Nokea
The client diagnosed with ARF is admitted to the intensive care department and placed on a therapeutic diet. Which diet is most appropriate for the client?
- A. A high-potassium and low-calcium diet.
- B. A low-fat and low-cholesterol diet.
- C. A high-carbohydrate and restricted-protein diet.
- D. A regular diet with six (6) small feedings a day.
Correct Answer: C
Rationale: ARF patients require a restricted-protein diet to reduce urea production and a high-carbohydrate diet to provide energy, minimizing protein catabolism. High-potassium diets are contraindicated due to hyperkalemia risk, and low-fat or regular diets are less specific.
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If this client is typical of others who acquire bladder cancer, which symptoms are most likely to have manifested in the early stage of this disease? Select all that apply.
- A. Difficulty voiding
- B. Persistent oliguria
- C. Painless hematuria
- D. Urethral discharge
- E. Painful urination
- F. Postvoid dribbling
Correct Answer: C
Rationale: Painless hematuria is the most common early symptom of bladder cancer.
The client diagnosed with CKD is receiving peritoneal dialysis. Which assessment data warrant immediate intervention by the nurse?
- A. Inability to auscultate a bruit over the fistula.
- B. The client’s abdomen is soft, is nontender, and has bowel sounds.
- C. The dialysate being removed from the client’s abdomen is clear.
- D. The dialysate instilled was 1,500 mL and removed was 1,500 mL.
Correct Answer: A
Rationale: Peritoneal dialysis does not involve a fistula, so inability to auscultate a bruit suggests a documentation error or confusion with hemodialysis, requiring immediate clarification. Soft abdomen, clear dialysate, and equal instill/removal volumes are normal findings.
Which client should the nurse not assign to a UAP working on a surgical floor?
- A. The client with a suprapubic catheter inserted yesterday.
- B. The client who has had an indwelling catheter for the past week.
- C. The client who is on a bladder-training regimen.
- D. The client who had a catheter removed this morning and is being discharged.
Correct Answer: C
Rationale: A client on a bladder-training regimen requires nursing judgment to assess progress and adjust the plan, which is outside the UAP’s scope. Routine catheter care or post-removal care can be assigned.
Which finding provides the best evidence that peritoneal dialysis is achieving a therapeutic effect?
- A. Urine output increases.
- B. Appetite improves.
- C. Red blood cell count is lower.
Correct Answer: B
Rationale: Improved appetite indicates reduced uremia, a sign that dialysis is effectively removing toxins.
Which response by the nurse is most appropriate?
- A. His bladder retraining is coming along, and before long he will be urinating like normal.
- B. He seems to have more incontinence in the afternoon and evening.
- C. In order to protect his privacy, I can't give you that information.
- D. Bladder retraining is slow work. We have to take him to the toilet every 2 hours.
Correct Answer: C
Rationale: To comply with HIPAA, the nurse must protect the client's privacy and not disclose health information without consent, making this the most appropriate response.