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Med-Surg I ATI: Renal & Urinary Practice
questions with answers
A nurse is planning care for a client who is postoperative following a nephrectomy. Which of the following assessments is the priority for the nurse to evaluate? a. bowel sounds b. WBC count c. pain level d. blood pressure - CORRECT ANSWERS โโd. blood pressure The greatest risk to the client is acute adrenal insufficiency. The adrenal gland can be removed or damaged during nephrectomy. The nurse should evaluate the client for hypotension, decreased urine output, and decreased level of consciousness. A nurse is caring for a client who has continuous bladder irrigation following a transurethral resection of the prostate. Upon detecting an output obstruction, which of the following actions should the nurse take first? a. irrigate the catheter with normal saline b. notify the provider c. check the irrigation tubing for kinks d. provide PRN pain medication - CORRECT ANSWERS โโc. check the irrigation tubing for kinks
This is the least invasive and most simple action the nurse can take before moving onto most invasive. A nurse is performing an admission assessment on a client who has severe chronic kidney disease (CKD). Which of the following statements by the client indicate an understanding of the teaching? a. "I will check my blood pressure once a week." b. "I will take magnesium antacid if constipated." c. "I will weigh myself every morning." d. "I will use a salt substitute in my diet." - CORRECT ANSWERS โโc. "I will weigh myself every morning." The client must weigh themselves daily to monitor fluid balance. BP must be taken daily. Magnesium antacids can cause magnesium toxicity for a CKD client. Salt substitutes should be avoided because they have potassium chloride and can cause hyperkalemia. A nurse is performing an admissions assessment on a client who has acute glomerulonephritis. The nurse should expect which of the following findings? a. Low BP b. Polyuria c. Dark-colored urine
d. place the client's urine specimen in a container with a preservative - CORRECT ANSWERS โโb. instruct the client to initiate the flow of urine before collecting the specimen Obtain a clean catch specimen for testing. A nurse is planning care for a client who has acute glomerulonephritis. The nurse should plan to provide which of the following interventions? a. weigh the client daily b. encourage the client to drink 2 to 3L of fluid per day c. instruct the client to ambulate every 2 hr. d. obtain the client's serum blood glucose - CORRECT ANSWERS โโa. weigh the client daily The nurse must monitor fluid retention by weighing the client daily. A decrease in weight indicates effectiveness of treatment. A nurse is caring for a client who has nephrotic syndrome and has been taking prednisone for 3 days. Which of the following adverse effects should the nurse monitor for and report to the provider? a. sore throat b. frequent stools c. drowsiness
d. tremors - CORRECT ANSWERS โโa. sore throat Glucocorticoids depress the natural immune system and increase the client's risk for infection. A sore throat can indicate an infection. A nurse is caring for a client following extra corporeal shock wave lithotripsy (ESWL) for the treatment of calcium phosphate kidney stones. Which of the following actions is appropriate for the nurse to take? a. monitor for the client's urine for ketones b. provide the client with anincreased animal protein diet c. limit the client's fluid intake to 1.5L per day d. strain all of the client's urine - CORRECT ANSWERS โโd. strain all of the client's urine Straining the client's urine can allow the nurse to detect any stone fragments. A nurse is assessing a client who has chronic kidney disease and has completed her third peritoneal dialysis (PD) treatment. Which of the following findings should the nurse report to the provider? a. greater outflow of dialysate than inflow b. weight loss c. cloudy dialysate effluent
d. "I will add salt to the foods I consume." - CORRECT ANSWERS โโb. "I will decrease my intake of foods high in phosphorus." Clients with CKD must limit phosphorous intake because it can cause bone damage. Foods high in protein can cause uremia and a build up of waste products from breakdown. A nurse is planning care for a group of clients. Which of the following clients should the nurse plan to monitor for signs of nephrotoxicity? a. a client who is receiving gentamicin for treatment of a wound infection. b. a client who is receiving digoxin for treatment of heart failure c. a client who is receiving methylprednisolone for treatment of hypertension d. a client who is receiving propranolol for treatment of hypertension - CORRECT ANSWERS โโa. a client who is receiving gentamicin for treatment of a wound infection. Antibiotics can be nephrotoxic. A nurse is caring for a hospitalized client who received hemodialysis 1 hr ago. when evaluating the clients status after dialysis which of the following info should the nurse assess first a. serum potassium level b. body weight
c. serum creatine d. vital signs - CORRECT ANSWERS โโd. vital signs The client is at risk for hypotension, dysrhythmia, and hemorrhage. A nurse is reviewing the medical history of a client who has end-stage kidney disease. The nurse should identify that which of the following factors in the client's history is a contraindication for receiving hemodialysis? a. History of hemophilia b. Difficulty with ambulation c. Decreased WBC d. Iodine allergy - CORRECT ANSWERS โโa. History of hemophilia This client will bleed excessively and is at high risk for extreme blood loss during hemodialysis. A nurse is planning care for a client who has chronic kidney disease (CKD) and a potassium level of 7.3 mEq/L. Which of the following interventions should the nurse plan to take? a. Initiate an IV of lactated Ringer's solution (Isotonic) b. Give spironolactone 50 mg PO BID c. Infuse regular insulin in dextrose 10% water
A nurse is preparing a teaching plan for a male client who has continent internal ileal reservoir following surgery to treat bladder cancer. Which of the following statements should the nurse include in the teaching plan? a. "this should not affect you ability to have sexual intercourse" b. "you should empty you new bladder when it feels full" c. "you will need to avoid foods that produce intestinal gas" d. "you must insert a catheter through your stoma to drain the urine" - CORRECT ANSWERS โโd. "you must insert a catheter through your stoma to drain the urine" A nurse is planning care for a client who is scheduled to undergo extracorporeal shock wave lithotripsy (ESWL) for urolithiasis. Which of the following actions should the nurse plan to take? a. place the client in a semi-Fowler's position b. assist with the client's intubation c. begin a 24-hr urine specimen collection after the procedure d. apply electrodes for cardiac monitoring - CORRECT ANSWERS โโd. apply electrodes for cardiac monitoring The nurse should apply electrodes for continuous monitoring of the client's cardiac rhythm during ESWL. The monitoring allows the provider to deliver shock waves that are synchronized with the R wave.
A nurse is monitoring a client following hemodialysis. The nurse should recognize that which of the following factors places the client at risk for seizures? a. Hypokalemia b. A rapid increase of catecholamines c. A rapid decrease in fluids d. Hypercalcemia - CORRECT ANSWERS โโc. A rapid decrease in fluids This can result in cerebral edema and increased ICP called disequilibrium syndrome A nurse is caring for a client the night before a scheduled intravenous urography. Which of the following is the nurse's priority intervention? a. inform the client about dietary limitations b. place the informed consent document in the client's record c. administer a bowel preparation to the client d. determine if the client is allergic to iodine of shellfish - CORRECT ANSWERS โโd. determine if the client is allergic to iodine of shellfish The test uses radiopaque contrast media and can have an allergic reaction.
A nurse is reviewing the laboratory reports of a client who has acute kidney injury (AKI). Which of the following findings should the nurse expect? (Select all that apply) a. BUN 30 mg/dL b. Urine output of 40mL in past 3hr c. Potassium 3.6 mEq/L d. Serum calcium 9.8 mg/dL e. Hematocrit 30% - CORRECT ANSWERS โโa. BUN 30 mg/dL b. Urine output of 40mL in past 3hr e. Hematocrit 30% A nurse is performing an admission assessment on a client who has severe chronic kidney disease (CKD). Which of the following findings should the nurse expect for this client? a. tachypnea b. hypotension c. exophthalmos d. insomnia - CORRECT ANSWERS โโa. tachypnea The client will be tachypeic due to metabolic acidosis.
A nurse is caring for a post-op client following arteriovenous (AV) fistula creation in her left arm. Which of the following actions should the nurse take? a. Measure BP in the client's left arm every 4 hrs. b. Keep the client's left arm in a dependent position. c. Auscultate for bruits in the left arm every 4 hrs. d. Instruct the client to sleep on the affected side. - CORRECT ANSWERS โโc. Auscultate for bruits in the left arm every 4 hrs. The client's arm should be elevated and NEVER take BP on this arm. A nurse is providing teaching for a client who has urge urinary incontinence. The nurse should include which of the following instructions? a. sit on the toilet with water running every 4hr. b. Increase the interval between urination by 15 minutes per day when able to remain continent. c. respond immediately to the urge to void d. self-catheterize daily following a regular voiding - CORRECT ANSWERS โโb. Increase the interval between urination by 15 minutes per day when able to remain continent. A nurse is teaching a client who has a new diagnosis of acute pyelonephritis. Which of the following instructions should the nurse include in the teaching?
