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ATI Renal System Detailed Answers
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Detailed Answer Keyquiz 4 Renal
1.A nurse in a prenatal clinic is caring for a client who is at 7 weeks of gestation. The client reports urinary frequency and asks if this will continue until delivery. Which of the following responses should the nurse make? A. "It's a minor inconvenience, which you should ignore." Rationale: This is a nontherapeutic response that disregards the client’s concern and offers unwarranted reassurance. B. "In most cases it only lasts until the 12th week, but it will continue if you have poor bladder tone." Rationale: The presence or absence of bladder tone has no bearing on urinary frequency during pregnancy. C. "There is no way to predict how long it will last in each individual client." Rationale: This is a nontherapeutic response that does not provide appropriate information to the client. D. "It occurs during the first trimester and near the end of the pregnancy." Rationale: Urinary frequency is due to increased bladder sensitivity during the first trimester and recurs near the end of the pregnancy as the enlarging uterus places pressure on the bladder. 2.A nurse is teaching a client who has a urinary tract infection (UTI) and is taking ciprofloxacin. Which of the following instructions should the nurse give to the client? A. "If the medicine causes an upset stomach, take an antacid at the same time." Rationale: Ciprofloxacin is best absorbed on an empty stomach with a full glass of water. Antacids containing either magnesium or aluminum can decrease the absorption of ciprofloxacin. If an antacid is taken, the nurse should instruct the client to wait at least 2 hr after administering the ciprofloxacin. B. "Limit your daily fluid intake while taking this medication." Rationale: The nurse should instruct the client that ciprofloxacin is a fluoroquinolone antibiotic used in the treatment of mild to severe infections. It is excreted primarily via the kidneys, and drinking extra fluids will reduce the risk of crystallization in the kidneys. C. "This medication can cause photophobia, so be sure to wear sunglasses outdoors." Rationale: Ciprofloxacin can cause phototoxicity, putting the client at risk for extreme sunburn from minimal sun exposure. The client should wear protective clothing when out in the sun. Photophobia is eye sensitivity to light. D. "You should report any tendon discomfort you experience while taking this medication." Rationale: The nurse should instruct the client to report any tendon discomfort as well as swelling or inflammation of the tendons due to the risk of tendon rupture. Created on:07/27/2023 Page 1 Detailed Answer Key
quiz 4 Renal
3.A nurse is planning care for a female client who has a T4 spinal cord injury and is at risk for acquiring urinary tract infections. Which of the following actions should the nurse include in the client's plan of care? A. Cleanse the perineum from back to front. Rationale: The perineum should be cleansed from front to back to limit the spread of bacteria from the perianal region to the urethra in female clients. B. Obtain a prescription for an indwelling urinary catheter. Rationale: Indwelling catheters are associated with a greatly increased risk for UTI and should be avoided whenever possible in a client who is at risk. Intermittent catheterization to empty the bladder of residual urine is more effective. C. Encourage fluid intake at and between meals. Rationale: Increased fluid intake dilutes the urine, reduces stasis, and greatly reduces the urinary bacterial count. Consequently, the risk of nosocomial (hospital-acquired) UTI is reduced, even for a client who has a spinal cord injury. D. Offer the client the bedpan every 2 hr. Rationale: The client will be unable to completely empty her bladder by herself. 4.A nurse is caring for a client who has an indwelling urinary catheter. Which of the following actions should the nurse take to prevent infection? A. Replace the catheter every 3 days. Rationale: The nurse should avoid routine catheter changes. The catheter should be changed only to correct a problem, such as a leakage or a blockage. B. Check the catheter tubing for kinks or twisting. Rationale: The nurse should check the catheter for twisting or kinks in the tubing. These obstructions can affect the flow of urine causing pooling in the tubing that could backflow into the bladder. C. Irrigate the catheter once each shift. Rationale: The nurse should avoid irrigation of the catheter unless there is an obstruction. D. Clean the perineal area with an antiseptic solution daily. Rationale: The nurse should clean the perineal area with soap and water at least twice per day. 5.A nurse is caring for a client who is 5 hr postoperative following a transurethral resection of the prostate (TURP). The nurse notes that the client's indwelling urinary catheter has not drained in the past hour. Which of the following actions should the nurse take first? A. Notify the provider. Rationale:
Created on:07/27/2023 Page 2 Detailed Answer Key
quiz 4 Renal
The nurse may need to notify the provider if unable to induce fluid flow from the catheter, or if the output is bright rad and thick; however, the nurse should attempt a different intervention first. B. Check the tubing for kinks. Rationale: When providing client care, the nurse should first use the least restrictive intervention; therefore, the nurse should check the catheter tubing for kinks. The nurse must ensure constant flow of the bladder irrigant into the catheter and outward drainage from the catheter to prevent clotting, which could occlude the catheter lumen. C. Adjust the rate of the bladder irrigant. Rationale: The nurse may need to increase the rate of bladder irrigant to stimulate removal of urine and clots; however, the nurse should use a less restrictive intervention first. D. Irrigate the catheter. Rationale: The nurse may need to irrigate the catheter to check for an internal obstruction; however, the nurse should use a less restrictive intervention first. 6.A nurse is caring for a client who has an indwelling urinary catheter and notes blood-tinged urine in the catheter bag. The nurse recognizes this finding can be a manifestation of which of the following urinary alterations? A. Pernicious anemia Rationale: Pernicious anemia is caused by a lack of intrinsic factor, a substance needed to absorb vitamin B12 from the gastrointestinal tract. Vitamin B12 is needed for the formation of red blood cells. Hematuria, or blood present in the urine, is not a manifestation of pernicious anemia. B. Dehydration Rationale: Dehydration is a manifestation of oliguria or a diminished urinary output. C. Prostate enlargement Rationale: Prostate enlargement is a manifestation of urinary hesitancy of difficulty initiating a stream of urine.
D. Bladder infection Rationale: The nurse should recognize that hematuria, or blood-tinged urine, can be a manifestation of a bladder or kidney infection. 7.A nurse is ready to insert an indwelling urinary catheter for a female client. Which of the following instructions should the nurse give the client as the catheter is inserted? A. Contract the pelvic muscles. Rationale: The nurse should instruct the client to contract her pelvic muscles to improve their strength and help manage urinary incontinence. This action does not ease the insertion of a urinary catheter. Created on:07/27/2023 Page 3 Detailed Answer Key
quiz 4 Renal
B. Take a sip of water. Rationale: Sipping water can help ease the insertion of a nasogastric tube, not a urinary catheter. C. Exhale slowly. Rationale: Asking the client to exhale slowly is an appropriate action when auscultating lung sounds. It does not ease the insertion of a urinary catheter. D. Bear down. Rationale: Bearing down gently as if to void relaxes the external sphincter and eases urinary catheter insertion.
8.A nurse is assessing a client who is experiencing prostatic hypertrophy. Which of the following findings associated with urinary retention should the nurse expect? (Select all that apply.) A. Report of feeling pressure B. Tenderness over the symphysis pubis C. Distended bladder D. Voiding 30 mL frequently E. Dysuria
Rationale: Report of feeling pressure is correct. Urinary retention is commonly seen in clients diagnosed with prostatic hypertrophy. Clinical findings of urinary retention include a report of feeling pressure.Tenderness over the symphysis pubis is correct. Urinary retention is commonly seen in clients diagnosed with prostatic hypertrophy. Clinical findings of urinary retention include tenderness over the symphysis pubis.Distended bladder is correct. Urinary retention is commonly seen in clients diagnosed with prostatic hypertrophy. Clinical findings of urinary retention include a distended bladder.Voiding 30 mL frequently is correct. Urinary retention is commonly seen in clients diagnosed with prostatic hypertrophy. Clinical findings of urinary retention include frequent voiding of 25 to 60 mL of urine.Dysuria is incorrect. Urinary retention is commonly seen in clients diagnosed with prostatic hypertrophy. Dysuria, or painful burning with urination, is not a finding associated with urinary retention. 9.A nurse is discussing indications for urinary catheterization with a newly licensed nurse. Which of following indications should the nurse include? (Select all that apply). A. Relief of urinary retention B. Convenience for the nursing staff or the client's family C. Measurement of residual urine after urination D. Routine acquisition of a urine specimen E. An open perineal wound Rationale:
Created on:07/27/2023 Page 4
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