Nokea
The nurse is caring for a client with chronic pyelonephritis. Which assessment data support the diagnosis of chronic pyelonephritis?
- A. The client has fever, chills, flank pain, and dysuria.
- B. The client complains of fatigue, headaches, and increased urination.
- C. The client had a group B beta-hemolytic strep infection last week.
- D. The client has an acute viral pneumonia infection.
Correct Answer: B
Rationale: Chronic pyelonephritis presents with subtle symptoms like fatigue, headaches, and polyuria due to long-term renal damage. Acute symptoms (fever, chills) are more typical of acute pyelonephritis. Strep or pneumonia are unrelated.
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Which statement indicates discharge teaching has been effective for the client who is postoperative TURP?
- A. I will call the surgeon if I experience any difficulty urinating.'
- B. I will take my Proscar daily, the same as before my surgery.'
- C. I will continue restricting my oral fluid intake.'
- D. I will take my pain medication routinely even if I do not hurt.'
Correct Answer: A
Rationale: Difficulty urinating post-TURP may indicate obstruction or complications, requiring prompt reporting. Proscar is typically discontinued post-TURP, fluid restriction is unnecessary, and routine pain meds are not advised.
Before peritoneal dialysis begins, the nurse correctly informs the client that the procedure involves the movement of urea and creatinine through the peritoneum by which means?
- A. Osmosis
- B. Diffusion
- C. Filtration
- D. Gravity
Correct Answer: B
Rationale: Diffusion is the primary mechanism by which urea and creatinine move across the peritoneal membrane during dialysis.
Which nursing intervention is most helpful in assisting the client undergoing hemodialysis to cope with the client and the patient to the patient?
- A. Giving the client literature to read about renal failure
- B. Advising the client's spouse to cook the client's favorite dishes
- C. Keeping the client informed of the latest research findings
- D. Exploring with the client how this disorder has affected life
Correct Answer: D
Rationale: Exploring the impact of the disorder on the client's life fosters emotional coping and supports psychosocial adjustment.
The nurse in the dialysis center is initiating the morning dialysis run. Which client should the nurse assess first?
- A. The client who has hemoglobin of 9.8 g/dL and hematocrit of 30%.
- B. The client who does not have a palpable thrill or auscultated bruit.
- C. The client who is complaining of being exhausted and is sleeping.
- D. The client who did not take antihypertensive medication this morning.
Correct Answer: B
Rationale: Absence of a thrill or bruit indicates a non-functioning dialysis access (e.g., AV fistula), which is critical for dialysis and requires immediate assessment to prevent treatment delays or complications. Anemia, exhaustion, or missed medication are less urgent.
The nurse is providing discharge teaching to the client diagnosed with polycystic kidney disease. Which statement made by the client indicates the teaching has been effective?
- A. I need to avoid any activity causing a risk for injury to my kidney.'
- B. I should avoid taking medications for high blood pressure.'
- C. When I urinate there may be blood streaks in my urine.'
- D. I may have occasional burning when I urinate with this disease.'
Correct Answer: A
Rationale: Polycystic kidney disease causes enlarged, cystic kidneys prone to rupture. Avoiding trauma (e.g., contact sports) is critical. BP meds are necessary, hematuria is not expected, and burning suggests UTI.