Nokea
The nurse is reviewing the results of a patient's urinalysis. Which of the following information indicates that the nurse should notify the health care provider?
- A. pH 6.2
- B. Trace protein
- C. WBC: 20-26/hpf
- D. Specific gravity: 1.021
Correct Answer: C
Rationale: The increased number of white blood cells (WBCs) indicates the presence of urinary tract infection or inflammation. Normal WBC result in a urinalysis report is 0-5/hpf. The other findings are normal.
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During assessment of a patient with decreased renal function, which of the following medications taken by the patient at home is of most concern to the nurse?
- A. Ibuprofen
- B. Warfarin
- C. Folic acid
- D. Penicillin
Correct Answer: A
Rationale: The nonsteroidal anti-inflammatory drugs (NSAIDs) are nephrotoxic and should be avoided in patients with impaired renal function. The nurse also should ask about reasons the patient is taking the other medications, but the medication of most concern is the ibuprofen.
Which of the following actions should the nurse plan to take first when admitting a patient who has a history of neurogenic bladder as a result of a spinal cord injury?
- A. Ask about the usual urinary pattern and any measures used for bladder control.
- B. Assist the patient to the toilet at scheduled times to help ensure bladder emptying.
- C. Check the patient for urinary incontinence every 2 hours to maintain skin integrity.
- D. Use intermittent catheterization on a regular schedule to avoid the risk of infection.
Correct Answer: A
Rationale: Before planning any interventions, the nurse should complete the assessment and determine the patient's normal bladder pattern and the usual measures used by the patient at home. All the other responses may be appropriate, but until the assessment is complete, an individualized plan for the patient cannot be developed.
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 preparing a patient with a decreased glomerular filtration rate for an intravenous pyelogram (IVP). Which of the following actions should be included in the plan of care?
- A. Monitor the urine output after the procedure.
- B. Assist with monitored anesthesia care (MAC).
- C. Give oral contrast solution before the procedure.
- D. Insert a large size urinary catheter before the IVP.
Correct Answer: A
Rationale: Patients with impaired renal function are at risk for decreased renal function after IVP because the contrast medium used is nephrotoxic, so the nurse should monitor the patient's urine output. MAC sedation and retention catheterization are not required for the procedure. The contrast medium is given intravenously, not orally.
The nurse is reviewing the result of a patient's creatinine clearance test which is 60 mL/minute. Which of the following values is the patient's glomerular filtration rate (GFR) in mL/minute?
- A. 30
- B. 60
- C. 120
- D. 240
Correct Answer: B
Rationale: The creatinine clearance approximates the GFR. The other responses are not accurate.