A nurse is caring for a client with Addison disease. Which information should the nurse include in a teaching plan to encourage this client to modify dietary intake?

1. Increased amounts of potassium are needed to replace renal losses.
2. Increased protein is needed to heal the adrenal tissue and thus cure the disease.
3. Supplemental vitamins are needed to supply energy and assist in regaining the lost weight.
4. Extra salt is needed to replace the amount being lost caused by lack of sufficient aldosterone to conserve sodium.

D. Extra salt is needed to replace the amount being lost caused by lack of sufficient aldosterone to conserve sodium.

A client is admitted with a diagnosis of cancer of the colon. What information about malignant tumors of the colon should the nurse consider when caring for this client?

1. They are detected easily.
2. They usually are localized.
3. Women are more at risk than men.
4. Colon obstructions usually are malignant.

D. Colon obstructions usually are malignant.

A client just has returned from the postanesthesia care unit after having a laparotomy. Which initial sign or symptom indicates to the nurse that peristalsis has begun to return?

1. Stool is evacuated.
2. Nausea is no longer present.
3. Borborygmi are auscultated.
4. Abdomen is no longer tender.

C. Borborygmi are auscultated.

Which statement by an older adult most strongly supports the nurse's conclusion that the client is impacted with stool?

1. "I have a lot of gas pains."
2. "I don't have much of an appetite."
3. "I feel like I have to go, but I just seep."
4. "I haven't had a bowel movement for several days."

C. "I feel like I have to go, but I just seep."

A client is diagnosed with a peptic ulcer. When teaching about peptic ulcers, the nurse instructs the client to report what kind of stools?

1. Frothy
2. Ribbon shaped
3. Pale or clay colored
4. Dark brown or black

D. Dark brown or black

A client with irritable bowel syndrome has instructions to take psyllium 2 rounded teaspoons full twice a day for constipation. What is most important for the nurse to include in the teaching plan?

1. Urine may be discolored.
2. Stop taking the laxative once a bowel movement occurs.
3. Each dose should be taken with a full glass of water or juice.
4. Daily use may inhibit the absorption of some fat-soluble vitamins.

C. Each dose should be taken with a full glass of water or juice.

A health care provider prescribes sodium biphosphate for a client before a colonoscopy. How does the drug accomplish its therapeutic effect?

1. Irritates the intestinal mucosa
2. Provides water-absorbing bulk
3. Softens stool by exerting a detergent effect
4. Increases osmotic pressure in the intestines

D. Increases osmotic pressure in the intestines

Four days after abdominal surgery a client has not passed flatus and there are no bowel sounds. Paralytic ileus is suspected. What does the nurse conclude is the most likely cause of the ileus?

1. Decreased blood supply
2. Impaired neural functioning
3. Perforation of the bowel wall
4. Obstruction of the bowel lume

B. Impaired neural functioning

A healthcare provider prescribes furosemide for a client with hypervolemia. The nurse recalls that furosemide exerts its effects in what part of the renal system?

1. Distal tubule
2. Collecting duct
3. Glomerulus of the nephron
4. Loop of Henle

D. Loop of Henle

A nurse is caring for a client with a ureteral calculus. Which are the most important nursing actions? Select all that apply.

1. Limiting fluid intake at night
2. Monitoring intake and output
3. Straining the urine at each voiding
4. Recording the client’s blood pressure
5. Administering the prescribed analgesic

B. Monitoring intake and output

C. Straining the urine at each voiding

E. Administering the prescribed analgesic

A nurse is caring for a client with acute kidney injury who is receiving a protein-restricted diet. The client asks why this diet is necessary. Which information should the nurse include in a response to the client’s questions?

1. A high-protein intake ensures an adequate daily supply of amino acids to compensate for losses.
2. Essential and nonessential amino acids are necessary in the diet to supply materials for tissue protein synthesis.
3. This supplies only essential amino acids, reducing the amount of metabolic waste products, thus decreasing stress on the kidneys.
4. Urea nitrogen cannot be used to synthesize amino acids in the body, so the nitrogen for amino acid synthesis must come from the dietary protein.

C. This supplies only essential amino acids, reducing the amount of metabolic waste products, thus decreasing stress on the kidneys.

An older adult client is admitted to the hospital with a diagnosis of chronic kidney disease. The nurse reviews the client’s medical record. Which clinical finding is a priority to be communicated to the primary healthcare provider?

1. Sodium level
2. Potassium level
3. Creatinine results
4. Blood pressure results

B. Potassium level

A nurse is caring for a client with acute kidney injury. Which findings should the nurse anticipate when reviewing the laboratory report of the client’s blood level of calcium, potassium, and creatinine?Select all that apply.

1. Calcium: 7.6 mg/dL (1.9 mmol/L)
2. Calcium: 10.5 mg/dL (2.6 mmol/L)
3. Potassium 6.0 mEq/L (6.0 mmol/L)
4. Potassium 3.5 mEq/L (3.5 mmol/L)
5. Creatinine: 3.2 mg/dL (194 mcmol/L)
6. Creatinine: 1.1 mg/dL (90 mcmol/L)

A. Calcium: 7.6 mg/dL (1.9 mmol/L)

C. Potassium 6.0 mEq/L (6.0 mmol/L)

E. Creatinine: 3.2 mg/dL (194 mcmol/L)

A client with end-stage kidney disease is receiving continuous ambulatory peritoneal dialysis. The nurse should monitor the client for which peritoneal dialysis complications? Select all that apply.

1. Pruritus
2. Oliguria
3. Tachycardia
4. Cloudy outflow
5. Abdominal pain

C. Tachycardia

D. Cloudy outflow

E. Abdominal pain

A client with a history of chronic kidney disease is hospitalized. Which assessment findings will alert the nurse to kidney insufficiency?

1. Facial flushing
2. Edema and pruritus
3. Dribbling after voiding and dysuria
4. Diminished force and caliber of stream

B. Edema and pruritus

A client is admitted to the hospital in the oliguric phase of acute kidney injury. The nurse estimates that the urine output for the last 12 hours is about 200 mL. The nurse reviews the plan of care and notes a prescription for 900 mL of water to be given orally over the next 24 hours. What does the nurse conclude about the amount of fluid prescribed?

1. It equals the expected urinary output for the next 24 hours.
2. It will prevent the development of pneumonia and a high fever.
3. It will compensate for both insensible and expected output over the next 24 hours.
4. It will reduce hyperkalemia, which can lead to life-threatening cardiac dysrhythmias.

C. It will compensate for both insensible and expected output over the next 24 hours.

A nurse is caring for a client with end-stage kidney disease who is about to receive a transplant. When the client returns from the postanesthesia care unit after a kidney transplant, how often should the nurse measure the client’s urinary output?

1. 1 hour
2. 2 hours
3. 15 minutes
4. 30 minutes

A. 1 hour

When monitoring a client 24 to 48 hours after abdominal surgery, the nurse should assess for which problem associated with anesthetic agents?

1. Colitis
2. Stomatitis
3. Paralytic ileus
4. Gastrocolic reflux

C. Paralytic ileus

A nurse is providing care to a client 8 hours after the client had surgery to correct an upper urinary tract obstruction. Which assessment finding should the nurse report to the surgeon?

1. Incisional pain
2. Absent bowel sounds
3. Urine output of 20 mL/hr
4. Serosanguineous drainage on the dressing

C. Urine output of 20 mL/hr

While reviewing the urinalysis reports of an elderly client, the nurse finds white blood cells (WBCs) in the urine. Which condition might the client have?

1. Pyelonephritis
2. Kidney trauma
3. Kidney infection
4. Acute tubular necrosis

C. Kidney infection

Which is an abnormal finding of the urinary system?

1. Nonpalpable left kidney
2. Presence of bowel sounds
3. Nonpalpable urinary bladder
4. Pain in the flank region upon hitting

D. Pain in the flank region upon hitting

A client is diagnosed with a pathology in the medulla of the kidney. Which part of the nephron is the region most likely affected by the pathology?

1. A – Bowman Capsule
2. B - glomerulus
3. C - distal convoluted tubule
4. D – descending loop of henle

D. D – descending loop of henle

A client has undergone pelvic surgery and the nurse removes the catheter in a week according to instructions. In the follow up within several hours, which finding in the client indicates a need for reinsertion of catheter?

1. Anuria
2. Polyuria
3. Retention
4. Incontinence

C. Retention

A child is administered a RotaTeq vaccine. What adverse drug effect should the nurse monitor for?

1. Intussusception
2. Encephalopathy
3. Thrombocytopenia
4. Guillain-Barré syndrome

A. Intussusception

Which vaccine may cause intussusception in children?

1. Rotavirus
2. Hepatitis
3. Measles, mumps, and rubella
4. Diphtheria, tetanus, and pertussis

A. Rotavirus