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WorksheetsNCLEX - RENAL Day1 (Part 2)
Total questions: 13
Worksheet time: 13mins
Name
Class
Date
1.
The nurse assesses a client during the dwell time of a peritoneal dialysis cycle. Which assessment would require immediate intervention?
a)
Blood pressure of 168/88 mm Hg and pulse of 72/min
b)
Client experiencing intermittent nausea
c)
Crackles present in the left and right lung bases
d)
Presence of 1+ pitting edema in ankles and feet bilaterally
e)
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2.
The nurse is caring for a client who received extracorporeal shock wave lithotripsy with ureteral stent placement for treatment of a kidney stone. Which discharge instructions provided by the nurse are appropriate? Select all that apply.
a)
Contact your health care provider if you develop a fever or chills.
b)
Except for using the bathroom, you should stay on bed rest for the next 48 hours.
c)
Increase your fluid intake to help flush out the kidney stone fragments.
d)
It is common to have some blood in the urine up to 24 hours after this procedure.
e)
You may develop some bruising on your back or on the side of your abdomen.
3.
The nurse is caring for a client who is receiving peritoneal dialysis. The client has chills and abdominal discomfort, and the nurse notes rebound tenderness on abdominal palpation. Which of the following actions should the nurse take?
a)
Place the client in the high-Fowler position.
b)
Warm the remaining dialysate fluid and increase the dwell time.
c)
Obtain a blood specimen to check the client's serum glucose level.
d)
Collect a specimen from the dialysate drainage bag for culture and sensitivity.
e)
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4.
The nurse is caring for a client with chronic kidney disease who just received hemodialysis for the first time. The client vomits once, reports a headache, and appears restless and disoriented. What is the priority nursing action?
a)
Administer antihypertensive medications that were held prior to hemodialysis
b)
Collect a blood specimen to check serum electrolyte levels
c)
Obtain the client's current blood pressure reading
d)
Request a prescription for ondansetron to relieve nausea
e)
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5.
A nurse is caring for a client 2 days after surgical creation of an arteriovenous fistula in the forearm. Which finding should the nurse report immediately to the health care provider?
a)
2+ pitting edema of the extremity with the arteriovenous fistula
b)
Loud swooshing sound auscultated over the arteriovenous fistula
c)
Pale skin of the hand of the arm with the arteriovenous fistula
d)
Surgical site pain reported by the client as 3 on a scale of 0–10 during hand exercises
e)
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6.
The home health nurse has reviewed the most recent laboratory test results for a client with chronic kidney disease. Which of the following would be an appropriate afternoon snack to recommend for the client?
a)
Carrot slices and milk
b)
Chips and avocado dip
c)
Oatmeal with apple slices
d)
Vanilla pudding with strawberries
e)
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7.
The nurse is caring for a client with chronic kidney disease. The nurse notes tall, peaked T waves on the continuous cardiac monitor. Which of the following actions would be a priority for the nurse to take?
a)
Administer IV calcium gluconate to the client
b)
Teach the client about high-potassium foods to be avoided
c)
Request a prescription for oral sodium polystyrene sulfonate for the client
d)
Prepare the client for placement of a temporary catheter for hemodialysis treatments
e)
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8.
The nurse is preparing to instill dialysate for a client who is receiving peritoneal dialysis. It would be a priority for the nurse to
a)
Place the client in the semi-Fowler position
b)
Record the characteristics of the dialysate output
c)
Use sterile technique when spiking and attaching the bag of dialysate
d)
Ensure that the drainage collection bag is below the level of the abdomen
e)
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9.
The nurse is caring for a client whose peritoneal dialysis is beginning to exhibit insufficient outflow. What actions should the nurse perform initially? Select all that apply.
a)
Assess for abdominal distention and constipation
b)
Contact the client's health care provider
c)
Examine the catheter for kinks and obstructions
d)
Flush the tubing with dialysate
e)
Place the client in a side-lying position
10.
A client has been given instructions about collecting a urine specimen to test creatinine clearance. Which client statement indicates a correct understanding of the specimen-collection procedure?
a)
A catheter is placed temporarily to collect urine and then removed.
b)
I must provide a midstream urine sample into a sterile container.
c)
I will void first and then collect all my urine in a container for 24 hours.
d)
The first morning specimen is best because it's more concentrated.
e)
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11.
The nurse is caring for a client with acute metabolic acidosis who received IV sodium bicarbonate. Which of the following findings would indicate that the sodium bicarbonate has been effective?
a)
Decreased pH
b)
Increased HCO3-
c)
Increased respiratory rate
d)
Increased serum potassium level
e)
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12.
The nurse assesses a client diagnosed with chronic kidney disease who had an internal arteriovenous fistula performed on the left arm yesterday. Which assessment finding would require immediate follow-up?
a)
A bruit cannot be auscultated over the fistula site
b)
Capillary refill of 1 second is assessed on the left hand
c)
Client reports squeezing a rubber ball with the left hand several times daily
d)
Incision is dry with no redness and has sterile skin closures in place
e)
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13.
The nurse is assessing a client who is receiving continuous bladder irrigation (CBI) after a transurethral resection of the prostate 10 hours ago. Which of the following findings would require follow-up?
a)
Small blood clots are noted in the urinary drainage bag
b)
Blood pressure of 116/70 mm Hg and heart rate of 68/min
c)
Client reports bladder spasms are relieved with administration of oxybutynin
d)
Bladder irrigation input of 3000 mL and output of 2400 mL over the past 4 hours
e)
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