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A nurse assesses a client who has a family history of polycystic kidney disease (PKD). For which clinical manifestations should the nurse assess? (Select all that apply.)
- A. Nocturia
- B. Dysuria
- C. Increased abdominal girth
- D. Dyspnea
- E. Hematuria
- F. Diarrhea
Correct Answer: B,C,E
Rationale: Clients with PKD commonly experience dysuria, increased abdominal girth due to kidney enlargement, and hematuria from cyst rupture or tissue damage. Nocturia, dyspnea, and diarrhea are not typically associated with PKD.
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After teaching a client with renal cancer who is prescribed temsirolimus (Torisel), the nurse assesses the client's understanding. Which statement made by the client indicates a correct understanding of the teaching?
- A. I will take this medication with food and plenty of water.
- B. I shall keep my appointment at the infusion center each week.
- C. I must limit my intake of green leafy vegetables while on this medication.
- D. I must not take this medication if I have an infection or am feeling ill.
Correct Answer: B
Rationale: Temsirolimus is administered weekly via intravenous infusion, so keeping infusion center appointments is correct. It is not taken orally, does not require dietary restrictions like limiting green leafy vegetables, and while infections should be reported, the statement about not taking it if ill is not accurate.
A nurse provides health screening for a community health center with a large population of African American clients. Which priority assessment should the nurse include when working with this population?
- A. Measure height and weight.
- B. Assess blood pressure.
- C. Measure blood pressure and pulse.
- D. Ask about medications.
Correct Answer: B
Rationale: African Americans have a high prevalence of hypertension, which is a leading cause of end-stage renal disease. Assessing blood pressure is a priority to monitor and manage this risk. While other assessments are important, blood pressure screening is critical for this population.
A nurse cares for a client who has pyelonephritis. The client states, 'I am embarrassed to talk about my symptoms and I don't want to talk to my nurse.' How should the nurse respond?
- A. I am a professional. Your symptoms will be kept in confidence.
- B. I understand. Elimination is a private topic and shouldn't be discussed.
- C. Take your time. It is okay to use words that are familiar to you.
- D. You seem anxious. Would you like a nurse of the same gender to care for you?
Correct Answer: C
Rationale: Encouraging the client to use familiar language helps facilitate discussion about sensitive genitourinary symptoms. Promising absolute confidentiality may not be feasible, dismissing the topic is inappropriate, and changing nurses does not address the client's discomfort with communication.
An emergency department nurse cares for a client who is severely dehydrated and is prescribed 3 L of intravenous fluid over 6 hours. At what rate should the nurse set the intravenous pump to infuse the fluids? (Record your answer using a whole number.)
- A. 100 ml/hr
- B. 250 ml/hr
- C. 500 ml/hr
- D. 750 ml/hr
Correct Answer: C
Rationale: To deliver 3 L (3000 ml) over 6 hours, the infusion rate is calculated as 3000 ml ÷ 6 hours = 500 ml/hr. This rate ensures the prescribed volume is administered within the specified time frame.
A nurse cares for a middle-aged female client with diabetes mellitus who is being treated for the third episode of acute pyelonephritis in the past year. The client asks, 'What can I do to help prevent these infections?' How should the nurse respond?
- A. Test your urine daily for the presence of ketone bodies and proteins.
- B. Use tampons rather than sanitary napkins during your menstrual period.
- C. Drink more water and empty your bladder more frequently during the day.
- D. Keep your hemoglobin A1C under 9% by keeping your blood sugar controlled.
Correct Answer: C
Rationale: Increasing fluid intake (especially water) and frequent voiding help flush bacteria from the urinary tract, reducing the risk of pyelonephritis. Chronically elevated blood glucose in diabetes can promote bacterial growth, but frequent voiding is the most direct preventive measure. Testing urine for ketones/proteins, using tampons, or controlling hemoglobin A1C are not as directly related to preventing urinary tract infections.