Nokea
The nurse is caring for a patient with an elevated blood urea nitrogen (BUN) and serum creatinine who is scheduled for a renal arteriogram. Which of the following bowel preparation prescriptions should the nurse question?
- A. Fleet enema
- B. Tap-water enema
- C. Bisacodyl tablets
- D. Castor oil
Correct Answer: A
Rationale: High-phosphate enemas, such as Fleet enemas, should be avoided in patients with elevated BUN and creatinine because phosphate cannot be excreted by patients with renal failure. The other medications for bowel evacuation are more appropriate.
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A creatinine clearance test is ordered for a hospitalized patient with possible renal insufficiency. Which of the following equipment will the nurse need to obtain?
- A. Sterile specimen cup
- B. Large container for urine
- C. Foley catheter and drainage bag
- D. Towelettes for perineal cleaning
Correct Answer: B
Rationale: Since creatinine clearance testing involves a 24-hour urine specimen, the nurse should obtain a large container for the urine collection. Catheterization, cleaning of the perineum with antiseptic towelettes, and a sterile specimen cup are not needed for this test.
The nurse is admitting an older-adult patient with benign prostatic hyperplasia. Which of the following actions should be included in the nursing plan of care?
- A. Limit fluid intake to no more than 1500 mL/day.
- B. Leave a light on in the bathroom during the night
- C. Pad the patient's bed to accommodate overflow incontinence.
- D. Ask the patient to use a urinal so that all urine can be measured.
Correct Answer: B
Rationale: The patient's age and diagnosis indicate a likelihood of nocturia, so leaving the light on in the bathroom is appropriate. Fluids should be encouraged because dehydration is more common in older patients. The information in the question does not indicate that measurement of the patient's output is necessary or that the patient has overflow incontinence.
The nurse is reviewing a patient's chart and notes that the patient has dysuria. To assess whether there is any improvement, which of the following questions should the nurse ask?
- A. Do you have any blood in your urine?
- B. Do you have to urinate very frequently?
- C. Do you have any pain when you urinate?
- D. Do you have to get up at night to urinate?
Correct Answer: C
Rationale: Dysuria is painful urination. The alternate responses are used to assess other urinary tract symptoms: hematuria, nocturia, and frequency.
The nurse is preparing a patient for a cystoscopy. Which of the following information should the nurse include in patient teaching about the procedure?
- A. NPO for 8 hours to prevent nausea and vomiting.
- B. Strict bed rest for about 4-6 hours.
- C. Request prescribed opioids as necessary for pain.
- D. May experience blood-tinged urine and urinary frequency.
Correct Answer: D
Rationale: Pink-tinged urine and urinary frequency are expected after cystoscopy. Burning on urination is common, but pain that requires opioids for relief is not expected. A good fluid intake is encouraged after this procedure. Bed rest is not required following cystoscopy.
The nurse is caring for a patient with diabetic nephropathy who is scheduled for a right renal biopsy. Immediately after the biopsy, which of the following actions is essential?
- A. Monitor the blood urea nitrogen (BUN) and creatinine to assess renal function.
- B. Check blood glucose to assess for hyperglycemia or hypoglycemia.
- C. Insert a straight catheter to check for gross or microscopic hematuria.
- D. Apply a pressure dressing and keep the patient prone for 30-60 minutes.
Correct Answer: D
Rationale: After the procedure, a pressure dressing is applied, and the patient is kept prone for 30-60 minutes. Usually bed rest is prescribed for 24 hours. The blood glucose and BUN/creatinine will not be affected by the biopsy. Although monitoring for hematuria is needed, there is no need for catheterization.