NCLEX 3000-Urinary(Questions With Complete Solutions)

NCLEX 3000-Urinary(Questions With Complete Solutions) The nurse is caring for a client with acute pyelonephritis. Which nursing intervention is most important? Increasing fluid intake to 3 L/day The nurse is teaching a client with genital herpes. Education for this client should include an explanation of: the importance of informing his partner of the disease. When a client with an indwelling urinary catheter insists on walking to the hospital lobby to visit with family members, the nurse teaches him how to do this without compromising the catheter. Which client action indicates an accurate understanding of this information? When a client with an indwelling urinary catheter insists on walking to the hospital lobby to visit with family members, the nurse teaches him how to do this without compromising the catheter. Which client action indicates an accurate understanding of this information? (SELECT ALL THAT APPLY) The nurse is teaching a client how to collect a 24-hour urine specimen for creatinine clearance. Which of the following directions should the nurse give the client? (2), "Discard the first voiding and record the time.", (4) "Refrigerate the urine sample or keep it on ice.", (5) "At the end of 24 hours, void and save the urine." A client is admitted with a diagnosis of acute renal failure. The nurse should monitor closely for: drug toxicity. The nurse is planning to administer a sodium polystyrene sulfonate (Kayexalate) enema to a client with a potassium level of 5.9 mEq/L. Correct administration and the effects of this enema would include having the client: retain the enema for 30 minutes to allow for sodium exchange; afterward, the client should have diarrhea. A client with dysuria is prescribed phenazopyridine (Pyridium). The nurse should advise the client that his urine will: appear orange. A client with benign prostatic hyperplasia (BPH) doesn't respond to medical treatment and is admitted to the facility for surgical intervention. Before providing preoperative and postoperative instructions to the client, the nurse asks the surgeon which prostatectomy procedure will be done. What is the most widely used procedure for treatment of BPH? Transurethral resection of the prostate (TURP) The red blood cell (RBC) production in a client with chronic renal failure (CRF) has decreased. The nurse should monitor this client for: fatigue and weakness. The nurse is caring for a client who had a stroke. Which nursing intervention promotes urinary continence? Encouraging intake of at least 2 L of fluid daily A client with chronic renal failure who receives hemodialysis three times weekly has a hemoglobin (Hb) level of 7 g/dl. The most therapeutic pharmacologic intervention would be to administer: epoetin alfa (Epogen) Which steps should the nurse follow to insert a straight urinary catheter? Prepare the client and the equipment, create a sterile field, put on gloves, clean the urinary meatus, and insert the catheter until urine flows. The nurse is reviewing the report of a client's routine urinalysis. Which value should the nurse consider abnormal? Urine pH of 3.0 Which of the following clinical findings would the nurse look for in a client with chronic renal failure? Uremia A client with suspected renal insufficiency is scheduled for a comprehensive diagnostic workup. After the nurse explains the diagnostic tests, the client asks which part of the kidney "does the work." Which answer is correct? The nephron A client with decreased urine output refractory to fluid challenges is evaluated for renal failure. Which condition may cause the intrinsic (intrarenal) form of acute renal failure? Nephrotoxic injury secondary to use of contrast media A client diagnosed with a sexually transmitted disease has been feeling poorly. A friend of the client's who is employed by the hospital asks a nurse why her friend is hospitalized. How should the nurse respond? Explain that although she is a friend of the client, the nurse can't violate client confidentiality. Which statement describes the therapeutic action of loop diuretics? They block sodium reabsorption in the ascending loop and dilate renal vessels. The nurse is completing an intake and output record for a client who is receiving continuous bladder irrigation after transurethral resection of the prostate. How many milliliters of urine should the nurse record as output for her shift if the client received 1,800 ml of normal saline irrigating solution and the output in the urine drainage bag is 2,400 ml? 600 A client receiving total parental nutrition is prescribed a 24-hour urine test. When initiating a 24-hour urine specimen, the collection time should: start after a known voiding that empties the bladder. A client is admitted for treatment of chronic renal failure (CRF). The nurse knows that this disorder increases the client's risk of: water and sodium retention secondary to a severe decrease in the glomerular filtration rate. The physician prescribes norfloxacin (Noroxin), 400 mg by mouth twice daily, for a client with a urinary tract infection (UTI). The client asks the nurse how long to continue taking the drug. For an uncomplicated UTI, the usual duration of norfloxacin therapy is: 7 to 10 days. The nurse is planning a group teaching session on the topic of urinary tract infection (UTI) prevention. Which point would the nurse want to include? Notify the physician if urinary urgency, burning, frequency, or difficulty occurs. A client who returns to the surgical floor after undergoing transurethral resection of the prostate complains of pain. Which action should the nurse take first? Check the client's medical record for postoperative orders. A client who has been treated for chronic renal failure (CRF) is ready for discharge. The nurse should reinforce which dietary instruction? "Make sure to include carbohydrates in your diet." A 25-year-old client comes to the emergency department with her clothes torn. She has visible cuts, bruises, and profuse vaginal bleeding. A nurse suspects that this client has been raped. What should the nurse do? Collect forensic evidence. A client with renal dysfunction of acute onset comes to the emergency department complaining of fatigue, oliguria, and coffee-colored urine. When obtaining the client's history to check for significant findings, the nurse should ask about: recent streptococcal infection. (SELECT ALL THAT APPLY) The nurse is collecting data on a client who has a urinary tract infection (UTI). Which statements should the nurse expect the client to make? (2) "I need to urinate frequently.", (3) "It burns when I urinate.", (5) "I need to urinate urgently." A client requires hemodialysis. Which of the following drugs should be withheld before this procedure? Cardiac glycosides A client comes to the emergency department complaining of severe pain in the right flank, nausea, and vomiting. The physician tentatively diagnoses right ureterolithiasis (renal calculi). When planning this client's care, the nurse should assign highest priority to which nursing diagnosis? Acute pain Which of the following is an appropriate nursing diagnosis for a client with renal calculi? Risk for infection A stepfather brings a child with a fever to the emergency department. The child is crying, calling for her mother, and attempting to get out of the stepfather's arms. Upon inspection, the nurse notes that the child's underpants are stained with a bloodlike substance. Which action should the nurse take? Report the suspected abuse according to facility policy. Four days after undergoing a right nephrectomy, a client develops a methicillin-resistant Staphylococcus aureus infection in the surgical incision. A physician orders contact isolation and dressing changes 3 times daily. How should the soiled dressing be handled during dressing changes? Discard the dressing in a biohazard bag located in the designated receptacle inside the client's room. A client with a history of heart failure is found to have a cystocele. When planning care for this client, the nurse is likely to formulate which nursing diagnosis? Stress urinary incontinence During rounds, a client admitted with gross hematuria asks the nurse about the physician's diagnosis. To facilitate effective communication, what should the nurse do? Provide privacy for the conversation. A client with an indwelling urinary catheter is suspected of having a urinary tract infection. The nurse should collect a urine specimen for culture and sensitivity by: wiping the self-sealing aspiration port or stopcock with antiseptic solution and aspirating urine with a sterile needle and a sterile syringe.