Nokea
The patient with nephrosis questions the need for bed rest. How would the nurse explain the benefit of bed rest?
- A. The recumbent position may initiate diuresis.
- B. It preserves the skin integrity.
- C. It lowers the level of albuminuria.
- D. It saves stress on joints.
Correct Answer: A
Rationale: It is believed that the recumbent position helps initiate diuresis.
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A 56-year-old patient with cancer of the bladder is recovering from a cystectomy with an ileal conduit. Which aspect is an important nursing intervention of the patient with an ileal conduit?
- A. Instructing the patient to report mucus from the stoma
- B. Maintaining skin integrity
- C. Limiting oral intake to 1000 mL/day
- D. Limiting acid-ash foods
Correct Answer: B
Rationale: Care of the patient with an ileal conduit is a nursing challenge because of the continual drainage of urine through the stoma. Complications of this procedure are wound infection, dehiscence, and urinary leakage. Maintaining skin integrity reduces the risk of infection. Mucus draining from the stoma is expected, due to secretions from the intestine. The patient is urged to drink adequate fluids to flush the conduit. Limiting acid-ash foods benefits some patients with kidney stones.
Which hormone from the posterior pituitary gland influences the amount of water that is eliminated with the urine?
- A. Pitocin
- B. Renin hormone
- C. Antidiuretic hormone (ADH)
- D. ACTH
Correct Answer: C
Rationale: ADH causes the cells of the distal convoluted tubules to increase their rate of water reabsorption.
In which way will the nurse instruct the patient to do before obtaining the urine specimen for a urine culture?
- A. Collect the urine for a 24-hour period.
- B. Obtain a clean-catch specimen.
- C. Bring in an early morning specimen.
- D. Limit fluid intake to concentrate the urine.
Correct Answer: B
Rationale: Urine cultures are dependent on a clean-catch or catheterized specimen.
A patient, age 78, has been admitted to the hospital with dehydration and electrolyte imbalance. The patient is confused and incontinent of urine on admission. Which nursing intervention does the nurse expect to see in the plan of care?
- A. Restrict fluids after the evening meal.
- B. Insert an indwelling catheter.
- C. Assist the patient to the bathroom every 6 hours.
- D. Apply absorbent incontinence pads.
Correct Answer: D
Rationale: Use of protective undergarments may help to keep the patient and the patient's clothing dry. Patients who are confused are high risk for falls. Restricting fluids will only decrease incontinence during the night and will exacerbate the dehydration and electrolyte imbalance.
An intravenous pyelogram confirms the presence of a large renal calculus in the proximal left ureter of a newly admitted patient. The patient is not a candidate for conservative measures, so surgical correction is recommended. In addition to observing the patient for hemorrhage, which aspect of care will be the nurse's postsurgical interventions included for this patient?
- A. Encouraging fluid intake
- B. Addressing anxiety related to unclear outcome of condition
- C. Monitoring the patient for signs of prostatic hypertrophy
- D. Recommending appropriate oral analgesics to the health care provider
Correct Answer: A
Rationale: After surgery, encourage fluid intake to prevent infection and to prevent further stones from developing.