Nokea
The nurse is assessing a client with an acute kidney injury (AKI). Which of the following findings would support a diagnosis of AKI?
- A. hypernatremia
- B. metabolic alkalosis
- C. oliguria
- D. hypokalemia
Correct Answer: C
Rationale: Oliguria is a hallmark of AKI due to reduced kidney perfusion and filtration.
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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.
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 nurse is caring for a client who was newly prescribed warfarin. Which medication on the client's medication list requires follow-up with the primary healthcare provider (PHCP)?
- A. Loratadine
- B. Saw Palmetto
- C. Furosemide
- D. Pantoprazole
Correct Answer: B
Rationale: Saw Palmetto can interact with warfarin by potentially increasing bleeding risk due to its antiplatelet effects, requiring follow-up with the PHCP. Loratadine (A), Furosemide (C), and Pantoprazole (D) have minimal interactions with warfarin.
The nurse is providing discharge instructions to a client prescribed phenazopyridine. Which of the following instructions should the nurse include?
- A. Discontinue this medication if urinary discoloration occurs
- B. Take this medication on an empty stomach
- C. This medication may increase the amount of urine you produce
- D. Urine may have a reddish or orange coloration after taking this medication
Correct Answer: D
Rationale: Phenazopyridine commonly causes reddish or orange urine, which is harmless and should be explained to the client. Discontinuing the medication (A) is unnecessary, it can be taken with or without food (B), and it does not increase urine output (C).
A nurse on a medical-surgical unit cares for a client who has just undergone a procedure for a Kock pouch as a treatment for bladder cancer. The initial nursing interventions for this client would include:
- A. Monitoring urine output, checking for indications of ostomy pouch leaks, and noting the size, shape, and color of the stoma.
- B. Speaking to the client's family and updating them regarding the client's status.
- C. Educating the client about stoma care and skincare.
- D. Irrigating the catheters as needed.
Correct Answer: A
Rationale: Initial interventions for a Kock pouch include monitoring urine output and stoma condition to ensure proper function and detect complications.