Med Surg (2) Flashcards
A nurse is teaching a client who has chronic kidney disease and is to begin hemodialysis. Which of the following information should the nurse include in the teaching?
A: Hemodialysis restores kidney function
B: Hemodialysis replaces the hormonal function of the renal system
C: Hemodialysis allows an unrestricted diet
D: Hemodialysis returns a balance to blood electrolytes
D
(dialysis removes excess sodium, potassium, fluids, and waste and restores balance)
A nurse is teaching a client who will have an x-ray of the kidneys, ureters, and bladder. Which of the following statements should the nurse include in the teaching
A: “You will receive contrast dye during the procedure”
B: “An enema is necessary before the procedure”
C: “You will need to lie in a prone position during the procedure”
D: “The procedure determines whether you have a kidney stone”
D
(Identifies calculi, strictures, calcium deposits, and obstructions in the renal system)
A nurse is monitoring a client who had a kidney biopsy for postoperative complications. Which of the following complications should the nurse identify as causing the greatest risk to the client?
A: Infection
B: Hemorrhage
C: Hematuria
D: Pain
B
(Lack of clotting ability at puncture site)
A nurse is planning post-procedure care for a client who received hemodialysis. Which of the following interventions should the nurse include in the plan of care. (SATA)
A: Check BUN and Blood Creatinine
B: Administer medications the nurse withheld prior dialysis
C: Observe for findings of hypovolemia
D: Assess the access site for bleeding
E: Evaluate blood pressure on the arm with AV access
A, B, C, D
A nurse is planning care for a client who has prerenal acute kidney injury following abdominal aortic aneurysm repair. Urinary output is 60mL in the past 2 hours, and blood pressure is 92/58. The nurse should expect which of the following interventions?
A: Prepare the client for a CT scan with contrast dye
B: Plan to administer nitroprusside
C: Prepare to administer a fluid challenge
D: Plan to position the client in Trendelenburg
C
(Hypovolemia, look at urine output and BP)
A nurse is reviewing client laboratory data. Which of the following findings is expected for a client who has stage 4 chronic kidney disease?
A: BUN 15mg/dL
B: GFR 20mL/min
C: Creatinine 1.1mg/dL
D: Potassium 5.0 mEq/L
B
(GFR is severely decreased)
A nurse is caring for a client who has a UTI. Which of the following is the priority intervention by the nurse?
A: Offer a sitz bath
B: Recommend drinking cranberry juice
C: Encourage increased fluids
D: Administer an antibiotic
D
(greatest risk is sepsis from UTI)
A nurse is reviewing urinalysis results for four clients. Which of the following urinalysis results indicated a UTI
A: Positive for hyaline casts
B: Positive for leukocyte esterase
C: Positive for ketones
D: Positive for crystals
B
A nurse is completing the admission assessment of a client who has renal calculi. Which of the following findings should the nurse expect?
A: Bradycardia
B: Diaphoresis
C: Nocturia
D: Bradypnea
B
A nurse is caring for a client who has a left renal calculus and an indwelling urinary catheter. Which of the following assessment findings is the priority for the nurse to report to the provider?
A: Flank pain that radiates to the lower abdomen
B: Client report of nausea
C: Absent urine output for 1 hour
D: Blood WBC count 15,000
C
(kidney damage indicator)
Which of the following is a complication that can develop if improper techniques are used to perform a peritoneal dialysis procedure
A: Acute pancreatitis
B: Peritonitis
C: Pericarditis
D: Acute Hepatitis
B
Which of the following is most seen when the peritoneal dialysis solution is drained
A: Loss of calcium
B: Loss of Iron
C: Loss of phosphorus
D: Loss of protein
D
Which of the following is a consideration with a patient undergoing hemodialysis
A: Episodic Hypertension
B: Cyclic Fever
C: Episodic bradycardia
D: Hypotension
A
Which of the following is a characteristic with peritoneal dialysis?
A: Slow Process
B: Painful Process
C: Vertigo
D: Dangerous Procedure
D
Which of the following is a consideration when caring for a patient undergoing hemodialysis
A: Do not elevate extremity
B: Vitamin Replacement
C: No BP in arm with shunt or fistula
D: No anticoagulation/antiplatelet
C
During hemodialysis, which of the following may occur while the patient is undergoing the treatment
A: Hypercoagulation
B: Hemolytic Anemia
C: Hypercholesterolemia
D: Rapid shifts of fluid and electrolytes
D
Inside the pancreas are special cells that secrete digestive enzymes and hormones. The cells that secrete digestive enzymes are known as what cells?
A: Islet of Lanham’s
B: Protease
C: Acinar
D: Amylase
C
You’re Caring for a 45-year-old patient who is admitted with suspected acute pancreatitis. The patient reports having extreme mid-epigastric pain that radiates to the back. The patient states the pain started last night after eating fast food. As the nurse, you know the two most common causes of acute pancreatitis are:
A: High cholesterol and alcohol abuse
B: History of diabetes and smoking
C: Pancreatic cancer and obesity
D: Gallstones and alcohol abuse
D
Which patient below is at MOST risk for chronic pancreatitis?
A: A 25-year-old female with a family history of gallstones
B: A 35-year-old male who reports social drinking of alcohol
C: A 15-year-old female with cystic fibrosis
D: a 66-year-old female with stomach cancer
C
Your patient with acute pancreatitis is scheduled for a test that will use a scope to assess the pancreas, bile ducts, and gallbladder. The patient asks you, “What is the name of the test I’m going for later today?” You tell the patient it is called:
A: MRCP
B: ERCP
C: CT scan of the abdomen
D: EGD
B
While assisting a patient with chronic pancreatitis to the bathroom, you note the patient’s stool to be oily/greasy in appearance. In your documentation, you note this as:
A: Melena
B: Currant
C: Hematochezia
D: Steatorrhea
D
A patient with acute pancreatitis is reporting excessive thirst, excessive voiding, and blurred vision. As the nurse, it is priority to you to:
A: Reassure the patient this is normal with pancreatitis
B: Check the patients blood glucose
C: Assist the patient with drinking a simple sugar drink like orange juice
D: Provide a dark and calm environment
B
Which of the following patients are most at risk for developing endocarditis (SATA)
A: A 25-year-old male who reports using IV drugs on a daily basis
B: A 55-year-old male who is post-op from aortic valve replacement
C: A 63-year-old female who is newly diagnosed with hyperparathyroidism and is taking aspirin
D: A 66-year-old female who recently had an invasive dental procedure performed 1 month ago and has a fever
A, B, D
A patient is receiving treatment for infective endocarditis. The patient has a history of IV drug use and underwent mitral valve replacement a year ago. The patient is scheduled for a TEE tomorrow. On assessment, you find tender, red lesions on the patient hands and feet. You know that this is a common finding in patients with infective endocarditis and is known as?
A: Janeway Lesions
B: Roth Spots
C: Osler Nodes
D: Trousseau Sign
C
A patient is admitted with sepsis. The patient has a temperature of 104.2 and is experiencing chills. On assessment, you note a mitral murmur which the patient states they’ve never had before, and dark, small lines on the patient’s fingernails. The patient has a history of IV drug use in the past. However, the patient states they are no longer using drugs. The physician suspects possible infective endocarditis. What diagnostic test do you expect the doctor to order to confirm the presence of infective endocarditis?
A: Abdominal Ultrasound
B: Heart Cath
C: TEE
D: WBC Count
C
Turner Syndrome
Greyish-Color (or discolorations) in flank region (hemorrhage)
