Nokea
Which clinical manifestations should the nurse expect to assess for the client diagnosed with a ureteral renal stone?
- A. Dull, aching flank pain and microscopic hematuria.
- B. Nausea; vomiting; pallor; and cool, clammy skin.
- C. Gross hematuria and dull suprapubic pain with voiding.
- D. The client will be asymptomatic.
Correct Answer: B
Rationale: Ureteral stones cause severe colicky pain, often with nausea, vomiting, pallor, and diaphoresis due to autonomic response. Flank pain and microscopic hematuria are more typical of renal pelvic stones, gross hematuria is less common, and stones are rarely asymptomatic.
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When the nurse is advising the client about the potential complications associated with peritoneal dialysis, which complication is most important to include?
- A. Pulmonary edema
- B. Abdominal peritonitis
- C. Abdominal hernia
- D. Ruptured aorta
Correct Answer: B
Rationale: Abdominal peritonitis is a significant and common complication of peritoneal dialysis due to the risk of infection.
The nurse is discussing kidney transplants with clients at a dialysis center. Which population is less likely to participate in organ donation?
- A. Caucasian.
- B. African American.
- C. Asian.
- D. Hispanic.
Correct Answer: B
Rationale: African Americans are statistically less likely to participate in organ donation due to cultural beliefs, mistrust in healthcare systems, and lower registration rates. Other groups have higher participation rates, though disparities exist across all populations.
While the fluid is being administered, which nursing assessment is most important?
- A. Checking for pedal edema
- B. Assessing the rapid weight gain
- C. Monitoring specific gravity
- D. Auscultating breath sounds
Correct Answer: D
Rationale: Auscultating breath sounds is critical during a fluid challenge to detect signs of fluid overload, such as pulmonary edema.
The clinic nurse is caring for a client diagnosed with chronic pyelonephritis who is prescribed trimethoprim-sulfamethoxazole (Bactrim), a sulfa antibiotic, twice a day for 90 days. Which statement is the scientific rationale for prescribing this medication?
- A. The antibiotic will treat the bladder spasms that accompany a urinary tract infection.
- B. If the urine cannot be made bacteria free, the Bactrim will suppress bacterial growth.
- C. In three (3) months, the client should be rid of all bacteria in the urinary tract.
- D. The HCP is providing the client with enough medication to treat future infections.
Correct Answer: B
Rationale: Chronic pyelonephritis often requires long-term antibiotics like Bactrim to suppress bacterial growth when complete eradication is not possible. It does not treat spasms, and 90 days may not eliminate all bacteria or be for future use.
The client diagnosed with ARF is placed on bedrest. The client asks the nurse, 'Why do I have to stay in bed? I don’t feel bad.' Which scientific rationale supports the nurse’s response?
- A. Bedrest helps increase the blood return to the renal circulation.
- B. Bedrest reduces the metabolic rate during the acute stage.
- C. Bedrest decreases the workload of the left side of the heart.
- D. Bedrest aids in reduction of peripheral and sacral edema.
Correct Answer: B
Rationale: Bedrest reduces the body’s metabolic demands, minimizing stress on the kidneys during the acute phase of ARF. It does not directly increase renal blood flow, reduce heart workload, or address edema in this context.