NURSE 208 Exam 2/3 NCLEX Qs || Answered Perfectly 100%.
When obtaining a health history from a 22-year-old female client who has new onset urinary
incontinence, which findings or factors does the nurse consider significant? (Select all that
apply.)
a. Chemical exposure in the workplace
b. A burning sensation occurring on urination
c. Urinating 10 times daily although fluid intake remains unchanged
d. A recent change in the client's oral contraceptive prescription
e. A new inability to hold urine (urgency)
f. A "stinky" odor from the urine correct answers ANS: B, C, E, F
Burning on urination, frequent urination without increasing fluid intake, urgency, and
malodorous urine are concerning changes in urine elimination. Although chemical exposure in
the workplace may cause kidney damage, it is not associated with new onset incontinence in a
young adult. Oral contraceptives do not contribute to problems with urination.
Cognitive Level: Applying or higher
Client Needs Category: Physiological Integrity
Nursing Process Step: Assessment
Which client being managed for dehydration does the nurse consider at greatest risk for possible
reduced kidney function?
a. An 80-year-old man who has benign prostatic hyperplasia
b. A 62-year-old woman with a known allergy to contrast media
c. A 48-year-old woman with established urinary incontinence
d. A 45-year-old man receiving oral and intravenous fluid therapy correct answers ANS: A
,Older adults have fewer nephrons and about half of the glomerular filtration rate of younger
adults. This change increases their risk for kidney dysfunction more profoundly and persistently
after dehydration of other conditions that can impair the renal system. Although an allergy to
contrast media can cause problems, the adult must be exposed to it first. Tests requiring contrast
media are not used to diagnose or manage dehydration. Urinary incontinence can lead to poor
quality of life and skin problems but does not reduce kidney function. The client receiving
hydration therapy with both oral and intravenous fluids is at risk for overhydration (fluid
overload), not dehydration-induced kidney damage.
Cognitive Level: Applying or higher
Client Needs Category: Safe and Effective Care Environment
Nursing Process Step: Evaluation
The nurse is admitting a client who has type 2 diabetes (T2D) and is scheduled for surgery.
Which laboratory findings from this client's admission panel does the nurse report as indicating
possible abnormal kidney function? (Select all that apply.)
a. Presence of ammonia in the urine
b. Urine microalbumin 240 mcg/24 hour (0.240 g/24 hour)
c. Urine specific gravity of 1.028
d. Blood urea nitrogen of 38 mg/dL (13.5 mmol/L)
f. Serum creatinine 2.2 mg/dL (294.3 mcmol/L)
g. Blood osmolarity 290 mOsm/kg (290 mmol/kg) correct answers ANS: B, D, E
Urine normally has a small amount of ammonia in it as a breakdown product of nitrogen. Other
normal values include the urine specific gravity (normal range of 1.005 to 1.030) and the blood
osmolarity (280 to 300 mOsm/kg; 280 to 300 mmol/kg). The urine microalbumin is much higher
than the normal levels (30 to 80 mcg/24 hour; 0.03 to 0.08 g/24 hour) and indicates abnormal
kidney function. Blood urea nitrogen is high (normal ranges 10 to 120 mg/dL; 3.6 to 7.1
mmol/L) as is the serum creatinine (normal ranges 0.5 to 1.2 mg/dL; 44 to 106 mcmol/L). Both
of these values indicate abnormal kidney function.
Cognitive Level: Applying or higher
Client Needs Category: Safe and Effective Care Environment
Nursing Process Step: Evaluation
, Which symptom(s) in a client during the first 12 hours after a kidney biopsy indicates to the
nurse a possible complication from the procedure?
a. The client experiences nausea and vomiting after drinking juice.
b. The biopsy site is tender to light palpation.
c. The abdomen is distended and the client reports abdominal discomfort.
d. The heart rate is 118, blood pressure is 108/50, and peripheral pulses are thready. correct
answers ANS: D
The most serious complication after a kidney biopsy is excessive bleeding. Nausea and vomiting
are not signs of bleeding. Some discomfort at the biopsy site is expected and not considered a
complication unless there is swelling and a large amount of bruising/discoloration in the flank
area. The kidneys are not in the abdomen. Bleeding from the kidney would cause flank pain and
swelling, not abdominal pain and swelling. The elevated pulse rate, thready peripheral pulses,
and low diastolic blood pressure are consistent with excessive bleeding.
Cognitive Level: Applying or higher
Client Needs Category: Safe and Effective Care Environment
Nursing Process Step: Evaluation
You are assessing a 66-year-old patient who is scheduled for surgical repair of a hip fracture
from a car crash 4 hours ago. The patient hit a telephone pole while traveling at 45 to 50 miles
per hour and was wearing a seat belt at the time of the accident. When the patient voids, you
notice that the urine is rust-colored. The patient reports a sensation of burning during this voiding
but no other subjective urinary symptoms.
1. What assessment information will you document in the chart? correct answers ANS: Urine
amount, color, odor, and clarity. Also record the patient's reported sensation with voiding.
Perform and record a flank assessment, noting whether there is any bruising or tenderness on
either flank. Examine the hip with the broken bone for the presence of a large hematoma. Rust-
colored urine could also indicate a massive breakdown of damaged muscle following traumatic
injury (rhabdomyolysis).
2. What additional information should you ask the patient and what else should you consider?
correct answers ANS: Ask the patient whether rust-colored urine is usual for him or her. (Some
foods, such as beets, and drugs, such as rifampin) can change urine color. Ask about all drugs
When obtaining a health history from a 22-year-old female client who has new onset urinary
incontinence, which findings or factors does the nurse consider significant? (Select all that
apply.)
a. Chemical exposure in the workplace
b. A burning sensation occurring on urination
c. Urinating 10 times daily although fluid intake remains unchanged
d. A recent change in the client's oral contraceptive prescription
e. A new inability to hold urine (urgency)
f. A "stinky" odor from the urine correct answers ANS: B, C, E, F
Burning on urination, frequent urination without increasing fluid intake, urgency, and
malodorous urine are concerning changes in urine elimination. Although chemical exposure in
the workplace may cause kidney damage, it is not associated with new onset incontinence in a
young adult. Oral contraceptives do not contribute to problems with urination.
Cognitive Level: Applying or higher
Client Needs Category: Physiological Integrity
Nursing Process Step: Assessment
Which client being managed for dehydration does the nurse consider at greatest risk for possible
reduced kidney function?
a. An 80-year-old man who has benign prostatic hyperplasia
b. A 62-year-old woman with a known allergy to contrast media
c. A 48-year-old woman with established urinary incontinence
d. A 45-year-old man receiving oral and intravenous fluid therapy correct answers ANS: A
,Older adults have fewer nephrons and about half of the glomerular filtration rate of younger
adults. This change increases their risk for kidney dysfunction more profoundly and persistently
after dehydration of other conditions that can impair the renal system. Although an allergy to
contrast media can cause problems, the adult must be exposed to it first. Tests requiring contrast
media are not used to diagnose or manage dehydration. Urinary incontinence can lead to poor
quality of life and skin problems but does not reduce kidney function. The client receiving
hydration therapy with both oral and intravenous fluids is at risk for overhydration (fluid
overload), not dehydration-induced kidney damage.
Cognitive Level: Applying or higher
Client Needs Category: Safe and Effective Care Environment
Nursing Process Step: Evaluation
The nurse is admitting a client who has type 2 diabetes (T2D) and is scheduled for surgery.
Which laboratory findings from this client's admission panel does the nurse report as indicating
possible abnormal kidney function? (Select all that apply.)
a. Presence of ammonia in the urine
b. Urine microalbumin 240 mcg/24 hour (0.240 g/24 hour)
c. Urine specific gravity of 1.028
d. Blood urea nitrogen of 38 mg/dL (13.5 mmol/L)
f. Serum creatinine 2.2 mg/dL (294.3 mcmol/L)
g. Blood osmolarity 290 mOsm/kg (290 mmol/kg) correct answers ANS: B, D, E
Urine normally has a small amount of ammonia in it as a breakdown product of nitrogen. Other
normal values include the urine specific gravity (normal range of 1.005 to 1.030) and the blood
osmolarity (280 to 300 mOsm/kg; 280 to 300 mmol/kg). The urine microalbumin is much higher
than the normal levels (30 to 80 mcg/24 hour; 0.03 to 0.08 g/24 hour) and indicates abnormal
kidney function. Blood urea nitrogen is high (normal ranges 10 to 120 mg/dL; 3.6 to 7.1
mmol/L) as is the serum creatinine (normal ranges 0.5 to 1.2 mg/dL; 44 to 106 mcmol/L). Both
of these values indicate abnormal kidney function.
Cognitive Level: Applying or higher
Client Needs Category: Safe and Effective Care Environment
Nursing Process Step: Evaluation
, Which symptom(s) in a client during the first 12 hours after a kidney biopsy indicates to the
nurse a possible complication from the procedure?
a. The client experiences nausea and vomiting after drinking juice.
b. The biopsy site is tender to light palpation.
c. The abdomen is distended and the client reports abdominal discomfort.
d. The heart rate is 118, blood pressure is 108/50, and peripheral pulses are thready. correct
answers ANS: D
The most serious complication after a kidney biopsy is excessive bleeding. Nausea and vomiting
are not signs of bleeding. Some discomfort at the biopsy site is expected and not considered a
complication unless there is swelling and a large amount of bruising/discoloration in the flank
area. The kidneys are not in the abdomen. Bleeding from the kidney would cause flank pain and
swelling, not abdominal pain and swelling. The elevated pulse rate, thready peripheral pulses,
and low diastolic blood pressure are consistent with excessive bleeding.
Cognitive Level: Applying or higher
Client Needs Category: Safe and Effective Care Environment
Nursing Process Step: Evaluation
You are assessing a 66-year-old patient who is scheduled for surgical repair of a hip fracture
from a car crash 4 hours ago. The patient hit a telephone pole while traveling at 45 to 50 miles
per hour and was wearing a seat belt at the time of the accident. When the patient voids, you
notice that the urine is rust-colored. The patient reports a sensation of burning during this voiding
but no other subjective urinary symptoms.
1. What assessment information will you document in the chart? correct answers ANS: Urine
amount, color, odor, and clarity. Also record the patient's reported sensation with voiding.
Perform and record a flank assessment, noting whether there is any bruising or tenderness on
either flank. Examine the hip with the broken bone for the presence of a large hematoma. Rust-
colored urine could also indicate a massive breakdown of damaged muscle following traumatic
injury (rhabdomyolysis).
2. What additional information should you ask the patient and what else should you consider?
correct answers ANS: Ask the patient whether rust-colored urine is usual for him or her. (Some
foods, such as beets, and drugs, such as rifampin) can change urine color. Ask about all drugs
