Nokea
Which statement by the client indicates a need for further teaching about the management of urolithiasis?
- A. I will drink at least 3 liters of water daily.
- B. I will strain all my urine to collect any stones.
- C. I will take my pain medication as prescribed.
- D. I will avoid drinking water to reduce urine output.
Correct Answer: D
Rationale: Avoiding water intake is incorrect, as increased fluid intake is essential to promote stone passage and prevent recurrence.
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The client diagnosed with a fluid and electrolyte disturbance in the emergency department is exhibiting peaked T waves on the STAT electrocardiogram. Which interventions should the nurse implement? List in order of priority.
- A. Assess the client for leg and muscle cramps.
- B. Check the serum potassium level.
- C. Notify the health-care provider.
- D. Arrange for a transfer to the telemetry floor.
- E. Administer Kayexalate, a cation resin.
Correct Answer: B,C,E,D,A
Rationale: Peaked T waves indicate hyperkalemia. Priority: 1) Check potassium level to confirm; 2) Notify HCP for orders; 3) Administer Kayexalate to lower potassium; 4) Transfer to telemetry for monitoring; 5) Assess cramps, a less urgent symptom.
Immediately after the dialysate solution has been instilled, which nursing action is correct?
- A. Clamping the tubing from the infusion
- B. Draining the infused dialysate solution
- C. Restricting the client's movement as much as possible
- D. Encouraging the client to drink fluids
Correct Answer: A
Rationale: Clamping the tubing after instillation allows the dialysate to dwell, facilitating the exchange of waste products.
The nurse is caring for clients on a renal surgery unit. After the afternoon report, which client should the nurse assess first?
- A. The male client who just returned from a CT scan who states he left his glasses in the x-ray department.
- B. The client who is one (1) day postoperative and has a moderate amount of serous drainage on the dressing.
- C. The client who is scheduled for surgery in the morning and wants an explanation of the operative procedure before signing the permit.
- D. The client who had ileal conduit surgery this morning and has not had any drainage in the drainage bag.
Correct Answer: D
Rationale: No drainage in the ileal conduit bag post-surgery suggests obstruction or complications, risking urine backup and renal damage. This is critical. Lost glasses, serous drainage, and surgical education are less urgent.
The nurse is observing the UAP providing direct care to a client with an indwelling catheter. Which data warrant immediate intervention by the nurse?
- A. The UAP secures the tubing to the client’s leg with tape.
- B. The UAP provides catheter care with the client’s bath.
- C. The UAP puts the collection bag on the client’s bed.
- D. The UAP cares for the catheter after washing the hands.
Correct Answer: C
Rationale: Placing the collection bag on the bed risks contamination and infection, as it should be below bladder level and off surfaces. Securing tubing, providing care during bathing, and hand washing are appropriate.
When performing a physical assessment, which sensation would the nurse expect to detect when palpating the site of the arteriovenous fistula?
- A. A pulse
- B. A bruit
- C. A thrill
- D. A click
Correct Answer: C
Rationale: A thrill, a buzzing sensation, is expected when palpating a functioning arteriovenous fistula, indicating proper blood flow.