Review Questions Flashcards

1
Q
Which medication taken at home by a 47 year old patient with decreased renal function will be of most concern to the nurse?
A. ibuprofen
B. warfarin
C. folic acid
D. penicillin
A

A. ibuprofen

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2
Q

The nurse completing a physical assessment for a newly admitted male patient is unable to feel either kidney on palpation. Which action should the nurse take next?
A. Obtain a urine specimen to check for hematuria
B. Document the information on the assessment form.
C. Ask the health care provider about scheduling a renal ultrasound.
D. Ask the patient about any history of recent sore throat.

A

B. Document the information on the assessment form.

Shouldn’t be able to palpate kidneys. Might be able to feel left kidney, but rarely.

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3
Q

The nurse caring for a patient after cystoscopy plans that the patient
A. learns to request narcotics for pain
B. understands to expect blood-tinged urine
C. restricts activity to bed rest for 4-6 hours
D. remains NPO for 8 hours to prevent vomiting

A

D. understands to expect blood-tinged urine.

Normal finding after cystoscopy.

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4
Q

A male patient in the clinic provides a urine sample that is red-orange in color. Which action should the nurse take first?
A. Notify the patient’s HCP
B. Teach correct midstream urine collection
C. Ask the patient about current medications
D. Question the patient about UTI risk factors

A

C. Ask the patient about current medications

Some medications can turn urine orange and stain items.

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5
Q
To assess whether there is any improvement in a patient's dysuria, which question will the nurse ask?
A. "Do you have to urinate at night?"
B, "Do you have blood in your urine?"
C. "Do you have to urinate frequently?"
D. "Do you have pain when you urinate?"
A

D. “Do you have pain when you urinate?”

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6
Q
A hospitalized patient with possible renal insufficiency after coronary artery bypass surgery is scheduled for a creatinine clearance test.  Which equipment will the nurse need to obtain?
A. Urinary catheter
B. Cleaning towelettes
C. Large container for urine
D. Sterile urine specimen cup
A

C. Large container for urine

24 hour urine collection

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7
Q

A 79 year old man has been admitted with benign prostatic hyperplasia. What is the most appropriate to include in the nursing plan of care?
A. Limit fluid intake to no more than 1000 mL/day
B. Leave a light on in the bathroom during the night
C. Ask the patient to use a urinal so that urine can be measured
D. Pad the patient’s bed to accommodate overflow incontinence

A

B. Leave a light on in the bathroom during the night

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8
Q
A patient has elevated BUN and serum creatinine levels.  Which bowel preparation order would the nurse question for this patient who is scheduled for a renal arteriogram?
A. Fleet enema
B. Tap-water enema
C. Senna/docusate (Senokot-5)
D. Bisacodyl (Dulcolax) tablets
A

B. Tap-water enema

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9
Q
Which information from a patient's urinalysis requires that the nurse notify the health care provider?
A. pH 6.2
B. Trace protein
C. WBC 20 - 26/hpf
D. Specific gravity 1.021
A

C. WBC 20 - 26/hpf

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10
Q

A 46 year old female patient returns to the clinic with recurrent dysuria after being treated with trimethoprim and sulfamethoxazole (Bactrim) for 3 days. Which action will the nurse plan to take?
A. Teach the patient to take the prescribed Bactrim for 3 more days.
B. Remind the patient about the need to drink 1000 mL of fluids daily.
C. Obtain a midstream urine specimen for culture and sensitivity training.
D. Suggest that the patient take acetaminophen (Tylenol) to treat the symptoms,

A

A. Teach the patient to take the prescribed Bactrim for 3 more days.

Need to take all of the antibiotics to treat the infection. 3 days alone is not enough.

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11
Q
It is most important that the nurse ask a patient admitted with acute glomerulonephritis about:
A. history of kidney stones
B. recent sore throat and fever
C. history of high blood pressure
D. frequency of bladder infections
A

B. recent sore throat and fever

Glomerulonephritis can occur from forms of streptococcus

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12
Q

A 28 year old male patient is diagnosed with polycystic kidney disease. Which information is most appropriate for the nurse to include in teaching at this time?
A. Complications of renal transplantation
B. Methods for treating severe chronic pain
C. Discussion of options for genetic counseling
D. Differences between hemodialysis and peritoneal dialysis

A

C. Discussion of options for genetic counseling

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13
Q

A 68 year old female patient admitted to the hospital with dehydration is confused and incontinent of urine. Which nursing action will be best to include in the plan of care?
A. Restrict fluids between meals and after the evening meal
B. Apply absorbent incontinent pads liberally over the bed linens
C. Insert an indwelling catheter until the symptoms have resolved
D. Assist the patient to the restroom every 2 hours during the day

A

D. Assist the patient to the restroom every 2 hours during the day

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14
Q

A patient is scheduled for cystometrography. Which instructions will the nurse provide to the patient about this procedure?
A. Pt will urinate into a specialized toilet to measure voiding pressure
B. Water will be instilled into the bladder through a catheter to assess bladder tone
C. Pt will urinate into a container to measure the time and volume of urine excretion
D. Bladder will be filled with contrast media, and fluoroscopic images will be taken during voiding

A

B. Water will be instilled into the bladder through a catheter to assess bladder tone

Cystometrography is an evaluation of bladder tone, sensations of filling, and bladder stability. Water or saline is instilled into the bladder through a urinary catheter.

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15
Q
The nurse is caring for a patient who has just undergone a cystoscopy.  Which assessment finding necessitates an immediate intervention by the nurse?
A. Back pain
B. Bright red urine
C. Urinary frequency
D. Burning on urination
A

B. Bright red urine

Bright red urine is not expected after a cystoscopy. Burning on urination, pink-tinged urine, and urinary frequency are expected effects.

during lecture teacher said A

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16
Q

The nurse identifies that the patient with the greatest risk for a UTI is
A. 37 year old man with renal colic associated with kidney stones
B. 26 year old pregnant woman who has a history of UTI
C. 69 year old man who has urinary retention caused by BPH
D. 72 year old woman hospitalized with a stroke who has a urinary catheter because of urinary incontinence

A

D. 72 year old woman hospitalized with a stroke who has a urinary catheter because of urinary incontinence

17
Q

A 48 year old patient with stage 2 CKD is scheduled for an IVP. Which order for the patient will the nurse question?
A. NPO for 6 hours before procedure
B. Ibuprofen (Advil) 400 mg PO PRN for pain
C. Dulcolax suppository 4 hours before procedure
D. Normal saline 500 mL IV infused before procedure

A

B. Ibuprofen (Advil) 400 mg PO PRN for pain

Chronic kidney disease: so do not add anything to irritate kidneys like ibuprofen, NSAIDs especially since you are adding the irritated of dye from the IVP (intravenous pyelogram)

18
Q
A 37 year old female patient hospitalized with acute kidney injury (AKI).  Which information will be most useful to the nurse in evaluating improvement in kidney function?
A. Blood urea nitrogen (BUN)
B. Creatinine level
C. Glomerular filtration rate (GFR)
D. Urine volume
A

C. Glomerular filtration rate (GFR)

Direct analysis of kidney function

19
Q

When caring for a patient with a left arm arteriovenous fistula, which action will the nurse include in the plan of care to maintain the patency of the fistula?
A. Auscultate for a bruit at the fistula site
B. Assess the quality of the left radial pulse
C. Compare BPs in left and right arms
D. Irrigate fistula site with saline q 8-12 hours

A

A. Auscultate for a bruit at the fistula site

Bruit and positive thrill show site is patent

20
Q

A 64 year old male patient who has progressive CKD for several years has just begun regular hemodialysis. Which information about diet will the nurse include in patient teaching?
A. Increased calories are needed because glucose is lost during hemodialysis
B. Unlimited fluids are allowed because retained fluid is removed during dialysis
C. More protein is allowed because urea and creatinine are removed by dialysis
D. Dietary potassium is not restricted because the level is normalized by dialysis

A

C. More protein is allowed because urea and creatinine are removed by dialysis

21
Q
The nurse in the dialysis clinic is reviewing the home medications of a patient with CKD.  Which medication reported by the patient indicates that patient teaching is required?
A. Multivitamin with iron
B. Calcium phosphate (PhosLo)
C. Acetaminophen (Tylenol)
D. Magnesium hydroxide
A

D. Magnesium hydroxide

22
Q
A 55 year old patient with ESKD is scheduled to receive a prescribed does of epoetin alfa.  Which information should the nurse report to the HCP before giving the medication?
A. Creatinine 1.6 mg/dL
B. Oxygen saturation 89%
C. Hemoglobin level 13 g/dL
D. BP 98/56 mmHg
A

C. Hemoglobin level 13 g/dL

Hemoglobin level is normal. No need for epoetin alfa.

23
Q
A 72 year old patient with a history of BPH is admitted with acute urinary retention and elevated BUN and creatinine levels.  Which prescribed therapy should the nurse implement first?
A. Insert urethral catheter
B. Obtain renal ultrasound
C. Draw CBC
D. Infuse normal saline at 50 mL/hr
A

A. Insert urethral catheter

24
Q

A 42 year old patient admitted with AKI due to dehydration has oliguria, anemia, and hyperkalemia. Which prescribed actions should the nurse take first?
A. Insert a urinary retention catheter
B. Give sodium polystyrene sulfonate
C. Administer epoetin alfa
D. Place the patient on a cardiac monitor

A

D. Place the patient on a cardiac monitor

25
Q
During routine hemodialysis, the 68 year old patient complains of N/V.  Which action should the nurse take first?
A. Slow down the rate of dialysis
B. Check patient's BP
C. Review the Hct level
D. Give prescribed PRN antiemetic drugs
A

B. Check patient’s BP

Assess, assess, assess. Assess first before doing interventions.

26
Q

After receiving change-of-shift report, which patient should the nurse assess first?
A. Patient who is scheduled for the drain phase of a peritoneal dialysis exchange
B. Patient with stage 4 CKD who has an elevated phosphate level
C. Patient with stage 5 CKD who has a potassium level of 3.4 mEq/L
D. Patient who has just returned from having hemodialysis and has a HR of 124/min

A

D. Patient who has just returned from having hemodialysis and has a HR of 124/min

Why is HR so high? What is going on? Others will be fine and can wait for assessments