Nokea
The nurse is admitting a patient with new onset nephrotic syndrome. Which of the following findings should the nurse expect to assess related to this illness?
- A. Poor skin turgor
- B. High urine ketones
- C. Recent weight gain
- D. Low blood pressure
Correct Answer: C
Rationale: The patient with a nephrotic syndrome will have weight gain associated with edema. Hypertension is a clinical manifestation of nephrotic syndrome. Skin turgor is normal because of the edema. Urine protein is high.
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The nurse is teaching a patient with interstitial cystitis about management of the condition. Which of the following patient statements indicate that further instruction is required?
- A. I will have to stop having coffee and orange juice for breakfast.
- B. I should start taking a high potency multiple vitamin every morning.
- C. I will buy some calcium glycerophosphate (Prelief) at the pharmacy.
- D. I should call the doctor about increased bladder pain or odorous urine.
Correct Answer: B
Rationale: High-potency multiple vitamins may irritate the bladder and increase symptoms. The other patient statements indicate good understanding of the teaching.
The nurse is assessing a patient who has a lower urinary tract infection (UTI). Which of the following symptoms should the nurse ask about initially?
- A. Nausea
- B. Flank pain
- C. Poor urine output
- D. Pain with urination
Correct Answer: D
Rationale: Pain with urination is a common symptom of a lower UTI. Urine output does not decrease, but frequency may be experienced. Flank pain and nausea are associated with an upper UTI.
A patient returns to the clinic with recurrent dysuria after being treated with trimethoprim-sulfamethoxazole for 3 days. Which of the following actions should the nurse plan to take?
- A. Remind the patient about the need to drink 1000 mL of fluids daily.
- B. Obtain a midstream urine specimen for culture and sensitivity testing.
- C. Teach the patient to take the prescribed trimethoprim-sulfamethoxazole for at least 3 more days.
- D. Suggest that the patient drink cranberry juice to treat the symptoms.
Correct Answer: B
Rationale: Since uncomplicated urinary tract infections (UTIs) are usually successfully treated with 3 days of antibiotic therapy, this patient will need a urine culture and sensitivity to determine appropriate antibiotic therapy. Although daily intake of cranberry juice has been purported to assist in treating, there is currently no conclusive evidence to support advocating this treatment. The fluid intake should be increased to at least 1000 mL/day. Since the UTI has persisted after treatment with trimethoprim-sulfamethoxazole, the patient is likely to need a different antibiotic.
The nurse is caring for a patient who had a nephrectomy after having massive trauma to the kidney. Which of the following assessment findings obtained postoperatively is most important to communicate to the surgeon?
- A. Blood pressure is 102/58.
- B. Incisional pain level is 8/10.
- C. Urine output is 20 ml/hour for 2 hours.
- D. Crackles are heard at both lung bases.
Correct Answer: C
Rationale: Because the urine output should be at least 0.5 ml/kg/hour, a 20 ml output for 2 hours indicates that the patient may have decreased renal perfusion because of bleeding, inadequate fluid intake, or obstruction at the suture site. The blood pressure requires ongoing monitoring but does not indicate inadequate perfusion at this time. The patient should cough and deep breathe, but the crackles do not indicate a need for an immediate change in therapy. The incisional pain should be addressed, but this is not as potentially life-threatening as decreased renal perfusion.
The nurse is obtaining the health history for a patient who smokes two packs of cigarettes daily. Which of the following conditions should the nurse include in the teaching plan that the patient is at an increased risk for developing?
- A. Kidney stones
- B. Bladder cancer
- C. Bladder infection
- D. Interstitial cystitis
Correct Answer: B
Rationale: Cigarette smoking is a risk factor for bladder cancer. The patient's risk for developing interstitial cystitis, urinary tract infection (UTI), or kidney stones will not be reduced by quitting smoking.