196 Nursezone Med-surg Nursing Final Coaching (By Doc Tacs) Part 1 (1 To 35)

1. SITUATION: Urinary tract infection is a common disease affecting the adult population. A nurse is expected to have a deep understanding regarding care for client with urinary tract infections Ciprofloxacin was given for a patient's complicated UTI. Because of its adverse effects, ciprofloxacin should not be given to:

Clients with heart failure

Clients with history of seizures

Female clients with peripheral vascular disease

Pregnant women and children

2. SITUATION: Renal failure is a common complication of clients suffering from hypertension and diabetes mellitus. The nurse should have deep knowledge to be able to care for client suffering from these complications The nurse assesses a client shortly after kidney transplant surgery. Which postoperative findings should the nurse report to the doctor immediately?

Serum potassium level of 4.9 mEq/L

Serum sodium level of 135 mEq/L

Temperature of 37.3°C

Urine output of 20 ml/hr

3. SITUATION: Urinary tract infection is a common disease affecting the adult population. A nurse is expected to have a deep understanding regarding care for client with urinary tract infections To assist with the prevention of urinary tract infections, the teenage girl should be taught to:

Drink citrus fruit juices

Avoid using tampons

Take showers instead of tub baths

Clean the perineum from front to back

4. SITUATION: Renal failure is a common complication of clients suffering from hypertension and diabetes mellitus. The nurse should have deep knowledge to be able to care for client suffering from these complications The client is admitted to the hospital in chronic renal failure. A diet low in protein is ordered. The rationale for a low-protein diet is:

Protein breaks down into blood urea nitrogen and other waste

High protein increases the sodium and potassium levels

A high-protein diet decreases albumin production

A high-protein diet depleted calcium and phosphorus

5. SITUATION: Renal failure is a common complication of clients suffering from hypertension and diabetes mellitus. The nurse should have deep knowledge to be able to care for client suffering from these complications A patient in renal failure has decreased ability to excrete protein wastes. Which test reflects this condition?

An elevated BUN

A drop in creatinine

Increased levels of WBC in the urine

An increased creatinine clearance level

6. SITUATION: Renal failure is a common complication of clients suffering from hypertension and diabetes mellitus. The nurse should have deep knowledge to be able to care for client suffering from these complications A patient is scheduled for peritoneal dialysis. What important nursing intervention must be taken before dialysis is initiated?

Weight the patient

Administer pain medication

Place patient in high-Fowler’s

Instruct on complications

7. SITUATION: A patient has severe right flank pain, nausea, and vomiting. The tentative diagnosis was ureterolithiasis, right The nurse is caring for a client following a right nephrolithotomy. Post-operatively, the client should be

On the right side

Supine

On the left side

Prone

8. SITUATION: Renal failure is a common complication of clients suffering from hypertension and diabetes mellitus. The nurse should have deep knowledge to be able to care for client suffering from these complications The nurse is teaching a client with peritoneal dialysis how to manage exchanges at home. The nurse should tell the client to notify the doctor immediately if:

The dialysate return become cloudy in appearance

The return of the dialysate is slower than usual

A “tugging” sensation is noted as the dialysate drains

A feeling of fullness is felt when the dialysate is instilled

9. SITUATION: Renal failure is a common complication of clients suffering from hypertension and diabetes mellitus. The nurse should have deep knowledge to be able to care for client suffering from these complications A client with end stage renal disease is being managed with peritoneal dialysis. If the dialysate return is slowed, the nurse should tell the client to:

Irrigate the dialyzing catheter with saline

Skip the next scheduled infusion

Gently retract the dialyzing catheter

Change the position or turn side to side

10. SITUATION: Fluid and electrolyte imbalance is a common complication among clients suffering from certain disorders. A nurse is expected to be knowledgeable regarding care of clients with fluid and electrolyte problems The nurse caring for a client with diarrhea will look for which sign of severe dehydration?

Tenting of chest skin when pinched

Collapsed hand veins

Absence of sweat

Dry oral mucosa

11. SITUATION: Fluid and electrolyte imbalance is a common complication among clients suffering from certain disorders. A nurse is expected to be knowledgeable regarding care of clients with fluid and electrolyte problems Which of the following values in a patient's urinalysis should the nurse consider abnormal?

Specific gravity of 1.005

Ketones: trace

Proteins: ++

WBC: 0 to 2/hpf

12. SITUATION: Urinary tract infection is a common disease affecting the adult population. A nurse is expected to have a deep understanding regarding care for client with urinary tract infections In guarding against UTI, which nursing intervention is best?

Frequent ambulation, ROM

Forcing fluids

Emptying bladder every 8 hours

Alkaline ash diet and increase fibers in the diet

13. SITUATION: Renal failure is a common complication of clients suffering from hypertension and diabetes mellitus. The nurse should have deep knowledge to be able to care for client suffering from these complications In caring for the patient in acute renal failure, the nurse is aware that a major complication is:

Hypertension

Hypocalcemia

Hyperkalemia

Hypokalemia

14. SITUATION: Renal failure is a common complication of clients suffering from hypertension and diabetes mellitus. The nurse should have deep knowledge to be able to care for client suffering from these complications The nurse assesses the renal patient's mental status. If there is a problem, what condition is most likely to be assessed?

Aggression

Delirium

Confusion

Intense anger

15. SITUATION: Renal failure is a common complication of clients suffering from hypertension and diabetes mellitus. The nurse should have deep knowledge to be able to care for client suffering from these complications Kenneth who has diagnosed with uremic syndrome ahs the potential to develop complications. Which among the following complications should the nurse anticipates?

Flapping hand tremors

An elevated hematocrit level

Hypotension

Hypokalemia

16. SITUATION: Urinary tract infection is a common disease affecting the adult population. A nurse is expected to have a deep understanding regarding care for client with urinary tract infections A 35 year old female was diagnosed with acute cystitis. Which clinical manifestations should the nurse expect?

Flank pain, urinary frequency, and elevated WBC

Lower abdominal pain, dysuria, and urinary frequency

Pyuria, hematuria, and groin pain

Urinary frequency and casts in the urine

17. SITUATION: Fluid and electrolyte imbalance is a common complication among clients suffering from certain disorders. A nurse is expected to be knowledgeable regarding care of clients with fluid and electrolyte problems Which nursing intervention would most likely lead to a hypo-osmolar state?

Performing nasogastric tube irrigation with normal saline solution

Weighing the patient daily and encouraging full meals

Administering tap water enema until return is clear

Encouraging patient with hyperhydrosis to drink Gatorade

18. SITUATION: Urinary tract infection is a common disease affecting the adult population. A nurse is expected to have a deep understanding regarding care for client with urinary tract infections The physician orders barium studies and an intravenous pyelogram. Which should the nurse schedule first?

The barium studies

The intravenous pyelogram

There is no difference

They should be performed at the same time

19. SITUATION: Fluid and electrolyte imbalance is a common complication among clients suffering from certain disorders. A nurse is expected to be knowledgeable regarding care of clients with fluid and electrolyte problems A nurse will use which type of solution to promote osmotic diuresis?

Hypertonic

Hypotonic

Isotonic

Alkaline

20. SITUATION: Renal failure is a common complication of clients suffering from hypertension and diabetes mellitus. The nurse should have deep knowledge to be able to care for client suffering from these complications A patient with an AV fistula is receiving hemodialysis treatments three times a week. Which observation by the nurse indicates arterial steal syndrome?

The abdomen is distended and tender upon palpation

The client is complaining of nausea, vomiting, and a headache

The presence of redness, warmth, and edema at the site of the fistula

The client appears pale and complains of numb fingers that are cool to the touch

21. SITUATION: A patient has severe right flank pain, nausea, and vomiting. The tentative diagnosis was ureterolithiasis, right The physician has ordered increased oral rehydration for a client with renal calculi. Unless contraindicated, the recommended oral intake for helping with removal of renal calculi is:

75 mL per hour

100 mL per hour

150 mL per hour

200 mL per hour

22. SITUATION: Renal failure is a common complication of clients suffering from hypertension and diabetes mellitus. The nurse should have deep knowledge to be able to care for client suffering from these complications The nurse should teach a client receiving cyclosporine about adverse drug reactions. What is the most severe adverse reaction that may occur?

Bone marrow suppression

Pulmonary edema

Drug fever

Nephrotoxicity

23. SITUATION: A patient has severe right flank pain, nausea, and vomiting. The tentative diagnosis was ureterolithiasis, right A patient with recurrent UTI is prescribed an alkaline ash diet. This diet is aimed at:

Increasing the urinary output of the client

Making the urine more basic

Preventing the occurrence of UTI

Eliminating the stones from the urinary tract

24. SITUATION: Renal failure is a common complication of clients suffering from hypertension and diabetes mellitus. The nurse should have deep knowledge to be able to care for client suffering from these complications The client is receiving peritoneal dialysis. If the dialysate returns cloudy, the nurse should:

Document the finding

Send a specimen to the lab

Strain the urine

Obtain a complete blood count

25. SITUATION: A patient has severe right flank pain, nausea, and vomiting. The tentative diagnosis was ureterolithiasis, right A client is being discharged after lithotripsy for removal of kidney stone. Which statement by the client indicates understanding of the nurse's instructions?

“I’ll need to strain my urine the first thing in the morning”

“I will be careful to strain all the urine and save the stone”

“I won’t need to strain my urine now that the procedure is complete”

26. SITUATION: Renal failure is a common complication of clients suffering from hypertension and diabetes mellitus. The nurse should have deep knowledge to be able to care for client suffering from these complications A client who underwent renal transplant should take cyclosporine daily along with other immunosuppressants. What action of cyclosporine is needed in this case?

Elimination of antigen-reactive T cells in the blood

Inhibition of RNA synthesis

Inhibition of helper T cells and suppressor T cells

Antagonistic metabolism of purine

27. SITUATION: Fluid and electrolyte imbalance is a common complication among clients suffering from certain disorders. A nurse is expected to be knowledgeable regarding care of clients with fluid and electrolyte problems The average adult normally excretes how much urine in a usual 24 hour period?

100 to 200 cc

500 to 700 cc

800 to 1200 cc

1200 to 1800 cc

28. SITUATION: A patient has severe right flank pain, nausea, and vomiting. The tentative diagnosis was ureterolithiasis, right Which should the nurse assign the highest priority?

Pain

Altered nutrition

Risk for infection

Altered urinary elimination

29. SITUATION: Renal failure is a common complication of clients suffering from hypertension and diabetes mellitus. The nurse should have deep knowledge to be able to care for client suffering from these complications An ICU nurse observes the patient with DM in renal failure for ECG changes, Kussmaul's breathing, and decreased LOC. This is to assess for:

Response to dialysis

Metabolic alkalosis

Electrolyte imbalance

Cardiac complications

30. SITUATION: Urinary tract infection is a common disease affecting the adult population. A nurse is expected to have a deep understanding regarding care for client with urinary tract infections A urine C&S is obtained in the patient with pyelonephritis. The nurse understands that this test is important because it is utilized in:

Confirming the diagnosis

Determining the length of treatment

Prescribing wide spectrum antibiotics

Selecting which pain medication works best

31. SITUATION: Fluid and electrolyte imbalance is a common complication among clients suffering from certain disorders. A nurse is expected to be knowledgeable regarding care of clients with fluid and electrolyte problems A healthy client who is 70 kg is expected to have a minimum urine output of:

30 cc/hr

35 cc/hr

60 cc/hr

40 cc/hr

32. SITUATION: A patient has severe right flank pain, nausea, and vomiting. The tentative diagnosis was ureterolithiasis, right The client was advised to be on an acid ash diet. The nurse understands that:

The client’s stones are mainly acidic in nature

The client may have fruits and vegetables but the bulk of the diet should be protein

The client has the tendency to develop large stones that can cause obstruction

The client is in metabolic alkalosis and therefore should be given acidic food

33. SITUATION: Renal failure is a common complication of clients suffering from hypertension and diabetes mellitus. The nurse should have deep knowledge to be able to care for client suffering from these complications A patient's wife asks why her husband on hemodialysis developed dialysis disequilibrium syndrome. The nurse's response should be based on the fact that the syndrome occurs as a result of:

A contaminated connection site between the catheter and machine

A rapid change is sodium and water levels

Too much absorption of aluminum from the dialysate

Too rapid decrease in the blood urea nitrogen levels

34. SITUATION: Renal failure is a common complication of clients suffering from hypertension and diabetes mellitus. The nurse should have deep knowledge to be able to care for client suffering from these complications A client with chronic renal failure receives hemodialysis and his condition stabilizes. The doctor orders amphojel with each meal. This drug is given to:

Remove protein wastes of metabolism

Bind phosphorus in the GI tract

Exchange sodium for potassium in the colon

Inhibit development of a stress ulcer

35. SITUATION: A patient has severe right flank pain, nausea, and vomiting. The tentative diagnosis was ureterolithiasis, right The physician orders a urine specimen to test for glucose and ketones. The nurse obtains which specimen?

Sterile

Midstream

Double voided

Clean single-voided