ATI Learning System = Medical-Surgical: Renal and Urinary

1. A nurse is reinforcing teaching with a client who has a history of UTIs. Which of the following statements should indicate to the nurse the need for additional instructions? - "I will use a vaginal douche daily" [The client should avoid vaginal douches, bubble baths, and any substances that can increase the risk for UTIs. The client should use mild soap and water to wash the perineal area.] 2. A nurse is reinforcing teaching a client prior to a renal biopsy. Which of the following statements should the nurse make? - "You will need to be on bed rest following the procedure" [A renal biopsy involves a tissue biopsy through needle insertion into the lower lobe of the kidney. The client should maintain bed rest in a supine position with a back roll for support for 2 to 24 hr following the procedure to reduce the risk for bleeding. The nurse can elevate the head of the bed.] 3. A nurse is collecting data for a client who has an injury to the lower abdomen following a motor-vehicle crash. The nurse should identify that which of the following findings is a manifestation of bladder trauma? - Hematuria [Manifestations of bladder trauma include hematuria, or blood in the urine; blood at the urinary meatus; pelvic pain; and anuria, or the absence of urine.] 4. A nurse is reinforcing teaching about the PSA test with a client. Which of the following statements should the nurse make? - "You don't need to fast prior to the PSA test." 5. A nurse is reinforcing teaching with a client who has CKD. Which of the following instructions should the nurse include? - Limit fluid intake [A client who has CKD should limit fluid intake to prevent hypervolemia, or excessive fluid overload.] 6. A nurse is collecting data from a client who is 1 week postop following a living donor kidney transplant. Which of the following findings should indicate to the nurse that the client is experiencing acute kidney rejection? - Blood pressure 160/90 mmHg [Due to the kidney's role in fluid and blood pressure regulation, a client who is experiencing rejection can have hypertension.] 7. A nurse is reinforcing dietary teaching with a client who has late-stage CKD. Which of the following nutrients should the nurse instruct the client to increase in her diet? - Calcium 8. A nurse is reinforcing teaching with a newly licensed nurse about caring for a client who has a new left arteriovenous fistula. Which of the following statements should the nurse make? - "Avoid taking blood pressures on the client's left arm." 9. A nurse is caring for a client who is receiving peritoneal dialysis. The nurse should monitor the client for which of the following adverse effects? - Respiratory distress [Respiratory distress can occur during peritoneal dialysis due to fluid overload.] 10. A nurse is reinforcing teaching about UTIs with a client. Which of the following manifestations should the nurse include? - Back pain 11. A nurse is caring for a client who has a diagnosis of renal calculi and reports severe flank pain. Which of the following is the priority nursing action? - Relieve the client's pain [The nurse should apply the urgent versus non-urgent priority-setting framework when caring for the client. Using this framework, the nurse should consider urgent needs to be the priority because they pose a greater threat to the client. The nurse might also need to use Maslow's hierarchy of needs, the ABC priority-setting framework, or nursing knowledge to identify which finding is the most urgent. The pain associated with renal calculi is severe and can lead to shock; therefore, this is the nurse's priority action.] 12. A nurse is collecting data from a client who is receiving continuous ambulatory peritoneal dialysis. Which of the following findings should the nurse report to the provider? - Cloudy, yellow drainage [Cloudy drainage is an early manifestation of peritonitis and the nurse should report this finding to the provider. Other manifestations include fever and abdominal tenderness.] [Abdominal fullness is an expected finding during the dwell period, when the dialysate stays in the peritoneal cavity. A supine, low-Fowler's position can reduce abdominal pressure.]