Nokea
The client is diagnosed with a uric acid stone. Which foods should the client eliminate from the diet to help prevent reoccurrence?
- A. Beer and colas.
- B. Asparagus and cabbage.
- C. Venison and sardines.
- D. Cheese and eggs.
Correct Answer: C
Rationale: Uric acid stones are linked to high purine intake. Venison and sardines are high-purine foods, increasing uric acid production. Beer/colas affect hydration, asparagus/cabbage are low-purine, and cheese/eggs are less relevant.
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Which medication is most appropriate to administer to the client who is having bladder spasms?
- A. Aspirin by mouth
- B. Acetaminophen (Tylenol) by mouth
- C. Meperidine hydrochloride (Demerol) intramuscularly
- D. Belladonna and opium (B&O) rectal suppository
Correct Answer: D
Rationale: Belladonna and opium suppositories are specifically used to relieve bladder spasms post-TURP.
The client diagnosed with cancer of the bladder is undergoing intravesical chemotherapy. Which instruction should the nurse provide the client about the pretherapy routine?
- A. Instruct the client to remain NPO after midnight before the procedure.
- B. Explain the use of chemotherapy in bladder cancer.
- C. Teach the client to administer Neupogen, a biologic response modifier.
- D. Have the client take Tylenol, an analgesic, before coming to the clinic.
Correct Answer: B
Rationale: Explaining intravesical chemotherapy (instilled into the bladder) ensures the client understands the procedure and its purpose. NPO is unnecessary, Neupogen is unrelated, and Tylenol is not routinely required.
Which signs/symptoms indicate to the nurse the client is in the recovery period of ARF? Select all that apply.
- A. Increased alertness and no seizure activity.
- B. Increase in hemoglobin and hematocrit.
- C. Denial of nausea and vomiting.
- D. Decreased urine-specific gravity.
- E. Increased serum creatinine level.
Correct Answer: A,C,D
Rationale: In the recovery phase, renal function improves, leading to increased alertness (reduced uremia), resolution of nausea/vomiting, and decreased urine-specific gravity as kidneys concentrate urine. Increased hemoglobin/hematocrit is not typical, and elevated creatinine indicates worsening, not recovery.
The nurse is preparing the discharge teaching plan for the male client with a left-sided nephrectomy. Which statement indicates the teaching is effective?
- A. I can’t wait to start back to work next week, I really need the money.
- B. I will take my temperature and if it is above 101 I will call my doctor.
- C. I am glad I won’t have to keep track of how much I urinate in the day.
- D. I am happy I will be able eat what I usually eat, I don’t like this food.
Correct Answer: B
Rationale: Effective discharge teaching post-nephrectomy includes recognizing signs of infection, such as fever above 101°F, requiring prompt reporting. Returning to work too soon, not monitoring urine output, or resuming a normal diet may be incorrect.
Which assessment supports the nurse's assumption that the client's sleep disturbance was most likely due to anxiety?
- A. The client was pacing the room before bedtime.
- B. The client's vital signs were stable during the night.
- C. The client requested a sleeping pill earlier.
- D. The client reported feeling rested in the morning.
Correct Answer: A
Rationale: Pacing before bedtime is a behavioral sign of anxiety, supporting the assumption that anxiety caused the sleep disturbance.