CHII Exam 2 - renal, endocrine Solutions Solved Correctly
Which statements made by a client who has diabetes insipidus indicates to the nurse that moreteaching
is needed?
Select all that apply.
A. If I gain more than 2 lb (1 kg) in a day, I'll limit my fluid intake.
B. If I become thirstier, I'll take another dose of the drug.
C. I'll avoid aspirin and aspirin-containing substances.
D. I'll stop taking the drug for 24 hours before I have any dental work performed.
E. I'll limit my intake of salt and sodium to no more than 2 g daily.
F. I'll wear my medical alert bracelet at all times. - Answers a,c,d,e (fluid overload is a complication of
not having enough ADH, NSAIDs= no-no's, Na+ restrictions)
In the preoperative holding area, the client who is scheduled to have an adrenalectomy for
hypercortisolism is prescribed to receive cortisol by IV infusion. What is the nurse's best action?
A. Request a "time-out" to determine whether this is a valid prescription.
B. Ask the client whether he or she usually takes prednisone.
C. Hold the dose because the client has a high cortisol level.
D. Administer the drug as prescribed. - Answers c
Which assessment finding of a client 10 hours after a subtotal thyroidectomy indicates to the nurse
possible airway obstruction?
A. The client is drooling.
B. The oxygen saturation is 97%.
C. The dressing has a moderate amount of serosanguinous drainage.
D. The client responds to questions correctly but does not open the eyes while talking. - Answers a
Which symptoms are most often seen in hypothyroidism?
Select all that apply.
A. Increased appetite
B. Cold intolerance
,C. Constipation
D. Hypotension
E. Exophthalmia
F. Palpitations
G. Tremors
H. Weight gain - Answers b,c,d,h
The client is a 62-year-old admitted 2 days ago with traumatic injuries and hypovolemic shock from a car
crash. The nurse reviewing the client's daily laboratory test results notices the following values. Which
result is most important to report to the primary health care provider immediately?
A. Serum sodium 132 mEq/L (mmol/L)
B. Serum potassium 6.9 mEq/L (mmol/L)
C. Blood urea nitrogen 24 mg/dL (mmol/L)
D. Hematocrit 32% (0.32 volume fraction); hemoglobin 9.2 g/dL (92 g/L) - Answers b
The nurse is preparing a client for discharge who developed an acute kidney injury during coronary
artery bypass graft surgery. The nurse notices that the client has a serum creatinine of 1.2mg/dL (106
mcmol/L) and a glomerular filtration rate (GFR) of 75 mL/kg/1.73 m2. Which is the priority nursing
action?
A. Reminding the client to remain hydrated by drinking 500 mL of an electrolyte-based solutiondaily
B. Encouraging the client to reduce protein intake to reduce creatinine production until the follow-up
visit with the nephrologist occurs
C. Checking the remaining values on the metabolic panel and informing the primary care provider of all
results before the client is discharged
D. Educating the client about the need for follow-up, including re-evaluation of serum creatinine with
the primary care provider or nephrologist in 8-12 weeks - Answers c
When the nurse caring for a client with severe chronic kidney disease asks what dietary modifications he
has made for the disease, he reports the following actions. Which action indicates to the nurse that
additional client education is needed?
A. Using a scale to measure protein weight
B. Taking calcium and vitamin D supplements daily
,C. Eliminating bananas, citrus fruits, and avocados
D. Using a salt-substitute instead of ordinary table salt - Answers d
For which adverse drug effects does the nurse assess in a client who is hospitalized for an acute problem
and is also prescribed an anticholinergic drug to manage incontinence? Select all that apply.
A. Insomnia
B. Blurred vision
C. Constipation
D. Dry mouth
E. Loss of sphincter control
F. Increased sweating
G. Worsening mental function
H. Hypotension - Answers b,c,d,g (Anticholinergic drugs tend to block the parasympathetic nervous
system and mimic the sympathetic nervous system responses. In addition to reducing urinary output,
these commonly include dry mouth, reduced gastric motility, constipation, blurred vision, hypertension,
increasing confusion, dizziness, and sleepiness)
For which hospitalized client does the nurse recommend the ongoing use of a urinary catheter?
A. 35-year-old woman who was admitted with a splenic laceration and femur fracture (closed repair
completed) following a car crash
B. 48-year-old man who has established paraplegia and is admitted for pneumonia
C. 61-year-old woman who is admitted following a fall at home and has new-onset dysrhythmia
D. 74-year-old man who has lung cancer with brain metastasis and is being transitioned to hospice for
end-of-life care - Answers D.
A 25-year-old sexually active female client diagnosed with cystitis tells the nurse that she doesn't
understand why she has these infections yearly because she tries to avoid them by drinking very little at
work so she doesn't have to use the "dirty" public toilet. Which suggestions or actions by the nurse are
most likely to help this client reduce her risk for cystitis? Select all that apply.
A. Reinforce her choice to avoid using a public toilet.
B. Teach her to shower immediately after having sexual intercourse
.C. Suggest that she drink at least 2-3 L of fluid throughout the day.
, D. Urge her to change her method of birth control from oral contraceptives to a barrier method.
E. Instruct her to always wipe her perineum from front to back after each toilet use.
F. Reinforce that she should complete the entire course of antibiotics as prescribed.
G. Instruct her to empty her bladder immediately before having intercou - Answers c,e,f,g
A client with diabetes has all of the following changes after a percutaneous nephrolithotomy procedure.
Which change is most important for the nurse need to immediately report to the healthcare provider?
A. Difficulty breathing and an oxygen saturation of 88% on 2 L of oxygen by nasal cannula
B. A point-of-care blood glucose of 150 mg/dL and client report of thirst
C. A decreased hematocrit by 1% (compared with preoperative values and hematuria
D. An oral temperature of 38° C (101° F) and cloudiness of urine draining from the nephrostomy tube
right after IV administration of a broad-spectrum antibiotic - Answers a. (This is NOT an expected
problem associated with the procedure and is potentially life-threatening. The blood glucose elevation,
thirst, temperature elevation, cloudiness of the urine, and slight decrease in hematocrit are expected
and do not pose an immediate threat.)
A 70-year-old client is seeing his primary care provider for an annual examination. Which assessment
finding alerts the nurse to an increased risk for bladder cancer?
A. A five-pack year history of smoking 45 years ago
B. Difficulty starting and stopping the urine stream
C. A 30-year occupation as a long-distance truck driver
D. A recent colon cancer diagnosis in his 72-year-old brother - Answers c. (The latest research indicates
exposure to gasoline and diesel fuel is a major risk factor for bladder cancer)
Which question does the nurse ask the client who has a urinary tract infection to assess the risk for
possible pyelonephritis?
A. What drugs do you take for asthma?
B. How long have you had diabetes?
C. How much fluid do you drink daily?
D. Do you take your antihypertensive drugs at night or in the morning? - Answers B. (Pyelonephritis risk
is increased in the client who has diabetes and a urinary tract infection (UTI). While it is important to
know all the drugs that a client takes, neither asthma drugs nor asthma itself increases the risk for
pyelonephritis. (An exception would be high-dose systemic corticosteroids; however, these are rarely
Which statements made by a client who has diabetes insipidus indicates to the nurse that moreteaching
is needed?
Select all that apply.
A. If I gain more than 2 lb (1 kg) in a day, I'll limit my fluid intake.
B. If I become thirstier, I'll take another dose of the drug.
C. I'll avoid aspirin and aspirin-containing substances.
D. I'll stop taking the drug for 24 hours before I have any dental work performed.
E. I'll limit my intake of salt and sodium to no more than 2 g daily.
F. I'll wear my medical alert bracelet at all times. - Answers a,c,d,e (fluid overload is a complication of
not having enough ADH, NSAIDs= no-no's, Na+ restrictions)
In the preoperative holding area, the client who is scheduled to have an adrenalectomy for
hypercortisolism is prescribed to receive cortisol by IV infusion. What is the nurse's best action?
A. Request a "time-out" to determine whether this is a valid prescription.
B. Ask the client whether he or she usually takes prednisone.
C. Hold the dose because the client has a high cortisol level.
D. Administer the drug as prescribed. - Answers c
Which assessment finding of a client 10 hours after a subtotal thyroidectomy indicates to the nurse
possible airway obstruction?
A. The client is drooling.
B. The oxygen saturation is 97%.
C. The dressing has a moderate amount of serosanguinous drainage.
D. The client responds to questions correctly but does not open the eyes while talking. - Answers a
Which symptoms are most often seen in hypothyroidism?
Select all that apply.
A. Increased appetite
B. Cold intolerance
,C. Constipation
D. Hypotension
E. Exophthalmia
F. Palpitations
G. Tremors
H. Weight gain - Answers b,c,d,h
The client is a 62-year-old admitted 2 days ago with traumatic injuries and hypovolemic shock from a car
crash. The nurse reviewing the client's daily laboratory test results notices the following values. Which
result is most important to report to the primary health care provider immediately?
A. Serum sodium 132 mEq/L (mmol/L)
B. Serum potassium 6.9 mEq/L (mmol/L)
C. Blood urea nitrogen 24 mg/dL (mmol/L)
D. Hematocrit 32% (0.32 volume fraction); hemoglobin 9.2 g/dL (92 g/L) - Answers b
The nurse is preparing a client for discharge who developed an acute kidney injury during coronary
artery bypass graft surgery. The nurse notices that the client has a serum creatinine of 1.2mg/dL (106
mcmol/L) and a glomerular filtration rate (GFR) of 75 mL/kg/1.73 m2. Which is the priority nursing
action?
A. Reminding the client to remain hydrated by drinking 500 mL of an electrolyte-based solutiondaily
B. Encouraging the client to reduce protein intake to reduce creatinine production until the follow-up
visit with the nephrologist occurs
C. Checking the remaining values on the metabolic panel and informing the primary care provider of all
results before the client is discharged
D. Educating the client about the need for follow-up, including re-evaluation of serum creatinine with
the primary care provider or nephrologist in 8-12 weeks - Answers c
When the nurse caring for a client with severe chronic kidney disease asks what dietary modifications he
has made for the disease, he reports the following actions. Which action indicates to the nurse that
additional client education is needed?
A. Using a scale to measure protein weight
B. Taking calcium and vitamin D supplements daily
,C. Eliminating bananas, citrus fruits, and avocados
D. Using a salt-substitute instead of ordinary table salt - Answers d
For which adverse drug effects does the nurse assess in a client who is hospitalized for an acute problem
and is also prescribed an anticholinergic drug to manage incontinence? Select all that apply.
A. Insomnia
B. Blurred vision
C. Constipation
D. Dry mouth
E. Loss of sphincter control
F. Increased sweating
G. Worsening mental function
H. Hypotension - Answers b,c,d,g (Anticholinergic drugs tend to block the parasympathetic nervous
system and mimic the sympathetic nervous system responses. In addition to reducing urinary output,
these commonly include dry mouth, reduced gastric motility, constipation, blurred vision, hypertension,
increasing confusion, dizziness, and sleepiness)
For which hospitalized client does the nurse recommend the ongoing use of a urinary catheter?
A. 35-year-old woman who was admitted with a splenic laceration and femur fracture (closed repair
completed) following a car crash
B. 48-year-old man who has established paraplegia and is admitted for pneumonia
C. 61-year-old woman who is admitted following a fall at home and has new-onset dysrhythmia
D. 74-year-old man who has lung cancer with brain metastasis and is being transitioned to hospice for
end-of-life care - Answers D.
A 25-year-old sexually active female client diagnosed with cystitis tells the nurse that she doesn't
understand why she has these infections yearly because she tries to avoid them by drinking very little at
work so she doesn't have to use the "dirty" public toilet. Which suggestions or actions by the nurse are
most likely to help this client reduce her risk for cystitis? Select all that apply.
A. Reinforce her choice to avoid using a public toilet.
B. Teach her to shower immediately after having sexual intercourse
.C. Suggest that she drink at least 2-3 L of fluid throughout the day.
, D. Urge her to change her method of birth control from oral contraceptives to a barrier method.
E. Instruct her to always wipe her perineum from front to back after each toilet use.
F. Reinforce that she should complete the entire course of antibiotics as prescribed.
G. Instruct her to empty her bladder immediately before having intercou - Answers c,e,f,g
A client with diabetes has all of the following changes after a percutaneous nephrolithotomy procedure.
Which change is most important for the nurse need to immediately report to the healthcare provider?
A. Difficulty breathing and an oxygen saturation of 88% on 2 L of oxygen by nasal cannula
B. A point-of-care blood glucose of 150 mg/dL and client report of thirst
C. A decreased hematocrit by 1% (compared with preoperative values and hematuria
D. An oral temperature of 38° C (101° F) and cloudiness of urine draining from the nephrostomy tube
right after IV administration of a broad-spectrum antibiotic - Answers a. (This is NOT an expected
problem associated with the procedure and is potentially life-threatening. The blood glucose elevation,
thirst, temperature elevation, cloudiness of the urine, and slight decrease in hematocrit are expected
and do not pose an immediate threat.)
A 70-year-old client is seeing his primary care provider for an annual examination. Which assessment
finding alerts the nurse to an increased risk for bladder cancer?
A. A five-pack year history of smoking 45 years ago
B. Difficulty starting and stopping the urine stream
C. A 30-year occupation as a long-distance truck driver
D. A recent colon cancer diagnosis in his 72-year-old brother - Answers c. (The latest research indicates
exposure to gasoline and diesel fuel is a major risk factor for bladder cancer)
Which question does the nurse ask the client who has a urinary tract infection to assess the risk for
possible pyelonephritis?
A. What drugs do you take for asthma?
B. How long have you had diabetes?
C. How much fluid do you drink daily?
D. Do you take your antihypertensive drugs at night or in the morning? - Answers B. (Pyelonephritis risk
is increased in the client who has diabetes and a urinary tract infection (UTI). While it is important to
know all the drugs that a client takes, neither asthma drugs nor asthma itself increases the risk for
pyelonephritis. (An exception would be high-dose systemic corticosteroids; however, these are rarely
