MSN 277 EXAM 3 2023/2024 REAL EXAM WITH a. Bladder distention
EXPERT VERIFIED ANSWERS 180+ Q AND A b. Foul-smelling urine
LATEST UPDATE c. Suprapubic discomfort
d. Costovertebral tenderness
Which action will the nurse in the hypertension clinic take in order to obtain an accurate Costovertebral tenderness
baseline blood pressure (BP) for a new patient? The nurse determines that further instruction is needed for a patient with interstitial cystitis
when the patient says which of the following?
a. Obtain a BP reading in each arm and average the results.
a. I should stop having coffee and orange juice for breakfast.
b.Deflate the BP cuff at a rate of 5 to 10 mm Hg per second.
b. I will buy calcium glycerophosphate (Prelief) at the pharmacy.
c.Have the patient sit in a chair with the feet flat on the floor.
c. I will start taking high potency multiple vitamins every morning.
d. Assist the patient to the supine position for BP measurements.
d. I should call the doctor about increased bladder pain or odorous urine.
Have the patient sit in a chair with the feet flat on the floor. I will start taking high potency multiple vitamins every morning.
A nurse is providing teaching to a male client who has a continent internal ileal reservoir It is most important that the nurse ask a patient admitted with acute glomerulonephritis about
following surgery to treat bladder cancer. Which of the following statements should the nurse
make? a.history of kidney stones.
a. "this should not affect your ability to function sexually"
b. "You should expect to gain some weight during the next few weeks." b. recent sore throat and fever.
c. "You will need to avoid foods that produce intestinal gas."
d. "you must insert a catheter through your stoma to drain the urine" c. history of high blood pressure.
"you must insert a catheter through your stoma to drain the urine"
a nurse in a women's health clinic is caring for a client who reports urinary urgency and dysuria. d. frequency of bladder infections.
which of the following additional finding should the nurse identify as an indication of a urinary recent sore throat and fever.
tract infection (UTI)? Which finding for a patient admitted with glomerulonephritis indicates to the nurse that
treatment has been effective?
a. vaginal discharge
b. pyuria a. The patient denies pain with voiding.
c. glycosuria
d. elevated creatine kinase-MB b. The urine dipstick is negative for nitrites.
pyuria
The nurse determines that instruction regarding prevention of future urinary tract infections c. The antistreptolysin-O (ASO) titer is decreased.
(UTIs) has been effective for a 22-year-old female patient with cystitis when the patient states
which of the following? d.nThe periorbital and peripheral edema is resolved.
The periorbital and peripheral edema is resolved
a.I can use vaginal antiseptic sprays to reduce bacteria. A nurse is caring for a client following extracorporeal shock wave lithotripsy (ESWL) for the
treatment of calcium phosphate kidney stones. Which of the following actions should the nurse
b. I will drink a quart of water or other fluids every day. take?
c. I will wash with soap and water before sexual intercourse. a. monitor the client's urine for ketones
b. provide the client with an increased animal protein diet.
d. I will empty my bladder every 3 to 4 hours during the day. c. Limit the client's fluid intake to 1.5L per day
I will empty my bladder every 3 to 4 hours during the day. d. Strain all of the client's urine
Which finding by the nurse will be most helpful in determining whether a 67-year-old patient Strain all of the client's urine
with benign prostatic hyperplasia has an upper urinary tract infection (UTI)? The nurse will anticipate teaching a patient with nephrotic syndrome who develops flank pain
about treatment with
, When planning teaching for a 59-year-old male patient with benign nephrosclerosis the nurse
a. antibiotics. should include instructions regarding
b. antifungals. a. preventing bleeding with anticoagulants.
c. anticoagulants. b. monitoring and recording blood pressure.
d. antihypertensives. c. obtaining and documenting daily weights.
anticoagulants.
d. measuring daily intake and output volumes.
monitoring and recording blood pressure.
Flank pain in a patient with nephrotic syndrome suggests a renal vein thrombosis, and A nurse is teaching a client who has a new diagnosis of acute pyelonephritis. Which of the
anticoagulation is needed. Antibiotics are used to treat a patient with flank pain caused by following instructions should the nurse include in the teaching?
pyelonephritis. Fungal pyelonephritis is uncommon and is treated with antifungals.
Antihypertensives are used if the patient has high blood pressure a. Drink up to 1,500ml of fluid per day
Calculating fluid recommendations b. avoid the use of NSAIDs for pain
Weight (lbs)/2= # of ounces of fluid/day recommended c. Check peripheral blood glucose levels twice per day
- Example: 150lbs/2=75 ounces/day d. Increase dietary protein intake.
- (-20%) will be obtained from food (15 oz): 60 oz fluid intake by drinking avoid the use of NSAIDs for pain
To prevent recurrence of uric acid renal calculi, the nurse teaches the patient to avoid eating A 68-year-old female patient admitted to the hospital with dehydration is confused and
incontinent of urine. Which nursing action will be best to include in the plan of care?
a.milk and cheese.
a. Restrict fluids between meals and after the evening meal.
b. sardines and liver.
b. Apply absorbent incontinent pads liberally over the bed linens.
c. legumes and dried fruit.
c. Insert an indwelling catheter until the symptoms have resolved.
d. spinach, chocolate, and tea.
sardines and liver. d.Assist the patient to the bathroom every 2 hours during the day.
The nurse teaches a 64-year-old woman to prevent the recurrence of renal calculi by Assist the patient to the bathroom every 2 hours during the day.
A nurse is planning care for a client who is scheduled for extracorporeal shock wave lithotripsy
a. using a filter to strain all urine. (ESWL) to treat urolithiasis, which of the following actions should the nurse plan to take?
A. place the client in a semi-fowler's position
b. avoiding dietary sources of calcium. b. prepare to intubate the client
c. monitor urine flow through a nephrostomy tube
c. choosing diuretic fluids such as coffee. d. apply electrodes for cardia monitoring.
apply electrodes for cardia monitoring.
d. drinking 2000 to 3000 mL of fluid a day. The home health nurse teaches a patient with a neurogenic bladder how to use intermittent
drinking 2000 to 3000 mL of fluid a day. catheterization for bladder emptying. Which patient statement indicates that the teaching has
A 56-year-old female patient is admitted to the hospital with new onset nephrotic syndrome. been effective?
Which assessment data will the nurse expect?
a. I will buy seven new catheters weekly and use a new one every day.
a. Poor skin turgor
b. I will use a sterile catheter and gloves for each time I self-catheterize.
b. Recent weight gain
c. I will clean the catheter carefully before and after each catheterization.
c. Elevated urine ketones
d. I will need to take prophylactic antibiotics to prevent any urinary tract infections.
d. Decreased blood pressure I will clean the catheter carefully before and after each catheterization.
Recent weight gain A 68-year-old male patient who has bladder cancer had a cystectomy with creation of an Indiana
pouch. Which topic will be included in patient teaching?
, a. Application of ostomy appliances d. changes in bowel habits.
trouble swallowing.
b. Barrier products for skin protection A patient arrives to the emergency department with complaints of lower abdominal pain and
hematuria. The patient is afebrile. The nurse next assesses the patient to determine a history of
c. Catheterization technique and schedule which condition?
a. Pyelonephritis
d. Analgesic use before emptying the pouch b. Glomerulonephritis
Catheterization technique and schedule c. Trauma to the bladder or abdomen
Which information from a patient who had a transurethral resection with fulguration for bladder d. Renal cancer in the patient's family
cancer 3 days ago is most important to report to the health care provider? Trauma to the bladder or abdomen
Several hours after an open surgical repair of an abdominal aortic aneurysm, the UAP reports to
a. The patient is voiding every 4 hours. the nurse that urinary output for the past 2 hours has been 40 mL. The nurse notifies the health
care provider and anticipates an order for a(n)
b. The patient is using opioids for pain.
a.hemoglobin count.
c. The patient has seen clots in the urine.
b. additional antibiotic.
d. The patient is anxious about the cancer.
The patient has seen clots in the urine. c. decrease in IV infusion rate.
When discussing risk factor modification for a 63-year-old patient who has a 5-cm abdominal
aortic aneurysm, the nurse will focus discharge teaching on which patient risk factor? d. blood urea nitrogen (BUN) level.
blood urea nitrogen (BUN) level.
a. Male gender A patient in the outpatient clinic has a new diagnosis of peripheral artery disease (PAD). Which
group of medications will the nurse plan to include when providing patient teaching about PAD
b. Turner syndrome management?
c. Abdominal trauma history a. Statins
d. Uncontrolled hypertension b. Antibiotics
. Uncontrolled hypertension
After the nurse teaches the patient with stage 1 hypertension about diet modifications that c. Thrombolytics
should be implemented, which diet choice indicates that the teaching has been effective?
d. Anticoagulants
a. The patient avoids eating nuts or nut butters. Statins
A 73-year-old patient with chronic atrial fibrillation develops sudden severe pain, pulselessness,
b.The patient restricts intake of dietary protein. pallor, and coolness in the right leg. The nurse should notify the health care provider and
immediately
c.The patient has only one cup of coffee in the morning.
a. apply a compression stocking to the leg.
d.The patient has a glass of low-fat milk with each meal.
The patient has a glass of low-fat milk with each meal. b. elevate the leg above the level of the heart.
A patient has a 6-cm thoracic aortic aneurysm that was discovered during a routine chest x-ray.
When obtaining an admission history from the patient, it will be most important for the nurse to c. assist the patient in gently exercising the leg.
ask about
d. keep the patient in bed in the supine position.
a. low back pain. keep the patient in bed in the supine position.
Which of the following can cause a catheter-assisted urinary tract infection (CAUTI)? Select all
b. trouble swallowing. that apply:
a. Cross-contamination
c. abdominal tenderness. b. Catheter care violations
EXPERT VERIFIED ANSWERS 180+ Q AND A b. Foul-smelling urine
LATEST UPDATE c. Suprapubic discomfort
d. Costovertebral tenderness
Which action will the nurse in the hypertension clinic take in order to obtain an accurate Costovertebral tenderness
baseline blood pressure (BP) for a new patient? The nurse determines that further instruction is needed for a patient with interstitial cystitis
when the patient says which of the following?
a. Obtain a BP reading in each arm and average the results.
a. I should stop having coffee and orange juice for breakfast.
b.Deflate the BP cuff at a rate of 5 to 10 mm Hg per second.
b. I will buy calcium glycerophosphate (Prelief) at the pharmacy.
c.Have the patient sit in a chair with the feet flat on the floor.
c. I will start taking high potency multiple vitamins every morning.
d. Assist the patient to the supine position for BP measurements.
d. I should call the doctor about increased bladder pain or odorous urine.
Have the patient sit in a chair with the feet flat on the floor. I will start taking high potency multiple vitamins every morning.
A nurse is providing teaching to a male client who has a continent internal ileal reservoir It is most important that the nurse ask a patient admitted with acute glomerulonephritis about
following surgery to treat bladder cancer. Which of the following statements should the nurse
make? a.history of kidney stones.
a. "this should not affect your ability to function sexually"
b. "You should expect to gain some weight during the next few weeks." b. recent sore throat and fever.
c. "You will need to avoid foods that produce intestinal gas."
d. "you must insert a catheter through your stoma to drain the urine" c. history of high blood pressure.
"you must insert a catheter through your stoma to drain the urine"
a nurse in a women's health clinic is caring for a client who reports urinary urgency and dysuria. d. frequency of bladder infections.
which of the following additional finding should the nurse identify as an indication of a urinary recent sore throat and fever.
tract infection (UTI)? Which finding for a patient admitted with glomerulonephritis indicates to the nurse that
treatment has been effective?
a. vaginal discharge
b. pyuria a. The patient denies pain with voiding.
c. glycosuria
d. elevated creatine kinase-MB b. The urine dipstick is negative for nitrites.
pyuria
The nurse determines that instruction regarding prevention of future urinary tract infections c. The antistreptolysin-O (ASO) titer is decreased.
(UTIs) has been effective for a 22-year-old female patient with cystitis when the patient states
which of the following? d.nThe periorbital and peripheral edema is resolved.
The periorbital and peripheral edema is resolved
a.I can use vaginal antiseptic sprays to reduce bacteria. A nurse is caring for a client following extracorporeal shock wave lithotripsy (ESWL) for the
treatment of calcium phosphate kidney stones. Which of the following actions should the nurse
b. I will drink a quart of water or other fluids every day. take?
c. I will wash with soap and water before sexual intercourse. a. monitor the client's urine for ketones
b. provide the client with an increased animal protein diet.
d. I will empty my bladder every 3 to 4 hours during the day. c. Limit the client's fluid intake to 1.5L per day
I will empty my bladder every 3 to 4 hours during the day. d. Strain all of the client's urine
Which finding by the nurse will be most helpful in determining whether a 67-year-old patient Strain all of the client's urine
with benign prostatic hyperplasia has an upper urinary tract infection (UTI)? The nurse will anticipate teaching a patient with nephrotic syndrome who develops flank pain
about treatment with
, When planning teaching for a 59-year-old male patient with benign nephrosclerosis the nurse
a. antibiotics. should include instructions regarding
b. antifungals. a. preventing bleeding with anticoagulants.
c. anticoagulants. b. monitoring and recording blood pressure.
d. antihypertensives. c. obtaining and documenting daily weights.
anticoagulants.
d. measuring daily intake and output volumes.
monitoring and recording blood pressure.
Flank pain in a patient with nephrotic syndrome suggests a renal vein thrombosis, and A nurse is teaching a client who has a new diagnosis of acute pyelonephritis. Which of the
anticoagulation is needed. Antibiotics are used to treat a patient with flank pain caused by following instructions should the nurse include in the teaching?
pyelonephritis. Fungal pyelonephritis is uncommon and is treated with antifungals.
Antihypertensives are used if the patient has high blood pressure a. Drink up to 1,500ml of fluid per day
Calculating fluid recommendations b. avoid the use of NSAIDs for pain
Weight (lbs)/2= # of ounces of fluid/day recommended c. Check peripheral blood glucose levels twice per day
- Example: 150lbs/2=75 ounces/day d. Increase dietary protein intake.
- (-20%) will be obtained from food (15 oz): 60 oz fluid intake by drinking avoid the use of NSAIDs for pain
To prevent recurrence of uric acid renal calculi, the nurse teaches the patient to avoid eating A 68-year-old female patient admitted to the hospital with dehydration is confused and
incontinent of urine. Which nursing action will be best to include in the plan of care?
a.milk and cheese.
a. Restrict fluids between meals and after the evening meal.
b. sardines and liver.
b. Apply absorbent incontinent pads liberally over the bed linens.
c. legumes and dried fruit.
c. Insert an indwelling catheter until the symptoms have resolved.
d. spinach, chocolate, and tea.
sardines and liver. d.Assist the patient to the bathroom every 2 hours during the day.
The nurse teaches a 64-year-old woman to prevent the recurrence of renal calculi by Assist the patient to the bathroom every 2 hours during the day.
A nurse is planning care for a client who is scheduled for extracorporeal shock wave lithotripsy
a. using a filter to strain all urine. (ESWL) to treat urolithiasis, which of the following actions should the nurse plan to take?
A. place the client in a semi-fowler's position
b. avoiding dietary sources of calcium. b. prepare to intubate the client
c. monitor urine flow through a nephrostomy tube
c. choosing diuretic fluids such as coffee. d. apply electrodes for cardia monitoring.
apply electrodes for cardia monitoring.
d. drinking 2000 to 3000 mL of fluid a day. The home health nurse teaches a patient with a neurogenic bladder how to use intermittent
drinking 2000 to 3000 mL of fluid a day. catheterization for bladder emptying. Which patient statement indicates that the teaching has
A 56-year-old female patient is admitted to the hospital with new onset nephrotic syndrome. been effective?
Which assessment data will the nurse expect?
a. I will buy seven new catheters weekly and use a new one every day.
a. Poor skin turgor
b. I will use a sterile catheter and gloves for each time I self-catheterize.
b. Recent weight gain
c. I will clean the catheter carefully before and after each catheterization.
c. Elevated urine ketones
d. I will need to take prophylactic antibiotics to prevent any urinary tract infections.
d. Decreased blood pressure I will clean the catheter carefully before and after each catheterization.
Recent weight gain A 68-year-old male patient who has bladder cancer had a cystectomy with creation of an Indiana
pouch. Which topic will be included in patient teaching?
, a. Application of ostomy appliances d. changes in bowel habits.
trouble swallowing.
b. Barrier products for skin protection A patient arrives to the emergency department with complaints of lower abdominal pain and
hematuria. The patient is afebrile. The nurse next assesses the patient to determine a history of
c. Catheterization technique and schedule which condition?
a. Pyelonephritis
d. Analgesic use before emptying the pouch b. Glomerulonephritis
Catheterization technique and schedule c. Trauma to the bladder or abdomen
Which information from a patient who had a transurethral resection with fulguration for bladder d. Renal cancer in the patient's family
cancer 3 days ago is most important to report to the health care provider? Trauma to the bladder or abdomen
Several hours after an open surgical repair of an abdominal aortic aneurysm, the UAP reports to
a. The patient is voiding every 4 hours. the nurse that urinary output for the past 2 hours has been 40 mL. The nurse notifies the health
care provider and anticipates an order for a(n)
b. The patient is using opioids for pain.
a.hemoglobin count.
c. The patient has seen clots in the urine.
b. additional antibiotic.
d. The patient is anxious about the cancer.
The patient has seen clots in the urine. c. decrease in IV infusion rate.
When discussing risk factor modification for a 63-year-old patient who has a 5-cm abdominal
aortic aneurysm, the nurse will focus discharge teaching on which patient risk factor? d. blood urea nitrogen (BUN) level.
blood urea nitrogen (BUN) level.
a. Male gender A patient in the outpatient clinic has a new diagnosis of peripheral artery disease (PAD). Which
group of medications will the nurse plan to include when providing patient teaching about PAD
b. Turner syndrome management?
c. Abdominal trauma history a. Statins
d. Uncontrolled hypertension b. Antibiotics
. Uncontrolled hypertension
After the nurse teaches the patient with stage 1 hypertension about diet modifications that c. Thrombolytics
should be implemented, which diet choice indicates that the teaching has been effective?
d. Anticoagulants
a. The patient avoids eating nuts or nut butters. Statins
A 73-year-old patient with chronic atrial fibrillation develops sudden severe pain, pulselessness,
b.The patient restricts intake of dietary protein. pallor, and coolness in the right leg. The nurse should notify the health care provider and
immediately
c.The patient has only one cup of coffee in the morning.
a. apply a compression stocking to the leg.
d.The patient has a glass of low-fat milk with each meal.
The patient has a glass of low-fat milk with each meal. b. elevate the leg above the level of the heart.
A patient has a 6-cm thoracic aortic aneurysm that was discovered during a routine chest x-ray.
When obtaining an admission history from the patient, it will be most important for the nurse to c. assist the patient in gently exercising the leg.
ask about
d. keep the patient in bed in the supine position.
a. low back pain. keep the patient in bed in the supine position.
Which of the following can cause a catheter-assisted urinary tract infection (CAUTI)? Select all
b. trouble swallowing. that apply:
a. Cross-contamination
c. abdominal tenderness. b. Catheter care violations
