Nokea
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.
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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.
After teaching a client with early polycystic kidney disease (PKD) about nutritional therapy, the nurse assesses the client's understanding. Which statement made by the client indicates a correct understanding of the teaching?
- A. I will take a laxative every night before going to bed.
- B. I must increase my intake of dietary fiber and fluids.
- C. I only use salt when I am cooking my own food.
- D. I can eat white bread to minimize gastrointestinal gas.
Correct Answer: B
Rationale: Clients with PKD often experience constipation, which can be managed by increasing dietary fiber and fluid intake. Laxatives should be used cautiously, salt intake should be restricted, and white bread is low in fiber, making it inappropriate for a high-fiber diet.
A nurse teaches a client with polycystic kidney disease (PKD). Which statements should the nurse include in this client's discharge teaching? (Select all that apply.)
- A. Take your blood pressure every morning.
- B. Weigh yourself at the same time each day.
- C. Adjust your diet to prevent diarrhea.
- D. Contact your provider if you have visual disturbances.
- E. Assess your urine for renal stones.
Correct Answer: A,B,D
Rationale: Clients with PKD should monitor blood pressure and weight daily to track hypertension and fluid status, and report visual disturbances, which may indicate a berry aneurysm. Adjusting diet to prevent constipation, not diarrhea, is appropriate, and renal stones are not a primary concern in PKD.
A nurse assesses a client who is recovering from a nephrostomy. Which assessment findings should alert the nurse to urgently contact the health care provider? (Select all that apply.)
- A. Clear drainage
- B. Cloudy drainage at site
- C. Client reports headache
- D. Foul-smelling drainage
- E. Urine draining from site
Correct Answer: B,D,E
Rationale: Cloudy or foul-smelling drainage and urine leaking from the nephrostomy site suggest infection or obstruction, requiring urgent provider notification. Clear drainage is normal, and a headache is unrelated unless accompanied by other concerning symptoms.
A nurse reviews laboratory results for a client with glomerulonephritis. The client's glomerular filtration rate (GFR) is 40 ml/min as measured by a 24-hour creatinine clearance. How should the nurse interpret this finding? (Select all that apply.)
- A. Excessive GFR
- B. Normal GFR
- C. Reduced GFR
- D. Potential for fluid overload
- E. Potential for dehydration
Correct Answer: C,D
Rationale: A GFR of 40 ml/min is significantly reduced compared to the normal range of 100-120 ml/min, indicating impaired kidney function. This reduction increases the risk of fluid overload, leading to hypertension and pulmonary edema, rather than dehydration.