Kaplan Renal Urological System A Exam
The nurse in the adult day care facility counsels a patient who states that she is having difficulty
with stress incontinence. The patient is a 78-year-old female, 5’2, weighs 180 lbs, and had 4 live
births. Which of the following statements by the nurse is MOST appropriate?
a) “There are some very good adult diapers available.”
b) “Let’s talk about ways to reduce your weight.”
c) “You should drink less water.”
d) “Incontinence is to be expected at your age.”
(Kaplan Renal-Uro System A) – correct answer✔✔ b) “Lets talk about ways to reduce your
weight.”
increased abdominal pressure caused by obesity contributes to stress incontinence; instruct
patient how to perform pelvic muscle exercises; inappropriate to refer to protective pads and
briefs as “adult diapers;” should avoid foods with caffeine and alcohol bc of their diuretic effect
(Kaplan Renal-Uro System A)
The nurse cares for patients in a residential care facility. The nurse notes that a patient is
suddenly disoriented to person, place, and time, and is falling. Which of the following actions
should the nurse take FIRST?
a) Obtain an order for a vest restraining
b) Frequently orient the patient to person, place, and time
c) Instruct the patient to call the nurses before ambulating
d) Assess for signs and symptoms of a urinary tract infection
(Kaplan Renal-Uro System A) – correct answer✔✔ d) Assess for signs and symptoms of a
urinary tract infection
increased mental function and unexplained falls may indicate a UTI in the elderly; also may
have loss of appetite, nocturia, and dysuria
(Kaplan Renal-Uro System A)
The nurse cares for a patient immediately after a complete cystectomy and ileal conduit. The
nurse is MOST concerned if which of the following is observed?
a) The nursing output is 60 mL per hour
b) The stoma appears red in color
c) The stoma is edematous
d) There is a small amount of serosanguineous drainage
(Kaplan Renal-Uro System A) – correct answer✔✔ c) The stoma is edematous
edema can cause obstruction of stoma; also observe for excessive bleeding or enlargement of
stoma
(Kaplan Renal-Uro System A)
During perioneal dialysis, a patient suddenly begins to breathe more rapidly. Which of the
following actions should the nurse take FIRST?
a) Discontinue the dialysis procedure
b) Check the patient’s vital signs
c) Notify the physician
d) Elevate the head of the bed
(Kaplan Renal-Uro System A) – correct answer✔✔ d) Elevate the head of the bed
will decrease the pressure of the dialysate on the diaphragm, and increase the vital capacity of
the lungs; draining the cavity of fluid will further decrease the pressure
(Kaplan Renal-Uro System A)
The client reports a fever for several days prior to admission to the hospital. The client’s
temperature is 101º F (38.4º C), and the client is started on penicillin therapy. It is ESSENTIAL
for the nurse to monitor the client for which finding?
a) Increased blood urea nitrogen (BUN)
b) Allergic reaction
c) Anemia
d) Decrease appetite
(Kaplan Renal-Uro System A) – correct answer✔✔ b) Allergic reaction
allergic reaction or anaphylaxis occurs within an hour, but usually within minutes after
administration of penicillin to a client who is hypersensitive; penicillin is not a nephrotoxic
antibiotic, so BUN does not have to be monitored
(Kaplan Renal-Uro System A)
The LPN reinforces instructions for a client who is to perform an intermittent self-catheterization. Which statement requires an intervention by the LPN?
I will decrease the amount of fluid I drink so I don’t have to use the catheter often
The LPN is asked by the neighbor, “What can I do? I wet my pants every time I sneeze.” Which is the best reply by the LPN?
You should seek the advice of your primary care health provider
The LPN cares for a female client diagnosed with urinary tract infection. Which statement by the client indicates understanding about urinary tract infection prevention?
I will avoid the use of powder in the area of my vagina and rectum
The LPN obtains health history data from a 68 year old client diagnosed with BPH. What is a clinical manifestation of BPH?
- nocturia
- urgency
- dribbling after urination
- weak stream
The LPN understands that primary causes of chronic kidney disease include
- diabetes mellitus
- hypertension
- acute kidney injury
The LPN explains to the client that there is a risk for developing
- hyperkalemia
- anemia
- Hyperkalemia
- Hypervolemia
3.Pruritus - monitor vital signs
administer prescribed PO loop diuretic - monitor for elevated blood pressure
maintain fluid restriction
monitor weight - report skin breakdown or rash
provide meticulous skin care/oral hygiene
administer antipruritic as prescirbed
The client is now in stage 4, severe CKD, and has decided to undergo hemodialysis.
- cleanses blood of accumulated waste products
- corrects electrolyte levels in the body
- removes the byproducts of protein metabolism
The LPN documents observations of the client prior to the dialysis session
- there is a small red streak around the access site and it is warm to the touch
- the client was taken by transport to the outpatient dialysis center prior to obtaining a weight
The nurse provides teaching to the client about CKD and hemodialysis. The LPN follows up on which 2 comments from the client?
- you can take my blood pressure on the side of my AV fistula but you cannot draw blood on that arm
- eating foods high in potassium is an important part of the kidney diet
The client who had a TURP asks the LPN, “What is the reason for that big bag of fluid that is hanging at the foot of the bed?” The LPN identifies which is the primary reason for this fluid?
to remove blood clots
The LPN reviews lab results for a client diagnosed with CKD. Which lab test is the most accurate indicator of the kidney function?
serum creatinine levels
The LPN recognizes that which is a sign or symptom of UTI specifically seen in the older adult client?
- altered sensorium
- incontinence
- low grade fever
What will the LPN expect to observe during the care of a client diagnosed with acute glomerulonephritis?
swelling around eyes
The lPN reinforces education to the clients at the local senior center. The LPN identifies that which is the primary causes of AGN?
prior viral or bacterial infection
The LPN reinforces instructions for a client diagnosed with kidney stones. Which statement by the client indicates understanding of the instructions?
I should drink more water every day
A client had an indwelling urinary catheter after total hip arthroplasty and is unable to void after the catheter is removed. The LPN is to perform an in and out catheterization. The client asks why the indwelling catheter cannot be replaced and stay in until it is easier to get in and out of bed.
Having a catheter puts you at risk for UTI
The LPN reinforces instructions for a client who is to perform Kegel exercises for the treatment of urinary incontinence. Which statement by the client indicates understanding of the instructions?
these exercises will strengthen the muscles in my pelvis
The client diagnosed six weeks ago with chronic glomerulonephritis asks the LPN, “Why do I have to take this medicine for high blood pressure? My blood pressure is okay. Which is the reason the LPN gives to the client
The medication is used to bring high blood pressure down to normal. If your blood pressure is okay, the medicine is working
The LPN reinforces instructions for a client diagnosed with CKD. Which statement indicates a need for further instruction?
I plan to use salt substitute now instead of table salt
The LPN cares for the client after elective surgery. The LPN notes the client’s urine output has decreased from 600 mL on the last shift to no urine for the first 4 hours of this shift. The client is experiencing acute kidney injury. The LPN recognizes which is the most probable cause for the AKI
hypotension during surgery
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