Exam (elaborations)
Renal/Urinary ATI (Concepts II - Acid And Renal)
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Renal/Urinary ATI (Concepts II - Acid And Renal)
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Renal/Urinary ATI (Concepts II - Acid And Renal)A nurse is collecting data from a client who is postoperative following a
transurethral resection of the prostate (TURP). After the nurse
discontinues the client's urinary catheters, which of the followings should
the nurse report to the provider.
1 - Pink-tinged urine
2 - Report of burning upon urination
3 - Stress incontinence
4 - Decreased urine output ✔️Ans - 4 - Decreased urine output
Rational
1 - Pink-tinged urine and blood clots are an expected finding for several
days following a TURP.
2 - Burning upon urination and urinary frequency are expected findings
after a TURP and should decrease after several days.
3 - Stress incontinence is an expected finding following a TURP due to poor
sphincter control.
4 - A decrease in urine output after a TURP indicates obstruction to urine
flow by a clot or residual prostatic tissue and should be reported to the
provider.
A nurse is reinforcing teaching with a client who is preoperative prior to a
transurethral resection of the prostate (TUPR). Which of the following
statements indicates an understanding of the information?
1 - "I will not need to have a urinary catheter following this procedure."
2 - "I will expect my urine to be cloudy after having this procedure."
3 - "At least I won't have leakage of urine after having this procedure."
4 - "I will feel the urge to urinate following this procedure." ✔️Ans - 4 -
"I will feel the urge to urinate following this procedure."
Rational
1 - The client will require an indwelling urinary catheter following a TURP
to monitor urine output and bleeding.
2 - Cloudy urine can be a manifestation of retrograde ejaculation or
infection. The client should report cloudy urine to the provider.
3 - The client might have temporary dribbling and leakage of urine
following a TURP. The nurse should reassure the client that these
manifestations will resolve.
,4 - After a TURP, the client will feel the urge to urinate. The nurse should
reassure him that he will receive analgesics to help relieve this discomfort.
A nurse is reinforcing dietary teaching with a client who has late-stage
chronic kidney disease (CKD). Which of the following nutrients should the
nurse instruct the client to increase in her diet.
1 - Calcium
2 - Phosphorous
3 - Potassium
4 - Sodium ✔️Ans - 1 - Calcium
Rational
1 - A client who has CKD can develop hypocalcemia due to the reduced
production of active vitamin D, which is needed for calcium absorption. The
client should supplement her diet with dietary calcium.
2 - A client who has CKD can develop hyperphosphatemia because
excretion of phosphorous by the kidneys is reduced.
3 - A client who has CKD can develop hyperkalemia because excretion of
potassium by the kidneys is reduced.
4 - A client who has CKD can develop hypernatremia because excretion of
sodium by the kidneys is reduced.
A nurse is collecting data from a client who is 1 week postoperative
following a living donor kidney transplant. Which of the following findings
should indicate to the nurse that the client is experiencing cute kidney
rejection
1 - Creatinine 0.8 mg/dL
2 - Blood pressure 160/90 mm Hg
3 - Sodium 137 mg/dL
4 - Urinary output 100 mL/hr ✔️Ans - 2 - Blood pressure 160/90 mm
Hg
Rational
1- Manifestations of acute kidney rejection can include an increase in
serum creatinine. This finding is within the expected reference range.
2 - Due to the kidney's role in fluid and blood pressure regulation, a client
who is experiencing rejection can have hypertension.
3 - Manifestations of acute kidney rejection can include an increase in
sodium. This finding is within the expected reference range.
,4 - Manifestations of acute kidney rejection can include decreased urine
output, anuria (no urine output) or oliguria (less than 30 mL/hr), and
weight gain.
A nurse is caring for a client who is receiving peritoneal dialyisis. The
nurse should monitor the client for which of the following adverse effects?
1 - Diarrhea
2 - Increased serum albumin
3 - Hypoglycemia
4 - Respiratory distress ✔️Ans - 4 - Respiratory distress
Rational
1 - Diarrhea is not an adverse effect of peritoneal dialysis. The nurse should
instruct the client to increase fiber intake to prevent constipation, which
can reduce dialysate flow.
2 - Decreased serum albumin is an adverse effect of peritoneal dialysis.
Protein can be lost through the dialysis exchange, resulting in protein
wasting. A decreased serum albumin level is a manifestation of protein
wasting.
3 - Hyperglycemia is an adverse effect that can occur in clients who have
diabetes mellitus and clients who absorb glucose from the dialysate.
4 - Respiratory distress can occur during peritoneal dialysis due to fluid
overload.
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?
1 - WBC 6,000/mm3
2 - Potassium 4.0 mEq/L
3 - Cloudy, yellow drainage
4 - Report of abdominal fullness ✔️Ans - 3 - Cloudy, yellow drainage
Rational
1 - A WBC count of 6,000/mm3 is within the expected reference range.
2 - A potassium level of 4.0 mEq/L is within the expected reference range.
3 - 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.
4 - 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.
, A nurse is caring for a client who is in the oliguric-anuric stage of acute
kidney injury. The client report diarrhea, a dull headache, palpitations, and
muscle tingling and weakness. Which of the following actions should the
nurse take first?
1 - Administer an analgesic to the client.
2 - Check the client's electrolyte values.
3 - Measure the client's weight.
4 - Restrict the client's protein intake. ✔️Ans - 2 - Check the client's
electrolyte values.
Rational
1 - Administering an analgesic for a dull headache is important to manage
the client's pain; however, there is another action that the nurse should
take first.
2 - 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 nurse should check the
client's most recent potassium value because these findings are
manifestations of hyperkalemia, which can lead to cardiac dysrhythmias;
therefore, this is the priority action.
3 - Measuring the client's weight is important to monitor the client's fluid
balance; however, there is another action the nurse should take first.
4 - Restricting the client's protein intake is important to manage the
client's acute kidney injury; however, there is another action the nurse
should take first.
A nurse is reinforcing teaching about urinary tract infections (UTI) with a
client. Which of the following manifestations should the nurse include?
1 - Weight gain
2 - Back pain
3 - Vaginal discharge
4 - Muscle cramps ✔️Ans - 2 - Back pain
Rational
1 - Weight gain is not a manifestation of a UTI, because a UTI does not
cause fluid retention. Weight gain can be a manifestation of acute kidney
injury and fluid overload.
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