(Answers and Rationale) NCLEX Questions for Kidney Stones, Bladder Cancer, Prostate Issues

1. A. Urine should be strained for calculi and sent to the lab for analysis. Fluid intake of 3 to 4 L is encouraged to flush the urinary tract and prevent further calculi formation. A low-calcium diet is recommended to help prevent the formation of calcium calculi. Ambulation is encouraged to help pass the calculi through gravity. 2. D. Cystitis is the most common adverse reaction of clients undergoing radiation therapy; symptoms include dysuria, frequency, urgency, and nocturia. Clients with radiation implants require a private room. Urine of clients with radiation implants for bladder cancer should be sent to the radioisotopes lab for monitoring. It is recommended that fluid intake be increased. 3. C. Infections is the major complication to watch for in clients on cyclosporine therapy because it’s an immunosuppressive drug. Depression may occur posttransplantation but not because of cyclosporine. Hemorrhage is a complication associated with anticoagulant therapy. Peptic ulcer disease is a complication of steroid therapy. 4. D. In a client with acute renal graft rejection, evidence of deteriorating renal function is expected. The nurse would see elevated WBC counts and fever because the body is recognizing the graft as foreign and is attempting to fight it. The client would most likely have acute hypertension. 5. D. The client undergoing a renal transplantation will need vigilant follow-up care and must adhere to the medical regimen. The client is most likely anuric or oliguric preoperatively, but postoperatively will require close monitoring of urine output to make sure the transplanted kidney is functioning optimally. While the client will always need to be monitored for signs and symptoms of infection,...

NCLEX Questions for Kidney Stones, Bladder Cancer, Prostate Issues

1. A client is complaining of severe flank and abdominal pain. A flat plate of the abdomen shows urolithiasis. Which of the following interventions is important? a. Strain all urine b. Limit fluid intake c. Enforce strict bed rest d. Encourage a high calcium diet 2. A client is receiving a radiation implant for the treatment of bladder cancer. Which of the following interventions is appropriate? a. Flush all urine down the toilet b. Restrict the client’s fluid intake c. Place the client in a semi-private room d. Monitor the client for signs and symptoms of cystitis 3. A client has just received a renal transplant and has started cyclosporine therapy to prevent graft rejection. Which of the following conditions is a major complication of this drug therapy? a. Depression b. Hemorrhage c. Infection d. Peptic ulcer disease 4. A client received a kidney transplant 2 months ago. He’s admitted to the hospital with the diagnosis of acute rejection. Which of the following assessment findings would be expected? a. Hypotension b. Normal body temperature c. Decreased WBC count d. Elevated BUN and creatinine levels 5. The client is to undergo kidney transplantation with a living donor. Which of the following preoperative assessments is important? a. Urine output b. Signs of graft rejection c. Signs and symptoms of rejection d. Client’s support system and understanding of lifestyle changes. 6. A client had a transurethral prostatectomy for benign prostatic hypertrophy. He’s currently being treated with a continuous bladder irrigation and is complaining of an increase in severity of bladder spasms. Which of the interventions should be done first? a. Administer an...

Answers and Rationale for Cardiac Surgical Patient

1. B. Arteries, not veins, supply the coronary arteries with oxygen and other nutrients. Atherosclerosis is a direct result of plaque formation in the artery. Hardened vessels can’t dilate properly and, therefore, constrict blood flow. 2. D. A paradoxical pulse (a palpable decrease in pulse amplitude on quiet inspiration) signals pericardial tamponade, a complication of CABG surgery. Left-sided heart failure can cause pulsus alternans (pulse amplitude alternation from beat to beat, with a regular rhythm). Aortic regurgitation may cause bisferious pulse (an increased arterial pulse with a double systolic peak). Complete heart block may cause a bounding pulse (a strong pulse with increased pulse pressure). 3. C. Check with Dani if you have issues with this problem. 4. C. The pulmonary artery pressures are used to assess the heart’s ability to receive and pump blood. The pulmonary capillary wedge pressure reflects the left ventricle end-diastolic pressure and guides the physician in determining fluid management for the client. The degree of coronary artery stenosis is assessed during a cardiac catherization. The peripheral arterial pressure is assessed with an arterial line. 5. A. In an immobilized client, calcium leaves the bone and concentrates in the ECF fluid. When a large amount of calcium passes through the kidneys, calcium can precipitate and form calculi. Nursing interventions that help prevent calculi include ensuring a liberal fluid intake (unless contraindicated). A diet rich in acid should be provided to keep the urine acidic, which increases the solubility of calcium. Preventing constipation is not associated with excessive calcium excretion. Limiting foods rich in calcium, such as dairy products, will help on preventing renal calculi. 6....

NCLEX Questions for Cardiac Surgical Patient

1. Atherosclerosis impedes coronary blood flow by which of the following mechanisms? a. Plaques obstruct the vein b. Plaques obstruct the artery c. Blood clots form outside the vessel wall d. Hardened vessels dilate to allow blood to flow through 2. A paradoxical pulse occurs in a client who had a coronary artery bypass graft (CABG) surgery 2 days ago. Which of the following surgical complications should the nurse suspect? a. Left-sided heart failure b. Aortic regurgitation c. Complete heart block d. Pericardial tamponade 3. After cardiac surgery, a client’s blood pressure measures 126/80. The nurse determines that the mean arterial pressure (MAP) is which of the following? a. 46 mm Hg b. 80 mm Hg c. 95 mm Hg d. 90 mm Hg 4. A woman with severe mitral stenosis and mitral regurgitation has a pulmonary artery catheter inserted. The physician orders pulmonary artery pressure monitoring, including pulmonary capillary wedge pressures. The purpose of this is to help assess the: a. Degree of coronary artery stenosis b. Peripheral arterial pressure c. Pressure from fluid within the left ventricle d. Oxygen and carbon dioxide concentration is the blood 5. For a client who excretes excessive amounts of calcium during the postoperative period after open heart surgery, which of the following measures should the nurse institute to help prevent complications associated with excessive calcium excretion? a. Ensure a liberal fluid intake b. Provide an alkaline-ash diet c. Prevent constipation d. Enrich the client’s diet with dairy products 6. A nurse is assessing the neurovascular of a client who has returned to the surgical nursing unit 4 hours ago after undergoing...

Answers for Seizure NCLEX Questions

1. A. The nurse should first attempt nursing interventions, such as repositioning the client to avoid neck flexion, which increases venous return and lowers ICP. If nursing measures prove ineffective, notify the physician, who may prescribe mannitol, pentobarbital, or hyperventilation therapy. 2. B. Dilantin IV shouldn’t be given at a rate exceeding 50 mg/minute. Rapid administration can depress the myocardium, causing arrhythmias. Therapeutic drug levels range from 10 to 20 mg/ml. Dilantin shouldn’t be mixed in solution for administration. However, because it’s compatible with normal saline solution, it can be injected through an IV line containing normal saline. When given through an IV catheter hand, dilantin may cause purple glove syndrome. 3. A. Urine output of 300 ml/hr may indicate diabetes insipidus, which is a failure of the pituitary to produce anti-diuretic hormone. This may occur with increased intracranial pressure and head trauma; the nurse evaluates for low urine specific gravity, increased serum osmolarity, and dehydration. There’s no evidence that the client is experiencing renal failure. Providing emollients to prevent skin breakdown is important, but doesn’t need to be performed immediately. Slowing the rate of IV fluid would contribute to dehydration when polyuria is present. 4. A. A normal PaCO2 value is 35 to 45 mm Hg. CO2 has vasodilating properties; therefore, lowering PaCO2 through hyperventilation will lower ICP caused by dilated cerebral vessels. Oxygenation is evaluated through PaO2 and oxygen saturation. Alveolar hypoventilation would be reflected in an increased PaCO2. 5. B. Frequent swallowing after brain surgery may indicate fluid or blood leaking from the sinuses into the oropharynx. Blood or fluid draining from the ear may indicate...

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