Nokea
A patient has nephrotic syndrome. Which statement made by the patient indicates understanding of the necessary diet modifications?
- A. I will need to increase protein and decrease sodium intake.'
- B. I will need to drink more milk to get my calcium.'
- C. Carbohydrate restriction will be difficult.'
- D. Potassium restriction won't be hard since I don't like fruit.'
Correct Answer: A
Rationale: Medical management for nephrotic syndrome depends on the extent of tissue involvement and may include the use of corticosteroids and a low-sodium, high-protein diet.
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When the patient receiving home health services is started on dialysis, the home health nurse refers the patient to a community support group that assists with the adjustments necessary to living with dialysis. Which group offers this service?
- A. National Kidney Foundation
- B. American Association of Kidney Patients
- C. American Red Cross
- D. Veterans Administration
Correct Answer: B
Rationale: The American Association of Kidney Patients offer support to the patient and family as they adapt to living with dialysis.
In which way will the nurse instruct the patient to do before obtaining the urine specimen for a urine culture?
- A. Collect the urine for a 24-hour period.
- B. Obtain a clean-catch specimen.
- C. Bring in an early morning specimen.
- D. Limit fluid intake to concentrate the urine.
Correct Answer: B
Rationale: Urine cultures are dependent on a clean-catch or catheterized specimen.
The patient, age 43, has cancer of the urinary bladder. The patient has received a cystectomy with an ileal conduit. Which characteristics would be considered normal for the patient's urine?
- A. Hematuria
- B. Clear amber with mucus
- C. Dark bile-colored
- D. Dark amber
Correct Answer: B
Rationale: There will be mucus present in the urine from the intestinal secretions.
Which action can reduce the risk of skin impairment secondary to urinary incontinence?
- A. Decreasing fluid intake
- B. Catheterization of the older adult patient
- C. Limiting the use of medication (diuretics, etc.)
- D. Frequent toileting and meticulous skin care
Correct Answer: D
Rationale: Frequent toileting of the incontinent patient will prevent retained moisture in undergarments and bed linens and will preserve the integrity of the skin.
A home health patient with end-stage renal disease (ESRD) verbalizes feeling helplessness related to this life-altering disease. Which nursing intervention would be most helpful?
- A. Ensure restricted protein intake to prevent nitrogenous product accumulation.
- B. Include the patient in making the plan of care.
- C. Counsel patient about end-of-life provisions.
- D. Write out a detailed schedule of health care provider's appointments.
Correct Answer: B
Rationale: Listen to the patient and allow time for discussion about concerns and the plan of care to return some sense of control. End-of-life discussions are premature and will not benefit the patient who is experiencing helplessness.