Nokea
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.
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The client diagnosed with diabetes insipidus weighed 180 pounds when the daily weight was taken yesterday. This morning’s weight is 175.6 pounds. One liter of fluid weighs approximately 2.2 pounds. How much fluid has the client lost?
Correct Answer: 2 L
Rationale: Weight loss: 180 - 175.6 = 4.4 pounds. Fluid loss: 4.4 pounds ÷ 2.2 pounds/L = 2 L. This calculation accounts for fluid loss typical in diabetes insipidus due to excessive urination.
If this client shares cultural characteristics of other Native Americans, which findings in the cultural assessment should be included in the client's care plan? Select all that apply.
- A. Native Americans may hesitate to share personal information with strangers.
- B. Questions regarding health history may be interpreted as prying.
- C. Native Americans value listening skills.
- D. Touching on the head is considered offensive.
- E. Native Americans pattern their lifestyle according to 'clock time.'
- F. Direct eye contact should be used when addressing the client or family.
Correct Answer: A,B,C
Rationale: These cultural characteristics reflect common Native American values and should guide culturally sensitive care.
Which client should the nurse not assign to a UAP working on a surgical floor?
- A. The client with a suprapubic catheter inserted yesterday.
- B. The client who has had an indwelling catheter for the past week.
- C. The client who is on a bladder-training regimen.
- D. The client who had a catheter removed this morning and is being discharged.
Correct Answer: C
Rationale: A client on a bladder-training regimen requires nursing judgment to assess progress and adjust the plan, which is outside the UAP’s scope. Routine catheter care or post-removal care can be assigned.
The client diagnosed with cancer of the bladder is scheduled to have a cutaneous urinary diversion procedure. Which preoperative teaching intervention specific to the procedure should be included?
- A. Demonstrate turn, cough, and deep breathing.
- B. Explain a bag will drain the urine from now on.
- C. Instruct the client on the use of a PCA pump.
- D. Take the client to the ICD so the client can become familiar with it.
Correct Answer: B
Rationale: A cutaneous urinary diversion (e.g., ileal conduit) requires a stoma and drainage bag. Explaining this prepares the client for post-op care. Coughing/breathing, PCA use, and ICU visits are general, not specific.
The nurse performs bladder irrigation through an indwelling catheter. The nurse instilled 90 mL of sterile normal saline. The catheter drained 710 mL. What is the client’s output?
Correct Answer: 620 mL
Rationale: Urine output = Total drainage - Irrigation fluid instilled = 710 mL - 90 mL = 620 mL. This isolates the client’s actual urine production from the irrigation fluid.