Deck 58: Caring Forclients With Disorders of the Kidneys and Ureters

Question 1

A male client undergoes nephrectomy and is admitted for postoperative care. However, during postoperative care, he suffers from a severe internal hemorrhage. The internal hemorrhage is stopped, and the client is allowed to rest. Which of the following interventions should the nurse provide to manage and minimize hemorrhage effectively?

A) Monitor vital signs every 1 to 4 hours.
B) Encourage the client to breathe deeply and cough every 2 hours.
C) Auscultate the lungs every 4 to 5 hours.
D) Use two hands to support the incision during coughing.

Answer 1

Monitor vital signs every 1 to 4 hours.

Question 2

A client is diagnosed with polycystic kidney disease. Which of the following would the nurse most likely assess?

A) Hypertension
B) Flank pain
C) Fever
D) Periorbital edema

Answer 2

Hypertension

Question 3

A client is prescribed an antispasmodic agent to help relieve bladder spasms associated with pyelonephritis. Which of the following would the nurse expect the physician to order?

A) Oxybutinin chloride
B) Ciprofloxacin
C) Trimethoprim-sulfamethoxazole
D) Gentamycin

Answer 3

Oxybutinin chloride

Question 4

A client is administered dialysate solution through an abdominal catheter. The nurse notices that the return flow rate is slow, so the nurse advises the client to move to the other side. However, even after changing the client's position, the nurse does not observe an increase in return flow. Which of the following actions should the nurse perform to help accelerate the return flow rate?

A) Disconnect the catheter and reapply.
B) Loosen the tubing clamp.
C) Inform the physician that catheter may need repositioning.
D) Stop the process for 5 minutes and resume later.

Question 5

A client, aged 75, is diagnosed with a renal disease and administered nephrotoxic drugs in normal doses. The nurse is aware that it is important to observe the client closely for any changes in renal status. Which of the following measures may help a nurse determine a change in renal status?

A) Observing the client's fluid intake.
B) Checking for a thrill or a bruit daily.
C) Observing the client's urinary output.
D) Observing the skin color and nail beds.

Question 6

A client, aged 87, undergoes continuous ambulatory peritoneal dialysis (CAPD) for acute renal failure (ARF). Which task would be most important for the nurse to do?

A) Monitor the client for hypoglycemia and hyperglycemia.
B) Ensure a diet rich in proteins and potassium.
C) Note a color change in the client's eyes, teeth, and nails.
D) Frequently monitor the client's progress.

Question 7

A male client has doubts about performing peritoneal dialysis at home. He informs the nurse about his existing upper respiratory infection. Which of the following suggestions can the nurse offer to the client while performing an at-home peritoneal dialysis?

A) Perform deep-breathing exercises vigorously.
B) Wear a mask when performing exchanges.
C) Auscultate the lungs frequently.
D) Avoid carrying heavy items.

Question 8

A client comes to the Emergency Department complaining of a sudden onset of sharp, severe flank pain. During the physical examination, the client indicates that the pain, which comes in waves, travels to the suprapubic region. He states, "I can even feel the pain at the tip of my penis." Which of the following would the nurse suspect?

A) Acute glomerulonephritis
B) Ureteral stricture
C) Urinary calculi
D) Renal cell carcinoma

Question 9

The nurse performs a physical examination on a client diagnosed with acute pyelonephritis to assist in determining which of the following?

A) Abnormalities in urine
B) Location of discomfort
C) Elevated calcium levels
D) Structural defects in the kidneys

Question 10

An instructor is preparing a class on renal cancer for a group of students. Which of the following would the instructor include as a possible risk factor?

A) Age below 40 years
B) Female gender
C) Obesity
D) Exposure to sunlight

Question 11

A nurse is reviewing the history of a client who is suspected of having glomerulonephritis. Which of the following would the nurse consider significant?

A) Previous episode of acute pyelonephritis
B) History of hyperparathyroidism
C) Recent history of streptococcal infection
D) History of osteoporosis

Question 12

The nurse is reviewing the results of a urinalysis on a client with acute pyelonephritis. Which of the following would the nurse most likely expect to find?

A) High specific gravity
B) Slightly acidic pH
C) Absent proteinuria
D) Pyuria

Question 13

After teaching a group of students about urolithiasis, the instructor determines that additional teaching is needed when the students identify which of the following as a possible risk factor?

A) Prolonged exercise
B) Gout
C) Diabetes
D) Decreased intake of Vitamin D

Question 14

A nurse identifies a nursing diagnosis of risk for ineffective breathing pattern related to incisional pain and restricted positioning for a client who has had a nephrectomy. Which of the following would be most appropriate for the nurse to include in the client's plan of care?

A) Administer isotonic fluid therapy as ordered.
B) Keep the drainage catheter below the level of insertion.
C) Encourage use of incentive spirometer every 2 hours.
D) Monitor temperature every 4 hours.

Question 15

When assessing a client with chronic glomerulonephritis, the nurse notes that the client has generalized edema. The nurse documents this as which of the following?

A) Periorbital edema
B) Anasarca
C) Uremic frost
D) Hydronephrosis

Question 16

A male client who is admitted with the diagnosis of urinary calculi complains of excruciating pain. The pain is suspected to be caused by increased pressure in the renal pelvis. Which measure would be most appropriate to provide pain relief?

A) Encourage frequent ambulation.
B) Encourage the client to void every 2 to 3 hours.
C) Restrict the client's sodium intake.
D) Encourage deep-breathing exercises.

Question 17

A group of students are reviewing the phases of acute renal failure. The students demonstrate understanding of the material when they identify which of the following as occurring during the second phase?

A) Diuresis
B) Oliguria
C) Acute tubular necrosis
D) Restored glomerular function

Question 18

A client is undergoing peritoneal dialysis as medical treatment for acute renal failure. Before the next instillation, the nurse observes that the client has marked abdominal distention accompanied by pain. Which of the following nursing actions is likely to offer an immediate solution to this problem?

A) Administer analgesics.
B) Delay the next dialysis cycle.
C) Instill more fluid.
D) Help the client to ambulate.

Question 19

The nurse is caring for several older clients. Which client would the nurse be especially alert for signs and symptoms of pyelonephritis?

A) A client with acute renal failure
B) A client with a urinary tumor
C) A female client with preexisting chronic glomerulonephritis
D) A client with urinary obstruction

Question 20

A client with decreased renal function is to receive a low-protein diet. The client asks the nurse why he needs this type of diet. The nurse would incorporate which reason into the response?

A) Improve digestion
B) Increase speed of treatment
C) Improve blood circulation
D) Lessen workload on the kidneys

Question 21

After teaching a group of students about how to perform peritoneal dialysis, which statement would indicate to the instructor that the students need additional teaching?

A) "It is important to use strict aseptic technique."
B) "It is appropriate to warm the dialysate in a microwave."
C) "The infusion clamp should be open during infusion."
D) "The effluent should be allowed to drain by gravity."

Question 22

Which of the following would a nurse classify as a prerenal cause of acute renal failure?

A) Polycystic disease
B) Ureteral stricture
C) Prostatic hypertrophy
D) Septic shock

Question 23

When preparing a client for hemodialysis, which of the following would be most important for the nurse to do?

A) Check for thrill or bruit over the access site.
B) Inspect the catheter insertion site for infection.
C) Add the prescribed drug to the dialysate.
D) Warm the solution to body temperature.

Question 24

A client with chronic renal failure comes to the clinic for a visit. During the visit, he complains of pruritus. Which suggestion by the nurse would be most appropriate?

A) "Try washing clothes with a strong detergent to ensure that all impurities are gone."
B) "When you shower, use really warm water and an antibacterial soap."
C) "Keep your showers brief, patting your skin dry after showering."
D) "Liberally apply alcohol to the areas of your skin where you itch the most."

Question 25

A client has undergone a renal transplant and returns to the health care agency for a follow-up evaluation. Which finding would lead to the suspicion that the client is experiencing rejection?

A) Hypotension
B) Weight loss
C) Polyuria
D) Abdominal pain

Question 26

Which of the following would the nurse expect to find when reviewing the laboratory test results of a client with renal failure?

A) Increased serum creatinine level
B) Decreased serum potassium level
C) Increased red blood cell count
D) Increased serum calcium level