Nokea
The nurse is preparing the discharge teaching plan for the male client with a left-sided nephrectomy. Which statement indicates the teaching is effective?
- A. I can’t wait to start back to work next week, I really need the money.
- B. I will take my temperature and if it is above 101 I will call my doctor.
- C. I am glad I won’t have to keep track of how much I urinate in the day.
- D. I am happy I will be able eat what I usually eat, I don’t like this food.
Correct Answer: B
Rationale: Effective discharge teaching post-nephrectomy includes recognizing signs of infection, such as fever above 101°F, requiring prompt reporting. Returning to work too soon, not monitoring urine output, or resuming a normal diet may be incorrect.
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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.
When asked about factors that are linked to bladder cancer, the nurse correctly identifies which factors? Select all that apply.
- A. Stress incontinence
- B. Frequent intercourse
- C. Sexual promiscuity
- D. Cigarette smoking
- E. History of prostate cancer
- F. Exposure to asbestos
Correct Answer: D
Rationale: Cigarette smoking is a well-established risk factor for bladder cancer.
The client diagnosed with chronic renal failure (CRF) is prescribed a 60-gm protein, 2,000-mg sodium diet. Which food choices indicate the client understands the dietary restrictions?
- A. A 4-ounce grilled chicken breast, broccoli, and small glass of unsweet tea.
- B. A baked potato with chopped ham and sour cream, 12-ounce steak, and beer.
- C. A double patty cheeseburger, french fries, and saccharin sweet Kool Aid.
- D. A roast beef sandwich, potato chips, and soft drink.
Correct Answer: A
Rationale: A 4-oz chicken breast (≈28 g protein), broccoli, and tea are low-sodium and fit the 60-g protein, 2,000-mg sodium diet. Other options exceed protein/sodium limits with high-sodium foods (ham, cheeseburger, chips).
The clinic nurse is caring for a client diagnosed with chronic pyelonephritis who is prescribed trimethoprim-sulfamethoxazole (Bactrim), a sulfa antibiotic, twice a day for 90 days. Which statement is the scientific rationale for prescribing this medication?
- A. The antibiotic will treat the bladder spasms that accompany a urinary tract infection.
- B. If the urine cannot be made bacteria free, the Bactrim will suppress bacterial growth.
- C. In three (3) months, the client should be rid of all bacteria in the urinary tract.
- D. The HCP is providing the client with enough medication to treat future infections.
Correct Answer: B
Rationale: Chronic pyelonephritis often requires long-term antibiotics like Bactrim to suppress bacterial growth when complete eradication is not possible. It does not treat spasms, and 90 days may not eliminate all bacteria or be for future use.
Which symptom indicative of renal failure would the nurse expect to note when assessing this client?
- A. Anemia
- B. Hypotension
- C. Weight loss
- D. Fever
Correct Answer: A
Rationale: Anemia is a common symptom of renal failure due to decreased erythropoietin production by the kidneys.