Nokea
Which problem is the nurse's immediate concern after kidney transplant surgery?
- A. Risk for infection
- B. Fluid overload
- C. Hypotension
- D. Pain management
Correct Answer: A
Rationale: Risk for infection is the immediate concern post-transplant due to immunosuppression, which increases susceptibility to infections.
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The client diagnosed with ARF is admitted to the intensive care department and placed on a therapeutic diet. Which diet is most appropriate for the client?
- A. A high-potassium and low-calcium diet.
- B. A low-fat and low-cholesterol diet.
- C. A high-carbohydrate and restricted-protein diet.
- D. A regular diet with six (6) small feedings a day.
Correct Answer: C
Rationale: ARF patients require a restricted-protein diet to reduce urea production and a high-carbohydrate diet to provide energy, minimizing protein catabolism. High-potassium diets are contraindicated due to hyperkalemia risk, and low-fat or regular diets are less specific.
Which nursing assessment is essential to add to the client's care plan?
- A. Monitor body temperature.
- B. Measure intake and output.
- C. Assess for urine retention.
- D. Check the urine for glucose.
Correct Answer: B
Rationale: Measuring intake and output is critical in renal failure to monitor fluid balance and kidney function.
The client diagnosed with diabetes insipidus weighed 180 pounds when the daily weight was taken yesterday. This morning’s weight is 175.6 pounds. One liter of fluid weighs approximately 2.2 pounds. How much fluid has the client lost?
Correct Answer: 2 L
Rationale: Weight loss: 180 - 175.6 = 4.4 pounds. Fluid loss: 4.4 pounds ÷ 2.2 pounds/L = 2 L. This calculation accounts for fluid loss typical in diabetes insipidus due to excessive urination.
Which of the following measures performed by the client would offer the best protection against acquiring a urinary tract infection?
- A. Wiping away from the urinary meatus after bowel elimination
- B. Performing appropriate hand washing after bowel elimination
- C. Using a feminine hygiene spray after bowel elimination
- D. Drying the perineum thoroughly after bowel elimination
Correct Answer: A
Rationale: Wiping away from the urinary meatus prevents fecal bacteria from being introduced into the urethra, reducing UTI risk.
The nurse performs bladder irrigation through an indwelling catheter. The nurse instilled 90 mL of sterile normal saline. The catheter drained 710 mL. What is the client’s output?
Correct Answer: 620 mL
Rationale: Urine output = Total drainage - Irrigation fluid instilled = 710 mL - 90 mL = 620 mL. This isolates the client’s actual urine production from the irrigation fluid.