Nokea
The nurse is teaching a client about a urologic diagnostic procedure. Which teaching philosophy provides the best manner to present the information to the client?
- A. Stand beside the client and direct all information in the client's direction.
- B. Begin with the information most difficult to understand.
- C. Include humorous pictures to lighten the mood.
- D. Move from general details of the procedure to specifics.
Correct Answer: D
Rationale: Move from the general aspects such as purpose of the procedure to specifics including how the client will assist in the procedure. Doing so provides a foundation of knowledge and proceeds to more specific information. The client is more willing to participate when knowing the rationale. Standing beside the client, particularly if the client is in bed or seated, is a position of power. Humorous pictures do not convey the importance of the procedure or client participation.
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The nurse reviews a client's history and notes that the client has a history of hyperparathyroidism. The nurse would identify that this client most likely would be at risk for which of the following?
- A. Kidney stones
- B. Neurogenic bladder
- C. Chronic renal failure
- D. Fistula
Correct Answer: A
Rationale: A client with hyperparathyroidism is at risk for kidney stones. The client with diabetes mellitus is a risk factor for developing chronic renal failure and neurogenic bladder. A client with radiation to the pelvis is at risk for urinary tract fistula.
A nurse is describing the renal system to a client with a kidney disorder. Which structure would the nurse identify as emptying into the ureters?
- A. Nephron
- B. Renal pelvis
- C. Parenchyma
- D. Glomerulus
Correct Answer: B
Rationale: The renal pelvis empties into the ureter which carries urine to the bladder for storage. The nephron consists of the glomerulus, afferent arteriole, efferent arteriole, Bowman's capsule, distal and proximal convoluted tubules, the loop of Henle, and collecting tubule. The nephron is located in the cortex and carries out the functions of the kidney. The parenchyma is made up of the cortex and medulla.
The nurse is caring for a client who has presented to the walk-in clinic. The client verbalizes pain on urination, feelings of fatigue, and diffuse back pain. When completing a head-to-toe assessment, at which specific location would the nurse assess the client's kidneys for tenderness?
- A. The upper abdominal quadrants on the left and right side
- B. The costovertebral angle
- C. Above the symphysis pubis
- D. Around the umbilicus
Correct Answer: B
Rationale: The nurse is correct to assess the kidneys for tenderness at the costovertebral angle. The other options are incorrect.
The nurse is caring for an 84-year-old client who is being admitted for diagnostic studies for a potential renal disorder. The nurse planning care has initiated a care plan of 'knowledge deficiency related to poor understanding of diagnostic studies as manifested by client statements of not understanding diagnostic procedures and elevated anxiety.' Which nursing intervention(s) does the nurse include in the plan of care?
- A. Assess client's level of understanding.
- B. Provide written reading material.
- C. Remain with client and answer questions.
- D. Administer an ordered sedative.
- E. Use simple language.
- F. Direct instruction to family.
Correct Answer: A,C,D,E
Rationale: The nurse is caring for a client who is unsure of the diagnostic study and is anxious. The nursing interventions to assist the client begin with understanding knowledge base following an assessment of understanding. Next, remaining with client and answering questions in simple terms alleviates anxiety and opens teaching and communication. If all consents are signed, an ordered sedative may diminish client anxiety. Providing written material at this time is not helpful and may increase anxiety. All instruction should be primarily directed toward the client but include all family members.
A gerontologic consideration of aging is the decreased ability to concentrate urine. This consideration leads to an increased susceptibility to dehydration further complicated by a deficit in thirst. Which nursing action would be most appropriate to address this concern?
- A. Encourage the client to decrease fluid intake.
- B. Instruct the client to double void.
- C. Offer the client use of the bathroom.
- D. Monitor the client for signs of drug toxicity.
Correct Answer: C
Rationale: A dull sound when percussing over the bladder indicates a full bladder. Because the bladder is full, the nurse would offer the client use of the bathroom. Tenderness over the kidney can indicate an infection or stones. Bruits are an abnormal vascular sound that does not indicate the need to use the bathroom. Ingesting water does not mean that the client has to void at this time.