Nokea
A nurse teaches a client who is recovering from a nephrectomy secondary to kidney trauma. Which statement should the nurse include in this client's teaching?
- A. Since you only have one kidney, a salt and fluid restriction is required.
- B. Your therapy will include hemodialysis while you recover.
- C. Medications will be prescribed to control your high blood pressure.
- D. You need to avoid participating in contact sports like football.
Correct Answer: D
Rationale: Clients with one kidney should avoid contact sports to prevent injury to the remaining kidney. Salt and fluid restriction, dialysis, or new hypertension medications are not typically required post-nephrectomy unless other complications arise.
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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 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.
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 client with autosomal dominant polycystic kidney disease (ADPKD). The client asks, 'Will my children develop this disease?' How should the nurse respond?
- A. No genetic link is present, so your children are not at increased risk.
- B. Your sons will develop this disease because it has a sex-linked gene.
- C. Only if both you and your spouse are carriers of this disease.
- D. Your children have a 50% chance of inheriting the gene that causes this disease.
Correct Answer: D
Rationale: ADPKD is an autosomal dominant disorder, meaning there is a 50% chance of passing the gene to each child, regardless of gender. It is not sex-linked, and only one parent needs to have the gene for the child to be at risk.
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.