Question 1 of 6
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Which intervention would the nurse implement first for a patient with accidental deep-penetrating renal trauma?
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- Monitoring intake and output of fluidThe nurse can perform other interventions when the patient is stable, such as monitoring intake and output.
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- Assessing for hematuria and myoglobinuriaThe nurse can perform other interventions when the patient is stable, such as assessing for hematuria and myoglobinuria.
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- Providing pain relief and comfort measuresThe nurse can perform other interventions when the patient is stable, such as providing pain relief and comfort measures.
- Correct
- Assessing for signs and symptoms of internal bleedingBecause the patient may have suffered significant blood loss, assessing the cardiovascular system and monitoring the patient for signs and symptoms of shock are the most urgent actions that the nurse would perform.
Question 2 of 6
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The nurse is caring for a patient with renal stenosis. Which nursing intervention is appropriate?
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- Encouraging intake of fluidsFluid intake is encouraged for patients with renal stones but not with renal stenosis. With renal stenosis, the blood pressure is already high and adding more fluids may increase it further.
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- Implementing a low-purine dietLow-purine diets are initiated for patients with uric acid renal stones, not renal stenosis.
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- Administering antihypertensives as prescribedAntihypertensives should be administered to patients with renal stenosis to lower blood pressure and improve blood flow to the kidney.
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- Anticipating an acute, rapid loss of kidney functionKidney function is gradually lost over time in cases of renal stenosis.
Question 3 of 6
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The nurse is caring for a patient recently diagnosed with a struvite renal stone. The patient asks how they can prevent these stones in the future. Which statement by the nurse is appropriate?
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- “Decrease intake of protein in your diet.”Protein intake should be decreased for patients with calcium phosphate or calcium oxalate renal stones.
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- “Take your gout medications as prescribed.”Gout is a risk factor for the development of uric acid stones, not struvite stones.
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- “Do your best to avoid urinary tract infections (UTIs).”UTIs are a major risk factor for the development of struvite renal stones, so it is important for the patient to avoid these infections if possible.
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- “There is nothing you can do because this condition is genetic.”Cystine stones are a genetic condition, not struvite stones.
Question 4 of 6
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Which nursing intervention would the nurse implement when caring for a patient with uric acid renal stones? Select all that apply. One, some, or all responses may be correct.
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- Encouraging oral fluid intakePatients with renal stones should be encouraged to drink more fluids to flush out the stones in the urine.
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- Administering allopurinol as prescribedBecause gout is a common cause of uric acid renal stones, it is important for the nurse to administer allopurinol as prescribed.
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- Avoiding administration of analgesicsAnalgesics should be given to patients with renal stones because they can be very painful.
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- Straining urine output to check for stone passageUrine should be strained to monitor for passage of kidney stones. Once a stone has been passed, it should be sent to the laboratory for analysis so that treatments can be implemented based on the specifics of the stone.
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- Preparing the patient for an emergent surgical procedureMost renal stones are passed on their own and do not require surgical intervention.
Question 5 of 6
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During the health history, the patient reports seeing blood in the urine as well as having the urge to urinate more often. Which condition does the nurse suspect the patient may have?
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- PeritonitisPeritonitis is a complication resulting from bladder perforation and is manifested with symptoms of infection such as fever.
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- Renal stonesClinical manifestations of renal stones are often severe pain, nausea, vomiting, and hematuria. Increased urinary frequency is not typically a symptom of renal stones.
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- Renal stenosisRenal stenosis is often accompanied by hypertension and symptoms of chronic renal failure.
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- Bladder cancerBladder cancer often presents with hematuria and urinary frequency.
Question 6 of 6
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Which nursing intervention is appropriate when caring for a patient after surgical placement of a ureterosigmoidostomy?
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- Monitoring the color of the stomaThere is no stoma placed with a ureterosigmoidostomy procedure.
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- Discussing the patient’s sexual concernsThe patient’s body image and sexual function concerns should be discussed before and after the procedure.
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- Teaching the patient how to self-catheterizeWith a ureterosigmoidostomy, the urine is excreted through the anus with feces, so there is no need to teach the patient to self-catheterize.
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- Reporting pink-tinged urine to the health care provider immediatelyPink-tinged urine is expected for 3 days after placement of a urinary diversion so this does not need to be reported to the health care provider.
