Nokea
The client had surgery to remove a kidney stone. Which laboratory assessment data warrant immediate intervention by the nurse?
- A. A serum potassium level of 3.8 mEq/L.
- B. A urinalysis shows microscopic hematuria.
- C. A creatinine level of 0.8 mg/100 mL.
- D. A white blood cell count of 14,000/mm3.
Correct Answer: D
Rationale: An elevated WBC (14,000/mm3) suggests infection, a serious post-surgical complication requiring immediate intervention. Normal potassium (3.8 mEq/L), creatinine (0.8 mg/dL), and microscopic hematuria are expected or benign.
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The male client diagnosed with CKD secondary to diabetes has been receiving dialysis for 12 years. The client is notified he will not be placed on the kidney transplant list. The client tells the nurse he will not be back for any more dialysis treatments. Which response by the nurse is most therapeutic?
- A. You cannot just quit your dialysis. This is not an option.'
- B. You’re angry at not being on the list, and you want to quit dialysis?'
- C. I will call your nephrologist right now so you can talk to the HCP.'
- D. Make your funeral arrangements because you are going to die.'
Correct Answer: B
Rationale: A therapeutic response acknowledges the client’s emotions and encourages discussion. Reflecting anger and the desire to quit dialysis validates feelings and opens dialogue. Other options are dismissive, confrontational, or non-therapeutic.
If the client asks the nurse to outline the benefits of the cystoscopy procedure, which ones should the nurse list as possible, the nurse is a child with a apply.
- A. Involves visual examination of the internal structure of the kidney
- B. Helps identify the sources of hematuria, incontinence, and urine retention
- C. Allows for collection of tissue samples, cell washings, and urine samples
- D. Requires no sedation because it is painless
- E. Excess the nurse to visualize the internal structure
- F. Requires no surgical incision because the scope is introduced into the urethra
Correct Answer: B,C,F
Rationale: Cystoscopy identifies causes of urinary symptoms, allows sample collection, and is minimally invasive via the urethra.
Which data support to the nurse the client’s diagnosis of acute bacterial prostatitis?
- A. Terminal dribbling.
- B. Urinary frequency.
- C. Stress incontinence.
- D. Sudden fever and chills.
Correct Answer: D
Rationale: Acute bacterial prostatitis presents with sudden systemic symptoms like fever and chills, often with dysuria. Terminal dribbling, frequency, and incontinence are more typical of BPH or chronic conditions.
Which intervention should the nurse include when assessing the client for urinary retention? Select all that apply.
- A. Inquire if the client has the sensation of fullness.
- B. Percuss the suprapubic region for a dull sound.
- C. Scan the bladder with the ultrasound scanner.
- D. Palpate from the umbilicus to the suprapubic area.
- E. Auscultate the two (2) lower abdominal quadrants.
Correct Answer: A,B,C,D
Rationale: Assessing urinary retention involves asking about fullness, percussing for dullness (indicating a full bladder), scanning with ultrasound for residual urine, and palpating for a distended bladder. Auscultation is not relevant.
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.