Nokea
The nurse is developing a nursing care plan for the client diagnosed with CKD. Which nursing problem is priority for the client?
- A. Low self-esteem.
- B. Knowledge deficit.
- C. Activity intolerance.
- D. Excess fluid volume.
Correct Answer: D
Rationale: Excess fluid volume is the priority in CKD due to impaired kidney excretion, leading to edema, hypertension, and heart failure risk. Fluid overload is a life-threatening issue, whereas self-esteem, knowledge, and activity intolerance are secondary.
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The client with a TURP who has a continuous irrigation catheter complains of the need to urinate. Which intervention should the nurse implement first?
- A. Call the surgeon to inform the HCP of the client’s complaint.
- B. Administer the client a narcotic medication for pain.
- C. Explain to the client this sensation happens frequently.
- D. Assess the continuous irrigation catheter for patency.
Correct Answer: D
Rationale: The urge to urinate may indicate a blocked catheter due to clots. Assessing patency ensures proper function and addresses the cause. Explaining the sensation, notifying the surgeon, or giving narcotics are secondary.
The nurse is discussing kidney transplants with clients at a dialysis center. Which population is less likely to participate in organ donation?
- A. Caucasian.
- B. African American.
- C. Asian.
- D. Hispanic.
Correct Answer: B
Rationale: African Americans are statistically less likely to participate in organ donation due to cultural beliefs, mistrust in healthcare systems, and lower registration rates. Other groups have higher participation rates, though disparities exist across all populations.
When teaching a client with cystitis about urinary tract irritants, the nurse correctly identifies which of the following substances as potential irritants to avoid? Select all that apply.
- A. Alcohol
- B. Milk
- C. Tea
- D. Chocolate
- E. Coffee
- F. Pears
Correct Answer: A,C,E
Rationale: Alcohol, tea, and coffee are bladder irritants that can exacerbate cystitis symptoms, while milk and pears are generally neutral.
The client diagnosed with cancer of the bladder states, 'I have young children. I am too young to die.' Which statement is the nurse’s best response?
- A. This cancer is treatable and you should not give up.'
- B. Cancer occurs at any age. It is just one of those things.'
- C. You are afraid of dying and what will happen to your children.'
- D. Have you talked to your children about your dying?'
Correct Answer: C
Rationale: Reflecting the client’s fear of dying and concern for their children validates emotions and encourages dialogue. Reassurance, generalizing cancer, or prompting child discussions may dismiss the client’s feelings.
The nurse writes the client problem of 'fluid volume excess' (FVE). Which intervention should be included in the plan of care?
- A. Change the IV fluid from 0.9% NS to D5W.
- B. Restrict the sodium in the client’s diet.
- C. Monitor blood glucose levels.
- D. Prepare the client for hemodialysis.
Correct Answer: B
Rationale: Restricting sodium reduces fluid retention in FVE, as sodium promotes water reabsorption. D5W provides free water, worsening FVE; glucose monitoring is unrelated; and hemodialysis is reserved for severe cases.