Deck 70: Care of Patients With Renal Disorders

Question 1

A client has nephrotic syndrome and a normal glomerular filtration.Which dietary selection shows that the client understands nutritional therapy for this condition?

A) Decreased intake of protein
B) Increased intake of protein
C) Decreased intake of carbohydrates
D) Increased intake of carbohydrates

Answer 1

Increased intake of protein

Question 2

A middle-aged client with diabetes mellitus is being treated for the third episode of acute pyelonephritis in the past year and asks what can be done to help prevent these infections.Which is the nurse's best response?

A) "Test your urine daily for the presence of ketone bodies and proteins."
B) "Use tampons rather than sanitary napkins during your menstrual period."
C) "Drink more water and empty your bladder every 2 to 3 hours during the day."
D) "Keep your hemoglobin A_1c under 9% by keeping your blood sugar controlled."

Answer 2

"Drink more water and empty your bladder every 2 to 3 hours during the day."

Question 3

A client is hospitalized with a urinary tract infection (UTI).Which clinical manifestation alerts the nurse to the possibility of a complication from the UTI?

A) Burning on urination
B) Cloudy, dark urine
C) Fever and chills
D) Hematuria

Answer 3

Fever and chills

Question 4

A client with glomerulonephritis has a glomerular filtration rate (GFR)of 40 mL/min,as measured by a 24-hour creatinine clearance.Which is the nurse's interpretation of this finding?

A) Excessive GFR, client at risk for dehydration
B) Excessive GFR, client at risk for fluid overload
C) Reduced GFR, client at risk for dehydration
D) Reduced GFR, client at risk for fluid overload

Question 5

A client with polycystic kidney disease (PKD)has received extensive teaching in the clinic.Which statement by the client indicates that an important goal related to nutrition is being met?

A) "I take a laxative every night before going to bed."
B) "I have a soft bowel movement every morning."
C) "Food tastes so much better since I can use salt again."
D) "The white bread I am eating does not cause gas."

Question 6

A client has a large renal calculus.Which assessment finding may indicate the development of a complication?

A) Blood pressure of 178/94 mmHg
B) Urine output of 5600 mL/24 hr
C) Client reports of pain on urination
D) Asymmetric, tender flank area

Question 7

A client has nephrotic syndrome.Which finding shows that therapy is effective?

A) Serum albumin level, 2.8 g/dL
B) Serum albumin level, 4 g/dL
C) Urine protein level, 3.7 g/24 hr
D) Potassium, 4.2 mEq/L

Question 8

A client is in the emergency department after experiencing kidney trauma.The abdomen is tender and distended,and blood is visible at the urinary meatus.Which action by the nurse is most appropriate?

A) Assess vital signs and abdominal pain every 5 to 15 minutes.
B) Consult with the provider before inserting a catheter.
C) Monitor the client's IV rate and prepare to give blood.
D) Assist with obtaining informed consent for surgery if needed.

Question 9

In assessing a client recently diagnosed with acute glomerulonephritis,the nurse asks which question to determine potential contributing factors?

A) "Are you sexually active?"
B) "Do you have pain or burning on urination?"
C) "Has anyone in your family had chronic kidney problems?"
D) "Have you had a cold or sore throat within the last 2 weeks?"

Question 10

In planning care for a client with renal cell carcinoma,the nurse monitors for which electrolyte imbalance?

A) Hyponatremia
B) Hypernatremia
C) Hypocalcemia
D) Hypercalcemia

Question 11

A client with polycystic kidney disease and hypertension is prescribed a diuretic for blood pressure control.Which statement by the client indicates the need for further teaching regarding these orders?

A) "I will weigh myself every day at the same time."
B) "I will drink only 1 liter of fluid each day."
C) "I will avoid aspirin and aspirin-containing drugs."
D) "I will avoid nonsteroidal anti-inflammatory drugs."

Question 12

A client returned to the nursing unit after having a nephrostomy performed.Over the next 6 hours,drainage in the tube has gone from 40 mL/hr to 12 mL over the last hour.Which intervention by the nurse is most appropriate?

A) Document the finding in the client's record.
B) Evaluate the tube as working in the hand-off report.
C) Clamp the tube in preparation for removing it.
D) Assess the client's abdomen and vital signs.

Question 13

On assessment of a client with polycystic kidney disease (PKD),which finding is of greatest concern to the nurse?

A) Flank pain
B) Periorbital edema
C) Bloody and cloudy urine
D) Enlarged abdomen

Question 14

The nurse completes which assessment in a client with acute glomerulonephritis and periorbital edema?

A) Auscultating breath sounds
B) Checking blood glucose levels
C) Measuring deep tendon reflexes
D) Testing urine for protein

Question 15

In assessing a client 6 hours after a radical nephrectomy for renal cell carcinoma,the nurse notes that the client's blood pressure has decreased from 134/90 to 100/56 mm Hg and urine output is 20 mL for this past hour.Which is the nurse's best action?

A) Position the client so that the remaining kidney is not dependent.
B) Measure the specific gravity of the client's urine.
C) Document the findings in the client's record.
D) Assess the pulse rate and quality, and then notify the provider.

Question 16

A client with diabetes is hospitalized with recurrent pyelonephritis.The provider orders IV gentamicin (Garamycin)before culture results come back.Which action by the nurse is best?

A) Monitor the client's blood sugar before and after each dose.
B) Consult with the pharmacist about the antibiotic selection.
C) Monitor the client's daily blood urea nitrogen and creatinine levels.
D) Check the client's most recent hemoglobin A_1c result.

Question 17

An older client is hospitalized with suspected heart failure.After 2 days of treatment,the client is not improving.Which laboratory value does the nurse report to the provider?

A) Potassium, 3.7 mEq/L
B) Sodium, 144 mEq/L
C) Glomerular filtration rate, 55 mL/min
D) Creatinine, 0.9 mg/dL

Question 18

Which statement by a client with hypertension secondary to renal disease indicates the need for further teaching?

A) "I can prevent more damage to my kidneys by managing my blood pressure."
B) "If I have increased urination at night, I need to drink less fluid during the day."
C) "I need to see the dietitian to discuss limiting my protein intake."
D) "It is important that I take my antihypertensive medications as directed."

Question 19

Which clinical manifestation indicates to the nurse that a client with glomerulonephritis (GN)is responding as expected to the prescribed treatment?

A) The client has lost 11 pounds in the past 10 days.
B) The client's urine specific gravity is 1.048.
C) No blood is observed in the client's urine.
D) The client's blood pressure is 152/88 mm Hg.

Question 20

A client with autosomal dominant polycystic kidney disease (ADPKD)asks whether his children could develop this disease.Which is the nurse's best response?

A) "No genetic link is known, so your children are not at increased risk."
B) "The disease is sex linked, so only your sons could be affected."
C) "Both you and your wife must have the disease for your children to develop it."
D) "Each of your children has a 50% risk of having ADPKD."

Question 21

The nurse monitors for which clinical manifestations in a client with nephrotic syndrome?

A) Proteinuria, >3.5 g/24 hr
B) Hypoalbuminemia
C) Dehydration
D) Lipiduria
E) Dysuria
F) Costovertebral angle (CVA) tenderness

Question 22

The visiting nurse has many clients who are African American.Which intervention is most important for the nurse to accomplish when seeing these clients?

A) Weigh the clients and compare their weights.
B) Assess the clients' blood pressure.
C) Observe the clients for any signs of abuse.
D) Ask the clients about their medications.

Question 23

A client presents to the emergency department with severe dehydration and is ordered to receive 3 L of fluid over 6 hours.The nurse sets the intravenous pump at a rate of ______ mL/hr.

Question 24

A client who had kidney trauma required a nephrectomy.What does the nurse teach the client about this condition?

A) "You need to avoid participating in contact sports like football."
B) "You probably will end up on dialysis a few years from now."
C) "You need medication to control your high blood pressure from the injury."
D) "You will always be required to restrict your salt and fluid intake."

Question 25

In interviewing a client with a family history of polycystic kidney disease (PKD),the nurse assesses for which clinical manifestations most carefully?

A) Nocturia
B) Flank pain
C) Diarrhea
D) Dysuria
E) Bloody urine
F) Increased abdominal girth