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Surgeries & Procedures
Medications
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According to ATI
Miscellaneous
100
The client is scheduled for an intravenous pyelogram (IVP) to determine the location of the renal calculi. Which of the following measures would be most important for the nurse to include in pretest preparation?
1. Ensuring adequate fluid intake on the day of the test.
2. Preparing the client for the possibility of bladder spasms during the test.
3. Checking the client's history for allergy to iodine.
4. Determining when the client last had a bowel movement.
3. Checking the client's history for allergy to iodine. A client scheduled for an IVP should be assessed for allergies to iodine and shellfish. Clients with such allergies may be allergic to the IVP dye and be at risk for an anaphylactic reaction. Adequate fluid intake is important after the examination. Bladder spasms are not common during an IVP. Bowel preparation is important before an IVP to allow visualization of the ureters and bladder, but checking for allergies is most important.
100
Phenazopyridine (Pyridium) is prescribed for a client for symptomatic relief of pain resulting from a lower urinary tract infection. The nurse should provide the client with which information regarding this medication?
a.Take the medication at bedtime
b. Take the medication before meals
c. Discontinue the medication if a headache occurs
d. A reddish orange discoloration of the urine may occur
d. A reddish orange discoloration of the urine may occur!!! The nurse should instruct the client that a reddish-orange discoloration of urine may occur. The nurse also should instruct the client that this discoloration can stain fabric.
100
1. A nurse is volunteering at a health screening sponsored by a local church and community center. The nurse is educating men about benign prostatic hyperplasia (BPH). Which of the following men is at greatest risk of developing BPH?
A. A 38 year old Japanese man who is a vegetarian
B. A 52 year old Caucasian man who has a family history of BPH
C. A 27 year old Hispanic man who has a family history of BPH
D. A 56 year old African American man who is a carnivore
D. A 56 year old African American man who is a carnivore
Rationale: Although the exact cause of BPH is unknown, risk factors include: age, family history, race (highest in African Americans and lowest in native Japanese), and a diet high in meat and fats. # 4 is the correct answer because the man’s race, age, and diet high in meat put him at the greatest risk for developing BPH.
100
A nurse is caring for a client with a history of cystitis. Which of the following statements indicates that the client needs additional teaching about the condition?
a. “I try to empty my bladder every 2-3 hours.”
b. “I drink 2-3 quarts of fluids a day.”
c. “I prefer to take baths instead of showers.”
d. “I use an oral contraceptive for birth control.”
C. "I prefer to take baths instead of showers
100
What is a common cause of acute glomerulonephritis although seemingly unrelated?
A) Polypharmacy
B) Glaucoma
C) Strep Throat
D) Staph infection of the skin
C. Strep Throat
200
A client has undergone urinary diversion after cystectomy for bladder cancer. The nurse assesses the urostomy stoma to ensure that it is:
a) pale and pink
b) pink and dry
c) red and moist
d) dusky to beefy colored
C. Red and Moist! - Following urostomy, the stoma should be red and moist. It may be edematous, but this will decrease after the first few days. A dusky or cyanotic color indicates insufficient circulation with impending necrosis and warrants notification of the surgeon immediately.
200
2. A client who has a cold is seen in the emergency department with an inability to void. Because the client has a history of benign prostatic hyperplasia, the nurse determines that the client should be questioned about the use of which medication?
a. Diuretics
b. Antibiotics
c. Antitussives
d. Decongestants
d. Decongestants!!! Episodes of urinary retention can be triggered by certain medications, such as decongestants, anticholinergics, and antidepressants.
200
3. A nurse is educating a group of women at a community center about the importance of being screened for cervical cancer. Which of the following clients is most at risk for cervical cancer?
A. A 40 year old Caucasian women who has one sexual partner, her husband, her entire life.
B. A 38 year old African American women who has a history of human papillomavirus (HPV)
C. A 26 year old Asian women who had her firs sexual encounter at 15 years old
D. A 55 year old Hispanic women who has tested negative for HPV.
A. 38 year old Africa American women who has a history of HPV
Rationale: Risk factors for cervical cancer include infection of the external genitalia and anus with HPV, first intercourse before 16 years of age, multiple sex partners or male partners with multiple sex partners, a history of sexually transmitted infections, and infection with HIV. The most important risk factor is infection by the HPV. Other risk factors include smoking and poor nutritional status, family history of cervical cancer, and exposure to DES (diethylstilbestrol) in utero. The incidence is greater in black women than in white women. # 2 is the correct answer because the client is African American and has had HPV in the past. This puts her at greatest risk.
200
A nurse is caring for a client who is receiving hemodialysis via the left ateriovenous distula. Which of the following statements made by the nurse is appropriate to include while teaching the client about self-care?
a. “Check the site hourly for patency.”
b. “Apply lotion to your arms.”
c. “Avoid tight clothing around your arms.”
d. “Sleep on the left side.”
C- "Avoid tight clothing around your arms
200
A patient comes into your clinic and you perform a routine urine test. The patients specific gravity is 1.004. The complaint that matches the lab test is
A) Glycosuria
B) Dehydration
C) Excessive, clear yellow urine
D) Dark amber, low urine output
C. Excessive, clear yellow urine
300
A client has a ureteral catheter in place after renal surgery. A priority nursing action for care of the ureteral catheter would be to:
1. Irrigate the catheter with 30 mL of normal saline every 8 hours.
2. Ensure that the catheter is draining freely.
3. Clamp the catheter every 2 hours for 30 minutes.
4. Ensure that the catheter drains at least 30 mL/ hour.
2. Ensure that the catheter is draining freely!!! The ureteral catheter should drain freely without bleeding at the site. The catheter is rarely irrigated, and any irrigation would be done by the physician. The catheter is never clamped. The client's total urine output (ureteral catheter plus voiding or indwelling urinary catheter output) should be 30 mL/ hour.
300
3. The nurse, who is administering bethanechol chloride (Urecholine), is monitoring for cholinergic overdose associated with the medication. The nurse should check the client for which sign of overdose?
a. Dry skin
b. Dry mouth
c. Bradycardia
d. Signs of dehydration
C. Bradycardia!! Cholinergic overdose produces manifestations of excessive muscarinic stimulation such as salivation, sweating, involuntary urination and defecations, bradycardia, and severe hypotension. Treatment includes supportive measures and the administration of atropine sulfate subcutaneously or intravenously
300
A patient diagnosed with pyelonephritis asks the nurse how she ended up with this infection in her kidneys. The nurse is correct when she explains that the infection reached her kidneys though
A) The bloodstream
B) A descending infection
C) A ascending infection
D) Food poisoning
C. A ascending infection
300
A nurse is caring for a client who has a renal tumor. The client will undergo a renal biopsy. Which of the following client care should the nurse provide?
a. Instruct the client that there is NPO 8 hr following the procedure.
b. Assess the client for a history of shellfish or iodine allergies prior to the procedure.
c. Maintain bed rest for 4-12 hours following the procedure.
d. Obtain a BUN and Creatinine clearance prior to the procedure.
C. Maintain Bed rest for 4-12 hours following the procedure
300
A client is admitted to the emergency department following a fall from a horse and the health care provider prescribes insertion of a Foley Catheter. While preparing for the procedure, the nurse notes blood at the urinary meatus. The nurse should take which action?
A. Notify the HCP
B. Use a small- sized catheter
C. Administer Pain medication before inserting the catheter
D. Use extra Povidone-iodine solution in cleansing the meatus
A. Notify the HCP- the presence of blood at the urinary meatus may indicate urethral trauma or disruption. They need to find the cause of the bleeding first
400
A nurse is caring for a client following a cystoscopy. Which assessment finding requires physician notification?
a) bladder spasm
b) complaints of fullness and burning in the bladder
c) clots in the urine
d) back pain
C- Clots in urine! - Back pain, bladder spasms, and feelings of fullness and burning in the bladder may be experienced by the client following a cystoscopy. Warm tub baths, mild analgesics, and antispasmodics will provide relief. Pink-tinged urine is common but any bright red bleeding or clots in the urine should be reported to the physician
400
4. Following kidney transplantation, cyclosporine (Sandimmune) is prescribed for a client. Which laboratory result would indicate an adverse effect from the use of this medication?
a. Normal hemoglobin level
b. Decreased creatinine level
c. Decreased white blood cell count
d. Elevated blood urea nitrogen level
D. elevated blood urea nitrogen level Nephrotoxicity can occur from the use of Sandimmune. Nephrotoxicity is evaluated by monitoring for elevated blood urea nitrogen and serum creatinine levels.
400
5. A 58 year old man has difficulty starting a urinary stream and benign prostatic hyperplasia (BPH) is suspected. What is involved in the assessment of the patient for the presence of BHP?
A. Palpating the scrotum and testes for a mass.
B. Palpating the base of the penis for enlargement
C. Palpating the inguinal ring while the patient bears down
D. A digital rectal examination to palpate the prostate gland
D. A digital rectal examination to palpate the prostate gland
Rationale: The prostate is palpated through the wall of the rectum with a digital rectal examination. Inguinal hernias are detected by palpating the inguinal ring while the patient bears down and scrotal palpation is done to detect testicular masses or tumors. No specific conditions are indicated by enlargement at the base of the penis.
400
A nurse is caring for a client who is to undergo a cystoscopy. When educating the client on post-procedure expectations, which of the following should the nurse state?
a. “It will be necessary to keep the sutures clean.”
b. “You will be placed in a dorsal recumbent position.”
c. “Expect to be o bed rest for 24 hours.”
d. “Pink-tinged urine and burning while urinating can be expected.”
D. "Pink-tinged urine and burning while urinating can be expected"
400
A client is admitted to the emergency department following a motor vehicle accident. The client was wearing a lap seat belt when the accident occurred and now the client has hematuria and lower abdominal pain. To assess further whether the pain is caused by bladder trauma, the nurse should ask the client if the pain is referred to which area?
A. Hip
B. Shoulder
C. Umbilicus
D. Costovertebral angle
B. shoulder!! Bladder trauma or injury is characterized by lower abdominal pain that may radiate to one of the shoulders due to phrenic nerve irritation
500
A week after kidney transplantation , a client develops a temperature of 101 F, The blood pressure is elevated, and the kidney is tender. The X-Ray indicates that the transplanted kidney is enlarged. Based on these assessment findings, the nurse suspects which complication?
A. Acute Rejection
B. Kidney infection
C. Chronic Rejection
D. Kidney Obstruction
A. Acute rejection! this most often occurs in the first 2 weeks after transplantation. Clinical manifestations include fever, malaise, elevated WBC, acute hypertension, graft tenderness, and manifestations of deteriorating renal function. Chronic rejection occurs gradually over a period of months to years
500
5. A client with a urinary tract infection is receiving ciprofloxacin (Cipro) by the intravenous route. The nurse appropriately administers the medication by performing which action?
a. Infusing slowly over 60 minutes
b. Infusing in a light-protective bag
c. Infusing only through a central line
d. Infusing rapidly as a direct intravenous push medication
a. Infusing slowly over 60 minutes!! Cipro is prescribed for treatment of mild, moderate, severe, and complicated infections of the urinary tract, lower respiratory tract, and skin and skin structure. A single dose is administered slowly over 60 minutes to minimize discomfort and vein irritation.
500
4. A 72 year old man asks the nurse whether it is normal for him to become impotent at his age. The best response by the nurse includes what information?
A. Most decreased sexual function in older adults is due to psychologic stress.
B. Physiologic changes of aging may require increased stimulation for an erection to occur.
C. Although the penis decreases in size in older men, there should be no change in sexual function.
D. Benign changes in the prostate gland that occur with aging can cause a decreased ability to attain an erection.
B. Physiologic changes of aging may require increased stimulation for an erection to occur
Rationale: Age-related changes in sexual function in men include a need for increase stimulation for an erection, a decrease need to ejaculate. There is a decreased response to sexual stimuli. There is a decreased ability to attain an erection but it is not related to prostatic changes.
500
A nurse is assessing a client in the oliguric anuric stage of acute renal failure. The assessment reveals a respiratory rate of 28/min, and the client reports nausea, a dull headache, palpitations, and general malaise. Which of the following is a priority action?
a. Administer an analgesic.
b. Check the latest electrolyte values.
c. Administer an antiemetic.
d. Check oxygen saturation levels.
B. Check the latest electrolyte values
500
A client is admitted to the hospital with a diagnosis of benign prostatic hyperplasia, and a transurethral resection of the prostate is performed. Four hours after surgery, the nurse takes the clients vital signs and empties the urinary drainage bag. which assessment finding indicates the need to notify the health care provider?
A. Red Bloody Urine
B. Pain related to bladder Spasms
C. Urinary output of 200 mL higher than intake
D. Blood pressure- 100/50mm Hg; Pulse- 130 Bpm
D. Blood pressure of 100/50 and a pulse of 130 is a potential sign of excessive blood loss frank bleeding may occur during the first day of surgery, urinary output of 200 mL is adequate and bladder spasms are expected