Nurse 221 Med-Surg Exam 2 (RENAL) Questions With
Complete Solutions
1. The client frequently finds lumps in her breasts, especially
around her menstrual
period. Which information should the nurse teach the client
regarding breast
self-care?
1. This is a benign process which does not require follow-up.
2. The client should eliminate chocolate and caffeine from the
diet.
3. The client should practice breast self-examination monthly.
4. This is the way breast cancer begins and the client needs
surgery. Correct Answers 3. The American Cancer Society no
longer
recommends breast self-examination
(BSE) for all women, but it is advisable
for women with known breast conditions
to perform BSE monthly to detect
potential cancer.
1. The nurse is admitting a client diagnosed with acute renal
failure (ARF). Which
question is most important for the nurse to ask during the
admission interview?
1. "Have you recently traveled outside the United States?"
2. "Did you recently begin a vigorous exercise program?"
3. "Is there a chance you have been exposed to a virus?"
4. "What over-the-counter medications do you take regularly?"
Correct Answers 4. Medications such as nonsteroidal
anti-inflammatory drugs (NSAIDs) and
,some herbal remedies are nephrotoxic;
therefore, asking about medications is
appropriate.
10. The client is admitted to the emergency department after a
gunshot wound to the
abdomen. Which nursing intervention should the nurse
implement first to prevent
ARF?
1. Administer normal saline IV.
2. Take vital signs.
3. Place client on telemetry.
4. Assess abdominal dressing. Correct Answers 1. Preventing
and treating shock with
blood and fluid replacement will
prevent acute renal failure from
hypoperfusion of the kidneys.
Significant blood loss is expected in
the client with a gunshot wound.
10. The client is being discharged after a left wedge resection.
Which discharge
instructions should the nurse include? Select all that apply.
1. Notify the HCP of a temperature of 100˚F.
2. Carry large purses and bundles with the right hand.
3. Do not go to church or anywhere with crowds.
4. Try to keep the arm as still as possible until seen by the HCP.
5. Have a mammogram of the right and left breast yearly.
Correct Answers 1,2,5
,11. The client who has had a mastectomy tells the nurse, "My
husband will leave me
now since I am not a whole woman anymore." Which response
by the nurse is most
therapeutic?
1. "You're afraid your husband will not find you sexually
appealing?"
2. "Your husband should be grateful you will be able to live and
be with him."
3. "Maybe your husband would like to attend a support group
for spouses."
4. "You don't know that is true. You need to give him a chance."
Correct Answers 1. This is restating the client's feelings
and is a therapeutic response.
11. The UAP tells the nurse the client with ARF has a white
crystal-like layer on top of
the skin. Which intervention should the nurse implement?
1. Have the assistant apply a moisture barrier cream to the skin.
2. Instruct the UAP to bathe the client in cool water.
3. Tell the UAP not to turn the client in this condition.
4. Explain this is normal and do not do anything for the client.
Correct Answers 2. These crystals are uremic frost resulting
from irritating toxins deposited in the
client's tissues. Bathing in cool water
will remove the crystals, promote client
comfort, and decrease the itching
resulting from uremic frost.
12. The client diagnosed with ARF is experiencing
hyperkalemia. Which medication
, should the nurse prepare to administer to help decrease the
potassium level?
1. Erythropoietin.
2. Calcium gluconate.
3. Regular insulin.
4. Osmotic diuretic. Correct Answers 3. Regular insulin, along
with glucose,
will drive potassium into the cells,
thereby lowering serum potassium
levels temporarily.
12. The client has been diagnosed with cancer of the breast.
Which referral is most
important for the nurse to make?
1. The hospital social worker.
2. CanSurmount.
3. Reach to Recovery.
4. I CanCope. Correct Answers 3. Reach to Recovery is a
specific referral
program for clients diagnosed with
breast cancer.
13. The nurse is caring for the client diagnosed with chronic
kidney disease (CKD) who
is experiencing metabolic acidosis. Which statement best
describes the scientific
rationale for metabolic acidosis in this client?
1. There is an increased excretion of phosphates and organic
acids, which leads to an
increase in arterial blood pH.
Complete Solutions
1. The client frequently finds lumps in her breasts, especially
around her menstrual
period. Which information should the nurse teach the client
regarding breast
self-care?
1. This is a benign process which does not require follow-up.
2. The client should eliminate chocolate and caffeine from the
diet.
3. The client should practice breast self-examination monthly.
4. This is the way breast cancer begins and the client needs
surgery. Correct Answers 3. The American Cancer Society no
longer
recommends breast self-examination
(BSE) for all women, but it is advisable
for women with known breast conditions
to perform BSE monthly to detect
potential cancer.
1. The nurse is admitting a client diagnosed with acute renal
failure (ARF). Which
question is most important for the nurse to ask during the
admission interview?
1. "Have you recently traveled outside the United States?"
2. "Did you recently begin a vigorous exercise program?"
3. "Is there a chance you have been exposed to a virus?"
4. "What over-the-counter medications do you take regularly?"
Correct Answers 4. Medications such as nonsteroidal
anti-inflammatory drugs (NSAIDs) and
,some herbal remedies are nephrotoxic;
therefore, asking about medications is
appropriate.
10. The client is admitted to the emergency department after a
gunshot wound to the
abdomen. Which nursing intervention should the nurse
implement first to prevent
ARF?
1. Administer normal saline IV.
2. Take vital signs.
3. Place client on telemetry.
4. Assess abdominal dressing. Correct Answers 1. Preventing
and treating shock with
blood and fluid replacement will
prevent acute renal failure from
hypoperfusion of the kidneys.
Significant blood loss is expected in
the client with a gunshot wound.
10. The client is being discharged after a left wedge resection.
Which discharge
instructions should the nurse include? Select all that apply.
1. Notify the HCP of a temperature of 100˚F.
2. Carry large purses and bundles with the right hand.
3. Do not go to church or anywhere with crowds.
4. Try to keep the arm as still as possible until seen by the HCP.
5. Have a mammogram of the right and left breast yearly.
Correct Answers 1,2,5
,11. The client who has had a mastectomy tells the nurse, "My
husband will leave me
now since I am not a whole woman anymore." Which response
by the nurse is most
therapeutic?
1. "You're afraid your husband will not find you sexually
appealing?"
2. "Your husband should be grateful you will be able to live and
be with him."
3. "Maybe your husband would like to attend a support group
for spouses."
4. "You don't know that is true. You need to give him a chance."
Correct Answers 1. This is restating the client's feelings
and is a therapeutic response.
11. The UAP tells the nurse the client with ARF has a white
crystal-like layer on top of
the skin. Which intervention should the nurse implement?
1. Have the assistant apply a moisture barrier cream to the skin.
2. Instruct the UAP to bathe the client in cool water.
3. Tell the UAP not to turn the client in this condition.
4. Explain this is normal and do not do anything for the client.
Correct Answers 2. These crystals are uremic frost resulting
from irritating toxins deposited in the
client's tissues. Bathing in cool water
will remove the crystals, promote client
comfort, and decrease the itching
resulting from uremic frost.
12. The client diagnosed with ARF is experiencing
hyperkalemia. Which medication
, should the nurse prepare to administer to help decrease the
potassium level?
1. Erythropoietin.
2. Calcium gluconate.
3. Regular insulin.
4. Osmotic diuretic. Correct Answers 3. Regular insulin, along
with glucose,
will drive potassium into the cells,
thereby lowering serum potassium
levels temporarily.
12. The client has been diagnosed with cancer of the breast.
Which referral is most
important for the nurse to make?
1. The hospital social worker.
2. CanSurmount.
3. Reach to Recovery.
4. I CanCope. Correct Answers 3. Reach to Recovery is a
specific referral
program for clients diagnosed with
breast cancer.
13. The nurse is caring for the client diagnosed with chronic
kidney disease (CKD) who
is experiencing metabolic acidosis. Which statement best
describes the scientific
rationale for metabolic acidosis in this client?
1. There is an increased excretion of phosphates and organic
acids, which leads to an
increase in arterial blood pH.
