NR 464 - Exam 1 questions (Saunders)
- Kidneys and Bladder
The nurse is assessing the patency of a client's left arm arteriovenous fistula prior to
initiating hemodialysis. Which finding indicates that the fistula is patent?
1. Palpation of a thrill over the fistula
2. Presence of a radial pulse in the left wrist
3. Visualization of enlarged blood vessels at the fistula site
4. Capillary refill less than 3 seconds in the nail beds of the fingers on the left hand -
✔️✔️1. Palpation of a thrill over the fistula
A client is admitted to the emergency department following a fall from a horse and the
health care provider (HCP) prescribes insertion of a urinary catheter. While preparing
for the procedure, the nurse notes blood at the urinary meatus. The nurse should take
which action?
1. Notify the HCP before performing the catheterization.
2. Use a small-sized catheter and an anesthetic gel as a lubricant.
3. Administer parenteral pain medication before inserting the catheter.
4. Clean the meatus with soap and water before opening the catheterization kit. -
✔️✔️1. Notify the HCP before performing the catheterization.
A client complains of fever, perineal pain, and urinary urgency, frequency, and dysuria.
To assess whether the client's problem is related to bacterial prostatitis, the nurse
reviews the results of the prostate examination for which characteristic of this disorder?
1. Soft and swollen prostate gland
2. Swollen, and boggy prostate gland
3. Tender and edematous prostate gland
4. Tender, indurated prostate gland that is warm to the touch - ✔️✔️4. Tender,
indurated prostate gland that is warm to the touch
A client with acute kidney injury has a serum potassium level of 7.0 mEq/L (7.0 mmol/L).
The nurse should plan which actions as a priority? Select all that apply.
1. Place the client on a cardiac monitor.
2. Notify the health care provider (HCP).
3. Put the client on NPO (nothing by mouth) status except for ice chips.
4. Review the client's medications to determine if any contain or retain potassium.
,5. Allow an extra 500 mL of intravenous fluid intake to dilute the electrolyte
concentration. - ✔️✔️1. Place the client on a cardiac monitor.
2. Notify the health care provider (HCP).
4. Review the client's medications to determine if any contain or retain potassium.
A client arrives at the emergency department with complaints of low abdominal pain and
hematuria. The client is afebrile. The nurse next assesses the client to determine a
history of which condition?
1. Pyelonephritis
2. Glomerulonephritis
3. Trauma to the bladder or abdomen
4. Renal cancer in the client's family - ✔️✔️3. Trauma to the bladder or abdomen
The nurse is collecting data from a client. Which symptom described by the client is
characteristic of an early symptom of benign prostatic hyperplasia?
1. Nocturia
2. Scrotal edema
3. Occasional constipation
4. Decreased force in the stream of urine - ✔️✔️4. Decreased force in the stream of
urine
The nurse monitoring a client receiving peritoneal dialysis notes that the client's outflow
is less than the inflow. Which actions should the nurse take? Select all that apply.
1. Check the level of the drainage bag.
2. Reposition the client to his or her side.
3. Contact the health care provider (HCP).
4. Place the client in good body alignment.
5. Check the peritoneal dialysis system for kinks.
6. Increase the flow rate of the peritoneal dialysis solution. - ✔️✔️1. Check the level of
the drainage bag.
2. Reposition the client to his or her side.
4. Place the client in good body alignment.
5. Check the peritoneal dialysis system for kinks.
A hemodialysis client with a left arm fistula is at risk for arterial steal syndrome. The
nurse should assess for which manifestations of this complication?
1. Warmth, redness, and pain in the left hand
2. Ecchymosis and audible bruit over the fistul
, 3. Edema and reddish discoloration of the left arm
4. Pallor, diminished pulse, and pain in the left hand - ✔️✔️4. Pallor, diminished pulse,
and pain in the left hand
The nurse is reviewing a client's record and notes that the health care provider has
documented that the client has chronic renal disease. On review of the laboratory
results, the nurse most likely would expect to note which finding?
1. Elevated creatinine level
2. Decreased hemoglobin level
3. Decreased red blood cell count
4. Increased number of white blood cells in the urine - ✔️✔️1. Elevated creatinine level
A client with chronic kidney disease returns to the nursing unit following a hemodialysis
treatment. On assessment, the nurse notes that the client's temperature is 38.5°C
(101.2°F). Which nursing action is most appropriate?
1. Encourage fluid intake.
2. Notify the health care provider.
3. Continue to monitor vital signs.
4. Monitor the site of the shunt for infection. - ✔️✔️2. Notify the health care provider.
A temperature of 101.2°F (38.5°C) is significantly elevated and may indicate infection.
The nurse should notify the health care provider (HCP). Dialysis clients cannot have
fluid intake encouraged. Vital signs and the shunt site should be monitored, but the HCP
should be notified first.
The nurse is performing an assessment on a client who has returned from the dialysis
unit following hemodialysis. The client is complaining of headache and nausea and is
extremely restless. Which is the priority nursing action?
1. Monitor the client.
2. Elevate the head of the bed.
3. Assess the fistula site and dressing.
4. Notify the health care provider (HCP). - ✔️✔️4. Notify the health care provider
(HCP).
Disequilibrium syndrome may be caused by rapid removal of solutes from the body
during hemodialysis. These changes can cause cerebral edema that leads to increased
intracranial pressure. The client is exhibiting early signs and symptoms of disequilibrium
syndrome and appropriate treatments with anticonvulsive medications and barbiturates
may be necessary to prevent a life-threatening situation. The HCP must be notified.
A client with severe back pain and hematuria is found to have hydronephrosis due to
urolithiasis. The nurse anticipates which treatment will be done to relieve the
obstruction? Select all that apply.
- Kidneys and Bladder
The nurse is assessing the patency of a client's left arm arteriovenous fistula prior to
initiating hemodialysis. Which finding indicates that the fistula is patent?
1. Palpation of a thrill over the fistula
2. Presence of a radial pulse in the left wrist
3. Visualization of enlarged blood vessels at the fistula site
4. Capillary refill less than 3 seconds in the nail beds of the fingers on the left hand -
✔️✔️1. Palpation of a thrill over the fistula
A client is admitted to the emergency department following a fall from a horse and the
health care provider (HCP) prescribes insertion of a urinary catheter. While preparing
for the procedure, the nurse notes blood at the urinary meatus. The nurse should take
which action?
1. Notify the HCP before performing the catheterization.
2. Use a small-sized catheter and an anesthetic gel as a lubricant.
3. Administer parenteral pain medication before inserting the catheter.
4. Clean the meatus with soap and water before opening the catheterization kit. -
✔️✔️1. Notify the HCP before performing the catheterization.
A client complains of fever, perineal pain, and urinary urgency, frequency, and dysuria.
To assess whether the client's problem is related to bacterial prostatitis, the nurse
reviews the results of the prostate examination for which characteristic of this disorder?
1. Soft and swollen prostate gland
2. Swollen, and boggy prostate gland
3. Tender and edematous prostate gland
4. Tender, indurated prostate gland that is warm to the touch - ✔️✔️4. Tender,
indurated prostate gland that is warm to the touch
A client with acute kidney injury has a serum potassium level of 7.0 mEq/L (7.0 mmol/L).
The nurse should plan which actions as a priority? Select all that apply.
1. Place the client on a cardiac monitor.
2. Notify the health care provider (HCP).
3. Put the client on NPO (nothing by mouth) status except for ice chips.
4. Review the client's medications to determine if any contain or retain potassium.
,5. Allow an extra 500 mL of intravenous fluid intake to dilute the electrolyte
concentration. - ✔️✔️1. Place the client on a cardiac monitor.
2. Notify the health care provider (HCP).
4. Review the client's medications to determine if any contain or retain potassium.
A client arrives at the emergency department with complaints of low abdominal pain and
hematuria. The client is afebrile. The nurse next assesses the client to determine a
history of which condition?
1. Pyelonephritis
2. Glomerulonephritis
3. Trauma to the bladder or abdomen
4. Renal cancer in the client's family - ✔️✔️3. Trauma to the bladder or abdomen
The nurse is collecting data from a client. Which symptom described by the client is
characteristic of an early symptom of benign prostatic hyperplasia?
1. Nocturia
2. Scrotal edema
3. Occasional constipation
4. Decreased force in the stream of urine - ✔️✔️4. Decreased force in the stream of
urine
The nurse monitoring a client receiving peritoneal dialysis notes that the client's outflow
is less than the inflow. Which actions should the nurse take? Select all that apply.
1. Check the level of the drainage bag.
2. Reposition the client to his or her side.
3. Contact the health care provider (HCP).
4. Place the client in good body alignment.
5. Check the peritoneal dialysis system for kinks.
6. Increase the flow rate of the peritoneal dialysis solution. - ✔️✔️1. Check the level of
the drainage bag.
2. Reposition the client to his or her side.
4. Place the client in good body alignment.
5. Check the peritoneal dialysis system for kinks.
A hemodialysis client with a left arm fistula is at risk for arterial steal syndrome. The
nurse should assess for which manifestations of this complication?
1. Warmth, redness, and pain in the left hand
2. Ecchymosis and audible bruit over the fistul
, 3. Edema and reddish discoloration of the left arm
4. Pallor, diminished pulse, and pain in the left hand - ✔️✔️4. Pallor, diminished pulse,
and pain in the left hand
The nurse is reviewing a client's record and notes that the health care provider has
documented that the client has chronic renal disease. On review of the laboratory
results, the nurse most likely would expect to note which finding?
1. Elevated creatinine level
2. Decreased hemoglobin level
3. Decreased red blood cell count
4. Increased number of white blood cells in the urine - ✔️✔️1. Elevated creatinine level
A client with chronic kidney disease returns to the nursing unit following a hemodialysis
treatment. On assessment, the nurse notes that the client's temperature is 38.5°C
(101.2°F). Which nursing action is most appropriate?
1. Encourage fluid intake.
2. Notify the health care provider.
3. Continue to monitor vital signs.
4. Monitor the site of the shunt for infection. - ✔️✔️2. Notify the health care provider.
A temperature of 101.2°F (38.5°C) is significantly elevated and may indicate infection.
The nurse should notify the health care provider (HCP). Dialysis clients cannot have
fluid intake encouraged. Vital signs and the shunt site should be monitored, but the HCP
should be notified first.
The nurse is performing an assessment on a client who has returned from the dialysis
unit following hemodialysis. The client is complaining of headache and nausea and is
extremely restless. Which is the priority nursing action?
1. Monitor the client.
2. Elevate the head of the bed.
3. Assess the fistula site and dressing.
4. Notify the health care provider (HCP). - ✔️✔️4. Notify the health care provider
(HCP).
Disequilibrium syndrome may be caused by rapid removal of solutes from the body
during hemodialysis. These changes can cause cerebral edema that leads to increased
intracranial pressure. The client is exhibiting early signs and symptoms of disequilibrium
syndrome and appropriate treatments with anticonvulsive medications and barbiturates
may be necessary to prevent a life-threatening situation. The HCP must be notified.
A client with severe back pain and hematuria is found to have hydronephrosis due to
urolithiasis. The nurse anticipates which treatment will be done to relieve the
obstruction? Select all that apply.
