Nokea
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.
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The client asks, 'What does an elevated PSA test mean?' On which scientific rationale should the nurse base the response?
- A. An elevated PSA can result from several different causes.
- B. An elevated PSA can be only from prostate cancer.
- C. An elevated PSA can be diagnostic for testicular cancer.
- D. An elevated PSA is the only test used to diagnose BPH.
Correct Answer: A
Rationale: Elevated PSA can result from prostate cancer, BPH, prostatitis, or other factors, requiring further evaluation. It is not specific to prostate cancer, testicular cancer, or BPH diagnosis alone.
When the client with an ileal conduit expresses concern about odor, which recommendation by the nurse is most effective?
- A. Place an aspirin tablet in the pouch.
- B. Use a deodorizing pouch spray.
- C. Change the pouch daily.
- D. Avoid acidic foods.
Correct Answer: B
Rationale: Using a deodorizing pouch spray effectively controls odor, addressing the client's concern.
Which intervention should the nurse implement for the client who has had an ileal conduit?
- A. Pouch the stoma with a one (1)-inch margin around the stoma.
- B. Refer the client to the United Ostomy Association for discharge teaching.
- C. Report to the health-care provider any decrease in urinary output.
- D. Monitor the stoma for signs and symptoms of infection every shift.
Correct Answer: D
Rationale: Monitoring the stoma for infection (e.g., redness, discharge) prevents complications. Pouching requires a precise fit, not a 1-inch margin; ostomy referrals are secondary; and decreased output is monitored but not always reported immediately.
Which intervention should the nurse implement when caring for the client with a nephrostomy tube?
- A. Change the dressing only if soiled by urine.
- B. Clean the end of the connecting tubing with Betadine.
- C. Clean the drainage system every day with bleach and water.
- D. Assess the tube for kinks to prevent obstruction.
Correct Answer: D
Rationale: Assessing for kinks ensures patency of the nephrostomy tube, preventing urine backup and complications. Dressings are changed regularly, Betadine is not used for tubing, and bleach cleaning is inappropriate.
The nurse caring for a client diagnosed with CKD writes a client problem of 'noncompliance with dietary restrictions.' Which intervention should be included in the plan of care?
- A. Teach the client the proper diet to eat while undergoing dialysis.
- B. Refer the client and significant other to the dietitian.
- C. Explain the importance of eating the proper foods.
- D. Determine the reason for the client not adhering to the diet.
Correct Answer: D
Rationale: Determining the reason for noncompliance (e.g., lack of understanding, financial barriers) is the first step to tailor interventions effectively. Teaching, referrals, or explaining importance are secondary until the root cause is identified.