Nokea
The nurse has taught a client about a scheduled intravenous (IV) urography (pyelogram). Which of the following statements by the client would indicate a correct understanding of the teaching?
- A. I should expect a temporary urinary catheter inserted during the procedure.
- B. I will take a laxative the night before to clear my bowels.
- C. I must fill my bladder with water immediately before the procedure.
- D. I may experience blood in my urine for a few days after this procedure.
Correct Answer: B
Rationale: A laxative is often required before IV urography to clear the bowels for better imaging.
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The nurse is caring for a client with urge incontinence. Which of the following actions would be appropriate for the nurse to take?
- A. Administer prophylactic antibiotics.
- B. Teach the client intermittent self-catheterization.
- C. Have the client void on a timed schedule.
- D. Provide caffeinated beverages with meals.
Correct Answer: C
Rationale: Timed voiding helps manage urge incontinence by preventing bladder overfilling, reducing involuntary contractions.
The nurse is caring for a client who has fluid volume deficit receiving intravenous fluids. Which of the following would indicate the client is achieving the treatment goals?
- A. urine output 20 mL/hr
- B. BUN 15 mg/dL (5.355 mmol/L) [10-20 mg/dL (3.6-7.1 mmol/L)]
- C. urine specific gravity 1.039 [1.005-1.030]
- D. flattened jugular veins
Correct Answer: B
Rationale: Normal BUN (15 mg/dL) indicates improved renal perfusion and fluid balance, suggesting effective treatment for fluid volume deficit.
The nurse is caring for a client with end-stage renal disease who receives prescribed sevelamer. Which of the following findings would indicate a therapeutic response?
- A. Decreased serum calcium levels
- B. Increased hemoglobin and hematocrit
- C. Decreased serum potassium levels
- D. Decreased serum phosphorus levels
Correct Answer: D
Rationale: Sevelamer is a phosphate binder used to lower serum phosphorus levels in end-stage renal disease, making decreased phosphorus levels the therapeutic response. It does not directly affect calcium (A), hemoglobin/hematocrit (B), or potassium (C).
The oncoming nurse learns that her new patient is suffering from Syndrome of Inappropriate Antidiuretic Hormone (SIADH) secretion. Which of the following nursing actions is the most important?
- A. Assess the patient's mental status
- B. Provide oral hygiene
- C. Keep accurate intake and output measurements
- D. Reduce stress and discomfort
Correct Answer: A
Rationale: SIADH causes hyponatremia, which can lead to neurological changes, making mental status assessment critical.
The nurse is administering phosphate excreting medications to a client with hypocalcemia. The reason for administering this medication is because
- A. as phosphorus exits the body so does calcium.
- B. calcium is managed by the excretion of phosphorus.
- C. when serum phosphorus decreases, serum calcium increases.
- D. phosphorus must be above 4.5 mg/dL (1.45 mmol/L) [3.0-4.5 mg/dL,0.81-1.58 mmol/L] before calcium can increase.
Correct Answer: C
Rationale: Phosphate-excreting medications reduce serum phosphorus levels, which inversely increases serum calcium levels due to the physiological relationship between phosphorus and calcium. Options A, B, and D are incorrect as they misrepresent this relationship.