Renal - Med surg
The registered nurse is preparing to assess a client's renal system. Which statement by the nurse indicates effective technique? "I must first palpate the client if a tumor is suspected." "I must first listen for normal pulse at the client's wrist region." "I must first auscultate the client and then proceed to percussion and palpation." "I must first examine tender abdominal areas and then proceed to nontender areas."
"I must first auscultate the client and then proceed to percussion and palpation."
A client is admitted with renal calculi. Which clinical manifestations does a nurse expect the client to report? Blood in the urine Irritability and twitching Dry, itchy skin and pyuria Frequency and urgency of urination Pain radiating from the kidney to a shoulder
Blood in the urine Frequency and urgency of urination
Which condition should be reported immediately to the primary healthcare provider? Pelvic pain immediately after colposcopy Light vaginal bleeding for 1 to 2 days following a hysterosalpingogram Rectal bleeding for 2 days after prostate biopsy Body temperature of 102° F with vaginal discharge 48 hours after cervical biopsy
Body temperature of 102° F with vaginal discharge 48 hours after cervical biopsy
A nurse is caring for a client with acute kidney injury. Which findings should the nurse anticipate when reviewing the laboratory report of the client's blood level of calcium, potassium, and creatinine? Calcium: 7.6 mg/dL (1.9 mmol/L) Calcium: 10.5 mg/dL (2.6 mmol/L) Potassium 6.0 mEq/L (6.0 mmol/L) Potassium 3.5 mEq/L (3.5 mmol/L) Creatinine: 3.2 mg/dL (194 mcmol/L) Creatinine: 1.1 mg/dL (90 mcmol/L)
Calcium: 7.6 mg/dL (1.9 mmol/L) Potassium 6.0 mEq/L (6.0 mmol/L) Creatinine: 3.2 mg/dL (194 mcmol/L)
What is the concentration of estradiol in the blood during the follicular phase of the menstrual cycle? 130 pg/mL 159 pg/mL 165 pg/mL 171 pg/mL
130 pg/mL
After surgery to create an ileal conduit, a client is admitted to the postanesthesia care unit. Which clinical finding during the first hour of the postoperative period should the nurse report to the primary healthcare provider? Edematous stoma Episodes of vomiting Diminished bowel sounds Absence of urinary output
Absence of urinary output
A client with acute kidney injury states, "Why am I twitching and my fingers and toes tingling?" Which process should the nurse consider when formulating a response to this client? Acidosis Calcium depletion Potassium retention Sodium chloride depletion
Calcium depletion
After reviewing the 24-hour urine collection reports of a client with kidney dysfunction, the nurse suspects diabetes mellitus. Which finding supports this suspicion? Calcium level: 500 mg/24 hr Sodium level: 300 mEq/24 hr Urea nitrogen level: 30 g/24 hr Creatinine level: 40 mg/kg/24 hr
Creatinine level: 40 mg/kg/24 hr
The urinalysis results of a female client shows the 17-ketosteroids value as 25 mg/24 hr. Which condition should the nurse monitor for in this client? Addison disease Ovarian neoplasms Ovarian dysfunction Cushing syndrome
Cushing syndrome
A client has been diagnosed with anemia. Which decreased hormone level may be the cause? Bradykinin Prostaglandin Erythropoietin Activated vitamin D
Erythropoietin
The nurse is assisting the primary healthcare provider while performing cervical dilation and curettage of a client. Which possible conditions are being treated in the client? Hernia Infertility Heavy bleeding Rectal prolapse into vagina Urinary bladder protrusion through vaginal wall
Infertility Heavy bleeding
A client who has had a continent urostomy created reports postoperative pain. What should the nurse do first? Tell the client to take deep breaths. Measure the client's current vital signs. Interview the client to gather more information. Administer the prescribed analgesic to the client.
Interview the client to gather more information.
The laboratory values of a client with renal calculi reveal a serum calcium within expected limits and an elevated serum purine. How should the nurse interpret these findings about the stone's composition? It contains cystine. It contains uric acid. It contains calcium oxalate. It contains magnesium ammonium phosphate.
It contains uric acid.
A client's urine specific gravity is being measured. For which condition should the nurse conduct a focused assessment when a client's specific gravity is increased? Polyuria Fluid overload Low-grade fever Diabetes insipidus
Low-grade fever
Which hormone is released in response to low serum levels of calcium? Renin Erythropoietin Parathyroid hormone Atrial natriuretic peptide
Parathyroid hormone
A client with chronic kidney disease is receiving medication to manage anemia. Which primary goal should the nurse include in the care plan from this information? Prevention of uremic frost Prevention of chronic fatigue Prevention of tubular necrosis Prevention of dependent edema
Prevention of chronic fatigue
Which instructions will be most beneficial for a diabetic client with renal disease? Recommend the client drink boiled water Suggest the client to go for a morning walk Instruct the client to check blood pressure regularly Contact the primary healthcare provider before taking ibuprofen Encourage the client to undergo a microalbuminuria test yearly
instruct the client to check blood pressure regularly Contact the primary healthcare provider before taking ibuprofen Encourage the client to undergo a microalbuminuria test yearly
An older adult client states, "I walk 2 miles [3.2 km] a day for exercise, but now that the weather is hot, I am worried about becoming dehydrated." What should the clinic nurse teach the client? "Drink fruit juices if you start to feel dehydrated." "Thirst is a good guide to use to determine fluid intake." "Fluids should be increased if the urine is getting darker." "Water should be consumed when the skin becomes dry."
"Fluids should be increased if the urine is getting darker."
A man with benign prostatic hyperplasia is scheduled for a transurethral incision of the prostate (TUIP). As he is being admitted to the surgical unit, he tells the nurse he is concerned that the operation will result in impotence. Which is the best response by the nurse? "It's understandable that you are worried; it is a very real possibility." "I can understand your concern, but this operation usually does not cause impotence." "Most men worry about their ability to function; you should speak with your primary healthcare provider." "You may be impotent for a while, but normal functioning probably will return within a few months."
"I can understand your concern, but this operation usually does not cause impotence."
A nursing student counsels a 70-year-old female client about changes in the reproductive system caused by aging. Which statement made by the client indicates effective learning? "I should reduce my intake of dietary calcium." "I should limit my Kegel exercises." "I should undergo regular clinical breast examinations." "I should report to my primary healthcare practitioner if my nipples do not become erect."
"I should undergo regular clinical breast examinations."
The registered nurse (RN) is teaching a nursing student about the care given to a female client before a prostate antigen-specific test. Which statement of the nursing student indicates a need for further teaching? "I will observe breast changes in the client." "I will ask if the client is having her menstrual cycle." "I will observe the venipuncture site for hematoma." "I will ask the client to have nothing by mouth (NPO)."
"I will ask the client to have nothing by mouth (NPO)."
Which dietary suggestion should the nurse provide while teaching a group of geriatric female clients who have reduced amounts of circulating estrogen? "Include fish in your diet." "Include fruits in your diet." "Include yogurt in your diet." "Include legumes in your diet."
"Include yogurt in your diet."
A client with an ileal conduit is being prepared for discharge. As part of the discharge teaching, which instruction should the nurse include? "Maintain fluid intake of at least 2 L daily." "Abstain from beer and alcohol consumption." "Avoid getting soap and water on the peristomal skin." "Notify the primary healthcare provider if the stoma size decreases."
"Maintain fluid intake of at least 2 L daily."
A client with urinary incontinence is prescribed amitriptyline. Which instruction should the nurse provide to the client? "You should avoid dehydration." "You should monitor your urine output." "You should rise slowly when getting up from a sitting or lying position." "You should periodically check your blood pressure when starting the medication."
"You should rise slowly when getting up from a sitting or lying position."
During an 8-hour shift a client has a 6-oz (180 mL) cup of tea and 360 mL of water; the client vomits 100 mL, and the intravenous (IV) fluids instilled equaled the urinary output. What is this client's fluid balance at the end of this 8-hour period that the nurse must document on the client's intake and output record? 240 mL 340 mL 440 mL 540 mL
440 mL
A client has undergone surgery with general anesthesia. Within how many hours after surgery should the nurse notify the primary healthcare provider if the client does not void? 4 hours 8 hours 10 hours 12 hours
8 hours
A nurse is caring for a client who is scheduled to have a paracentesis. Immediately before the procedure, the nurse asks the client to void. What is the rationale for asking the client to void? A full bladder decreases the intraabdominal pressure. A full bladder decreases the amount of fluid in the abdominal cavity. A full bladder increases the danger of puncture during the procedure. A full bladder increases the presence of urea in the intraabdominal fluid.
A full bladder increases the danger of puncture during the procedure.
A client is diagnosed with bladder cancer, and a cystectomy and creation of an ileal conduit are scheduled. What should the nurse plan to do preoperatively? Limit fluid intake for 24 hours. Teach range-of-motion and Kegel exercises. Explain the procedure for irrigating the ileal conduit. Administer cleansing enemas and laxatives as prescribed.
Administer cleansing enemas and laxatives as prescribed. Preoperative cleansing of the bowel is necessary before surgical resection and formation of a urinary conduit. Fluids should not be restricted until after midnight or based on the specific prescriptions of the primary healthcare provider. Range-of-motion and Kegel exercises have no direct effect on this procedure. An ileal conduit is not irrigated.
The client's serum sodium is 123 mEq/L (123 mmol/L). Which prescription should the nurse question? Provide pretzels as a snack daily. Restrict fluid intake to 1000 mL per day. Assess neurologic status every 2 hours. Administer intravenous fluid of one-half normal saline (NS) at 125 mL/hr.
Administer intravenous fluid of one-half normal saline (NS) at 125 mL/hr.
The nurse is providing education to a client with calculi in the calyces of the right kidney. The client is scheduled to have the calculi removed. Which information should the nurse include in the teaching? The surgery will be performed transurethrally. During the surgery, the right ureter will be removed. After surgery, a suprapubic catheter will be in place. After surgery, there will be a small incision in the right flank area.
After surgery, there will be a small incision in the right flank area.
A client with acute kidney failure becomes lethargic and fatigued. Upon reviewing the client's medical record, which finding does the nurse determine is the most likely cause of this behavior? Hyperkalemia Hypernatremia A limited fluid intake An increased blood urea nitrogen level
An increased blood urea nitrogen level
A client with end-stage renal disease is hospitalized. For which complications should the nurse monitor the client? Anemia Dyspnea Jaundice Hyperexcitability Hypophosphatemia
Anemia Dyspnea
The nurse is performing an assessment of a female client's reproductive system. Which action should the nurse take? Maintain friendly demeanor with the client during assessment Ask about sexual practices at the beginning of assessment Ask about menstrual history at the beginning of assessment Maintain gender-specific terms while questioning during assessment
Ask about menstrual history at the beginning of assessment
A client with a suspected kidney disorder reports flank pain. Which nursing interventions should be conducted while performing flank assessment? Percussing the tender flank first Forming both hands into a clenched fist Asking the client to assume a sitting position Placing one hand flat on costovertebral angle (CVA) Delivering a firm hand thump over the lower abdomen
Asking the client to assume a sitting position Placing one hand flat on costovertebral angle (CVA)
A client with kidney dysfunction is about to undergo renal testing using a contrast medium. Which nursing interventions should be conducted before the procedure to ensure the client's safety? Assessing the client for a history of cirrhosis Asking the client if he or she has a known shellfish allergy Assessing the client for a history of lactic acidosis Assessing the client's hydration status by checking blood pressure and respiratory rate Asking the client to discontinue metformin 12 hours before the procedure
Assessing the client for a history of cirrhosis Asking the client if he or she has a known shellfish allergy Assessing the client's hydration status by checking blood pressure and respiratory rate
An ambulatory client with benign prostatic hyperplasia tells the nurse on morning rounds that he has not been able to void. The nurse assesses the client and determines that the bladder is distended. What should the nurse do? Ask him to use a urinal. Encourage increased fluids. Assist him into a warm shower. Exert pressure over the pubic area.
Assist him into a warm shower.
A nurse is caring for a client with end-stage renal disease. Which clinical indicators of end-stage renal disease should the nurse expect? Polyuria Jaundice Azotemia Hypertension Polycythemia
Azotemia Hypertension
The nurse is teaching a client receiving peritoneal dialysis about the reason dialysis solution is warmed before it is instilled into the peritoneal cavity. Which information will the nurse share with the client? Because it forces potassium back into the cells, thereby decreasing serum levels Because it adds extra warmth to the body because metabolic processes are disturbed Because it helps prevent cardiac dysrhythmias by speeding up removal of excess potassium Because it encourages removal of serum urea by preventing constriction of peritoneal blood vessels
Because it encourages removal of serum urea by preventing constriction of peritoneal blood vessels
A nurse is reviewing the clinical record of a client with a diagnosis of benign prostatic hyperplasia (BPH). Which test result will the nurse check to confirm the diagnosis? Rectal examination Serum phosphatase level Biopsy of prostatic tissue Massage of prostatic fluid
Biopsy of prostatic tissue
The nurse reviews the medical records of four male clients. Which client will the nurse assess most closely for developing prostate cancer? Black 55-year-old White 45-year-old Asian 55-year-old Hispanic 45-year-old
Black 55-year-old
What is the cup-like structure that collects a client's urine and is located at the end of each papilla? Calyx Capsule Renal cortex Renal columns
Calyx
Which is a primary glomerular disease? Diabetic glomerulopathy Chronic glomerulonephritis Hemolytic-uremic syndrome Systemic lupus erythematosus (SLE)
Chronic glomerulonephritis
A nurse is caring for a client during the early postoperative period after a prostatectomy. Which action is the priority? Have the client stand to void. Discourage straining for a bowel movement. Use a bulb syringe to aspirate urine from the retention catheter. Notify the primary healthcare provider if the client does not void by bedtime.
Discourage straining for a bowel movement.
What age-related changes are associated with the female genitalia? Dry vagina Firm breasts Erected nipples Graying of pubic hair Decreased size of the labia majora
Dry vagina Graying of pubic hair Decreased size of the labia majora
A residual urine test is prescribed for a client with benign prostatic hyperplasia. What should the nurse instruct the client to do? Void after a urinary catheter is removed. Collect a specimen of urine during midstream. Attempt to void when a urinary catheter is in place. Empty the bladder before a urinary catheter is inserted.
Empty the bladder before a urinary catheter is inserted.
A client has a kidney transplant. The nurse should monitor for which assessment findings associated with rejection of the transplant? Fever Oliguria Jaundice Polydipsia Weight gain
Fever Oliguria Weight gain
Which complications does the nurse expect in the client with a renal disorder who has a blood urea nitrogen (BUN)/creatinine ratio of 28? . Malnutrition Hepatic damage Kidney impairment Fluid volume deficit Obstructive uropathy
Fluid volume deficit Obstructive uropathy
The blood urea nitrogen (BUN)/creatinine ratio of a client is 3. Which condition does the nurse suspect in the client? Fluid volume excess Obstructive uropathy Severe hepatic damage Gastrointestinal (Gl) bleeding
Fluid volume excess
A 75-year-old male with a history of cancer of the prostate is admitted for a prostatectomy. The client's prostate specific antigen (PSA) levels have been increasing. This finding should prompt the nurse to include what in the client's plan of care? Measure intake and output. Institute seizure precautions. Monitor the plasma pH for acidosis. Handle the client gently when turning.
Handle the client gently when turning.
A nurse reviews the history of a client who is hospitalized with a diagnosis of urinary calculi and identifies that which factor may have contributed to the development of the calculi? Increased fluid intake Urine specific gravity of 1.017 Jogging 3 miles (4.8 km) a day History of hyperparathyroidism
History of hyperparathyroidism
In which medical conditions do the client's chloride levels in the 24-hour urine sample test increase? Heart failure Emphysema Hypokalemia Pyloric obstruction Adrenal insufficiency
Hypokalemia Adrenal insufficiency
A nurse educates the client about the relationship between the kidneys and blood pressure. Which term should the nurse use to describe the part of the kidney that senses changes in blood pressure? Calices Glomerulus Macula densa Juxtaglomerular cells
Macula densa
The nurse is providing care to a client who has had a transurethral resection of the prostate (TURP). Which goal is the priority? Maintain patency of the cystostomy tube. Prevent wound hemorrhage and infection. Maintain patency of the indwelling catheter. Prevent the abdominal dressing from draining.
Maintain patency of the indwelling catheter.
A nurse is caring for a client who is experiencing urinary incontinence. The client has an involuntary loss of small amounts (25 to 35 mL) of urine from an overdistended bladder. How should this be documented in the client's medical record? Urge incontinence Stress incontinence Overflow incontinence Functional incontinence
Overflow incontinence
A client is at high risk for developing ascites because of cirrhosis of the liver. How should the nurse assess for the presence of ascites? Observe the client for signs of respiratory distress. Percuss the client's abdomen and listen for dull sounds. Palpate the lower extremities over the tibia and observe for edema. Listen for decreased or absent bowel sounds while auscultating the abdomen.
Percuss the client's abdomen and listen for dull sounds.
Which phase of the woman's sexual response is characterized by elevation of the uterus? Plateau phase Orgasmic phase Excitation phase Resolution phase
Plateau phase
The nurse finds that a client has dysuria, hesitancy, urinary urgency, and leaking. The laboratory reports of the client reveal serum PSA levels of 5 ng/mL and elevated prostatic acid phosphatase (PAP) levels. Which disease condition does the nurse suspect? Orchitis Hydrocele Prostatitis Prostate cancer
Prostate cancer
A client is transferred to the postanesthesia care unit after undergoing a pyelolithotomy. The client's urinary output is 50 mL/hr. What should the nurse do? Record the output as an expected finding. Encourage the client to drink oral fluids. Milk the client's nephrostomy tube. Notify the primary healthcare provider.
Record the output as an expected finding.
During an examination of a client with kidney dysfunction, the nurse finds the presence of glucose in the urine. Which nursing intervention is beneficial for this client? Administering oral fluids Noting the finding down as normal Administering hypoglycemic medication Reporting this finding to the primary healthcare provider
Reporting this finding to the primary healthcare provider
After interacting with a client, a nurse finds that a 23-year-old client has never undergone a Papanicolaou (Pap) test. What should the nurse suggest to the client? Schedule a Pap test immediately Schedule a Pap test during menses Schedule a Pap test every five years Schedule a Pap test and human papillomavirus test
Schedule a Pap test immediately
A client with a history of excessive alcohol use develops hepatic portal hypertension and an elevated serum aldosterone level. For which complications should the nurse assess this client? Chloride depletion and hypovolemia Potassium retention and dysrhythmias Sodium retention and fluid accumulation Calcium depletion and pathologic fractures
Sodium retention and fluid accumulation
A nurse is caring for a client with continuous bladder irrigation. Which action should the nurse take? Monitor urinary specific gravity to determine hydration. Subtract irrigant from output to determine urine volume. Record urinary output every hour to determine kidney function. Obtain a 24-hour urine specimen to determine urine concentration.
Subtract irrigant from output to determine urine volume.
Which natural physiologic process helps prevent bacterial infections within the client's bladder containing urine? The secretions of the urothelium The relaxation of the detrusor muscle The contraction of the external sphincter The muscle tone of the internal sphincter
The secretions of the urothelium
The nurse instructs a client suspected of bladder cancer to discard the morning first-voided urine and to collect a fresh urine specimen. The nurse also sends the specimen to the laboratory within 1 hour of collection. Which diagnostic procedure requires this intervention? Residual urine Concentration test Urine cytologic study Protein determination
Urine cytologic study
A client begins therapy with a new medication. One month later the client notices blood in the urine. Which drug does the nurse anticipate as the cause? Warfarin Nifedipine Nitrofurantoin Phenazopyridine
Warfarin
A nurse is performing peritoneal dialysis for a client. Which action should the nurse take? Place the client in a side-lying position. Warm the dialysate solution slightly before instillation. Infuse the dialysate solution slowly over several hours. Withhold the routine medications until after the procedure.
Warm the dialysate solution slightly before instillation.