NCLEX - RENAL Day1

A client diagnosed with end-stage renal disease comes to the dialysis clinic for treatment. Which actions should the nurse take to prepare the client for hemodialysis? Select all that apply.

• Administer subcutaneous heparin to decrease clotting during dialysis
• Administer the client's morning doses of carvedilol and lisinopril
• Check the client's medical records to determine the last post-dialysis weight
• Obtain a set of client vital signs and the client's current weight
• Palpate the fistula in the client's arm for a thrill and auscultate for a bruit

The nurse caring for multiple clients who underwent renal system diagnostic testing should report which post-procedure finding to the health care provider?

• 150 mL residual urine on bladder scan
• Burning sensation when voiding after cystoscopy
• Increased urinary output after arteriogram
• Less than 10,000 organisms/mL on urine culture
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The nurse is caring for a client receiving peritoneal dialysis. Which findings are essential for the nurse to report to the health care provider? Select all that apply.

• Cloudy outflow
• Low-grade fever
• Oliguria
• Pruritus
• Tachycardia

A client with chronic kidney disease has an arteriovenous fistula placed in the left wrist for hemodialysis. Which statements indicate that the client understands how to care for the fistula properly? Select all that apply.

• I should not worry if I have slight numbness or tingling in my left arm
• I will be sure to avoid sleeping on my left arm
• I will make sure that I always have my blood pressure taken in my left arm
• I will squeeze a small sponge with my left hand several times a day
• I will touch the site and feel for a vibration several times a day

The health care provider prescribes phenazopyridine hydrochloride for a client with a urinary tract infection. What would the office nurse teach the client to expect while taking this medication?

• Constipation
• Difficulty sleeping
• Discoloration of urine
• Dry mouth
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The nurse cares for a client scheduled for a percutaneous left kidney biopsy as an outpatient. Which intervention should the nurse include in the client's post-procedure care plan?

• Compare pre- and post-procedure BUN and creatinine levels
• Insert and maintain the patency of an indwelling urinary catheter
• Maintain prone position for at least 30 minutes
• Monitor vital signs every 15 minutes for the first hour
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The nurse is teaching a client with benign prostatic hyperplasia who has a new prescription for terazosin. What should the nurse include?

• You may continue to consume alcohol while taking this medication
• Change positions slowly when moving from lying to standing
• Take the first dose of this medication in the morning
• You may notice that your stools become darker
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The nurse is caring for a client who had a percutaneous nephrolithotripsy 3 hours ago. The nurse notes that the nephrostomy tube has drained 0 mL since the procedure, and the client is reporting flank discomfort and nausea. Which of the following actions would be most appropriate for the nurse to take?

• Irrigate the client's nephrostomy tube
• Encourage the client to increase fluid intake
• Place the client in the prone position
• Assist the client to ambulate in the hallway
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The nurse is preparing to administer IV furosemide to a client with chronic kidney disease. Why should the nurse administer it slowly?

• Oliguria
• Ototoxicity
• Bradycardia
• Hypertension
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The nurse is providing discharge instructions to a client receiving oxybutynin for overactive bladder. Which statement needs follow-up?

• I am looking forward to our summer vacation at the beach
• I plan to eat more fruits and vegetables to prevent constipation
• I should not drive until I know how this drug affects me
• I will drink at least 6-8 glasses of water daily
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