NURS 2207 GU/Men's Health Final Exam And Answers Already Passed.
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Course
NURS 2207
Institution
NURS 2207
When providing care for a client who had a nephrectomy secondary to renal cancer, which factor affects the client's ability to perform his or her postoperative deep breathing and coughing requirements?
1. Location of the client's surgical incision
2. Increased anxiety about the prognosis
...
NURS 2207 GU/Men's Health Final Exam
And Answers Already Passed.
When providing care for a client who had a nephrectomy secondary to renal cancer, which factor affects
the client's ability to perform his or her postoperative deep breathing and coughing requirements?
1. Location of the client's surgical incision
2. Increased anxiety about the prognosis
3. Inflammatory process associated with surgery
4. Pulmonary congestion from preoperative medications - Answer 1. Location of the client's surgical
incision
Rationale:
The location of the surgical site in relation to the diaphragm increases incisional pain when deep
breathing or coughing. Anxiety about the prognosis should not interfere with the ability to deep breathe
and cough, especially when encouraged by the nurse. Inflammatory changes will cause discomfort in the
area of any incision but are not necessarily the prime factor preventing deep breathing after a
nephrectomy. The client will need to cough and deep breathe if there is congestion in the lungs.
The nurse writes a goal of preventing renal calculi in a care plan for a client who has paraplegia. Which
information provides the rationale for selecting this goal?
1. High fluid volume intake
2. Increased calcium intake
3. Inadequate kidney function
,4. Accelerated bone demineralization - Answer 4. Accelerated bone demineralization
Rationale:
Calcium that has left the bones as a response to prolonged inactivity enters the blood and may
precipitate in the kidneys, forming calculi. Increased fluid intake is helpful in preventing this condition by
preventing urinary stasis. Calcium intake usually is limited to prevent the increased risk for calculi. Calculi
may develop despite adequate kidney function; kidney function may be impaired by the presence of
calculi and urinary tract infections associated with urinary stasis or repeated catheterizations.
The laboratory values of a client with renal calculi reveal a serum calcium within expected limits and an
elevated serum purine. Which type of stone composition is consistent with these laboratory values?
Purines are precursors of uric acid, which crystallizes. Cystine stones are caused by a rare hereditary
defect resulting in defective absorption of cysteine in the gastrointestinal tract and kidneys (inborn error
of cystine metabolism). Serum purine will not be elevated if the stone is composed of calcium oxalate. A
struvite stone sometimes is called a magnesium ammonium phosphate stone and is precipitated by
recurrent urinary tract infections.
Which foods would the nurse teach a client to avoid when diagnosed with calcium oxalate renal calculi?
Select all that apply. One, some, or all responses may be correct.
1. Milk
,2. Tea
3. Liver
4. Spinach
5. Rhubarb - Answer ANS: 2, 4, 5
Rationale:
Tea, rhubarb, and spinach are high in calcium oxalate. Limiting oxalate-rich foods limits oxalate
absorption and the formation of calcium oxalate calculi. Milk is an acceptable calcium-rich protein and is
avoided with calcium stones, but not with oxalate stones. Liver is a purine-rich food and avoided with
uric acid renal calculi or gout.
Which information would the nurse include in the home care instructions for a client being discharged
post-lithotripsy for renal calculi?
1. "Increase your intake of dairy products for 5 days."
2. "Drink at least 3 L of fluid daily for 4 weeks."
3. "Do not take any medications after this treatment."
4. "Call us back immediately if you observe any blood in your urine." - Answer 2. "Drink at least 3 L of
fluid daily for 4 weeks."
Rationale:
Increasing fluid intake aids in the passage of fragments of the calculus that remain after the lithotripsy.
Calcium is the major component of the most common type of calculus; the intake of dairy products,
which are high in calcium, should be limited. The client will take antibiotics after the treatment and
should complete the entire regimen. Hematuria (blood in the urine) after lithotripsy is an expected
response and does not require notification.
, After an unsuccessful lithotripsy to break up renal calculi, a nephrolithotomy was successful in removing
the client's renal calculi. Which clinical indicator would the nurse monitor during the postoperative
period and report immediately to the primary health care provider?
1. Continuous passage of pink-tinged urine
2. Pink drainage on the client's surgical dressing
3. Total intake volume of 2000 mL in 24 hours
4. Urinary output of 20 to 30 mL/h - Answer 4. Urinary output of 20 to 30 mL/h
Rationale:
The client's urinary output should be at least 30 mL/h; a decreased output may indicate obstruction,
impaired kidney function, or fluid volume deficit. Blood, tinting the urine pink, is expected. Drainage on
the surgical dressing may be pink; the nurse would report bright red drainage. The intake of 2000 mL in
24 hours is adequate; however, a higher intake usually is preferred to prevent fluid volume deficit (e.g.,
>2000-3000 mL).
Which clinical manifestations would the nurse expect the client to report when experiencing renal
calculi? Select all that apply.
1. Blood in the urine.
2. Irritability and twitching
3. Dry, itchy skin and pyuria
4. frequency and urgency of urination
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