Nokea
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.
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The female client in an outpatient clinic is being sent home with a diagnosis of urinary tract infection (UTI). Which instruction should the nurse teach to prevent a recurrence of a UTI?
- A. Clean the perineum from back to front after a bowel movement.
- B. Take warm tub baths instead of hot showers daily.
- C. Void immediately preceding sexual intercourse.
- D. Avoid coffee, tea, colas, and alcoholic beverages.
Correct Answer: D
Rationale: Avoiding bladder irritants like coffee, tea, colas, and alcohol reduces UTI recurrence risk. Wiping back to front increases infection risk, tub baths are less effective than showers, and voiding before intercourse is less critical than after.
The nurse is caring for a client diagnosed with rule-out ARF. Which condition predisposes the client to developing prerenal failure?
- A. Diabetes mellitus.
- B. Hypotension.
- C. Aminoglycosides.
- D. Benign prostatic hypertrophy.
Correct Answer: B
Rationale: Prerenal failure results from decreased renal perfusion. Hypotension reduces blood flow to the kidneys, directly causing prerenal ARF. Diabetes and aminoglycosides contribute to intrinsic renal damage, while BPH causes postrenal issues.
The nurse identifies the concepts of elimination and immunity for a female client diagnosing with a urinary tract infection. Which discharge instructions should the nurse provide the client? Select all that apply.
- A. Teach the client to wipe from front to back after voiding.
- B. Encourage the client to drink cranberry juice each morning.
- C. Inform the client that frequent episodes of incontinence are expected.
- D. Discuss the signs and symptoms of a recurrent infection.
- E. Have the client fill a container of water to sip until at least 2,000 mL is consumed.
- F. Request that the client sit in a tub of warm water twice a day for 25 minutes.
Correct Answer: A,B,D,E
Rationale: Wiping front to back prevents bacterial spread, cranberry juice may reduce UTI risk, discussing recurrent symptoms aids early detection, and 2,000 mL fluid intake flushes the bladder. Incontinence is not expected, and tub baths increase infection risk.
The client with possible renal calculi is scheduled for a renal ultrasound. Which intervention should the nurse implement for this procedure?
- A. Ask if the client is allergic to shellfish or iodine.
- B. Keep the client NPO eight (8) hours prior to the ultrasound.
- C. Ensure the client has a signed informed consent form.
- D. Explain the test is noninvasive and there is no discomfort.
Correct Answer: D
Rationale: Renal ultrasound is noninvasive, painless, and requires minimal preparation. Explaining this reduces anxiety. No contrast (iodine) is used, NPO is unnecessary, and informed consent is not typically required.
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.