Urinary Elimination NCLEX RN Questions Related

The nurse is caring for a client who has bacterial cystitis. The physician prescribes the client gentamicin. To prevent a complication associated with this medication, the nurse should monitor the client's?

• A. intake and output ratio.
• B. creatinine.
• C. visual acuity.
• D. fasting blood glucose.

The nurse is caring for an assigned client. Which prescription requires clarification based on the laboratory data? See the exhibit. Select all that apply. Prescribed Medications: vancomycin 1-gram IVPB daily, furosemide 40 mg PO daily, 500 mL of 0.9% sodium chloride bolus x 1 dose, diltiazem XR 120 mg PO daily, Ketorolac 15 mg IV push every eight hours PRN pain. Laboratory Results: Sodium 145 mEq/L (145 mmol/L), Potassium 3.7 mEq/L (3.7 mmol/L), Calcium 9.3 mg/dL (2.32 mmol/L), BUN 25 mg/dL (8.93 mmol/L), Creatinine 2.1 mg/dL (185.64 umol/L)

• A. vancomycin 1-gram IVPB Daily
• B. furosemide 40 mg PO Daily
• C. 500 ml of 0.9% Saline IV Bolus x 1
• D. diltiazem XR 120 mg PO Daily
• E. ketorolac 15 mg IV Q 8 hours

Which nursing assessment finding are consistent with hypocalcemia? Select all that apply.

• A. Chvostek's sign
• B. Grey-Turner's sign
• C. Homan's sign
• D. Trousseau's sign
• E. Numbness and tingling of the fingers and toes

The nurse is educating a client about a transurethral resection of the prostate (TURP). Which of the following statements should the nurse make to the client regarding this surgery?

• A. This surgery will remove your entire prostate.
• B. You will have a nasogastric tube (NGT) left in place following this surgery.
• C. You will need to complete a bowel prep the night before this surgery.
• D. A urinary catheter will remain in place following this procedure.

The following scenario applies to the next 6 items.
The nurse in the emergency department (ED) is caring for a 57-year-old male client.
Item 3 of 6
History and Physical
A 57-year-old male client with stage three small cell lung cancer. The client had suddenly become disoriented and did not recognize his family members and relatives. He reports severe lower extremity weakness and has had three episodes of diarrhea in the past four hours. The client is undergoing 6 cycles of chemotherapy with cisplatin and etoposide. He is currently taking a 14-day course of 15 mg of prednisone. He is on his third day of steroid treatment. He has a medical history of dyslipidemia and advanced chronic obstructive pulmonary disease.

Nurses' Notes
0759: Client is completely disoriented and required maximum assistance to the stretcher because of unsteady gait. Lung sounds clear bilaterally. Alopecia noted. Skin is warm and dry and normal for ethnicity. Peripheral pulses 2+. No skin tenting. Hyperactive bowel sounds in all quadrants. 20-gauge peripheral vascular access device placed in the left antecubital space. T 97.8° F (36.6° C) P 88 RR 21 BP 123/68 Pulse oximetry reading 91% on room air.

Laboratory Results
• Hemoglobin 14 g/dL [14-18 g/dL (140–180 g/L)]
• Hematocrit 42% (0.42) [42-52% (0.42-0.52)]
• White Blood Cell 11,000 mm3 [5-10 mm3]
• Platelet Count 140,000 mm3 [150-400 mm3 (150–400 × 109/L)]
• Glucose 139 mg/dL (7.72 mmol/L) [70–110 mg/dL (4-6 mmol/L)]
• Sodium 116 mEq/L [136–145 mEq/L (mmol/L)]
• Potassium 3.3 mEq/L [3.5–5.0 mEq/L (mmol/L)]
• Creatinine 0.7 mg/dL (61.88 mmol/L) [0.6–1.2 mg/dL (53–106 mmol/L)]
• Blood Urea Nitrogen 8 mg/dL (2.86 mmol/L) [10–20 mg/dL (3.6–7.1 mmol/L)]
• Serum Osmolality 277 mOsm/kg [285-295 mOsm/kg (285–295 mmol/kg)]

The client is demonstrating manifestations consistent with......... due to.......

• A. Cushing's syndrome
• B. diabetes insipidus
• C. syndrome of inappropriate antidiuretic hormone
• D. advanced chronic obstructive pulmonary disease.
• E. small cell lung cancer.
• F. corticosteroid usage.