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    Exam Review

    1. A 42-year-old woman is admitted with complaints of dysuria, frequency, and lower back pain. The urinalysis report is positive for red blood cells and the blood work shows an elevated white blood cell count. Which medication will the nurse anticipate that the healthcare provider will order.
      A)Bethanechol chloride.
      B)Meperidine.
      C)Metronidazole.
      D)Ciprofloxacin.
    2. Which statement by a patient on dialysis, taking gentamicin, should cause the nurse the most concern.
      A)I am thirsty and I cannot get enough water.
      B)I have a horrible headache.
      C)I have had diarrhea once or twice today.
      D)Speak up, I cannot hear you.
    3. What discharge teaching is appropriate for the nurse to provide to a patient who has had a lithotripsy.
      A)Watch for stone debris in the urine in 1 to 4 weeks.
      B)Decrease fluid intake to 1000 milliliters per day.
      C)Remain on restricted activity for a week.
      D)Check for edema of the legs and ankles.
    4. A nurse is caring for a client who has end-stage kidney disease who will soon begin hemodialysis treatments. Which of the following restrictions should the nurse discuss with the client that may impact quality of life.(SATA)
      A)Restricting foods high in potassium, sodium, and phosphorus.
      B)Driving restrictions.
      C)Limiting social activities to twice a week.
      D)Restricting fluid intake.
      E)Time constraints.
      F)Restricting airplane travel.
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    Exam Review

    1. A nurse is collecting data from a hospital patient who has been admitted with pyelonephritis. He is acutely ill with a high fever, chills, nausea, and vomiting. He also has severe pain in the flank area. What is the primary goal of treatment.
      A)Provide adequate nutrition with a stable body weight.
      B)Give pain relief with analgesics and antispasmodics.
      C)Prevent further damage to his kidneys that could lead to renal failure.
      D)Provide adequate hydration with pulse and blood pressure within patient norms.
    2. A nurse is reinforcing teaching with a client who has kidney stones. Which of the following instructions should the nurse include.
      A)Limit your calcium intake.
      B)Drink 1 liter of fluid each day.
      C)Filter your urine each day.
      D)Choose sugar-sweetened beverages.
    3. What is the action of urinary antimicrobial agents.
      A)Have an antiseptic effect on the urine and the urinary tract.
      B)Eliminate urinary retention.
      C)Enhance output enough to flush out the infection from the urinary tract.
      D)Reduce pain associated with bladder spasms caused by the infection.
    4. A nurse assesses a Grey Turner sign in a patient who was admitted 2 days earlier after an automobile accident. What does this finding indicate.
      A)Bladder spasms on palpation of abdomen.
      B)Hematuria with abdominal bruising.
      C)Distended bladder with painful urination.
      D)Retroperitoneal bleeding and bruising over the flank.
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    Exam Review

    1. When collecting a urine specimen, the nurse notices dark red urine. What condition may this indicate?
      A)Excessive red meat in the patient's diet.
      B)Bleeding from the kidney.
      C)Bleeding from the lower urinary tract.
      D)Dehydration.
    2. A patient on dialysis asks why he is receiving aluminum hydroxide gel (Amphojel), a phosphate binder, for his renal disorder. What should the nurse explain regarding the action of that Amphojel?
      A)Increases the appetite.
      B)Calms the frequent upset stomach experienced by patients on dialysis.
      C)Binds with phosphorus to increase the serum calcium level.
      D)Corrects the pH of the bowel.
    3. A nurse reviews the medication prescriptions for a client with chronic kidney disease (CKD). Which of the following prescriptions should the nurse ask about due to the potential to worsen the client's renal function?
      A)Folic acid supplement daily.
      B)Lisinopril 10 mg orally daily to control hypertension.
      C)Ibuprofen 400 mg orally every 6 hours as needed for pain.
      D)Epoetin alfa subcutaneously three times weekly.
    4. A nurse is assessing a patient with renal impairment. Which facial characteristic is a sign of fluid retention?
      A)Periorbital edema.
      B)Rash on cheeks and neck.
      C)Broken blood vessels around the nose.
      D)Facial twitching.
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    Exam Review

    1. What is the usual cause of the autoimmune disease of acute glomerulonephritis?
      A)Streptococcal infection.
      B)Childhood disease of mumps.
      C)Recent wound infection.
      D)Frequent cystitis.
    2. The nurse is teaching a patient about the anticholinergic agent prescribed for urinary retention. Which statement by the patient indicates a need for further teaching?
      A)I will not drive if I develop blurred vision.
      B)I will limit my fluid intake.
      C)I will eat fresh fruits.
      D)I will chew gum to relieve dry mouth.
    3. A patient with chronic kidney disease (CKD) is admitted with fatigue, peripheral edema, and elevated blood pressure that is difficult to control with antihypertensives. Laboratory results show elevated blood urea nitrogen (BUN), creatinine, and hyperkalemia. Which nursing intervention should be prioritized to address the patient's current condition?
      A)Administer iron supplements immediately to treat anemia without further assessment.
      B)Limit protein intake drastically to prevent further kidney damage without consulting dietitian.
      C)Encourage increased oral fluid intake to promote kidney filtration and reduce creatinine levels.
      D)Administer prescribed diuretics to reduce fluid overload and monitor potassium levels closely.
    4. A patient comes to the medical clinic with complaints of urgency, frequency, pain in the area of the symphysis pubis, and dark cloudy urine. What should the nurse suspect that this patient has?
      A)Interstitial cystitis.
      B)Kidney infection, most likely pyelonephritis.
      C)Cystitis, probably from bacterial contamination.
      D)Urinary calculi, probably located in the ureter.
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    Exam Review

    1. A patient has a nephrostomy tube that has been inserted because of an obstruction in the ureter. What special precautions in the care of the nephrostomy tube should the nurse implement?
      A)Instilling no more than 50 mL of sterile water if sterile irrigations are ordered.
      B)Being certain the tube is connected, not kinked, or not clamped to ensure that it continually drains.
      C)Clamping every 2 hours to allow expansion of the kidney pelvis.
      D)Leaving the nephrostomy site open to air.
    2. During a home visit, a nurse observes a patient performing a peritoneal dialysis exchange. Which technique observed by the nurse indicates that the patient requires additional teaching?
      A)The patient measures and documents vital signs and daily weight before and after dialysis exchanges.
      B)The patient inspects the catheter insertion site daily for redness, swelling, or discharge and reports any abnormalities.
      C)The patient uses sterile gloves and performs meticulous hand hygiene before connecting the dialysis catheter.
      D)The patient drains the dialysate bag onto the floor and replaces it with a fresh bag without cleaning the floor first.
    3. A nurse is performing frequent catheterizations for residual urine. What causes the greatest concern for the nurse?
      A)Causing urethral erosion.
      B)Introduction of pathogens into the bladder.
      C)Frequent genital exposure of the patient.
      D)Presence of the indwelling catheter.
    4. Which outcome is most necessary for a patient diagnosed with renal calculi?
      A)Patient will avoid infections and situations that would increase stress.
      B)Patient states an awareness of signs and symptoms of kidney stones.
      C)Patient is able to describe measures to prevent recurrence of calculi.
      D)Patient will measure intake and output so that they will be approximately equal.
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