Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is caring for a client who has acute glomerulonephritis.
Which of the following findings should the nurse expect?
A. Hematuria
Hematuria is the presence of red blood cells in the urine, which can make it appear pink or cola-colored. Hematuria is a common sign of glomerulonephritis, which is inflammation of the tiny filters in the kidneys (glomeruli) that remove waste and excess fluid from the blood. Hematuria occurs because the inflamed glomeruli allow some blood cells to leak into the urine.
B. Polyuria
, is wrong because polyuria is the production of abnormally large amounts of urine. Polyuria is not a typical feature of acute glomerulonephritis, which may actually cause reduced urine output due to fluid retention and decreased kidney function
C. Weight loss.
is wrong because weight loss is not a common symptom of acute glomerulonephritis. On the contrary, weight gain may occur due to fluid retention and edema (swelling) in the face, hands, feet and abdomen.
D. Hypotension
because hypotension is low blood pressure. Hypotension is not usually associated with acute glomerulonephritis, which may cause high blood pressure (hypertension) due to fluid overload and impaired sodium excretion by the kidneys.
This question is an excerpt from Nurse Dive's nursing test bank - ATI Comprehensive Predictor 2023 Exit Proctored Exam A. Take the full exam now
Full Explanation
The correct answer is choice A, hematuria.
Hematuria is the presence of red blood cells in the urine, which can make it appear pink or cola-colored. Hematuria is a common sign of glomerulonephritis, which is inflammation of the tiny filters in the kidneys (glomeruli) that remove waste and excess fluid from the blood.
Hematuria occurs because the inflamed glomeruli allow some blood cells to leak into the urine.
Choice B, polyuria, is wrong because polyuria is the production of abnormally large amounts of urine. Polyuria is not a typical feature of acute glomerulonephritis, which may actually cause reduced urine output due to fluid retention and decreased kidney function.
Choice C, weight loss, is wrong because weight loss is not a common symptom of acute glomerulonephritis. On the contrary, weight gain may occur due to fluid retention and edema (swelling) in the face, hands, feet and abdomen.
Choice D, hypotension, is wrong because hypotension is low blood pressure. Hypotension is not usually associated with acute glomerulonephritis, which may cause high blood pressure (hypertension) due to fluid overload and impaired sodium excretion by the kidneys.
Normal ranges for blood pressure are less than 120/80 mmHg for adults.
Normal ranges for urine output are about 800 to 2000 mL per day for adults.
Normal ranges for protein in the urine are less than 150 mg per day for adults. Normal ranges for red blood cells in the urine are less than 3 per high-power field for men and less than 5 per high-power field for women.
Similar Questions
A nurse is caring for a client who has given informed consent for electroconvulsive therapy (ECT). Just before the procedure, the client expresses to the nurse that she is having second thoughts and is considering not going through with the treatment. What is the most appropriate response for the nurse in this situation?
A. "It's understandable to feel nervous before this treatment. Most people feel better after, but you have the right to change your mind at any time."
Acknowledges the client's feelings:It's important for the nurse to validate the client's concerns and let them know that it's understandable to feel nervous or uncertain about ECT. Provides information about the treatment:The nurse can offer information about the potential benefits of ECT,but it's important not to pressure the client or make them feel like they have to go through with it. Reassures the client of their right to change their mind:This is a crucial aspect of informed consent.The client has the right to withdraw their consent at any time,even after signing the consent form.
B. "I know this is a difficult decision, but the doctor believes ECT is the best option for you. Are you sure you want to cancel?"
Places undue pressure on the client:This response implies that the doctor knows what's best for the client and that the client should go through with the treatment even if they have doubts.This can undermine the client's autonomy and decision-making ability.
C. "That's completely fine! We can reschedule for another time when you're feeling more ready."
May minimize the client's concerns:While rescheduling the treatment is an option,it's important to explore the client's concerns more thoroughly before suggesting this.It's possible that the client has valid reasons for not wanting to go through with ECT,and these reasons should be addressed.
D. "You signed the consent form, so you need to go through with the treatment. It's important to follow through on your commitments."
Is disrespectful of the client's autonomy:This response suggests that the client is obligated to go through with the treatment simply because they signed a consent form.This ignores the fact that people can change their minds and that consent is an ongoing process.
Full Explanation
The correct answer is Choice A.
Choice A rationale:
- Acknowledges the client's feelings: It's important for the nurse to validate the client's concerns and let them know that it's understandable to feel nervous or uncertain about ECT.
- Provides information about the treatment: The nurse can offer information about the potential benefits of ECT, but it's important not to pressure the client or make them feel like they have to go through with it.
- Reassures the client of their right to change their mind: This is a crucial aspect of informed consent. The client has the right to withdraw their consent at any time, even after signing the consent form.
Choice B rationale:
- Places undue pressure on the client: This response implies that the doctor knows what's best for the client and that the client should go through with the treatment even if they have doubts. This can undermine the client's autonomy and decision-making ability.
Choice C rationale:
- May minimize the client's concerns: While rescheduling the treatment is an option, it's important to explore the client's concerns more thoroughly before suggesting this. It's possible that the client has valid reasons for not wanting to go through with ECT, and these reasons should be addressed.
Choice D rationale:
- Is disrespectful of the client's autonomy: This response suggests that the client is obligated to go through with the treatment simply because they signed a consent form. This ignores the fact that people can change their minds and that consent is an ongoing process.
A nurse is caring for a client who has given informed consent for electroconvulsive therapy. Just before the procedure, the client tells the nurse she is considering not going forward with the treatment.
A. “It’s okay to be nervous before this treatment.”.
It’s okay to be nervous before this treatment.” is wrong because it minimizes the patient’s feelings and does not address the patient’s wish to cancel the treatment. It may also imply that the patient’s doubts are irrational or unfounded, which may undermine the patient’s trust and confidence in the nurse.
B. “Most people who have this procedure feel better following the treatment.”.
C. “Your doctor wouldn’t have ordered this treatment unless it was necessary.”.
D. “You don’t have to go through with the treatment
This is because informed consent is a fundamental principle in medical decision-making, and it requires that the patient has the capacity, information, and voluntariness to consent to a treatment. Electroconvulsive therapy (ECT) is a treatment that involves applying electrical currents to the brain to induce seizures and improve symptoms of certain mental disorders. ECT has proven efficacy and safety, but it also has potential risks and side effects, such as memory impairment, headache, nausea, and confusion. Therefore, patients who are considering ECT should be fully informed of the benefits and risks of the procedure, as well as the alternatives and consequences of refusing treatment. If a patient who has given informed consent for ECT expresses doubts or reluctance before the procedure, the nurse should respect the patient’s autonomy and right to withdraw consent at any time. The nurse should not coerce, manipulate, or pressure the patient to undergo ECT, but rather provide support, reassurance, and clarification as needed. The nurse should also inform the patient’s doctor and the ECT team of the patient’s change of mind, and explore the reasons and concerns behind the patient’s decision.
A quality control nurse is reviewing medication prescriptions for a group of clients.
Which of the following medication prescriptions should the nurse identify as being complete?
A. Cimetidine PO twice daily.
is wrong because it does not specify the dose of cimetidine. PO twice daily is not enough information to administer the medication safely.
B. Tetracycline 200 mg PO.
wrong because it does not specify the frequency of tetracycline. 200 mg PO is not enough information to administer the medication safely.
C. Epoetin alfa 150 units/kg three times weekly.
wrong because it does not specify the route of epoetin alfa. 150 units/kg three times weekly is not enough information to administer the medication safely.
D. Digoxin 0.25 mg PO daily. Answer and explanation.
This prescription is complete because it includes the medication name, dose, route, and frequency. A complete prescription should also include the client’s name, date, time, signature of the prescriber, and any special instructions.
Full Explanation
This prescription is complete because it includes the medication name, dose, route, and frequency.
A complete prescription should also include the client’s name, date, time, signature of the prescriber, and any special instructions.
Choice A is wrong because it does not specify the dose of cimetidine.
PO twice daily is not enough information to administer the medication safely.
Choice B is wrong because it does not specify the frequency of tetracycline.
200 mg PO is not enough information to administer the medication safely.
Choice C is wrong because it does not specify the route of epoetin alfa.
150 units/kg three times weekly is not enough information to administer the medication safely.
Normal ranges for digoxin are 0.5 to 2 ng/mL for heart failure and 0.8 to 2 ng/mL for atrial fibrillation.
Normal ranges for cimetidine are 50 to 150 ng/mL.
Normal ranges for tetracycline are 1 to 10 mcg/mL.
Normal ranges for epoetin alfa are not applicable as it is a synthetic hormone that stimulates red blood cell production.