Exam (elaborations)
NCLEX Urinary Renal Exam – Qs & As
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- NCLEX RENAL
NCLEX Urinary Renal Exam – Qs & As
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NCLEX Urinary Renal Exam – Qs & Asdietary instructions to a client who is being treated with continuous
ambulatory peritoneal dialysis (CAPD) ✔️Ans - Proteins eaten should
be high quality to replace those lost during dialysis. A high-calorie diet is
encouraged. Usually there is a modest restriction of fluids when the client
is on dialysis. Usually there is a restriction of high-potassium foods when
the client is on dialysis.
Reason the dialysis solution is warmed to body temperature before it is
instilled into the peritoneal cavity ✔️Ans - Encouraging the removal of
serum urea by preventing constriction of peritoneal blood vessels
promotes vasodilation so that urea, a large-molecular substance, is shifted
from the body into the dialyzing solution. Heat does not affect the shift of
potassium into the cells. The removal of metabolic wastes is affected in
kidney failure, not the metabolic processes. Excess serum potassium is
removed by dialyzing with a potassium-free solution, not by heat.
continuous ambulatory peritoneal dialysis (CAPD) treatment ✔️Ans -
Dialysate is introduced into the peritoneal cavity, where fluids, electrolytes,
and wastes are exchanged through the peritoneal membrane. The client can
dialyze alone in any location without the need for machinery and
continuous technical supervision. Hemodialysis is not necessary with this
procedure. Each exchange involves 2 to 3 L of dialysate intraperitoneally,
not interperitoneally, for a specified time (dwell time) before being
drained.
hemodialysis ✔️Ans - Following hemodialysis the client's vital signs
are monitored to determine whether the client is remaining
hemodynamically stable and for comparison to predialysis measurements.
The client's blood pressure and weight are expected to be reduced as a
result of fluid removal. Laboratory studies are done as per protocol but are
not necessarily done after the hemodialysis treatment has ended.
Chronic kidney disease ✔️Ans - Chronic kidney disease is a condition
in which the kidneys are unable to excrete wastes, concentrate urine, and
conserve electrolytes. A component of treatment is hemodialysis.
Hemodialysis requires the use of a dialyzer that is connected to a shunt,
,fistula, or other device that allows access to the client's bloodstream. The
client's blood is transported from the body through the dialyzer, which
removes wastes and excess fluids from the blood. The cleaned blood is then
returned to the client's body. You will learn about chronic kidney disease
and hemodialysis in your medical-surgical nursing course when you study
renal disorders.
transurethral resection of the prostate ✔️Ans - An indwelling urethral
catheter is used because surgical trauma can cause edema and urinary
retention, leading to additional complications, such as bleeding. Urinary
control is not lost in most cases; loss of control usually is temporary if it
does occur. Sexually ability usually is not affected; sexual ability is
maintained if the client was able to perform before surgery. A cystotomy
tube is not used if a client has a transurethral resection; however, it is used
if a suprapubic resection is done.
renal colic ✔️Ans - Sharp, severe pain (renal colic) radiating toward
the genitalia and thigh is caused by ureteral distention and smooth muscle
spasm; relief from pain is the priority. Although the client is overweight
and weight loss is desirable, it is a long-term goal. Although hematuria
needs to be monitored, blood loss usually is not massive with ureteral colic.
Mild hypertension is not the priority when a client is in severe pain.
client with acute kidney failure who is receiving a protein restricted diet
✔️Ans - The amount of protein permitted in the diet (usually less than 50
g) depends on the extent of kidney function; excess protein causes an
increase in urea concentration, which should be avoided Adequate calories
are provided to prevent tissue catabolism that also results in an increase in
metabolic waste products. In kidney failure the kidneys are unable to
eliminate the waste products of a high-protein diet. The body is able to
synthesize the nonessential amino acids. Urea is a waste product of protein
metabolism; the body is able to synthesize the nonessential amino acids.
cranberry juice effect on UTIs ✔️Ans - Cranberry juice is excreted as
hippuric acid, which helps acidify the urine (decrease the pH) and inhibit
bacterial growth. Although bacterial growth may be inhibited, bacteria are
not destroyed. Glomerular filtration is unaffected by cranberry juice.
Cranberry juice acidifies the urine and may increase the burning sensation
associated with urination when an infection is present.
, ✔️Ans - Pain after a suprapubic prostatectomy may indicate retention
of urine as a result of blocked drainage tubes or infection, or it may be an
expected response to surgery. The possibility of any complication must be
investigated. Analgesics can be administered after the cause of pain is
investigated. Encouraging fluids without a patent drainage tube will
increase pressure and discomfort; assessment should occur before
implementation. The need to measure vital signs is dependent upon the
analgesic prescribed; assessing the cause of pain takes priority.
taping an indwelling catheter for a male client to prevent pressure on the
urethra at the penoscrotal junction ✔️Ans - the lower abdomen or the
inner aspect of the thigh are the recommended sites to eliminate the
penoscrotal angle and prevent the formation of a urethrocutaneous fistula
A client has been diagnosed with a kidney stone lodged within the medulla
of the right kidney. What will the stone most likely affect? ✔️Ans - the
collection of urine
During an abdominal assessment of a male client, the nurse palpates a a
large, round mass in the hypogastric region. What is the nurse palpating?
✔️Ans - A distended or full bladder
When performing an assessment on a client the nurse notes tenderness to
blunt percussion of the costovertebral angle. What might this finding
suggest? ✔️Ans - inflammation of the kidneys
A client three weeks postpartum comes into a clinic with complains of
urinary frequency and burning with urination. What can the nurse explain
to the patient about these symptoms? ✔️Ans - these are consistent
with a UTI, after having a baby the bladder may not completely empty,
increasing risk of UTI
An elderly female tells the nurse "I wish I could have a good night's sleep
without having to get up every two hours to urinate." The nurse realizes
that the client is experiencing ✔️Ans - nocturia
The nurse is assessing the client for urinary incontinence. The client is at
risk for ✔️Ans - psychosocial problems
, A 55 year old female tells the nurse "Since I stopped having my menstrual
periods about a year ago I've noticed a leakage of urine". What should the
nurse explain to the client? ✔️Ans - there is a decrease in estrogen
after menopause which affects the strength of the pubic muscles and can
lead to urine leakage
A nurse is providing education to a patient with a history of renal caliculi.
What should the nurse include? ✔️Ans - drink enough fluids in 24
hours to produce 2 quarts of urine
What findings might the nurse note when performing an assessment on a
client with long standing renal disease? ✔️Ans - the client appears
fatigued, peripheral edema, indication of pruritis, crackles at the bases of
the lungs
The mother of a 2 year old tells the nurse her child was born deaf. The
most appropriate action for the nurse is to ✔️Ans - assess the child's
urinary elimination patterns
Where should the nurse place their stethoscope to assess the renal arteries
for the presence of bruits? ✔️Ans - extended midclavicular line
Objectives of Healthy People 2020 is to reduce the rate of new cases of
ESRD. What activities are recommended to achieve this? ✔️Ans - early
identification of people at risk, control of diabetes and hypertension,
education related to diet and exercise
When performing an assessment on an adult client the nurse is unable to
palpate both kidneys. What does this finding suggest? ✔️Ans - this is a
normal, expected finding
An elderly client reports that is she incontinent of urine when she coughs
of sneezes. The client is experiencing ✔️Ans - stress incontinence
The mother of a 4 year old boy states "I can't believe he's still wetting the
bed at night". The nurse tells the mother ✔️Ans - this is not unusual
for children of his age
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