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The client is reporting chills, fever, and left costovertebral pain. Which diagnostic test should the nurse expect the HCP to prescribe first?
- A. A midstream urine for culture.
- B. A sonogram of the kidney.
- C. An intravenous pyelogram for renal calculi.
- D. A CT scan of the kidneys.
Correct Answer: A
Rationale: Chills, fever, and costovertebral pain suggest pyelonephritis. A midstream urine culture is the first test to identify the causative organism. Imaging (sonogram, IVP, CT) is secondary to confirm complications or other diagnoses.
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The nurse is planning the care of a postoperative client with an ileal conduit. Which intervention should be included in the plan of care?
- A. Provide meticulous skin care and pouching.
- B. Apply sterile drainage bags daily.
- C. Monitor the pH of the urine weekly.
- D. Assess the stoma site every day.
Correct Answer: A
Rationale: Meticulous skin care and proper pouching prevent skin breakdown and infection around the ileal conduit stoma. Sterile bags are unnecessary, weekly pH monitoring is not standard, and daily stoma assessment is part of skin care.
The nurse is caring for the client recovering from a percutaneous renal biopsy. Which data indicate the client is complying with client teaching?
- A. The client is lying flat in the saline position.
- B. The client continues oral fluids restriction while on bedrest.
- C. The client uses the bedside commode to urinate.
- D. The client refuses to ask for any pain medication.
Correct Answer: A
Rationale: Post-renal biopsy, lying flat (supine, assuming 'saline' is a typo) prevents bleeding complications, indicating compliance. Fluid restriction is unnecessary, using a commode risks bleeding, and refusing pain meds is unrelated.
The client is experiencing urinary incontinence. Which intervention should the nurse implement?
- A. Teach the client to drink prune juice weekly.
- B. Encourage the client to eat a high-fiber diet.
- C. Discuss the need to urinate every six (6) hours.
- D. Explain the importance of wearing cotton underwear.
Correct Answer: B
Rationale: A high-fiber diet prevents constipation, which can exacerbate incontinence by pressuring the bladder. Prune juice is too specific, voiding every 6 hours is too infrequent, and cotton underwear is secondary.
Which nursing intervention is most helpful in assisting the client undergoing hemodialysis to cope with the treatment?
- A. Giving the client literature to read about renal failure
- B. Advising the client's spouse to cook the client's favorite dishes
- C. Keeping the client informed of the latest research findings
- D. Exploring with the client how this disorder has affected life
Correct Answer: D
Rationale: Exploring the impact of the disorder on the client's life fosters emotional coping and supports psychosocial adjustment.
When documenting the client's urine output in the medical record, which measurement is correct for the nurse to record?
- A. Only the output from the urethral catheter
- B. Only the output from the wound catheter
- C. The outputs from each catheter separately
- D. The combined output from both catheters
Correct Answer: D
Rationale: The combined output from both catheters provides the total urine output, which is essential for accurate monitoring.