Download NR-426 EXAM |ALCOHOL QUESTIONS WITH CORRECT ANSWERS |100% VERIFIED| 2023-2024 GRADED A+ and more Exams Nursing in PDF only on Docsity! NR-426 EXAM |ALCOHOL QUESTIONS WITH CORRECT ANSWERS |100% VERIFIED| 2023-2024 GRADED A+ The nurse conducts a health history interview for a pediatric client with a differential diagnosis of obstructive uropathy. Which question should the nurse ask to determine risk factors for this disease process? "Does your child often have back pain?" "Have you noticed blood in your child's urine?" Has your child had any bed-wetting after toilet training?" "Does your child have a history of prune-belly syndrome? Which nursing action is the highest priority for a child who is awaiting surgery for Wilms tumor? Listen for the presence of adventitious breath sounds every two hours Blood pressure monitoring every 15 minutes until surgery Determine the developmental level of this child Educate all caregivers not to palpate the abdomen The nurse reviews the prescribed medications for a pediatric client who is diagnosed with nephrotic syndrome. Which medication is prescribed to induce prolonged remission? Albumin Furosemide Cyclophosphamide Hydrochlorothiazide A client taking nitrofurantoin for prophylactic purposes has called to report new symptoms of urinary burning and urgency. Which direction from the health care provider should the nurse anticipate? Increase the dose to the dose for an active infection for 7 days. Schedule the client to come in for a urinalysis with culture and sensitivity today. Call in a prescription for phenazopyridine to the client's pharmacy. Teach the client to increase fluid intake to keep the urine very dilute A client taking dutasteride for 9 months with good results now reports having difficulty starting the urine stream and does not fully empty the bladder. Which action should the nurse make? Notify the health care provider because of the possibility of prostate cancer Teach the client that this is a normal occurrence because the medication becomes ineffective after several months of use Teach the client to empty his bladder every 2-3 hours to promote complete emptying Notify the health care provider and anticipate an increase in the prescribed dosage When evaluating the effectiveness of tamsulosin, which information will the nurse obtain from the client? Experiencing burning during urination or cloudy urine 0000 Urine is rusty colored or foamy Any change in bowel elimination Having trouble starting the stream or dribbling of urine The nurse provides care for an adolescent client who is diagnosed with chronic kidney disease (CKD) and is prescribed hemodialysis. The client states, "I hate the way my arm looks!" Which action by the nurse is best to promote the child's body image? Support the client's choice for clothing. Tell the client. "It could be much worse." Educate the client on why dialysis is important Ask the client. "Do you know anyone else with a fistula? A client is leaving the unit to go to hemodialysis. In which way should the nurse manage the client's medications? Give all of the client's medications since they will be gone for several hours Hold the client's antihypertensives because of the risk of hypotension during hemodialysis Do not give any of the client's medications the morning of dialysis because they will all be removed during dialysis Only subcutaneous and IV medications may be given prior to dialysis After receiving polystyrene sulfonate 2 hours ago for hyperkalemia, the client is now experiencing diarrhea. Which action should the nurse take? Administer a PRN dose of loperamide Notify the health care provider and recommend that the medication be discontinued Premature Infant Pain Profile (PIPP) Which parental statement alerts the nurse to the need for additional discharge instructions regarding the home care of a child who is diagnosed with nephrotic syndrome? "A healthy diet with close monitoring of salt intake is very important for our child." "If any swelling or weight gain is noticed, a fluid restriction will be started." "It is okay to have friends over during times of relapse to help with recovery." "Testing for protein in the urine is very important to do at least once per day." An adolescent client is admitted for a kidney transplant for the treatment of end-stage kidney failure. Which psychosocial stage of development should the nurse include in the child's nursing plan of care? Initiative versus guilt Trust versus mistrust Industry versus inferiority Identify versus role confusion The nurse provides education to the family of a pediatric client who is diagnosed with nocturnal enuresis. Which statement by the child's parent indicates a need for additional instruction regarding the management of this disorder? "I will limit my child's intake of chocolate." "I will limit my child's fluid intake after dinner each evening." "My child will wear a pull-up each night in case of bedwetting. "My child should be woken up at 11 pm each night to use the bathroom, The nurse provides care for a school-age client who requires peritoneal dialysis for the treatment of chronic kidney disease (CKD). The child states, "I am always the different one in every group. I just want to fit in with my friends." Which action by the nurse is best to promote the child's self-esteem? Asking the client, "Why do you feel different?" Encouraging the client to discuss feelings with a therapist Introducing the client to another child who requires the same treatment Telling the client. "It is easy to hide the catheter required for this form of dialysis." The nurse provides care for a pediatric client who is diagnosed with nephrotic syndrome and prescribed furosemide. Which assessment data indicates hypokalemia? QT prolongation noted on electrocardiogram (ECG) Urine output that is 2 mL/kg/hour Nausea and vomiting Abdominal pain The nurse provides care for a preschool-age client who is hospitalized for the treatment of glomerulonephritis. Which expected psychosocial stage of development for this child should the nurse consider in the provision of care? Initiative versus guilt Trust versus mistrust Industry versus inferiority Autonomy versus shame and doubt Which nursing intervention is appropriate when providing care for a child who is diagnosed with acute glomerulonephritis (AGN)? Select all that apply. Monitor blood pressure. Assess color and clarity of urine. Implement energy conservation activities. Obtain daily weights Measurements of intake and output Restriction of sodium. A client has a new prescription for tamsulosin. Which information should the nurse teach the client regarding safe use of the medication? "Make sure others wear gloves when giving you this medication." "Rise slowly and make sure you have your balance before walking." "This causes sleepiness so avoid driving for two hours after taking this medicine." "Your risk of infection is increased so avoid large crowds while taking this medicine." The nurse provides care for a 3-year-old client who is diagnosed with nephrotic syndrome and has the following laboratory values: serum albumin is 1.5 g/dL (15 g/L), serum total cholesterol is 285 mg/dL (7.4 mmol/L), and urinalysis indicates 3+ protein. Which pathological process does this data reflect as the cause of the client's diagnosis? Glomerular injury. Genetic hypercholesterolemia. Liver damage. Severe malnutrition. The nurse provides care for a preschool-age client who is prescribed furosemide for the edema associated with nephrotic syndrome. Which laboratory result requires practition notification? Serum hematocrit 38% Serum glucose 75 mg/dL Serum sodium 134 mEq/L Serum potassium 3 mEq/L The nurse develops a plan of care to address activity intolerance for a pediatric client who is diagnosed with chronic kidney disease (CKD) and edema. Which intervention should the nurse include in the plan of care to address this nursing diagnosis? Encourage the child to ambulate. Monitor the child's intake and output. Provide the child with high calorie meals. Administer the child's prescribed diuretics. Which assessment finding is most concerning to the nurse for a child who is diagnosed with diarrhea caused by Escherichia coli (E. coli)? Small amount of blood in stool. The child consumes fruit juice. Skin turgor that is tenting. Abdominal petechiae. Phenazopyridine for a client with urinary tract paint A client with a history of recurrent urinary tract infections and kidney stones asks if cranberry supplements should be used. Which response should the nurse make? "I suggest cranberry juice for you since that will also increase your fluids and help prevent kidney stones." "Cranberry capsules are probably the easiest way to take in sufficient cranberry to help so I'd suggest that you take them according to the bottle directions." "Cranberries contain oxalates which are a component in most kidney stones so I wouldn't suggest those for you." "Cranberries are all natural so any form you like is safe." Which information will the nurse include when teaching a client about oxybutynin for overactive bladder? Select all that apply. Can cause dry mouth so good daily oral hygiene will be important Can cause drowsiness so avoid driving until effects are known Can cause constipation so increased fiber and fluid intake may be indicated Can lead to glaucoma so annual ophthalmic appointments are recommended Can cause excessive perspiration so extra strength antiperspirant may be desired A client with chronic kidney stones has a 3 mm "passable" ureter stone. In addition to pain medication, which medication should the nurse anticipate being prescribed to promote passage of urine and the stone? Fesoterodine Tamsulosin Oxybutynin Darifenacin A client with a history of urinary tract infections (UTI) is diagnosed with another one. Which medication should the nurse expect the health care provider to prescribe to prevent another UTI? Oxybutynin Nitrofurantoin Phenazopyridine Bethanechol A client with incontinence reports feeling embarrassed if urine leaks when coughing or laughing and needing spare clothes since incontinence pads are not enough. Which response should the nurse make? "How long has this been going on?" "I know how you feel. I have had this issue too!" "This issue can be so difficult and embarrassing." "If I was you, I wouldn't be embarrassed. It just happens." A client prescribed phenazopyridine refuses to take the medication because the urine stains the toilet causing embarrassment at work. Which response should the nurse make? "The medication is only for symptom relief so you can avoid taking it right before work and during your work day if you wish." "If you drink a lot of water when you're taking it, the orange color will be very faint and won't stain." "It's really important that you take the medication to help resolve your infection." "OK. I'll document that in your chart." When a client is prescribed a urinary antispasmodic for overactive bladder which side effects will t nurse teach the client to recognize as signs of a possibly life-threatening reaction? Swelling of the face, lips, or tongue Headache and dizziness Nausea, vomiting, and diarrhea: Itching of the palms and soles of the feet The nurse develops a plan of care for a pediatric client who is diagnosed with chronic kidney disease (CKD) and experiencing fluid volume excess. Which intervention should the nurse include to address this issue? Cluster the child's nursing care. Assess the child's food preferences. Ensure the child voids prior to bedtime. Monitor the extent of the child's edema. The nurse provides care for a pediatric client who is diagnosed with anemia due to chronic kidney disease (CKD). The child is prescribed a transfusion of packed red blood cells (RBCs). A review of the child's psychosocial history reveals that the family are practicing Jehovah's Witnesses. Which action by the nurse is best? Requesting a meeting with the hospital's ethics committee Asking the child's parents if they are opposed to a blood transfusion Administering the prescribed transfusion without informed consent Telling the child's practitioner of the family's documented religious affiliation The nurse provides care for a pediatric client who is diagnosed with acute glomerulonephritis. The client is currently experiencing bilateral pitting edema of the lower extremities, hypertension, and proteinuria. Which is the best indicator for fluid loss or gain in the provision of care for this client? Observing for an increase or decrease in edema. Measuring intake and output every shift. Monitoring weight daily. Assessing the blood pressure. The nurse provides care for a client who is prescribed a polystyrene sulfonate retention enema. Which comprehensive explanation should the nurse provide to the client as to why this therapy is prescribed? Select all that apply. "This procedure helps the large intestine to evacuate potassium rich waste lowering the serum potassium level." "This procedure is administered in an emergency situation to help the bowel rid the body of excess potassium." "This procedure is administered to trigger serum blood levels to decrease the amount of potassium that is excreted." "This procedure is administered to completely cleanse the bowel before a procedure to visualize the colon." "This procedure is used for constipation that is caused by opioid pain medications after surgery." The medication will cause your urine to be bright orange Avoid wearing soft contact lenses while taking the medication Take a dose one hour prior to coming in for a urinalysis recheck The medication will improve your symptoms of urinary infection but will not treat your infection Which intervention should the nurse consider implementing prior to administering the prescribed sodium zirconium cyclosilicate to a client with a serum potassium level of 6.5 mEq/L? Select all that apply. Completing a focused abdominal assessment and reviewing the number of stools over the past several days. Teaching the client to avoid potassium rich foods in the diet. Monitoring the client for edema. Recognizing that the medication should not be given in an emergent situation. Withholding the medication if the client is not ambulatory. The nurse preceptor reviews hand hygiene practices for a novice nurse who provides care for a pediatric client who requires peritoneal dialysis for the treatment of chronic kidney disease (CKD). is the order for hand hygiene with soap and water that the nurse preceptor should review with the novice nurse? Place the steps in the correct sequence. All options must be used. Answer Example: 13254 1. Dry the hands using a paper towel. 2. Scrub the hands for at least 20 seconds. 3. Rinse the hands with clean, running water. 4. Lather the hands by rubbing them together. 5. Wet the hands and apply soap. 34521 A client taking dutasteride for benign prostatic hypertrophy states his ejaculate is much less than it used to be. Which information should the nurse include in the conversation with the client? Select all that apply. The need for a condom during intercourse with a female of childbearing age The health care provider should be notified because a dosage decrease may be needed That decreased ejaculate is expected but should not impair normal sexual performance To hold a dose until after intercourse if sexual activity is planned To report worsening in urinary symptoms A client with chronic kidney disease is prescribed epoetin. Which prescription should the nurse expect to be prescribed for this client's safety? Weekly hemoglobin and hematocrit while receiving epoetin Discontinue the client's iron supplement while taking epoetin Daily calcium supplement to be given with iron supplement Hold epoetin if blood pressure is greater than 140/90 mm Hg A client who took nitrofurantoin 2 weeks ago reports 2 days of profuse diarrhea. Which action should the nurse take? Recommend using an over the counter antidiarrheal according to directions on the box. Teach the client that this is a delayed side effect of the nitrofurantoin and will resolve on its own in a few days. Teach the client that nitrofurantoin does not have delayed side effects and inquire about possible dietary causes. Instruct the client to collect a stool specimen in a clean container and bring it to the clinic for clostridium difficile testing A client taking sulfamethoxazole/trimethoprim (SMZ/TMP) for a urinary tract infection has a fever of 38.4 C and a painful blister-like rash spreading over the body. Which action should the nurse take? Instruct the unlicensed assistive personnel to monitor temperature every 2 hours and apply moisturizing cream to the rash Teach the client that this is a harmless side effect often associated with this antibiotic and that it will resolve after treatment Place the client in isolation due to suspected outbreak of herpes infection Notify the health care provider of these findings and request evaluation for Stevens Johnson syndrome A client taking oxybutynin for an overactive bladder is humiliated by the condition. Which response should the nurse make? "Don't worry, oxybutynin is a miracle drug." "Having children wreaks havoc on women's bodies." "I am sorry. Why does this make you feel humiliated?" "Tell me more about what you are feeling. The nurse provides care for a school-age client who is hospitalized for diagnostic testing for persistent nocturnal enuresis. The client is at risk for impaired skin integrity due to urinary incontinence. Which intervention should the nurse include in the provision of care to decrease the child's risk for skin breakdown? Administering the prescribed imipramine Restricting fluid intake after 1900 each day Instructing the child to use zinc-oxide protective spray Reminding the child to change positions every two hours Which member of the interdisciplinary team should the nurse consult with for a pediatric client, diagnosed with nephrotic syndrome, when developing the nursing plan of care to address the child's nutritional needs? Dietician Psychiatrist Physical therapist Administer the child's prescribed diuretics. The nurse receives the morning shift report on four clients. Which client should the nurse assess first? "Don't worry, oxybutynin is a miracle drug." "Having children wreaks havoc on women's bodies." "I am sorry. Why does this make you feel humiliated?" "Tell me more about what you are feeling. A client with kidney failure is beginning hemodialysis. Which medication should the nurse anticipate being prescribed to supplement red blood cell production? Voiding frequently while awake Taking phenazopyridine for spasms Wiping from front to back after urinating Using a warm heating pad on the abdomen A client in end stage renal failure taking oral calcium acetate with meals wants to take the medication after eating. Which response should the nurse make? "That is fine as long as you take it after every meal." "That is the best time to take it because it can irritate your stomach otherwise." "It works best if you take it right before eating." "If you take it in the middle of your meal, you will have fewer side effects. The nurse provides education to the parents of a child who is 4 years of age who is postoperative for kidney transplantation and on long-term immunosuppressive therapy to decrease the likelihood of organ rejection. Which scheduled immunization can be safely administered to this pediatric client? Select all that apply. Varicella (VAR). Influenza (IIV4). Inactivated polio (IPV). Measles, mumps, rubella (MMR). Diphtheria, tetanus, and acellular pertussis (DTaP). A client is prescribed finasteride for benign prostatic hyperplasia (BPH). Which response should the nurse make when the client asks if the medication causes sexual dysfunction? "Men are always worried about that!" "If I was you, I would not want to urinate all the time." "Tell me what you know about this medication." "Don't worry about sexual dysfunction. It is a rare occurrence." The nurse provides care for a school-age client who is admitted for the treatment of chronic kidney disease (CKD) that requires hemodialysis. The child is crying and states, "I am scared to have surgery! What if I don't wake up?" Which response by the nurse is therapeutic? "I will ask your doctor for medication that will calm you." "Tell me more about what is scaring you about surgery," "Your parents will be disappointed that you aren't being brave." "Your surgery is common and there is no reason to be scared." While teaching a client about nitrofurantoin, which statement intervention by the nurse? the client requires prompt "I feel like may have a sinus infection too so I'm really glad to get this antibiotic." "I have constipation pretty often." "I took this last year. I remember it made my urine a little dark." "I knew I shouldn't take that bubble bath. won't do that again!" A client with urinary retention is prescribed bethanechol 25 mg PO TID. In which way should the nurse schedule the medication doses to prevent the side effect of nausea ? 1 hour before each meal At meal time 2000 1 hour after each meal Every 8 hours regardless of mealtimes A client who is diagnosed with anemia caused by chronic kidney disease (CKD) is scheduled to receive erythropoietin alfa and ferric gluconate. Based on the below data, which is the priority nursing action? Laboratory values: Hemoglobin 9.0 g/dL (90 g/L); Hematocrit 28 % (0.28 Assessment data: Blood pressure 175/90 mm Hg; Pulse 88 beats/minute; Respirations 12 breaths/minute; Temperature: 98.8 F (37.1 C) Asking the client to identify the site of the previous erythropoietin alpha injection. Assessing the client for weight gain, edema, and urine output before administering the prescribed ferric gluconate Clarifying the current prescription for erythropoietin alfa with the healthcare provider (HCP) prior to administration. Obtaining a new set of laboratory data before infusing the iron. The nurse provides care for a client who is prescribed sodium polystyrene sulfonate by mouth. Current laboratory data is as follows: creatinine 3.8 mg/dL; blood urea nitrogen (BUN) 22 mg/dL; serum potassium 6.5 mEq/L; and serum sodium 155 mEq/L. Which new laboratory result indicates that the prescribed medication is effective? BUN 20 mg/dL Creatinine 3.3 mg/dL. Potassium 5.5 mEq/L. Sodium 155 mEq/L The nurse reviews a client's laboratory results and medication administration record (MAR) at the start of a shift. The client is newly prescribed an intravenous (IV) potassium chloride (KCI) infusion at 50 mL/hour into an existing peripheral IV located in the right forearm. The client reports stinging and pain at the site with the infusion of KCI. Which is the priority action by the nurse? Laboratory Results: Potassium 2.5 mEq/L; Medication Administration Record (MAR): 20 mEq potassium (KCI) in 100 mL of normal saline to infuse over 2 hours intravenous piggyback (IVPB). Apply an ice pack at the IV insertion site for comfort. Stop the medication and check for any signs of infiltration. Immediately stop IV medication and notify healthcare provider (HCP). Slow the rate of infusion by half and notify the healthcare provider (HCP) A male client has experienced urinary frequency for several months. Which statement should the nurse make after learning the client has recently sought help and prescribed tamsulosin? "Why have you waited so long to come in?" "If I was you, I would have been here a long time ago!" "This medication should help you void more completely" "You know there is treatment for this problem?"