PNVN1631 (Medical - Surgical Nursing I) Module 8 Exam Questions With Answers (Genitourinary System) Verified Answers 2023.

PNVN1631 (Medical - Surgical Nursing I) Module 8 Exam Questions With Answers (Genitourinary System) Verified Answers 2023. An older client has been treated for dehydration and pneumonia. The nurse evaluates that the client’s dehydration has been successfully treated if the blood urea nitrogen (BUN) level drops to: 46 mg/dL 19 mg/dL 32 mg/dL 5 mg/dL Rationale: The normal BUN for the older adult is 8 to 21 mg/dL. Thus option 1 is correct. Values such as those in options 3 and 4 are high and reflect continued dehydration. Option 2 reflects a lower-than-normal value, which can occur with fluid overload. Question 13 1 / 1 pts A nurse is assisting in planning a diet for the client with acute renal failure (ARF). The nurse plans to restrict which of the following dietary components from this client's diet? Potassium Fat Vitamins Carbohydrates Rationale: In the client with renal failure, potassium intake must be restricted as much as possible (30 to 50 mEq/day). The primary mechanism of potassium removal during ARF is dialysis. Options 1, 2, and 3 are not normally restricted in the client with ARF. Question 14 1 / 1 pts The following constituent of the urinalysis test indicates possible renal disease, muscle exertion, or dehydration positive blood bacteriuria proteinuria positive glucose Rationale: Protein in the urine usually indicates possible renal disease, muscle exertion, or dehydration. Positive glucose indicates diabetes. Positive bilirubin indicates liver disease with obstruction or damage. Positive bacteria indicate urinary infection. Question 15 1 / 1 pts A hemodialysis client with a left arm fistula is at risk for arterial insufficiency syndrome. The nurse monitors this client for which manifestation of this disorder? Aching pain, pallor, and edema of the left arm Warmth, redness, and pain in the left hand Edema and red discoloration of the left arm Pallor, cool to touch, diminished pulse, and pain in the left hand Rationale: Arterial insufficiency syndrome results from vascular insufficiency after creation of a fistula. The client exhibits pallor and diminished pulse distal to the fistula and complains of pain distal to the fistula, which is caused by tissue ischemia. Warmth, redness, and pain would more likely characterize a problem with infection. Options 3 and 4 are not characteristics of steal syndrome. Question 16 1 / 1 pts A nurse is reviewing the client's record and notes that the physician has documented that the client has a renal disorder. On review of the laboratory results, the nurse would most likely expect to note which of the following? Decreased red blood cell (RBC) count Decreased white blood cell (WBC) count Elevated blood urea nitrogen (BUN) and creatinine level Decreased hemoglobin level Rationale: BUN testing is a frequently used laboratory test to determine renal function. The BUN level starts to rise when the glomerular filtration rate falls below 40% to 60%. A decreased hemoglobin and RBC count may be noted if bleeding from the urinary tract occurs or if erythropoietic function by the kidney is impaired. An increased WBC is most likely to be noted in renal disease. Question 17 1 / 1 pts A nurse collects a urine specimen for a urinalysis from a client recently diagnosed with polycystic disease of the kidneys. The nurse documents that the urine is dilute and that the specific gravity of the urine is low. Based on this documentation, which of the following specific gravity results was present? 1.020 1.000 1.030 1.010 Rationale: Specific gravity is a measure of the concentration of particles in the urine. A normal range of urine specific gravity is approximately 1.005 to 1.030. Early in polycystic kidney disease, the ability of the kidneys to concentrate urine decreases. Options 2, 3, and 4 indicate a normal range for specific gravity. IncorrectQuestion 18 0 / 1 pts Approximately how much volume of urine would stimulate the conscious desire to urinate? 150 ml 1500 ml 750 ml 250 ml IncorrectQuestion 19 0 / 1 pts A patient with hypertension for 10 years has been told by his health care provider that he has developed nephrotic syndrome, causing generalized edema. Which of the following diuretics will work in the treatment of his condition? Polythiazide, a thiazide diuretic Metolazone, a sulfonamide diuretic Spironolactone, a potassium-sparing diuretic Furosemide, a loop diuretic Rationale: Loop diuretics work well on patients with very low glomerular filtration rates, because they are so efficient in limiting the reabsorption of sodium. They are often used for patients with kidney disease and to treat chronic heart failure, cirrhosis of the liver, and nephrotic syndrome of kidney disease in which a powerful diuretic is required. Question 20 1 / 1 pts Which of the following is a normal constituent of urine? protein glucose urea red blood cells Rationale: Nitrogenous waste products that constitute urine include urea, ammonia and creatinine Question 21 1 / 1 pts ABG Value pH: 7.28 [HCO3 - ]: 28 mEq/L PaCO2: 46 mmHg normal ABG respiratory acidosis, partial compensated metabolic alkalosis, complete compensation respiratory alkalosis, partial compensated metabolic acidosis, partial uncompensated Question 22 1 / 1 pts A nurse is caring for a hospitalized client following cystoscopy and is monitoring for signs of complications associated with the procedure. Which of the following, if noted in the first few hours following the procedure, indicates the need to notify the registered nurse? Clear urine Bloody urine with clots Yellow-colored urine Pink-tinged urine Rationale: The client may have clear, yellow, or pink-tinged urine after cystoscopy. Bloody urine with clots is always an abnormal finding and should be reported immediately. Question 23 1 / 1 pts A client with acute renal failure (ARF) has been treated with sodium polystyrene sulfonate (Kayexalate) by mouth. The nurse evaluates this therapy as effective if which of the following values is noted on follow-up laboratory testing? Sodium 142 mEq/L Phosphorus 3.9 mg/dL Potassium 4.9 mEq/L Calcium 9.8 mg/dL Rationale: Of all the electrolyte imbalances that accompany renal failure, hyperkalemia is the most dangerous because it can lead to cardiac dysrhythmias and death. If the potassium level rises too high, sodium polystyrene sulfonate may be given to cause excretion of potassium through the gastrointestinal tract. Each of the electrolyte levels noted in the question falls within the normal reference range for that electrolyte. The potassium level is measured following administration of this medication to note the extent of its effectiveness. Question 24 1 / 1 pts Which can reduce the risk of skin impairment secondary to urinary incontinence? Frequent offer of toileting and meticulous skin care Decreasing fluid intake Catheterization of the elderly patient Limiting the use of medication (diuretics, etc.) Frequent toileting schedule and reminders and can help patients especially elderly clients avoid accidents or skin integrity issues. Question 25 1 / 1 pts Of the following laboratory tests, which one is most important for the nurse to monitor when caring of the client with glomerulonephritis? Blood glucose Blood urea nitrogen (BUN) Complete blood count (CBC) Serum amylase Rationale: The blood urea nitrogen test (BUN) is primarily used along with creatinine level to evaluate kidney function and to monitor clients with acute or chronic kidney dysfunction or failure. It indicates how effective the glomeruli are removing nitrogen wastes from the blood. Question 26 1 / 1 pts When a patient on Lasix, a loop diuretic, complains of weakness and irregular pulse, there may be an electrolyte deficiency of potassium. calcium. magnesium. sodium. Rationale: The loop diuretic prototype, furosemide (Lasix), affects electrolytes to cause hypokalemia, the deficiency of the electrolyte can cause arrhythmias and muscle weakness. Question 27 1 / 1 pts A nurse is providing information to the mother of a child with nephrotic syndrome regarding the edematous appearance of the child. Which of the following statements should the nurse make to the mother? “The child will always have this appearance, and preparing the child for the body image change is important.” “Children always look a little bit fat, so don’t be concerned.” “Dress the child in loose-fitting clothing to hide the extra weight.” “The fluid retention should be controlled by medication and diet.” Rationale: Most children experience remission with treatment and corticosteroids. Diuretics may also be a component of the treatment plan, and a restricted sodium diet is recommended. It is important to give the parent information in a matter-of-fact manner and address the issue that is the parent’s concern. Options 1, 2, and 4 are inaccurate and inappropriate statements to the mother. Question 28 1 / 1 pts A client has an arteriovenous (AV) shunt in place for hemodialysis. The nurse would take which of the following priority precautions, knowing that bleeding is a potential complication? Check the results of blood tests as they are ordered. Ensure that small clamps are attached to the AV shunt dressing. Observe the site once per shift. Check the shunt for the presence of a bruit and thrill. Rationale: An AV shunt is a cannula with two ends that are tunneled subcutaneously into an artery and a vein. An AV shunt is a less common form of access site but carries a risk for bleeding when it is used. If accidental disconnection occurs, the client could lose blood rapidly. For this reason, small clamps are attached to the dressing that covers the insertion site for use if needed. The shunt site should also be observed at least every 4 hours. Once per shift is insufficient. Checking for blood results, bruit, and thrill all apply to the care of this client but do not focus on bleeding.