NCLEX Questions on Genitourinary System
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Question 1 of 5.
The clinic nurse is caring for a client diagnosed with chronic pyelonephritis who is prescribed trimethoprim-sulfamethoxazole (Bactrim), a sulfa antibiotic, twice a day for 90 days. Which statement is the scientific rationale for prescribing this medication?
A. The antibiotic will treat the bladder spasms that accompany a urinary tract infection.
B. If the urine cannot be made bacteria free, the Bactrim will suppress bacterial growth.
C. In three (3) months, the client should be rid of all bacteria in the urinary tract.
D. The HCP is providing the client with enough medication to treat future infections.
Explanation: Chronic pyelonephritis often requires long-term antibiotics like Bactrim to suppress bacterial growth when complete eradication is not possible. It does not treat spasms, and 90 days may not eliminate all bacteria or be for future use.
Question 2 of 5.
Which signs/symptoms indicate to the nurse the client is in the recovery period of ARF? Select all that apply.
A. Increased alertness and no seizure activity.
B. Increase in hemoglobin and hematocrit.
C. Denial of nausea and vomiting.
D. Decreased urine-specific gravity.
E. Increased serum creatinine level.
Explanation: In the recovery phase, renal function improves, leading to increased alertness (reduced uremia), resolution of nausea/vomiting, and decreased urine-specific gravity as kidneys concentrate urine. Increased hemoglobin/hematocrit is not typical, and elevated creatinine indicates worsening, not recovery.
Question 3 of 5.
The client diagnosed with ARF is placed on bedrest. The client asks the nurse, 'Why do I have to stay in bed? I don't feel bad.' Which scientific rationale supports the nurse's response?
A. Bedrest helps increase the blood return to the renal circulation.
B. Bedrest reduces the metabolic rate during the acute stage.
C. Bedrest decreases the workload of the left side of the heart.
D. Bedrest aids in reduction of peripheral and sacral edema.
Explanation: Bedrest reduces the body's metabolic demands, minimizing stress on the kidneys during the acute phase of ARF. It does not directly increase renal blood flow, reduce heart workload, or address edema in this context.
Question 4 of 5.
The client diagnosed with ARF is experiencing hyperkalemia. Which medication should the nurse prepare to administer to help decrease the potassium level?
A. Erythropoietin.
B. Calcium gluconate.
C. Regular insulin.
D. Osmotic diuretic.
Explanation: Regular insulin, often given with glucose, drives potassium into cells, temporarily lowering serum potassium levels in hyperkalemia. Calcium gluconate stabilizes cardiac membranes, erythropoietin treats anemia, and osmotic diuretics are not used for hyperkalemia.
Question 5 of 5.
The nurse is developing a nursing care plan for the client diagnosed with CKD. Which nursing problem is priority for the client?
A. Low self-esteem.
B. Knowledge deficit.
C. Activity intolerance.
D. Excess fluid volume.
Explanation: Excess fluid volume is the priority in CKD due to impaired kidney excretion, leading to edema, hypertension, and heart failure risk. Fluid overload is a life-threatening issue, whereas self-esteem, knowledge, and activity intolerance are secondary.
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