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ATI MED SURG PROCTORED
RETAKE STUDY GUIDE LATEST
VERSION 2025
1.A nurse is reinforcing teaching a client who will have an x-ray of the kidneys, ureters and bladder. Which of the following statements should the nurse include? A) "You will receive contrast dye during the procedure." B) "An enema is necessary before the procedure." C) "You will need to lie in a prone position during the procedure." D) "The procedure determines whether you have a kidney stone." D) "The procedure determines whether you have a kidney stone." 2.A nurse is monitoring a client who had a kidney biopsy for postoperative complications. Which of the following complications should the nurse identify as causing the greatest risk to the client? A) Infection B) Hemorrhage C) Hematuria D) Pain B) Hemorrhage
3.A nurse is preparing to begin a 24 hr urine collection for a client. Which of the following actions should the nurse take? A) Store collected urine in a designated container at room temperature. B) Discard the first voiding when beginning the test. C) Post a notice on the client's door regarding the testing. D) Document any urine collection that was missed during the 24 hr of the testing. B) Discard the first voiding when beginning the test. 4.A nurse is collecting data from a client who has returned to the medical-surgical unit following a CT scan of the kidneys with IV contrast. Which of the following findings should the nurse identify as an indication the client is experiencing an allergic reaction to the contrast material? A) Bradycardia B) Pink-tinged urine C) Hyperpyrexia D) Skin hives D) Skin hives 5.A nurse is reinforcing teaching with a client who has chronic kidney disease and is to begin hemodialysis. Which of the following information should the nurse include? A) Hemodialysis restores kidney function. B) Hemodialysis replaces hormonal function of the renal system. C) Hemodialysis allows an unrestricted diet.
A) Check BUN and blood creatinine. B) Administer medications the nurse withheld prior to dialysis. D) Monitor for shortness of breath. 8.A nurse is contributing to the plan of care for a client who has chronic kidney disease. Which of the following actions should the nurse recommend to include in the plan of care? (SATA) A) Monitor for pulmonary edema. B) Provide frequent mouth rinses. C) Restrict fluids based on urinary output. D) Provide a high-sodium diet. E) Monitor for weight gain trends. A) Monitor for pulmonary edema. B) Provide frequent mouth rinses. C) Restrict fluids based on urinary output. E) Monitor for weight gain trends. 9.A nurse is reviewing client laboratory data. Which of the following findings is expected for a client who has stage 4 chronic kidney disease? A) Blood urea nitrogen (BUN) 15mg/dL B) Glomerular filtration rate (GFR) 20mL/min C) Blood creatinine mg/dL D) Blood potassium mEq/L
B) Glomerular filtration rate (GFR) 20mL/min 10.A nurse is collecting data from a client who has prerenal AKI. Which of the following findings should the nurse expect? (SATA) A) Reduced BUN B) Elevated cardiac enzymes C) Reduced urine output D) Elevated blood creatinine E) Elevated blood calcium C) Reduced urine output D) Elevated blood creatinine 11.A nurse is reviewing information with a female client who has frequent urinary tract infections. Which of the following information should the nurse include? (SATA) A) Avoid sitting in a wet bathing suit. B) Wipe the perineal area back to front following elimination. C) Empty the bladder when there is an urge to void. D) Wear synthetic fabric underwear. E) Take a sower instead of a bath. A) Avoid sitting in a wet bathing suit. C) Empty the bladder when there is an urge to void. E) Take a sower instead of a bath.
D) Bradypnea B) Diaphoresis 15.A nurse is reinforcing teaching with a client who is scheduled for extracorporeal shock wave lithotripsy (ESWL). Which of the following statements by the client indicates understanding of the instructions? A) "I will be fully awake during the procedure." B) "Lithotripsy will reduce my chances of having stones in the future." C) "I will report any bruising that occurs to my doctors." D) "Straining my urine following the procedure is important." D) "Straining my urine following the procedure is important." 16.A nurse is caring for a client who has a left renal calculus and an indwelling urinary catheter. Which of the following data collection findings is the priority for the nurse to report to the provider? A) Flank pain that radiates to the lower abdomen. B) Client report of nausea. C) Absent urine output for 1 hr. D) Blood WBC count 15,000/mm C) Absent urine output for 1 hr. 17.A nurse is reinforcing discharge instructions with a client who has spontaneously passed a calcium oxalate calculus. To decrease the chance of
recurrence, the nurse should instruct the client to avoid which of the following foods? (SATA) A) Red meat. B) Black tea. C) Cheese. D) Whole grains. E) Spinach. B) Black tea. E) Spinach. 18.Monitoring a dialysis graft (AV fistula) site for a bruit and a thrill, which one is palpated and which one is auscultated? (page 365) Presence of bruit is auscultated, palpable thrill is palpated. 19.UA that is positive for leukocyte esterase indicates what? (page 350) UTI, urinary tract infection.
20.What can an untreated UTI cause? (page 349)
Untreated UTIs can lead to pyelonephritis and urosepsis, which can result in septic shock and death.
Reinforce client teaching regarding the testing procedure. Void prior to defecating. Avoid placing toilet paper into urine collection container. To begin the test, have client void. This test begins at the time of the first void. This first void is discarded. However, all subsequent urine is collected for the next 24hr. Post notices on the client's medical record and over the toilet alerting all personnel of the ongoing test. Collect all urine voided over the the next 24r in an approved container that is kept on ice or refrigerated. Collect the last urine sample as close to the end of the 24hr as possible. The test must b e restarted if any urine is missed. 26.When inserting an indwelling urinary catheter, the catheter is mistakenly inserted in the vagina, what is the procedure? (page ) Remove and begin another attempt with a new sterile catheter. 27.When taking phenazopyridine (Pyridium) what is the expected color of urine and what is it ordered for? (page 350 ) Phenazopyridine: bladder analgesic used to treat UTIs that will tur n the urine orange. 28.Disequilibrium syndrome (page 336) Disequilibrium syndrome results from too rapid a decrease of BUN and circulating fluid volume. It can result in cerebral edema and increased ICP. Signs and symptoms: nausea, vomiting, changes in level of consciousness, seizures and agitation. Advanced age is a risk factor for dialysis disequilibrium and hypotension due to rapid changes in fluid and electrolyte status.
Potassium and foods... Bananas; orange juice, tomatoes and potatoes are high in potassium. Apples are low in potassium. For high potassium what needs to be monitored related to cardiac? (page ) Cardiac arrhythmias (patient is at risk for cardiac arrest) Why is an allergy to shellfish or iodine a red flag for someone who is to receive contrast dye with CT scan of the kidney? (page 341) Also refer to intrarenal AKI Chemical injury and possible allergic reaction to contrast media. What is the definition of the prefix cyst/o? (LOM page 969 ) urinary bladder; cyst; sac of fluid What is the purpose of straining urine in a client with renal calculi? (page 356) Strain all urine to check for passage of the calculus and save the calculus for laboratory analysis.
BUN 10-20 mg/dL Creatinine 0.5-1.5 mg/dL What is oliguria? (page 341) Second phase of acute kidney injury. Begins with kidney insult; urine output is 100- 400 mL/24hr with or without diuretics and last for 1-3 weeks. What is stage 5 kidney disease? (page 342) End stage: kidney disease requiring dialysis or kidney transplant. What is the drug category for medications ending in 'pril' (ex. Lisinopril) refer to prefix/suffix medication hand out. ACE Inhibitor. Antihypertensive. Blocks ACE in lungs from converting angiotensin I to angiotensin II (powerful vasoconstrictor). Decreases BP, Decreased Aldosterone secretions, Sodium and fluid loss. Of the following diuretics which one is potassium sparing and which one is not? Furosemide and spironolactone. (hand out) Furosemide: potassium wasting. Spironolactone: potassium sparing.
What is the difference between anticholinergic and cholinergic effects? (Every Mark K video) Anticholinergic: decreases output (can't see, pee, spit or shit!) Cholinergic: increases salivation; tears; stimulates urination and GI peristalsis. Remember weight gain of ___-___lbs overnight or _____lbs in a week should be reported to the health care provider. 2-3lbs; 5lbs What is BPH and what are its effects on urine output? (page 387 ) Benign prostatic hyperplasia (BPH.) Enlargement of the prostate gland begins to cause urinary disfunction (frequency; urgency; hesitancy or incontinence; incomplete emptying of the bladder; dribbling, post voiding; nocturia; diminished force of urinary str eam. What is the medication finasteride and its effects on BPH? (page 387) 5 alpha reductase inhibitor (5-ARI), such as finasteride decreases the production of testosterone in the prostate gland; often decreasing the size of the prostate gland.
