Nokea
The clinic nurse is caring for a client diagnosed with chronic pyelonephritis who is prescribed trimethoprim-sulfamethoxazole (Bactrim), a sulfa antibiotic, twice a day for 90 days. Which statement is the scientific rationale for prescribing this medication?
- A. The antibiotic will treat the bladder spasms that accompany a urinary tract infection.
- B. If the urine cannot be made bacteria free, the Bactrim will suppress bacterial growth.
- C. In three (3) months, the client should be rid of all bacteria in the urinary tract.
- D. The HCP is providing the client with enough medication to treat future infections.
Correct Answer: B
Rationale: Chronic pyelonephritis often requires long-term antibiotics like Bactrim to suppress bacterial growth when complete eradication is not possible. It does not treat spasms, and 90 days may not eliminate all bacteria or be for future use.
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The nurse is caring for a client with a TURP. Which expected outcome indicates the client’s condition is improving?
- A. The client is using the maximum amount allowed by the PCA pump.
- B. The client’s bladder spasms are relieved by medication.
- C. The client’s scrotum is swollen and tender with movement.
- D. The client has passed a large, hard, brown stool this morning.
Correct Answer: B
Rationale: Relief of bladder spasms indicates reduced irritation and healing post-TURP. Maximum PCA use, scrotal swelling, or hard stools do not reflect improvement and may indicate complications.
If the client asks the nurse to outline the benefits of the cystoscopy procedure, which ones should the nurse list as possible? Select all that 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. Allows 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.
The client diagnosed with ARF is experiencing hyperkalemia. Which medication should the nurse prepare to administer to help decrease the potassium level?
- A. Erythropoietin.
- B. Calcium gluconate.
- C. Regular insulin.
- D. Osmotic diuretic.
Correct Answer: C
Rationale: Regular insulin, often given with glucose, drives potassium into cells, temporarily lowering serum potassium levels in hyperkalemia. Calcium gluconate stabilizes cardiac membranes, erythropoietin treats anemia, and osmotic diuretics are not used for hyperkalemia.
When managing catheter care, which nursing action is most important for promoting wound healing?
- A. Avoid tension on the catheter.
- B. Encourage oral fluid intake.
- C. Clean the urethral meatus daily.
- D. Clamp and release the catheter every 2 hours.
Correct Answer: A
Rationale: Avoiding tension on the catheter prevents trauma to the surgical site, promoting healing.
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.