Urinary System Disorders | NCLEX Quiz 118

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  • 1/10 Questions

    The nurse has completed client teaching with the hemodialysis client about self-monitoring between hemodialysis treatments. The nurse determines that the client best understands the information given if the client states to record the daily:

    • Pulse and respiratory rate
    • Intake. output. and weight
    • BUN and creatinine levels
    • Activity log
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Urinary System Disorders | NCLEX Quiz 118 - Quiz

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  • 2. 

    The client being hemodialyzed suddenly becomes short of breath and complains of chest pain. The client is tachycardic. pale. and anxious. The nurse suspects air embolism. The nurse should:

    • Continue the dialysis at a slower rate after checking the lines for air

    • Discontinue dialysis and notify the physician

    • Monitor vital signs every 15 minutes for the next hour

    • Bolus the client with 500 ml of normal saline to break up the air embolism.

    Correct Answer
    A. Discontinue dialysis and notify the physician
    Explanation
    If the client experiences air embolus during hemodialysis. the nurse should terminate dialysis immediately. notify the physician. and administer oxygen as needed.

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  • 3. 

    The nurse is caring for a hospitalized client who has chronic renal failure. Which of the following nursing diagnoses are most appropriate for this client? Select all that apply.

    • Excess Fluid Volume

    • Imbalanced Nutrition; Less than Body Requirements

    • Activity Intolerance

    • Impaired Gas Exchange

    Correct Answer
    A. Excess Fluid Volume
    Explanation
    Appropriate nursing diagnoses for clients with chronic renal failure include excess fluid volume related to fluid and sodium retention; imbalanced nutrition. less than body requirements related to anorexia. nausea. and vomiting; and activity intolerance related to fatigue.Options D and E: The nursing diagnoses of impaired gas exchange and pain are not commonly related to the chronic renal failure.

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  • 4. 

    The nurse assesses the client who has chronic renal failure and notes the following: crackles in the lung bases. elevated blood pressure. and weight gain of 2 pounds in one day. Based on these data. which of the following nursing diagnoses is appropriate?

    • Excess fluid volume related to the kidney’s inability to maintain fluid balance.

    • Increased cardiac output related to fluid overload.

    • Ineffective tissue perfusion related to interrupted arterial blood flow.

    • Ineffective Therapeutic Regimen Management related to lack of knowledge about therapy.

    Correct Answer
    A. Excess fluid volume related to the kidney’s inability to maintain fluid balance.
    Explanation
    Crackles in the lungs. weight gain. and elevated blood pressure are indicators of excess fluid volume. a common complication in chronic renal failure. The client’s fluid status should be monitored carefully for imbalances on an ongoing basis.

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  • 5. 

    The client with chronic renal failure has an indwelling catheter for peritoneal dialysis in the abdomen. The client spills water on the catheter dressing while bathing. The nurse should immediately:

    • Reinforce the dressing

    • Change the dressing

    • Flush the peritoneal dialysis catheter

    • Scrub the catheter with povidone-iodine

    Correct Answer
    A. Change the dressing
    Explanation
    Clients with peritoneal dialysis catheters are at high risk for infection. A dressing that is wet is a conduit for bacteria for bacteria to reach the catheter insertion site. The nurse assures that the dressing is kept dry at all times.Option A: Reinforcing the dressing is not a safe practice to prevent infection in this circumstance.Option C: Flushing the catheter is not indicated.Option D: Scrubbing the catheter with povidone-iodine is done at the time of connection or disconnecting of peritoneal dialysis.

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  • 6. 

    The client with acute renal failure has a serum potassium level of 5.8 mEq/L. The nurse would plan which of the following as a priority action?

    • Allow an extra 500 ml of fluid intake to dilute the electrolyte concentration.

    • Encourage increased vegetables in the diet

    • Place the client on a cardiac monitor

    • Check the sodium level

    Correct Answer
    A. Place the client on a cardiac monitor
    Explanation
    The client with hyperkalemia is at risk for developing cardiac dysrhythmias and cardiac arrest. Because of this. the client should be placed on a cardiac monitor.Option A: Fluid intake is not increased because it contributes to fluid overload and would not affect the serum potassium level significantly.Option B: Vegetables are a natural source of potassium in the diet. and their use would not be increased.Option D: The nurse may also assess the sodium level because sodium is another electrolyte commonly measured with the potassium level. However. this is not a priority action at this time.

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  • 7. 

    The client with chronic renal failure who is scheduled for hemodialysis this morning is due to receive a daily dose of enalapril (Vasotec). The nurse should plan to administer this medication:

    • Just before dialysis

    • During dialysis

    • On return from dialysis

    • The day after dialysis

    Correct Answer
    A. On return from dialysis
    Explanation
    Antihypertensive medications such as enalapril are given to the client following hemodialysis. This prevents the client from becoming hypotensive during dialysis and also from having the medication removed from the bloodstream by dialysis. No rationale exists for waiting a full day to resume the medication. This would lead to ineffective control of the blood pressure.

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  • 8. 

    The nurse is instructing a client with diabetes mellitus about peritoneal dialysis. The nurse tells the client that it is important to maintain the dwell time for the dialysis at the prescribed time because of the risk of:

    • Infection

    • Hyperglycemia

    • Fluid overload

    • Disequilibrium syndrome

    Correct Answer
    A. Hyperglycemia
    Explanation
    An extended dwell time increases the risk of hyperglycemia in the client with diabetes mellitus as a result of absorption of glucose from the dialysate and electrolyte changes. Diabetic clients may require extra insulin when receiving peritoneal dialysis.

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  • 9. 

    The client with an arteriovenous shunt in place for hemodialysis is at risk for bleeding. The nurse would do which of the following as a priority action to prevent this complication from occurring?

    • Check the results of the PT time as they are ordered.

    • Observe the site once per shift

    • Check the shunt for the presence of a bruit and thrill

    • Ensure that small clamps are attached to the AV shunt dressing.

    Correct Answer
    A. Ensure that small clamps are attached to the AV shunt dressing.
    Explanation
    An AV shunt is a less common form of access site but carries a risk of bleeding when it is used because two ends of an external cannula are tunneled subcutaneously into an artery and a vein and the ends of the cannula are joined. If accidental connection occurs. the client could lose blood rapidly. For this reason. small clamps are attached to the dressing that covers the insertion site to use if needed.Option B: The shunt site should be assessed at least every four hours.

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  • 10. 

    The nurse is monitoring a client receiving peritoneal dialysis and nurse notes that a client’s outflow is less than the inflow. Select actions that the nurse should take.

    • Place the client in good body alignment

    • Check the level of the drainage bag

    • Contact the physician

    • Check the peritoneal dialysis system for kinks

    Correct Answer
    A. Place the client in good body alignment
    Explanation
    If outflow drainage is inadequate. the nurse attempts to stimulate outflow by changing the client’s position. Turning the client to the other side or making sure that the client is in good body alignment may assist with outflow drainage. The drainage bag needs to be lower than the client’s abdomen to enhance gravity drainage. The connecting tubing and the peritoneal dialysis system is also checked for kinks or twisting and the clamps on the system are checked to ensure that they are open. There is no reason to contact the physician.

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  • Current Version
  • Aug 20, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Oct 09, 2017
    Quiz Created by
    Santepro
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