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ATI URINARY ELIMINATION EXAM LATEST ACTUAL EXAM
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ATI URINARY ELIMINATION EXAM LATEST ACTUAL EXAM
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ATI URINARY ELIMINATION EXAM LATEST ACTUAL EXAM
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ATI URINARY ELIMINATION EXAM LATEST ACTUAL EXAMA nurse is caring for a client with recurrent kidney stones. The provider order several
diagnostic studies, including intravenous pyelogram (IVP), urine culture and
sensitivity, and strain all urine. The nurse needs to inquire further if the client states
which of the following? - ANSWER: "I never eat shellfish because they give me
hives."
Rationale: Getting hives after eating shellfish is a likely indication of an allergy. The
contrast medium used for IVP dye is typically an iodine or shellfish derivative. A
client with sensitivity to iodine or shellfish may have an anaphylactic reaction after
the contrast material is injected.
A nurse is caring for a client who is receiving hemodialisis via the left arteriovenous
fistula for management of chronic renal disease. Which of the following teaching
points should the nurse reinforce? - ANSWER: Avoid tight clothing around the access
site.
Rationale: Tight clothing may decrease the blood flow and cause clotting.
A nurse is caring for a client with chronic renal failure. Which of the following client
statements indicates an understanding of the dietary needs for lifestyle
management of this disease? - ANSWER: "I will limit my fluid intake."
Rationale: The client who has chronic renal failure needs to avoid hypovolemia, or
fluid overload , by following the fluid restriction each daily. Protein restriction will
also be necessary to avoid elevating the serum BUN levels.
A nurse is caring for a client who was brought to the emergency room following an
accident. The nurse suspects a ruptured bladder.Which of the following is consistent
with this diagnosis? - ANSWER: Hematuria
Rationale: The cheif manifestation of a ruptured bladder are hematuria (blood in the
urine), pelvic pain, and oliguria (low urine output).
A nurse is caring for a client who just had a transurethral resection of the prostate
(TURP). Which of the following should the nurse remind the client to report to the
provider? - ANSWER: Painful urination
Rationale:The client should notify the provider of any signs of urinary tract infection,
such as fever, urinary frequency, or painful urination.
A nurse is caring for a client who is to undergo a cystoscopy. When reinforcing
teaching to the client on post-procedure expectations, which of the following should
the nurse state? - ANSWER: "Pink tinged urine and burning while urinating can be
expected."
Rationale: Cystoscopy is a direct look inside the clients bladder through a small
camera that is inserted through the urethra. It is a common test used to look for
causes to bleeding in the urine and other bladder problems. Following the
procedure, pink tinged urine and burning on urination is to be expected.
,A nurse is caring for a client with a history of cystitis.
Which of the following statements indicates a need for further education? -
ANSWER: "I prefer to take baths instead of showers."
Rationale: Women who have frequent uti's are encouraged to take showers instead
of baths. A tub bath is more likely to cause irritation and contamination of the
urethra; therefor, leading to frequent uti's.
A nurse is caring for a client with chronic kidney disease. The nurse anticipates that
the provider will prescribe a diet that has which of the following restrictions? -
ANSWER: Protein
Rationale: Chronic kidney disease is irreversible loss of kidney ability to excrete
waste, concentrate urine, and conserve electrolytes. A diet low in protein supplies
only essential amino acids reducing the amount of metabolic waste products and
may help to preserve a degree of kidney function.
A nurse is reinforcing teachings to a client scheduled for a vasectomy about the
procedure. Which of the following client statements indicates an understanding of
the procedure? - ANSWER: "I need to have a two follow-up negative sperm count."
Rationale: Contraceptive measures need to be used until after sperm analysis are
negative. Sperm can remain viable for up to 6month in the vas deferens.
A nurse is caring for a client who has a diagnosis of renal calculi. Which of the
following is a priority nursing action? - ANSWER: Relieve Pain
Rationale: The pain associated with renal calculi is severe and should be addressed
immediately.
A nurse is caring for a client who is suspected of having a UTI. The provider
prescribes a urine specimen. Which of the following findings should confirm to the
nurse that an upper UTI involving the kidney is present? - ANSWER: Casts
Rationale: Casts are protein structures that are precipitated in the renal tubules.
Presence of the these in the urine indicates a pathologic condition of the kidney.
A nurse is collecting a 24hr creatinine clearance. During the collection, the client
accidentally discards a specimen. Which of the following is an appropriate nursing
action? - ANSWER: Discard the previous collection and start the collection again.
Rationale: All urine voided in a 24hr must be collected, or the test results will not be
accurate.
A nurse is caring for a client who has under-gone a non-related living donor kidney
transplant. On the 5th postoperative day, the nurse notes that the client has gained
1kg of body weight since the previous day. The nurse suspects rejection. Which of
the following would also be seen in a client experiencing rejection? - ANSWER: Blood
Pressure of 160/90mm/Hg
Rationale: If the client is having kidney rejection, that will be accompanied by kidney
failure. Consequently, due to the kidneys role in fluid and blood pressure regulation,
the client experiencing rejection will typically be hypertensive.
,A nurse is caring for a client who has chronic renal failure. Which of the following
should the nurse remind the client to increase in her diet? - ANSWER: Calcium
The client should supplement calcium in to her diet because the kidneys are unable
to activate calcium through the gastrointestinal track.
A nurse is reinforcing education on prostate health to a client. Which of the following
statements is an appropriate statement for the nurse to make regarding a PSA test. -
ANSWER: The PSA should not be given within 48hrs of a rectal exam.
Rationale: PSA is a glycoprotein that is found only in cytoplasm of the epithelial cells
of the prostate.
A nurse is caring for a client receiving peritoneal dialysis. The nurse notes that the
client's dialysate output is less than the input, the abdomen is distended, and the
client is reporting pain. Which of the following is an appropriate nursing action? -
ANSWER: Change the client's position.
Rationale: Dialysate solution is infused through the catheter in the abdominal wall
into the peritoneal space. If the client appears to be retaining the dialysate solution,
the client should change positions to facilitate the drainage of the solution from the
peritoneal cavity.
A nurse is caring for a client with suspected acute renal failure who is to undergo a
renal biopsy. Which of the following positions should the nurse assist the client into?
- ANSWER: The client is positioned prone with a pillow elevating the abdomen. A
renal biopsy is the insertion of a needle into the kidney just below the twelfth rib to
obtain diagnostic specimens.
A nurse is caring for a client receiving peritoneal dialysis. Which of the following is a
complication of this procedure? - ANSWER: Infection
Rationale: The danger of peritonitis requires a sterile techniques, closed sterile
instillation and drainage systems, and frequent cultures of peritoneal drainage.
A nurse is caring for a client with acute pyelonephritis. Which of the following is an
appropriate response by the nurse regarding home care. - ANSWER: You should
complete the entire cycle of antibiotic therapy.
Rationale: It is important that the client take the full prescription of antibiotic
therapy to decrease the chance of regrowth of the causative organism.
A nurse is caring for a younger adult client who sustained massive damage to the
bladder. An emergency cystectomy and ileal conduit was performed. After viewing
the appliance for the first time, the client tells the nurse, "Well, I guess my sex life is
over now." The most therapeutic response from the nurse would be which of the
following? - ANSWER: Lets talk about why you feel that way.
Rationale: In the therapeutic response the nurse acknowledges the client's feelings
first and offer's to discuss the client's concerns. The nurse knows that ostomates live
full, active and happy lives (including sexual expression) with ileal conduits and
external appliances
, ABG's - ANSWER: Blood gas measurements are used to evaluate a person's lung
function and acid/base balance.
BG Element Normal Value Range
pH 7.4 7.35 to 7.45
Pa02 90mmHg 80 to 100 mmHg
Sa02 93 to 100%
PaC02 40mmHg 35 to 45 mmHg
HC03 24mEq/L 22 to 26mEq/L
Metabolic acidosis is characterized by a lower pH and decreased HCO3-, causing the
blood to be too acidic for proper metabolic/kidney function. Causes include
diabetes, shock, and renal failure
Specific gravity - ANSWER: Norm: 1.005 - 1.030
urine pH - ANSWER: Norm: 4.5 - 8
BUN ( blood urea nitrogen) - ANSWER: Norm: 5-20
↑20 BUN levels suggest impaired kidney function.
Cholesterol (total) - ANSWER: Desirable: A cholesterol below 200 mg/dL
High risk: A cholesterol ↑ or equal to 240 mg/dL
Glucose - ANSWER: From 70 to 99 mg/dL Normal fasting glucose
From 100 to 125 mg/dL Prediabetes
126 mg/dL Diabetes
Glycosylated Hemoglobin (HgbA1C) - ANSWER: A non-diabetic person will have an
A1c result ↓ than 5.7%
Diabetes: A1c level is 6.5% or higher
Increased risk of developing diabetes in the future: A1c of 5.7% to 6.4%
Hematocrit
Male:
Female: - ANSWER: Hematocrit is often performed as part of a CBC, results from
other components are taken into consideration. A rise or drop in the hematocrit
must be interpreted in conjunction with other parameters, such as RBC count,
hemoglobin, reticulocyte count and/or red blood cell indices.
Men: 40%-55% Women:36%-46%
Cause ↑ Kidney tumor
Cause ↓ Kidney failure
platelets - ANSWER: Norm: 150,000 and 450,000 platelets per microlite
↓ 150,000 thrombocytopenia
↑ 450,000 thrombocytosis
potassium - ANSWER: Norm: 3.5-5.5 mmol/L
↑ potassium levels: Acute or chronic kidney failure, Addison's disease, Diabetes
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