Med-surg II Exam 3 : Simplified study
guide
What indicates patient understanding for undergoing a uterosigmoidoscopy?
- watch for s/sx of infection
- empty bladder q2h
- i do not have to wear an appliance
- drain urine from pouch
i do not have to wear an appliance
For a patient with a cutaneous urinary diversion, what is included in the plan of
care? SATA
- How to assess and manage urinary diversion
- change the appliance, managing odor, cleaning the appliance
- How to deal with body changes
- How to assess and manage urinary diversion
- change the appliance, managing odor, cleaning the appliance
- How to deal with body changes
Pt is on dialysis, brought in with an infection, what would you question?
- fluid administration
- IV abx
- oral abx after dialysis
fluid administration
- increase Na
- increase protein
- increase phosphorus
- restrict K
- restrict Na
- Restrict protein
- restrict phosphorus
What is the RIFLE Acronym and what is it for?
Risk
Injury
Failure
Loss
ESKD
If the GFR decreases, what else happens?
- creatinine clearance decreases/BUN increases
- Creatinine clearance increases/BUN increases
- Creatinine Clearance decreases/BUN decreases
creatinine clearance decreases/BUN increases
Where is the AVF usually located?
in the forearm
What would lab values show for fluid deprivation test?
if pt has DI, no change in specific gravity and osmolality
,A client is diagnosed with acute renal failure and is admitted to the critical care
unit. the pt is placed on a restricted diet d/t the diagnosis. what is the most
appropriate?
- regular diet with 6 small meals a day
- low fat, low cholesterol diet
- high carb, restricted protein diet
- high potassium, low calcium diet
high carb, restricted protein diet
The RN is evaluating the d/c teaching for a client who has an ileal conduit. Which
statements indicate that the client has correctly understood the teaching? SATA
- I should empty my ostomy pouch of urine when it is full
- I must use skin barriers to protect my skin from urine's acidity
- I can usually keep my ostomy pouch on for 3-7 days before changing it
- I can place an aspirin tablet in my pouch to decrease odor
- If I limit my fluid intake, I wont have to empty my ostomy pouch as often
- I must use skin barriers to protect my skin from urine's acidity
- I can usually keep my ostomy pouch on for 3-7 days before changing it
When teaching the pt care for an ileal conduit, the RN instructs the pt to empty
the appliance frequently. What outcome indicates the client is following
instructions?
- The skin around the stoma is red
- The seal around the stoma is intact
- The urine is deep yellow
- There is no odor present
- The seal around the stoma is intact
The RN is assessing the urine of the client with an ileal conduit and notes there is
a moderate amount of mucus in the urine. What should the RN do next?
- Encourage a high fluid intake
- Obtain a urine specimen for culture
- Notify PCP
- Change the appliance bag
- Encourage a high fluid intake
A pt is scheduled to undergo weekly intravesical chemotherapy for bladder
cancer for 8 weeks. What statement indicates the client understands how to
manage urine as a biohazard?
- I should use a separate bathroom from the rest of the family for the next 8 weeks
- It is important to clean the bathroom daily with disinfectant wipes
- I can disinfect the urine and toilet with bleach for 6 hours following a treatment
- I will void into a bedpan then empty the urine in the toilet
- I can disinfect the urine and toilet with bleach for 6 hours following a treatment
A pt with chronic renal failure is receiving hemodialysis and has an AVF on the L
arm. What should the RN instruct the patient to do? SATA
- Obtain BP from the left arm
- Assess fingers on the L arm for warmth
- Wear wristwatch on the R arm
, - Avoid sleeping on the L arm
- Remind HCP to draw blood from veins on the L arm
- Assess fingers on the L arm for warmth
- Wear wristwatch on the R arm
- Avoid sleeping on the L arm
The RN warms the dialysis solution before use in peritoneal dialysis. What is the
expected outcome after warming the solution?
- Promoted abdominal muscle relaxation
- Encourage the removal of serum urea
- Add extra warmth to the body
- Forces potassium back into the cells
Encourage the removal of serum urea
The pt performs self-peritoneal dialysis. What should the RN teach the client
about preventing peritonitis? SATA
- Peritonitis is the most common and serious complications of peritoneal dialysis
- Peritonitis is characterized by cloudy dialysate drainage and abdominal
discomfort
- Clean technique is permissible for prevention of peritonitis
- Abx may be added to the dialysate to treat peritonitis
- Broad spectrum abx may be administered to prevent infection
- Peritonitis is the most common and serious complications of peritoneal dialysis
- Peritonitis is characterized by cloudy dialysate drainage and abdominal discomfort
- Abx may be added to the dialysate to treat peritonitis
- Broad spectrum abx may be administered to prevent infection
The RN is admitting a client dx with acute renal failure. Which question is most
important for the nurse to ask during the admission interview?
- Have you been outside the US recently?
- Did you recently begin a vigorous exercise program?
- What OTC medications do you take regularly?
- Is there a change you may be exposed to a virus?
- What OTC medications do you take regularly?
Which statement indicates d/c teaching has been effective for a pt who is s/t
TURP procedure?
- I will take my pain meds routinely even if I am not in pain
- I will continue to restrict my oral fluid intake
- I will call the surgeon if I experience any difficulty urinating or notice purulent
drainage
- I can resume sexual activity within 7-10 days
- I will call the surgeon if I experience any difficulty urinating or notice purulent drainage
A pt dx with chronic renal failure is prescribed hemodialysis on MWF. Which
intervention should the dialysis nurse implement? SATA
- Keep up a lively conversation during treatments
- Monitor the hemodialysis site continuously
- Provide potato chips or pretzels as a snack
- Discuss the recommended fluid restriction
- Weigh the client before and after tx
guide
What indicates patient understanding for undergoing a uterosigmoidoscopy?
- watch for s/sx of infection
- empty bladder q2h
- i do not have to wear an appliance
- drain urine from pouch
i do not have to wear an appliance
For a patient with a cutaneous urinary diversion, what is included in the plan of
care? SATA
- How to assess and manage urinary diversion
- change the appliance, managing odor, cleaning the appliance
- How to deal with body changes
- How to assess and manage urinary diversion
- change the appliance, managing odor, cleaning the appliance
- How to deal with body changes
Pt is on dialysis, brought in with an infection, what would you question?
- fluid administration
- IV abx
- oral abx after dialysis
fluid administration
- increase Na
- increase protein
- increase phosphorus
- restrict K
- restrict Na
- Restrict protein
- restrict phosphorus
What is the RIFLE Acronym and what is it for?
Risk
Injury
Failure
Loss
ESKD
If the GFR decreases, what else happens?
- creatinine clearance decreases/BUN increases
- Creatinine clearance increases/BUN increases
- Creatinine Clearance decreases/BUN decreases
creatinine clearance decreases/BUN increases
Where is the AVF usually located?
in the forearm
What would lab values show for fluid deprivation test?
if pt has DI, no change in specific gravity and osmolality
,A client is diagnosed with acute renal failure and is admitted to the critical care
unit. the pt is placed on a restricted diet d/t the diagnosis. what is the most
appropriate?
- regular diet with 6 small meals a day
- low fat, low cholesterol diet
- high carb, restricted protein diet
- high potassium, low calcium diet
high carb, restricted protein diet
The RN is evaluating the d/c teaching for a client who has an ileal conduit. Which
statements indicate that the client has correctly understood the teaching? SATA
- I should empty my ostomy pouch of urine when it is full
- I must use skin barriers to protect my skin from urine's acidity
- I can usually keep my ostomy pouch on for 3-7 days before changing it
- I can place an aspirin tablet in my pouch to decrease odor
- If I limit my fluid intake, I wont have to empty my ostomy pouch as often
- I must use skin barriers to protect my skin from urine's acidity
- I can usually keep my ostomy pouch on for 3-7 days before changing it
When teaching the pt care for an ileal conduit, the RN instructs the pt to empty
the appliance frequently. What outcome indicates the client is following
instructions?
- The skin around the stoma is red
- The seal around the stoma is intact
- The urine is deep yellow
- There is no odor present
- The seal around the stoma is intact
The RN is assessing the urine of the client with an ileal conduit and notes there is
a moderate amount of mucus in the urine. What should the RN do next?
- Encourage a high fluid intake
- Obtain a urine specimen for culture
- Notify PCP
- Change the appliance bag
- Encourage a high fluid intake
A pt is scheduled to undergo weekly intravesical chemotherapy for bladder
cancer for 8 weeks. What statement indicates the client understands how to
manage urine as a biohazard?
- I should use a separate bathroom from the rest of the family for the next 8 weeks
- It is important to clean the bathroom daily with disinfectant wipes
- I can disinfect the urine and toilet with bleach for 6 hours following a treatment
- I will void into a bedpan then empty the urine in the toilet
- I can disinfect the urine and toilet with bleach for 6 hours following a treatment
A pt with chronic renal failure is receiving hemodialysis and has an AVF on the L
arm. What should the RN instruct the patient to do? SATA
- Obtain BP from the left arm
- Assess fingers on the L arm for warmth
- Wear wristwatch on the R arm
, - Avoid sleeping on the L arm
- Remind HCP to draw blood from veins on the L arm
- Assess fingers on the L arm for warmth
- Wear wristwatch on the R arm
- Avoid sleeping on the L arm
The RN warms the dialysis solution before use in peritoneal dialysis. What is the
expected outcome after warming the solution?
- Promoted abdominal muscle relaxation
- Encourage the removal of serum urea
- Add extra warmth to the body
- Forces potassium back into the cells
Encourage the removal of serum urea
The pt performs self-peritoneal dialysis. What should the RN teach the client
about preventing peritonitis? SATA
- Peritonitis is the most common and serious complications of peritoneal dialysis
- Peritonitis is characterized by cloudy dialysate drainage and abdominal
discomfort
- Clean technique is permissible for prevention of peritonitis
- Abx may be added to the dialysate to treat peritonitis
- Broad spectrum abx may be administered to prevent infection
- Peritonitis is the most common and serious complications of peritoneal dialysis
- Peritonitis is characterized by cloudy dialysate drainage and abdominal discomfort
- Abx may be added to the dialysate to treat peritonitis
- Broad spectrum abx may be administered to prevent infection
The RN is admitting a client dx with acute renal failure. Which question is most
important for the nurse to ask during the admission interview?
- Have you been outside the US recently?
- Did you recently begin a vigorous exercise program?
- What OTC medications do you take regularly?
- Is there a change you may be exposed to a virus?
- What OTC medications do you take regularly?
Which statement indicates d/c teaching has been effective for a pt who is s/t
TURP procedure?
- I will take my pain meds routinely even if I am not in pain
- I will continue to restrict my oral fluid intake
- I will call the surgeon if I experience any difficulty urinating or notice purulent
drainage
- I can resume sexual activity within 7-10 days
- I will call the surgeon if I experience any difficulty urinating or notice purulent drainage
A pt dx with chronic renal failure is prescribed hemodialysis on MWF. Which
intervention should the dialysis nurse implement? SATA
- Keep up a lively conversation during treatments
- Monitor the hemodialysis site continuously
- Provide potato chips or pretzels as a snack
- Discuss the recommended fluid restriction
- Weigh the client before and after tx
