Nokea
The patient has end-stage renal disease (ESRD) and is admitted to the hospital with a blood urea nitrogen (BUN) level of 48 mg/dL. An excessive elevation of BUN could cause which problem?
- A. dehydration.
- B. disorientation.
- C. edema.
- D. catabolism.
Correct Answer: B
Rationale: If the BUN is elevated, preventive nursing measures will be instituted to protect the patient from possible disorientation or seizures.
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A home health patient with end-stage renal disease (ESRD) verbalizes feeling helplessness related to this life-altering disease. Which nursing intervention would be most helpful?
- A. Ensure restricted protein intake to prevent nitrogenous product accumulation.
- B. Include the patient in making the plan of care.
- C. Counsel patient about end-of-life provisions.
- D. Write out a detailed schedule of health care provider's appointments.
Correct Answer: B
Rationale: Listen to the patient and allow time for discussion about concerns and the plan of care to return some sense of control. End-of-life discussions are premature and will not benefit the patient who is experiencing helplessness.
The patient is on postoperative day 1 after having undergone a Transurethral resection of the prostate (TURP) procedure. He has continuous bladder irrigation (CBI). Actual urine output during continuous bladder irrigation in which manner?
- A. measuring and recording all fluid output in the drainage bag.
- B. measuring the total output and deducting the total of the irrigating and intravenous solutions.
- C. adding the total of the intravenous and irrigating solutions and then deducting the amount of output.
- D. measuring total output and deducting the amount of irrigating solution used.
Correct Answer: D
Rationale: To determine urine output, the nurse will subtract the amount of irrigation fluid used with the Foley catheter output to calculate urine output.
A male patient, age 71, is recovering from a trans-urethral prostatic resection (TURP). The health care provider requests removal of the indwelling catheter 2 days after the TURP procedure. Which occurrence might the patient experience after the catheter is removed?
- A. Burning on urination
- B. Passing of blood clots in the urine
- C. Dribbling of urine
- D. Coffee-colored urine
Correct Answer: C
Rationale: The patient is informed that initially he may experience frequency and voiding small amounts with some dribbling. There should be no hematuria or clots after 2 days.
Which portion of the nephron is involved with filtration?
- A. Glomerulus of the Bowman capsule
- B. Henle loop
- C. Proximal convoluted tubule
- D. Distal convoluted tubule
Correct Answer: A
Rationale: Filtration of water and blood products occurs in the glomerulus of the Bowman capsule.
In the nephrotic syndrome, the glomeruli are damaged by inflammation and allow small ___ to pass through into the urine.
- A. proteins
Correct Answer: proteins
Rationale: In nephrotic syndrome, the glomeruli are damaged by inflammation and allow small proteins such as albumin to enter the urine. This creates a deficit of protein in the circulation volume (hypoalbuminemia), which leads to massive edema.