy is performed for a client with a diagnosis of bladder cancer, and a Kock pouch is created for urinary diversion. In creating a discharge teaching plan for the client, the nurse should include which instruction in the plan?

Technique of catheterization

A client complains of fever, perineal pain, and urinary urgency, frequency, and dysuria. To assess whether the client's problem is related to bacterial prostatitis, the nurse reviews the results of the prostate examination for which characteristic of this disorder?

Tender, indurated prostate gland that is warm to the touch

A client with an arteriovenous fistula in the left arm who is undergoing hemodialysis is at risk for infection. Which should the nurse formulate as the best outcome goal for this client problem?

The client's white blood cell (WBC) count remains within normal limits.

A female client who has been receiving radiation therapy for bladder cancer tells the nurse that it feels as if she is voiding through the vagina. The nurse interprets that the client may be experiencing which problem?

The development of a vesicovaginal fistula

A client is experiencing the syndrome of inappropriate antidiuretic hormone (ADH) secretion. When explaining this disorder to the client and family, the nurse recalls that ADH works to reabsorb water in which parts of the nephron?

The distal tubule and the collecting duct

The nurse is caring for an older client. Which finding should the nurse expect to note in this client while evaluating renal function?

The glomerular filtration rate (GFR) diminishes

The nurse is caring for a client immediately after nephrectomy and renal transplantation. What is the most appropriate datum to use in planning administration of intravenous fluids to this client?

The number of milliliters in the previous hour's urine output

The nurse has performed a nutritional assessment on a client with cystitis. The nurse should tell the client to consume which beverage to minimize recurrence of cystitis?

Water

The nurse is preparing to care for a client after a renal scan. Which intervention should the nurse include in the postprocedure plan of care?

Wear gloves if contact with the client's urine will occur.

A client with renal cancer is being treated preoperatively with radiation therapy. What statement by the client demonstrates understanding of proper care of the skin over the treatment field?

"I need to avoid skin exposure to direct sunlight and chlorinated water."

A client with end-stage renal disease (ESRD) has the problem of ineffective coping. Which nursing interventions are appropriate in working with this client? Select all that apply.

Acknowledge the client's feelings. 2. Assess the client and family's coping patterns. 3. Explore the meaning of the illness with the client Give the client information when the client is ready to listen.

The nurse is assessing a client with epididymitis. The nurse anticipates which findings on physical examination?

Fever, nausea, vomiting, and painful scrotal edema

A client with uric acid calculi is placed on a low-purine diet. The nurse instructs the client to restrict the intake of which food?

Fish

A client has been diagnosed with polycystic kidney disease. On assessment of the client, the nurse should observe for which most common manifestation of this disorder?

Flank pain and hematuria

A client being discharged home after renal transplantation has a risk for infection related to immunosuppressive medication therapy. The nurse determines that the client needs further teaching on measures to prevent and control infection if the client states that it is necessary to take which action?

Monitor urine character and output at least 1 day each week.

A client with renal cell carcinoma of the left kidney is scheduled for nephrectomy. The right kidney appears normal at this time. The client is anxious about whether dialysis will ultimately be needed. The nurse should plan to use which information in discussions with the client to alleviate anxiety?

One kidney is adequate to meet the needs of the body as long as it has normal function.

The nurse provides instructions to a client about newly prescribed furosemide. Which information should the nurse use to provide instructions in this teaching session?

The medication acts on the loop of Henle in the nephron.

A client with urolithiasis (struvite stones) has a history of chronic urinary tract infections. What should the nurse plan to teach the client to avoid?

Wearing synthetic underwear and pantyhose

The registered nurse is instructing a new nursing graduate about hemodialysis. Which statement made by the new nursing graduate indicates an understanding of the procedure for hemodialysis? Select all that apply.

"Heparin sodium is administered during dialysis." 4. "Dialysis cleanses the blood of accumulated waste products." 5. "Warming the dialysate increases the efficiency of diffusion."

The nurse has provided instructions regarding home care measures for a client with acute pyelonephritis. Which statement by the client indicates a need for further teaching?

"I need to avoid alcohol and highly spiced foods but may continue to drink my coffee every day."

The nurse has given instructions about Kegel exercises to a female client with a cystocele. The nurse determines that the client needs further instruction if she makes which statement?

"I should begin voiding and then stop the stream, holding residual urine for an hour."

The nurse provides home care instructions to a client undergoing hemodialysis with regard to care of a newly created arteriovenous (AV) fistula. Which client statement indicates that teaching was effective?

"I should check the fistula every day by feeling it for a vibration."

A client with prostatitis following kidney infection has received instructions on management of the condition at home and prevention of recurrence. The nurse determines that education was effective if the client makes which statement?

"I should use warm tub baths and analgesics to increase comfort."

A client has chronic kidney disease (CKD) that does yet not require dialysis. Which client statement indicates the need for further teaching?

"I will reduce the sodium in my diet, and I can use salt substitutes to spice my food."

The ambulatory care nurse is providing instructions to a client after a cystoscopy. Which statement by the client indicates a need for further teaching?

"If I notice any pink-tinged urine, I should contact the health care provider."

The graduate nurse is caring for a client with decreased renal perfusion. The registered nurse determines that the graduate nurse demonstrates understanding of why this is occurring if which statement is made?

"It may be a consequence of decreased dopaminergic receptor stimulation."

Which client is most at risk for developing a Candida urinary tract infection (UTI)?

A young woman on antibiotic therapy

A client diagnosed with chronic kidney disease (CKD) is scheduled to begin hemodialysis. The nurse determines that which neurological and psychosocial manifestations, if exhibited by this client, are related to the CKD? Select all that apply.

Agitation Depression 4. Withdrawal 5. Labile emotions

The nurse is working with a client newly diagnosed with chronic kidney disease (CKD) to set up a schedule for hemodialysis. The client states, "This is impossible! How can I even think about leading a normal life again if this is what I'm going to have to do?" The nurse determines that the client is exhibiting which problem?

Anger

A client is having difficulty coughing and deep-breathing because of pain after a nephrectomy. Which action by the nurse is helpful in promoting optimal respiratory function?

Assisting the client to splint the incision during respiratory exercise

A client passes a urinary stone, and laboratory analysis of the stone indicates that it is composed of calcium oxalate. On the basis of these data, which should the nurse specifically include in the dietary instructions?

Avoid green, leafy vegetables such as spinach.

The nurse is caring for a client just after ureterolithotomy and is monitoring the drainage from the ureteral catheter hourly. Suddenly, the catheter stops draining. The nurse assesses the client and determines that which could be the cause of the problem? Select all that apply.

Blood clots 2. Mucous shreds Chemical sediment 5. Catheter displacement

A client is admitted to the hospital with a diagnosis of benign prostatic hyperplasia, and a transurethral resection of the prostate is performed. Four hours after surgery, the nurse takes the client's vital signs and empties the urinary drainage bag. Which assessment finding indicates the need to notify the health care provider (HCP)?

Blood pressure, 100/50 mm Hg; pulse, 130 beats/minute

The nurse is providing dietary instructions to a client with an oxalate kidney stone. The nurse should instruct the client to avoid which food?

Chocolate

The home health nurse is planning to make a home visit to a client who has undergone surgical creation of an ileal conduit. The nurse should include which information on ostomy care in discussion with the client?

Cleanse the skin around the stoma, using gentle soap and water, and then rinse and dry well.

A client has urinary calculi composed of uric acid. The nurse is teaching the client dietary measures to prevent further development of uric acid calculi. The nurse should inform the client that it is acceptable to consume which item?

Cottage cheese

In performing a physical assessment of a client with chronic kidney disease (CKD), which finding should the nurse anticipate?

Crackles auscultated in the lungs

A client undergoing hemodialysis begins to experience muscle cramping. What is the best action by the hemodialysis nurse in this situation?

Decrease the ultrafiltration rate.

A male client has a tentative diagnosis of urethritis. The nurse should assess the client for which manifestation of the disorder?

Dysuria and penile discharge

The nurse is reviewing a client's record and notes that the health care provider has documented that the client has chronic renal disease. On review of the laboratory results, the nurse most likely would expect to note which finding?

Elevated creatinine level

A client with a bladder injury has had surgical repair of the injured area with placement of a suprapubic catheter. Which is the most appropriate nursing action to prevent complications of this procedure?

Ensure that the catheter tubing is not kinked.

The nurse has taught the client with polycystic kidney disease about management of the disorder and prevention and recognition of complications. The nurse should determine that the client understands the instructions if the client states that which should be reported to the health care provider (HCP)? Select all that apply.

Frequent urination 2. Burning on urination 3. A temperature of 100.6°F (38.1°C) 4. New-onset shortness of breath

The client newly diagnosed with chronic kidney disease recently has begun hemodialysis. Knowing that the client is at risk for disequilibrium syndrome, the nurse should assess the client during dialysis for which associated manifestations?

Headache, deteriorating level of consciousness, and twitching

The client diagnosed with benign prostatic hyperplasia (BPH) is scheduled for a transrectal ultrasound examination and a test to measure the level of prostate-specific antigen (PSA). The client says to the nurse, "I can't remember . . . can you tell me again why I need these tests to be done?" The nurse responds, knowing that these tests are done for which purpose?

Help to rule out the possibility of cancer

The nursing student is caring for a client with benign prostatic hyperplasia (BPH). The nursing instructor asks the student to identify the clinical manifestations associated with this condition. The student needs further teaching if the student states that which finding is an early symptom of BPH?

Hematuria

The nurse is instructing a client with diabetes mellitus about peritoneal dialysis. The nurse tells the client that it is important to maintain the prescribed dwell time for the dialysis because of the risk of which complication?

Hyperglycemia

The nurse is participating in a prostate screening clinic for men. Which complaints by a client are associated with prostatism? Select all that apply.

Inability to stop urinating 2. Postvoid dribbling of urine 3. Increased episodes of nocturia Hesitancy on initiating the urinary stream

The nurse provides discharge instructions to a client after prostatectomy. What is the priority discharge instruction for this client?

Increase fluid intake to at least 2.5 L/day.

A week after kidney transplantation, a client develops a temperature of 101°F (38.3°C), the blood pressure is elevated, and there is tenderness over the transplanted kidney. The serum creatinine is rising and urine output is decreased. The x-ray indicates that the transplanted kidney is enlarged. Based on these assessment findings, the nurse anticipates which treatment?

Increased immunosuppression therapy

The nurse is monitoring the fluid balance of an assigned client. The nurse determines that the client has proper fluid balance if which 24-hour intake and output totals are noted?

Intake 1800 mL, output 1750 mL

A client with chronic kidney disease (CKD) is prescribed aluminum hydroxide. Which information should the nurse include while instructing the client regarding the action of this medication?

It combines with phosphorus and helps eliminate phosphates from the body.

The nurse is planning teaching for a female client diagnosed with urethritis caused by chlamydial infection. Which information should the nurse plan to include in the teaching session?

Keep follow-up appointments for repeat cultures in 4 to 7 days.

A client has just had a Foley catheter removed and is to be started on a bladder retraining program. Which intervention will provide the most useful information about the client's ability to empty the bladder?

Measuring postvoid residual using a bladder scan

The nurse is creating a plan of care for a client with a diagnosis of nephrotic syndrome whose glomerular filtration rate (GFR) is normal. Which interventions should the nurse include in the plan of care? Select all that apply.

Monitor daily weight. 2. Maintain sodium restrictions Monitor intake and output (I&O). 5. Maintain bed rest when edema is severe.

The nurse is admitting a client from the postanesthesia care unit who has had percutaneous nephrolithotomy for calculi in the renal pelvis. The nurse anticipates that the client's care will most likely involve monitoring which device?

Nephrostomy tube

The nurse is conducting an interview of an older client and is concerned about the possibility of benign prostatic hyperplasia (BPH). Which are characteristics of this disorder? Select all that apply.

Nocturia 2. Incontinence 3. Enlarged prostate

A client is admitted to the emergency department following a fall from a horse and the health care provider (HCP) prescribes insertion of a urinary catheter. While preparing for the procedure, the nurse notes blood at the urinary meatus. The nurse should take which action?

Notify the HCP before performing the catheterization.

The nurse is monitoring the urine output of a client with low serum protein level and urinary output less than 30 mL in the last hour. Based on these data, the nurse understands that low urinary output is caused by which force within the kidneys?

Oncotic pressure

The nurse is assessing the patency of a client's left arm arteriovenous fistula prior to initiating hemodialysis. Which finding indicates that the fistula is patent?

Palpation of a thrill over the fistula

A client undergoing hemodialysis is at risk for bleeding from the heparin used during the hemodialysis treatment. The nurse assesses for this occurrence by periodically checking the results of which laboratory test?

Partial thromboplastin time (PTT)

A client with acute kidney injury has a serum potassium level of 7.0 mEq/L (7.0 mmol/L). The nurse should plan which actions as a priority? Select all that apply.

Place the client on a cardiac monitor. 2. Notify the health care provider (HCP). 3. Put the client on NPO (nothing by mouth) status except for ice chips. 4. Review the client's medications to determine if any contain or retain potassium.

The nurse is planning discharge teaching for a client newly diagnosed with chronic kidney disease (CKD). Which factor will enhance the educational process?

Presence of family

The nursing student is assigned to care for a client with a diagnosis of acute kidney injury (AKI), diuretic phase. The nursing instructor asks the student about the primary goal of the treatment plan for this client. Which goal, if stated by the nursing student, indicates an adequate understanding of the treatment plan for this client?

Prevent loss of electrolytes.

The nurse has provided instructions to a client with a urinary tract infection regarding foods and fluids to consume that will acidify the urine. Which fluids should the nurse include in the client's teaching plan that will aid in acidifying the urine? Select all that apply.

Prune juice 3. Apricot juice 4. Cranberry juice

A client with chronic kidney disease (CKD) is being managed by continuous ambulatory peritoneal dialysis (CAPD). During outflow, the nurse notes that only half of the 2-L dialysate has returned and the flow has stopped. Which interventions should the nurse take to enhance the outflow? Select all that apply.

Reposition the client. Make sure the peritoneal catheter is not kinked. Check that the drainage bag is lower than the client's abdomen. 6. Assess the stool history, and institute elimination measures if the client is constipated.

The nurse has provided dietary instructions to a client with renal calculi who must learn about the foods that yield an alkaline residue in the urine. The nurse determines that education was effective if the client chooses which selections from a diet menu?

Spinach salad, milk, and a banana

A client with chlamydial infection has received instructions on self-care and prevention of further infection. The nurse determines that the client needs further teaching if the client states that he or she will take which action?

Take an antibiotic so as to prophylactically prevent symptoms of Chlamydia.

A client experiencing end-stage kidney disease has an arteriovenous (AV) fistula placed surgically for hemodialysis. Which action is most appropriate for the nurse to document in the plan for care of the AV fistula?

Teach the client to avoid carrying heavy objects that would compress the AV fistula and cause thrombosis.

A client is scheduled for surgical creation of an internal arteriovenous (AV) fistula on the following day. The client says to the nurse, "I'll be so happy when the fistula is made tomorrow. This means I can have that other hemodialysis catheter pulled right out." Which interpretation should the nurse make based on the client's statement?

The client does not understand that the site needs to mature or develop for 1 to 2 weeks before use.

The nurse is caring for a client who has just returned from having a cystoscopy. The nurse should recognize which as an abnormal assessment finding for this client?

The nurse notes bright red urine output.

The nurse is caring for a client with a bladder infection. The nurse plans care understanding that the primary risk factor for spread of infection in this client is dysfunction of which structure?

Ureterovesical junction

The nurse instructs a client about continuous ambulatory peritoneal dialysis (CAPD). Which statement by the client indicates an accurate understanding of CAPD?

"No machinery is involved, and I can pursue my usual activities."

The nurse is giving general instructions to a client receiving hemodialysis. Which statement would be most appropriate for the nurse to include?

"Several types of medications should be withheld on the day of dialysis until after the procedure."

The nurse instructor is evaluating a nursing student for knowledge regarding care of a client with acute kidney injury. Which statement by the student demonstrates the need for further teaching about the diuretic phase of acute kidney injury?

"The diuretic phase is characterized by an increase in urine output of about 500 mL in a 24-hour period."

The nurse is teaching a client with renal cancer who is scheduled for a renal artery embolization about the procedure. Which statement by the client indicates that the educational session was effective?

"This will decrease the size of the tumor because its blood supply will be removed after placement of an absorbable gelatin sponge."

The nurse is assessing the renal function of a client at risk for acute kidney injury. After noting the amount of urine output and urine characteristics, the nurse proceeds to assess which as the best indirect indicator of renal status?

Blood pressure

The nurse has administered a dose of meperidine hydrochloride to a client with renal colic as treatment for pain. The nurse carefully monitors this client for which side and adverse effect of this medication?

Urinary retention

The nurse caring for a client immediately after transurethral resection of the prostate (TURP) notices that the client has suddenly become confused and disoriented. Which is the priority nursing action for this client?

Notify the health care provider (HCP).