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55 Cards in this Set

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High level of protein in the blood sign of

Renal damage and cardiac diease

A school nurse assesses a child who has an erythematous circular patch of vesicles on her scalp with alopecia and complains of pain and pruritis. Why would the nurse use a Woods lamp?A. To dry out the lesionsB. To reduce the pruritusC. To kill the fungusD. To cause fluorescence of the infected hairs

D. To cause fluorescence of the infected hairsRationale: Tinea capitis is commonly known as ringworm of the scalp. Microsporum audouinii is the major fungal pathogen. The use of the diagnostic Woods lamp causes the infected hairs to turn a brilliant blue green.

The nurse is caring for a 26-year-old male patient who was burned 72 hours ago. He has partial-thickness burns to 24% of his body surface area. He begins to excrete large amounts of urine. What should the nurse do?A. Increase the IV rate and monitor for burn shockB. Monitor for signs of seizure activityC. Assess for signs of fluid overloadD. Raise the foot of the bed and apply blankets

C. Assess for signs of fluid overloadRationale: As the blood volume increases, the cardiac output increases to increase renal perfusion. The result includes diuresis. However, a great risk for the patient includes fluid overload because of the rapid movement of fluid back into the intravascular space.

What would the nurse stress to the 17-year-old girl who has been prescribed Accutane for her acne?A. Avoid alcoholic beveragesB. Drink at least 1000mL of fluid dailyC. Use dependable birth control to avoid pregnancyD. Avoid exposure to the sun

C. Use dependable birth control to avoid pregnancyRationale: Accutane has a destructive effect on fetal development. Dependable birth control is important to avoid a pregnancy.

A patient, age 27, sustained thermal burns to 18% of her body surface area. After the first 72 hours, the nurse will have to observe for the most common cause of burn-related deaths, which is:A. ShockB. Respiratory arrestC. HemorrhageD. Infection

D. InfectionRationale: Infection is the most common complication and cause of death after the first 72 hours.

The home health nurse assessing skin lesions uses the PQRST mnemonic as a guide. What does the S in the guide indicate?A. Severity of the symptomsB. Site of the lesionsC. Symptomatology of the lesionsD. Surface area of the lesions

A. Severity of the symptomsRationale: The mnemonic PQRST stands for Provocative factors (causes), Quantity, Region of the body, Severity of the symptoms, Time (length of time the disorder has been present).

A nurse can assess cyanosis in a dark-skinned patient by noting the color of the:A. ConjunctivaB. ScleraC. Lips and mucous membranesD. Soles of the feet

C. Lips and mucous membranesRationale: Assessment of color is more easily made in areas where the epidermis is thin, such as the lips and mucous membranes.

Most of the deaths from burn trauma in the emergent phase that require a referral to a burn center result from:A. InfectionB. Arrhythmias with cardiac arrestC. Hypovolemic shock and renal failureD. Adrenal failure

C. Hypovolemic shock and renal failureRationale: Hypovolemic shock is frequently lethal in the emergent period of a severe burn because of the transfer of fluids into the interstitial tissue from the circulating volume.

A patient has herpes zoster (shingles) and is being treated with acyclovir (Zovirax). What should the nurse do when administering this drug?A. Apply lightly, being carful not to completely cover the lesionB. After application, wrap in warm wet dressingsC. Use glovesD. Rub medications into lesions

C. Use glovesRationale: The topical application requires that the nurse uses gloves, completely covers the lesion gently, then leaves it open to the air.

A child has been sent to the school nurse with pruritus and honey-colored crusts on the lower lip and chin. The nurse believes theses lesions most likely are:A. ChickenpoxB. ImpetigoC. ShinglesD. Herpes simplex type 1 .

B. ImpetigoRationale: Impetigo is seen at all ages, but is particularly common in children. The crust is honey-colored and easily removed and is associated with pruritis. The disease is highly contagious and spreads by contact

What should the nurse examine in assessing a patient for tinea corporis?A. Soles of the feetB. ScalpC. ArmpitsD. Abdomen

D. AbdomenRationale: Tinea corporis is known as ringworm of the body. It occurs on parts of the body with little or no hair.

Melanocytes give rise to the pigment melanin, which is responsible for skin color. Where can the melanocytes be found?A. DermisB. Superficial fasciaC. EpidermisD. Loose connective tissue .

C. EpidermisRationale: A layer in the epidermis contains highly specialized cells called melanocytes

What should the nurse examine in assessing a patient for tinea corporis?A. Soles of the feetB. ScalpC. ArmpitsD. Abdomen

D. AbdomenRationale: Tinea corporis is known as ringworm of the body. It occurs on parts of the body with little or no hair.

Select all that apply:During primary survey assessment of a burn patient, the nurse checks for which of the following as early signs of carbon monoxide poisoning?A. DizzinessB. UrticariaC. VomitingD. HeadacheE. VertigoF. Unsteady gait D. HeadacheF. Unsteady gait

C. Vomiting

Rationale: Early signs of carbon monoxide poisoning include headache, nausea, vomiting, and unsteady gait.

A 30-year-old African American had surgery 6 months ago and the incision site is now raised, indurated, and shiny. This is most likely which type of tissue growth?A. AngiomaB. KeloidC. MelanomaD. Nevus

B. KeloidRationale: Keloids, which originate in scars, are hard and shiny and are seen more often in African Americans than in whites.

What should a patient be assessed for upon the diagnosis of genital herpes?A. Hepatitis BB. SyphilisC. Human immunodeficiency virus (HIV)D. Cirrhosis 

C. Human immunodeficiency virus (HIV)Rationale: Persons with genital herpes should be assessed for HIV because the therapy for herpes is suppressive; persons with HIV are not candidates for suppressant therapy.

Urinary antiseptic are divided into 4 groups





Interstitial cystitis is characterized by

urinary frequency, urgency, suprapubic pain and dyspareunia.

Intravenous (IVP) also called Intravenous urography (IVU)

Evaluate structures of the urinary tract , filling of the renal pelvis with urine, and transport of urine via the ureters and bladders.

Which organ in the urinary system excrete creatinine

Creatinine like BUN, is excreted by the kidneys.

Therefore normal serum creatinine level are a sign of normal renal excretory functions.

Elevated serum creatinine level may be caused by

Acute tubular necrosis, glomerulonephritis, pyelonephritis, reduced kidney functions, and renal failure.

What are serum creatinine test, BUN used to diagnosed?

Impaired kidney functions.

Beside impaired kidney functions what else does the BUN assessed?

Dehydration, malnutrition, or hepatic function

What are the accepted serum creatinine levels?

Female 0.5- 1.1mg/dL

Male 0.6- 1.2 mg/dL

Creatinine depends on muscle mass, which fluctuate little. This is explains the lower creatinine levels in women.

We usually have less muscle mass

Creatinine is generating through what metabolic activity?

Muscle contraction and then excreted by glomerular filtration.

An elevated serum creatinine level with a decline in urine creatinine level indicates

Renal diease

Normal ranges

Serum 0.5- 1.1 mg/dL (female)

0.6- 1.2 mg/dL (male)

Urine 87- 107 mL/min (female)

107- 139 mL/ min (male)

Organ- specific glycoprotein produced by normal prostatic tissue

Prostate- specific antigen (psa)

Normal range is less than 4 ng/mL

Elevated Prostate specific antigen

Is a sign of prostate cancer, inflammation or infection, urinary tract infection , recent cystoscopy or prostatic biopsy

Urine osmolarity

More informative than urine specific gravity. More difficult test to perform.

Kidney Ureter bladder radiograph

Assess the general status of the abdomen and the size , structure, and position of the urinary tract structures.

No special preparation needed. Remind the patient that they will have to change position on the table which is uncomfortable.

Intravenous pyelography (IVP) (IVU)

Evaluate structures of the urinary tract,

filling of the renal pelvis with urine

Transport of urine via the ureters to the bladder

The course of ARF is divided into phases.

Oliguric phase - high serum creatinine and BUN levels rise while urinary output is less than 400 mL/24 hrs.

Diuretic phase- blood chemistry levels begin to return to normal and urinary output increase to 1- 2 L/24 hours.

Recovery phase- return to normal or near normal functions.

Clinical manifestation ARF

Anorexia, nausea, vomiting edema, and associated signs and symptoms of diminished kidney function.

Diagnosis of Acute renal failure

Physical assessment


Elevated blood chemistry test BUN and creatinine (azotemia)

Medical management of ARF

Administration of fluids and osmotic prep to prevent decreased renal perfusion, manage fluid volume and treat electrolytes imbalances .

Diet high in carbohydrates, protein sparing ; low in potassium and sodium.

Drug therapy includes

-Diuretics to increase urinary output

- Potassium lowering agents; sodium polystyrene sulfonate (Kayexalate)


(azot, "nitrogen" + -emia, "blood condition") is a medical condition characterized by abnormally high levels of nitrogen-containing compounds (such as urea, creatinine, various body waste compounds, and other nitrogen-rich compounds) in the blood.

A pt. with ESRD has an arteriovenous fistula in the left arm for hemodialysis. Which intervention do you include in his plan of care?

A.Apply pressure to the needle site upon discontinuing hemodialysis

B. Keep the head of the bed elevated 45 degrees

C. Place the left arm on an arm board for at least 30 minutes

D. Keep the left arm dry


Question 1 Explanation: Apply pressure when discontinuing hemodialysis and after removing the venipuncture needle until all the bleeding has stopped. Bleeding may continue for 10 minutes in some patients.

Immunosuppression following Kidney transplantation is continued:

AFor life

B.24 hours after transplantation

C.A week after transplantation

D.Until the kidney is not anymore rejected

A. For life

Which action is most important during bladder training in a patient with a neurogenic bladder?

A.Encourage the use of an indwelling urinary catheter

B.Set up specific times to empty the bladder

C.Encourage Kegel exercises

D.Force fluids

B. Set up a specific time to empty the bladder

The most common early sign of kidney disease is:

A. Sodium retention

B. Elevated BUN level

C. Development of metabolic acidosis

D. Inability to dilute or concentrate urine

Elevated BUN levels

Which drug is indicated for pain related to acute renal calculi?A.Narcotic analgesics

B.Nonsteroidal anti-inflammatory drugs (NSAIDS)

C.Muscle relaxants


A. Narcotic analgesic

Narcotic analgesics are usually needed to relieve the severe pain of renal calculi. Muscle relaxants are typically used to treat skeletal muscle spasms. NSAIDS and salicylates are used for their anti-inflammatory and antipyretic properties and to treat less severe pain.

Which sign indicated the second phase of acute renal failure?ADaily doubling of urine output (4 to 5 L/day)BUrine output less than 400 ml/dayCUrine output less than 100 ml/dayDStabilization of renal function

Wait for the answer

Explanation: Daily doubling of the urine output indicates that the nephrons are healing. This means the patient is passing into the second phase (dieresis) of acute renal failure.

Your patient becomes restless and tells you she has a headache and feels nauseous during hemodialysis. Which complication do you suspect?A.Infection

B.Disequilibrium syndrome

C.Air embolus

D.Acute hemolysis

Disequilibrium syndrome

What is the priority nursing diagnosis with your patient diagnosed with end-stage renal disease?AActivity intoleranceBFluid volume excessCKnowledge deficitDPain


Your patient is complaining of muscle cramps while undergoing hemodialysis. Which intervention is effective in relieving muscle cramps?A. Increase the rate of dialysis

B.Infuse normal saline solution

C.Administer a 5% dextrose solution

D.Encourage active ROM exercises

B. Infuse normal saline solution

A patient returns from surgery with an indwelling urinary catheter in place and empty. Six hours later, the volume is 120ml. The drainage system has no obstructions. Which intervention has priority?AGive a 500 ml bolus of isotonic salineBEvaluate the patient’s circulation and vital signsCFlush the urinary catheter with sterile water or salineDPlace the patient in the shock position, and notify the surgeon

Wait for the answer

Which of the following causes the majority of UTI’s in hospitalized patients?

A.Lack of fluid intake

B.Inadequate perineal care

C.Invasive procedures


C. Invasive procedure

Your patient returns from the operating room after abdominal aortic aneurysm repair. Which symptom is a sign of acute renal failure?





C. Oliguria

You have a paraplegic patient with renal calculi. Which factor contributes to the development of calculi?

A.Increased calcium loss from the bones

B.Decreased kidney function

C.Decreased calcium intake

D High fluid intake

A. Increased calcium loss from the bones

A patient is experiencing which type of incontinence if she experiences leaking urine when she coughs, sneezes, or lifts heavy objects?





C. Stress

Immediately post-op after a prostatectomy, which complications requires priority assessment of your patient?



C.Urine retention

D.Deep vein thrombosis

B. Hemorrhage

Hemorrhage is a potential complication. Urine retention isn’t a problem soon after surgery because a catheter is in place. Pneumonia may occur if the patient doesn’t cough and deep breathe. Thrombosis may occur later if the patient doesn’t ambulate.Question 17 WRONG

A patient diagnosed with sepsis from a UTI is being discharged. What do you plan to include in her discharge teaching?

ATake cool baths

BAvoid tampon use

CAvoid sexual activity

DDrink 8 to 10 eight-oz glasses of water daily

D. Drink 8 to 10 eight glasses of water daily

Drinking 2-3L of water daily inhibits bacterial growth in the bladder and helps flush the bacteria from the bladder. The patient should be instructed to void after sexual activity.

Your patient has complaints of severe right-sided flank pain, nausea, vomiting and restlessness. He appears slightly pale and is diaphoretic. Vital signs are BP 140/90 mmHg, Pulse 118 beats/min., respirations 33 breaths/minute, and temperature, 98.0F. Which subjective data supports a diagnosis of renal calculi?A.Pain radiating to the right upper quadrantB.History of mild flu symptoms last weekC.Dark-colored coffee-ground emesisD. Dark, scanty urine output

D. Dark scanty urine output

Explanation: Patients with renal calculi commonly have blood in the urine caused by the stone’s passage through the urinary tract. The urine appears dark, tests positive for blood, and is typically scant.

What is the most important nursing diagnosis for a patient in end-stage renal disease?

A. for injury

B.Fluid volume excess

C.Altered nutrition: less than body requirements

D.Activity intolerance

B. Fluid volume excess

Explanation: Kidneys are unable to rid the body of excess fluids which results in fluid volume excess during ESRD.