■ 4. Swelling at the shunt site. 51. The client with acute renal failure is recovering and asks the nurse, “Will my kidneys ever function normally again?” The nurse’s response is based on knowledge that the client’s renal status will most likely: ■ 1. Continue to improve over a period of weeks. ■ 2. Result in the need for permanent hemodialysis. ■ 3. Improve only if the client receives a renal transplant. ■ 4. Result in end-stage renal failure. The Client with Urinary Tract Infection 52. The nurse is teaching an 80-year-old client with a urinary tract infection about the importance of increasing fl uids in the diet. Which of the following puts this client at a risk for not obtaining suffi - cient fl uids? ■ 1. Diminished liver function. ■ 2. Increased production of antidiuretic hormone. ■ 3. Decreased production of aldosterone. ■ 4. Decreased ability to detect thirst. 53. A client with a urinary tract infection is to take nitrofurantoin (Macrodantin) four times each day. The client asks the nurse, “What should I do if I forget a dose?” What should the nurse tell the client? ■ 1. “You can wait and take the next dose when it is due.” ■ 2. “Double the amount prescribed with your next dose.” ■ 3. “Take the prescribed dose as soon as you remember it, and if it is very close to the time for the next dose, delay that next dose.” ■ 4. “Take a lot of water with a double amount of your prescribed dose.” 54. A nurse is assessing a client with a urinary tract infection who takes an antihypertensive drug. The nurse reviews the client’s urinalysis results (see chart). The nurse should: ■ 1. Encourage the client to increase fl uid intake. ■ 2. Withhold the next dose of antihypertensive medication. ■ 3. Restrict the client’s sodium intake. ■ 4. Encourage the client to eat at least half of a banana per day. Laboratory Results Test Result pH 6.8 Red blood cells 3 per high power fi eld Color Yellow Specifi c gravity 1.030 55. A client has nephropathy. The physician orders that a 24-hour urine collection be done for
■ 3. Low-protein, low-sodium, low-potassium. ■ 4. Low-protein, high-potassium. 89. The nurse is discussing concerns about sexual activity with a client with chronic renal failure. Which one of the following strategies would be most useful? ■ 1. Help the client to accept that sexual activity will be decreased. ■ 2. Suggest using alternative forms of sexual expression and intimacy. ■ 3. Tell the client to plan rest periods after sexual activity. ■ 4. Suggest that the client avoid sexual activity to prevent embarrassment. 90. A client with chronic renal failure has asked to be evaluated for a home continuous ambulatory peritoneal dialysis (CAPD) program. The nurse should explain that the major advantage of this approach is that it: ■ 1. Is relatively low in cost. ■ 2. Allows the client to be more independent. ■ 3. Is faster and more effi cient than standard peritoneal dialysis. ■ 4. Has fewer potential complications than standard peritoneal dialysis. 91. The client asks about diet changes when using continuous ambulatory peritoneal dialysis (CAPD). Which of the following would be the nurse’s best response? ■ 1. “Diet restrictions are more rigid with CAPD because standard peritoneal dialysis is a more effective technique.” ■ 2. “Diet restrictions are the same for both CAPD and standard peritoneal dialysis.” ■ 3. “Diet restrictions with CAPD are fewer than with standard peritoneal dialysis because dialysis is constant.” ■ 4. “Diet restrictions with CAPD are fewer than with standard peritoneal dialysis because CAPD works more quickly.” 92. A client is receiving continous ambulatory peritoneal dialysis (CAPD). The nurse should assess the client for which of the following signs of peritoneal infection? ■ 1. Cloudy dialysate fl uid. ■ 2. Swelling in the legs. ■ 3. Poor drainage of the dialysate fl uid. ■ 4. Redness at the catheter insertion site. The Client with Urinary Incontinence 93. What should the nurse teach the client to do to prevent stress incontinence? Select all that apply. ■ 1. Use techniques that strengthen the sphincter and structural supports of the bladder, such as Kegel exercises.