Nokea
Which nursing intervention promotes the spontaneous passage of ureteral stones?
- A. Encouraging ambulation as tolerated
- B. Restricting fluid intake
- C. Administering diuretics
- D. Keeping the client on bed rest
Correct Answer: A
Rationale: Encouraging ambulation promotes gravity-assisted stone movement through the ureter, facilitating spontaneous passage.
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Which diagnostic test, considered a sensitive indicator of advanced kidney disease, will need to be closely monitored by the nursing team?
- A. Serum creatinine level
- B. Serum sodium level
- C. Uric acid level
- D. Urine specific gravity
Correct Answer: A
Rationale: Serum creatinine is a sensitive indicator of kidney function, as it rises with advanced kidney disease due to impaired filtration.
The nurse is inserting an indwelling catheter into a female client. Which interventions should be implemented? Rank in the order of performance.
- A. Explain the procedure to the client.
- B. Set up the sterile field.
- C. Inflate the catheter bulb.
- D. Place absorbent pads under the client.
- E. Clean the perineum from clean to dirty with Betadine.
Correct Answer: A,D,B,E,C
Rationale: Correct order: 1) Explain the procedure to gain consent and reduce anxiety; 2) Place absorbent pads to maintain a clean field; 3) Set up the sterile field to prepare equipment; 4) Clean the perineum (front to back, not clean to dirty, assuming document error) to reduce infection risk; 5) Inflate the catheter bulb after insertion to secure it.
The nurse is preparing a teaching care plan for the client diagnosed with nephrotic syndrome. Which intervention should the nurse include?
- A. Stop steroids if a moon face develops.
- B. Provide teaching for taking diuretics.
- C. Increase the intake of dietary sodium.
- D. Report a decrease in daily weight.
Correct Answer: B
Rationale: Diuretics are commonly prescribed in nephrotic syndrome to manage edema. Teaching proper diuretic use (e.g., timing, side effects like hypokalemia) is essential. Stopping steroids for moon face is incorrect, increasing sodium worsens edema, and weight loss is expected, not a concern.
The client who has undergone an exploratory laparotomy and subsequent removal of a large intestinal tumor has a nasogastric tube (NGT) in place and an IV running at 150 mL/hr via an IV pump. Which data should be reported to the HCP?
- A. The pump keeps sounding an alarm indicating the high pressure has been reached.
- B. Intake is 1,800 mL, NGT output is 550 mL, and Foley output is 950 mL.
- C. On auscultation, crackles and rhonchi in all lung fields are noted.
- D. Client has negative pedal edema and an increasing level of consciousness.
Correct Answer: C
Rationale: Crackles and rhonchi suggest pulmonary edema, a critical complication possibly due to fluid overload, requiring immediate HCP notification. Pump alarms, intake/output, and edema status are less urgent unless associated with other critical findings.
Which of the following findings is the most significant information to report when caring for a client undergoing peritoneal dialysis?
- A. Loss of body weight
- B. Decreased serum creatinine
- C. Elevated body temperature
- D. Output that exceeds intake
Correct Answer: C
Rationale: An elevated body temperature may indicate infection, a serious complication of peritoneal dialysis, and must be reported.