Nokea
The nurse is caring for an assigned client. Which prescription requires clarification with the primary healthcare provider (PHCP) based on the laboratory data?
- A. furosemide
- B. vancomycin
- C. ibuprofen
- D. citalopram
- E. enalapril
Correct Answer: C
Rationale: Ibuprofen can worsen renal function in kidney injury, requiring clarification.
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The nurse is caring for a client with urge incontinence. Which of the following actions would be appropriate for the nurse to take?
- A. Administer prophylactic antibiotics.
- B. Teach the client intermittent self-catheterization.
- C. Have the client void on a timed schedule.
- D. Provide caffeinated beverages with meals.
Correct Answer: C
Rationale: Timed voiding helps manage urge incontinence by preventing bladder overfilling, reducing involuntary contractions.
The nurse is caring for a client who has fluid volume deficit receiving intravenous fluids. Which of the following would indicate the client is achieving the treatment goals?
- A. urine output 20 mL/hr
- B. BUN 15 mg/dL (5.355 mmol/L) [10-20 mg/dL (3.6-7.1 mmol/L)]
- C. urine specific gravity 1.039 [1.005-1.030]
- D. flattened jugular veins
Correct Answer: B
Rationale: Normal BUN (15 mg/dL) indicates improved renal perfusion and fluid balance, suggesting effective treatment for fluid volume deficit.
The nurse preceptor is orienting a newly hired nurse caring for a client with advanced polycystic kidney disease (PKD). Which of the following actions by the newly hired nurse would require follow-up by the nurse preceptor?
- A. Requesting a prescription for ketorolac to help relieve the client's pain.
- B. Instructing the client on how to use guided imagery as a comfort strategy.
- C. Applying dry heat to the client's abdomen or flank for pain relief.
- D. Provides the client with foods high in fiber and low in salt.
Correct Answer: A
Rationale: Ketorolac, an NSAID, can worsen renal function in PKD and requires follow-up.
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).