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Which action is most appropriate on a patient with high BP who is asymptomatic and coming from ED in 20 minutes?
A. Have UAP admit the new patient while you administer IV metoprolol
B. Call ED and have them hold the patient until you have assessed all of your current patients
C. Ask the charge nurse to give the IV metoprolol while you complete your assessments on your other patients
D. Go assess your other patients. Since pt. is asymptomatic so you can wait to give the metoprolol
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Terms in this set (66)
Which action is most appropriate on a patient with high BP who is asymptomatic and coming from ED in 20 minutes?
A. Have UAP admit the new patient while you administer IV metoprolol
B. Call ED and have them hold the patient until you have assessed all of your current patients
C. Ask the charge nurse to give the IV metoprolol while you complete your assessments on your other patients
D. Go assess your other patients. Since pt. is asymptomatic so you can wait to give the metoprolol
C
Which problem has the highest priority when planning care for a patient with kidney stones?
A. Acute pain
B. Risk for infection
C. Risk for injury
D. Impaired coping
A
You begin a scheduled infusion of ceftriaxone. Which parameters are most important to monitor while the patient is receiving this drug?
A. PT and INR
B. BUN and creatinine
C. CBC and differential
D. Liver function studies
B
Which statement would be most appropriate when teaching about her Kidney disease?
A. "The damage to your kidneys will likely require dialysis"
B. "You will need to be in the hospital for a 2 week course of IV antibiotic"
C. "It is very important that you maintain adequate hydration to flush your kidneys"
D. "You will not need further antibiotic once you are discharged from the hospital"
C
55 y/o woman who is morbid obesity and 2 days post-op knee surgery. There is a strong scent of urine when you enter the room. There is a bedside commode and a bedpan in the room. What should you do first?
A. Instruct AP to assist patient with hygiene
B. Try to determine the source of the urine odor
C. Check records for urine output and the nurses notes for problems with voiding
D. Review the medical records for the history or urinary incontinence
B
For Mrs S, which tasks related to urinary incontinence would be delegated to the UAP? SELECT ALL
A. Assist the patient ro use bedpan as needed
B. Empty and Clean the commode chair after every use
C. Assist the patient to don and change absorbent pads or undergarments as needed
D. Assist the patient to get up to the bedside commode whenever she calls for help
E. Frequently check the bed linens and the patient clothes for moisture and change as needed
F. Coach the patient to perform kegel exercises
A B C E
Which orders related to the urinary system would you question? Select all
A. Insert an indwelling urinary catheter with a urometer
B. Measure I&O every hour
C. obtain a urine sample for urinalysis
D. perform crede maneuver every 4 hrs
E. up to bedside commode with assistance as needed
F. Apply skin barrier paste to perineal area as needed
A B D
Mr. A is a 70 year old man with Alzheimer who was admitted with pneumonia. The family reports that he is usually independent with ADLs at home, but has been very confused in the hospital. You find him urinating in the corner of his room. What is the priority response?
A. "would you be willing to wear a condom catheter and leg bag so that we can keep your dry"
B. "If you feel like you need to urinate, just push the call button and someone will come help you."
C. "Let me help you clean up and then I will call your family to come and sit with you"
D. "Mr. A, you are in the hospital. I am your nurse. The doctor is treating you for pneumonia."
D
The nurse plans to try habit training with Mr. A to address his functional incontinence. Which task would be best to delegate to the UAP?
A. Observe patient for toileting habits and behavior
B. Encourage the patient to consume extra fluid in the morning
C. Assist patient to the toilet on a regular schedule
D. Check clothes every 2 hours for moisture or odor
C
Mr. A urinates in the bed and his daughter is very upset. "He never said he wanted to pee. You people should do something! You are responsible for taking care of him!" What is the best way to handle this situation?
A. instruct the UAP to clean up MR. A and then stay with the patient
B. clean up Mr. A yourself and have the daughter speak with the patient advocate
C. instruct the UAP to clean up MR. A while you obtain an order for an indwelling catheter
D. Clean up Mr. A and then talk to the daughter about the ways the staff/family can help
D
Mrs B. has marked the menu for tomorrow's breakfast, which selection is most likely to prompt the nurse to teach about nutrition therapy for urge incontinence? A. Two soft-boiled eggs with butter B. Large coffee with artificial sweetener C. Sliced mixed fruit with yogurt D. Oatmeal with milk and raisinsBYou are working as the charge nurse in the ED when a 60 y/o who has had N/V for the last 2 days arrives. Vitals T 101.8, P 112, RR 24, BP 88/60. Which action prescribed by the HCP will you implement first? A. give metoclopramide 10 mg IV B. Infuse 1 L of normal saline over 60 min C. Draw blood for complete blood count and blood chemistries D. Administer acetaminophen (tylenol) 650 mg rectal suppositoryBThe patient was admitted to the medical unit with a diagnosis of dehydration. 48 hr later you are reviewing the results of today's diagnostic testing. Which result is most important to report to the HCP? A. Blood urea nitrogen (BUN) 76 mg/dL B. Hematocrit 33% C. serum POTASSIUM 7.2 mEq/L D. GFR 25CWhich assessment finding for this patient with sepsis is the most important report to the HCP? A. HR of 46 and prolonged QRS duration B. Crackles at lung bases and peripheral edema C. Confusion and 1+ deep tendon reflexes D. Nausea and abdominal distentionAHCP prescribed these orders. Which will you implement first? A. Decrease IV fluids from 100mL to 50 mL/hr B. Administer calcium chlorides 1000 mg IV C. Give sodium polystyrene sulfonate (kayexalate) 15 g D. Notify the dialysis department to prepare for CCRTCPt is treated with hyperkalemia and continuous renal replacement is initiated. Which actions will you delegate to the UAP who are working with you to care for this patient? SELECT ALL A. Replace EKG legs B. Check the dialysis tubing for clot formation C. Monitor changes in orientation D. Inspect the oral mucosa for dryness or cracking E. Obtain BP and UO hourlyA EWhich lab results are most important for the nurse to communicate to HCP? A. Electrolytes B. BUN and creatinine C. Lactate and glucose level D. WBC count and hematocritAHCP prescribed these diagnostic tests. Which test will be most important for the nurse to question? A. Bladder scan B. Bilateral renal ultrasonography C. Abdominal CT scan with and without contrast D. X-ray of the kidneys, ureters, and bladder (KUB)CPt is admitted with diagnosis of dehydration and possible AKI, and with instructions from the HCP to "continue patients usual home medications." Which medications will the nurse need to discuss with the HCP prior to administering? SELECT ALL A. Lisinopril 10 mg/day B. Citalopram 10 mg/day C. Gabapentin 800 mg TUD D. Ibuprofen 200 mg every 6 hrs PRN E. Acetaminophen 850 mg every 8 hr F. Hydrochlorothiazide 25 mg/dayA D FPt is 54 y/o male with CKD, who has performed continuous ambulatory peritoneal dialysis (CAPD) QID, 7 days a week for the past 6 months, During initial assessment, the patient reports abdominal pain, nausea with vomiting, and constipation. Assessment findings include diminished bowel sounds, rebound tenderness and abdominal distention. Vital signs include HR 112 and T 101.8. What is a major complication? A. Hemorrhage B.. Fibrin clot formation C. Peritonitis D. Exit site infectionCWhich task could the nurse assign to the licensed practice nurse (LPN/LVN) working with you to provide care for the patient. SELECT ALL A. Check vital signs every 4 hours B. Weigh the patient everyday after dialysate drain C. Administering oral analgesics as needed D. Measure abdomen circumference every shift E. Creating a nursing care plan for the patient F. Recording the shift physical assessmentA B C DThe patient's outflow (effluent) is cloudy as reported by the LPN/LVN. What would the nurse instruct the LPN/LVN to do at this time? A. Empty the outflow bag into the sink B. Send a sample of effluent to the lab C. Tell the patient to drink lots of fluid D. Change the dressing around the patient dialysis catheterBWhich patient statement most indicates a need for follow up by the nurse about CAPD? A. "I am supposed to use sterile technique when connecting or disconnecting the catheter tube" B. "I usually perform my dialysis exchanges in the dining room on the table" C. "I run the dialysate in quickly over 10 to 20 minutes" D. "I will be able to travel on vacation with my PD"BThe nurse notes that the pt has poor dialysis flow. Which question will the nurse ask to determine the cause of this complication A. "how much fluid did you consume today?" B. Do you havea regular exercise regimem C. When was your last bowel movement?" D. "which drugs have been prescibed for you?"CTo prevent poor dialysis flow, whihc key points would the nurse teach this patient about peritoneal dialysis?. SELECT ALL A. be sure to consume a high fiber diet B. remember to take daily stool softener C. warm the dialysate bags in microwave oven D. an enema before PD may be helpful E. expect the PD outflow to be cloudy F. check for kinked or clamped connecting tubingA B D FNurse is providing teaching who has frequent UTI. which of the following statements by the client indicates an understanding of the teaching? A. I will be sure to take the time to urinate at least every 4 hr B. I will take tub baths rather than showers when I think im getting an infection C. I will make sure I drink a total of 50 oz of water every day D. I will buy some new nylon underwearAWhat causes urinary incontinence? A. Weak pelic floor B. spastic bladder C. overactive bladder D. low estrogen e. all of the aboveEwhat causes urinary retention?obstructionnon-pharmacological treatment for urinary incontinence?Kegel exercises, weight loss, stop smokingnon-pharmacological treatment for urinary retentionUrinary catheter, urinary diversion, behavior modifications (be warm, drink small amounts, drink coffee/tea)pharmacologic treatment for urinary incontinenceAnticholinergics: Oxybutynin, antispasmodics, topical hormone, tricyclics, CCBSpharmacologic treatment for urinary retentionbethanecholcomplications with urinary incontinenceUTI and skin breakdown and infection riskcomplications with urinary retentionAcute urinary retention = medical emergency, hydronephrosis, AKI, UTI due to incomplete bladder emptyingA charge nurse is providing staff education about healthcare associated infections. Which of the following is the most effective way to reduce the risk of gram-negative septicemia in clients admitted to healthcare facilities? (E. coli from stool and poor wiping → UTIs) A. Limiting visitor contact B. Limiting unnecessary urinary tract catheterization C. Using negative pressure airflow D. Using N95 respiratorBA nurse is caring for a client with dysuria. A urine specimen is sent to the lab for routine urinalysis. Which of the following findings is most specific for a UTI? A. Nitrite B. Protein C. Bilirubin D. ErythrocytesAA nurse is reviewing the laboratory results of a middle aged client who has Stage 4 chronic kidney disease. Which of the following findings should the nurse expect? A. Blood urea nitrogen (BUN) 15 mg/dL B. GFR of 20 mL/min C. Creatinine 1.1 mg/dL D. Potassium 5.0 mEq/LBA nurse is preparing to initiate hemodialysis through an Arteriovenous (AV) fistula for a client who has end stage kidney disease. Which of the following actions should the nurse take? Select all A. Review the client's current medications B. Assess the AV fistula for a bruit C. Calculate the client;s hourly urine output D. Measure the client;s weight E. Administer heparin subq F. Obtain pre-dialysis serum laboratory from a site distal to the fistulaA DA nurse is caring for an older client with chronic kidney disease who was admitted with cholangitis. The client has a temperature of 103 and a BP of 90/60. Which of the following orders should the nurse question, based on the information provided under "Exhibit"? A. Continue the home dose of lisinopril B. Obtain blood and urine cultures before administering antibiotics C. Obtain a CT of the abdomen without contrast D. Administer IV antibioticsAAfter surgery to create a urinary diversion (stoma of some sort), the client is at risk for a UTI. The nurse should plan to incorporate which of the following interventions into the client's care? A. Clamp the appliance at night B Empty urinary appliance when one-third full C. Administer prophylactic antibiotics D. change the urinary appliance dailyBOne of the most common causes of end-stage renal disease requiring hemodialysis is: A. Peripheral vascular disease B. Diabetes Mellitus and HTN C. Rheumatoid arthritis D. Hepatic encephalopathyBA nurse is preparing to give Furosemide (Lasix) to a client with heart failure. The nurse knows that it causes which of the following effects? Select all A. Dry mouth B. Hearing loss C. Weight gain D. Migraine headaches E. HypercalcemiaA BA nurse is providing information about a client with renal calculi. Which of the following is true about renal calculi? A. Proteus bacteria causes struvite stones idk?? B. Increased purine intake causes renal calculi C. Cystine stones occur in 15-20% of cases D. Allopurinol is prescribed to treat oxalate calculi E. Acidic urine is a risk factorB CA nurse is caring for a client receiving gentamicin (Garamycin). Which of the following lab tests should be the primary concern for this client? A. Hemoglobin and hematocrit B. Sodium and chloride C. BUN and creatinine D. Bicarb and potassiumCA nurse is instructing a female client to collect a midstream urine sample. Which of the following should the nurse include in the instructions? A. Ask the client to urinate a small amount and then hold the stream while the specimen cup is placed B. Cleanse the vaginal area by wiping from front to back C. Collect a minimum of 20 mL of urine into the specimen cup D. Avoid using a single cleansing wipe more than two timesBA nurse is teaching a client who has chronic kidney disease (CKD) about dietary management. What should the nurse include in the teaching instructions? A. Restrict protein intake B. Maintain a high-phosphorus diet C. Increase intake of foods high in potassium D. Calcium intake should be increasedAA nurse is assessing a client with symptoms of a UTI. Which of the following findings suggest a diagnosis of pyelonephritis (kidney infection vs UTI) A. Urinary frequency B. Fever and cills C. Urinary urgency D. Hematuria E. Dark urineBA nurse is caring for a client with diabetic nephropathy who is receiving peritoneal dialysis and experiences abdominal pain and chills. The client has a temperature of 100.3 and a glucose level of 180 mg/dL. Which of the following is the priority nursing intervention? A. Assist the client to the high-Fowler's position B. Administer IV insulin C. Obtain peritoneal fluid for culture and sensitivity D. Warm the dialysateCA nurse is caring for a client who has undergone a surgical procedure earlier in the day. The client has been treated with oxycodone for acute pain and has not voided in 5 hours. Which of the following actions will the nurse prioritize when urinary retention is suspected in a post-op client? A. Assessment of fluid intake B. Palpation of the suprapubic area C. Asking the client if he or she needs a bedpan or assistance to the bathroom D. Assessment skin turgor and mucous membranesAA nurse in an outpatient clinic is assessing a client with type 1 diabetes mellitus. Which of the following lab results should the nurse prioritize for reporting to the HCP? A. Serum potassium of 4.0 mEq/L B. Fasting blood glucose 90 mg/dL C. Serum sodium 138 mEq/L D. Serum creatinine 2.2 mg/dLDA nurse is caring for a client who has chronic pyelonephritis. Which of the following actions should the nurse take? Select all A. Encourage the client to restrict daily fluid intake to 1 L B. Arrange a consultation with a registered dietician C. Palpate the costovertebral angles of the client D. Instruct the client to void every 2 hours E. Monitor the client's creatinine levelB C D EA nurse is caring for a client in the ICU who has acute renal failure. Which of the following ECG findings indicate hyperkalemia? A. Prominent delta waves B. Peaked T wave C. Prominent U waves D. Prominent J wavesBA nurse is planning an in-service about acute poststreptococcal glomerulonephritis (APSGN) for staff members. Which of the following manifestations should the nurse include in the teaching? Select all A. Frothy urine B. Weak, thready pulse C. Appears ill D. Decreased creatinine E. HypertensionC EA nurse is caring for a client with a UTIwho has a new prescription for phenazopyridine (Pyridium). When providing client teaching about this medication, the nurse will advise the client about which of the following changes in the urine? A. The urine will develop a "musty" smell B. The urine may have small white clumps C. The urine may be orange in color D. The urine volume will decreaseCA nurse is providing discharge instructions for a clarinet who is to begin dialysis. Which of the following instructions about protein intake should the nurse include? Select all A. Consume 1.2 g of protein per kg of body weight B. Take phosphate binders when eating protein-rich foods C. Increase intake of complete sources of protein D. Increase protein intake by 50% of the recommended dietary allowance (RDA) E. Consume daily protein intake in the morningA B DIf calcium is low in blood system, phosphorus is high and body is trying to get calcium from bonesOSTEOPOROSISIf phosphorus is low what can we give to treat?bisphophonateswhich diagnostic study Done at bedside, no special prep, can detect stones, verify NG tubeKUB x-raywhich diagnostic study done at bedside, no special prep, can detect size of kidneysrenal ultrasoundwhich diagnostic study test for presence of WBC to determine UTIurinalysiswhich diagnostic study can remove urolithiasis, burning expected, monitor for hematuriacystocopywhich diagnostic study with or without contrast, can detect abscesses and tumors, NPO/enemaCT/MRIwhich diagnostic study most accurate indicator of renal function, closely approximates GFR24 hour urine collectionwhich diagnostic study most accurate test to determine cause of kidney disease, lie on affected side post procedure due to bleeding riskrenal biopsywhich diagnostic study always uses contrast to visualize urinary tract and structures, evaluate kidney function before and after/assess shellfish allergyIV pyelogramwhich diagnostic study for renal artery stenosis, uses contrast, strict bedrest post-procedure due to bleeding riskRenal angiogram