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A client experiencing an acute exacerbation of ulcerative colitis underwent diagnostic testing and was found to have elevated serum osmolality and urine specific gravity. Which of the following is related to these findings?
- A. Renal insufficiency
- B. Diabetes insipidus
- C. Hypoaldosteronism
- D. Deficient fluid volume
Correct Answer: D
Rationale: Elevated serum osmolality and urine specific gravity indicate deficient fluid volume due to dehydration from colitis.
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The nurse is working with a client who has been diagnosed with hypervolemia. Which of the following conditions can cause hypervolemia? Select all that apply.
- A. Heart failure
- B. Renal failure
- C. Type 1 Diabetes Mellitus
- D. Third degree burns
- E. Hormonal imbalances
Correct Answer: A,B,E
Rationale: Heart failure, renal failure, and hormonal imbalances (e.g., SIADH) impair fluid excretion, causing hypervolemia.
The nurse is educating a client about a transurethral resection of the prostate (TURP). Which of the following statements should the nurse make to the client regarding this surgery?
- A. This surgery will remove your entire prostate.
- B. You will have a nasogastric tube (NGT) left in place following this surgery.
- C. You will need to complete a bowel prep the night before this surgery.
- D. A urinary catheter will remain in place following this procedure.
Correct Answer: D
Rationale: A urinary catheter is used post-TURP to manage bleeding and ensure bladder drainage.
The nurse reviews a client's laboratory data. Which laboratory data requires follow-up?
- A. Sodium
- B. Potassium
- C. Calcium
- D. BUN
- E. Creatinine
Correct Answer: B,C,D,E
Rationale: Abnormal potassium, calcium, BUN, and creatinine require follow-up due to potential renal or electrolyte imbalances.
The nurse is caring for a client with hyperkalemia. Which of the following treatments would the nurse recognize as appropriate options for treating this electrolyte imbalance? Select all that apply.
- A. Spironolactone
- B. Sodium polystyrene
- C. Regular insulin
- D. Hemodialysis
- E. Magnesium sulfate
Correct Answer: B,C,D
Rationale: Sodium polystyrene (B) binds potassium in the gut, regular insulin (C) shifts potassium into cells, and hemodialysis (D) removes potassium from the blood, all effective for hyperkalemia. Spironolactone (A) is a potassium-sparing diuretic and would worsen hyperkalemia. Magnesium sulfate (E) is not used for hyperkalemia.
The client is diagnosed with acute kidney failure. Which of the following is an appropriate psychosocial problem for the nurse to include in the care plan?
- A. Imbalanced nutrition: less than body requirements related to altered metabolic state and dietary restrictions.
- B. Anxiety related to the disease process and uncertainty of prognosis.
- C. Excess fluid volume related to compromised regulatory mechanisms secondary to acute renal failure.
- D. Risk for infection related to invasive procedures and an altered immune response secondary to renal failure.
Correct Answer: B
Rationale: Anxiety is a psychosocial issue related to the uncertainty and stress of acute kidney failure, unlike the other physiological options.