Deck 28: Nursing Care of Patients with Kidney Disorders

Question 1

A patient is diagnosed with 45% of normal glomerular filtration. The nurse realizes that this patient is experiencing which of the following?

A)renal insufficiency
B)acute renal failure
C)chronic renal failure
D)end-stage renal disease

Answer 1

renal insufficiency

Question 2

A patient with chronic kidney disease is diagnosed with hypertension. The nurse realizes that this patient's blood pressure needs to be controlled because of which of the following?

A)It can slow the decline of kidney function.
B)It is the easiest diagnosis to treat.
C)There are medications available to treat this disorder.
D)Everyone should have low-normal blood pressure.

Answer 2

It can slow the decline of kidney function.

Question 3

A patient is scheduled to have an arteriovenous (AV) fistula created for hemodialysis. Which of the following statements are appropriate for this patient? Select all that apply.

A)Always use the dominant hand and arm for blood pressure readings.
B)A functioning fistula has a palpable pulse and bruit.
C)Ensure the use of the dominant hand and arm for placement.
D)The fistula can be used immediately after its creation.
E)Venipunctures should be performed on the arm with the fistula.

Answer 3

Always use the dominant hand and arm for blood pressure readings.
A functioning fistula has a palpable pulse and bruit.

Question 4

A patient who is diagnosed with renal cancer states, "I only lost a few pounds! I had no other symptoms!" The nurse realizes that the only consistent symptom of renal cancer is which of the following?

A)hematuria
B)flank pain
C)nausea
D)vomiting

Question 5

A patient is diagnosed with hypertension caused by polycystic kidney disease. Which of the following might be helpful to control this patient's blood pressure?

A)ACE inhibitors
B)kidney transplant
C)dialysis
D)peritoneal dialysis

Question 6

A patient who received a kidney transplant seven years ago is seen for increasing blood pressure and proteinuria. The nurse realizes that this patient is demonstrating signs of which of the following?

A)chronic kidney rejection
B)acute kidney rejection
C)renal artery stenosis
D)pyelonephritis

Question 7

A patient with acute renal failure (ARF) is prescribed furosemide (Lasix). The nurse realizes that this medication will be helpful to the patient because it will do which of the following?

A)reduce edema
B)keep sodium in the body
C)preserve protein
D)be the gentlest diuretic to use

Question 8

A patient with diabetes and heart disease is diagnosed with chronic renal failure. The nurse realizes that this patient should NOT be prescribed which of the following classifications of medications?

A)oral antihyperglycemic agents
B)beta-blockers
C)calcium channel blockers
D)analgesics

Question 9

Which of the following should be assessed in an elderly patient with age-related renal dysfunction?

A)evidence of medication or drug toxicity
B)recreational activities
C)activity status
D)daily meal pattern

Question 10

A patient is admitted with signs of chronic renal failure. Which of the following is indicative of metabolic acidosis?

A)Kussmaul's respirations
B)low urine output
C)muscle cramps
D)diarrhea

Question 11

Which of the following should be included when providing instructions to a patient who is recovering from a nephrectomy for kidney cancer?

A)early recognition of a urinary tract infection (UTI)
B)ways to limit fluids
C)promote high-impact sports and activities
D)organ donor information

Question 12

A patient with chronic renal failure is trying to decide between hemodialysis and peritoneal dialysis. Which of the following are advantages of peritoneal dialysis for this patient? Select all that apply.

A)minimal vascular complications
B)liberal intake of fluids
C)better self-management
D)better metabolite elimination
E)lower risk of infection

Question 13

An elderly patient is admitted to the hospital with cardiac complications associated with diabetes. What should be of concern to the nurse regarding this patient's medications?

A)the type and amount of medications in relation to the patient's renal function
B)if the patient taking the prescribed dosages
C)what vitamins and supplements this patient is taking
D)the costs of the patient's medications

Question 14

Three weeks after being treated for strep throat, a patient comes into the clinic with signs of acute glomerulonephritis. Which of the following symptoms will the nurse most likely find upon assessment of this patient?

A)periorbital edema
B)hunger
C)polyuria
D)polyphagia

Question 15

Which of the following interventions would be appropriate for a patient in renal failure with the diagnosis of Imbalanced Nutrition: Less than Body Requirements?

A)Provide mouth care before meals.
B)Schedule meals for three times each day.
C)Provide antiemetics after meals.
D)Weigh once per week.

Question 16

A patient is diagnosed with postrenal acute renal failure. The nurse realizes that this type of renal failure can be caused by which of the following?

A)an enlarged prostate
B)hypovolemia
C)sepsis
D)drug toxicity

Question 17

Which of the following interventions would be appropriate for a patient with Fluid Volume Excess related to chronic glomerulonephritis?

A)Weigh daily on the same scale.
B)Document energy level.
C)Schedule activities to conserve energy.
D)Assess for signs of infection.

Question 18

A patient who is recovering from acute renal failure is being discharged. Which of the following should the nurse include in this patient's instructions?

A)Avoid alcohol consumption.
B)Use over-the-counter medications as needed.
C)Instruct to weigh self at least once a week.
D)Resume a normal diet.

Question 19

The nurse is planning the care of a patient with chronic glomerulonephritis. The goal of treatment for this patient should include which of the following?

A)maintaining renal function
B)achieving maximum independence
C)returning to work as soon as possible
D)lifestyle changes

Question 20

An elderly patient is scheduled for a CT scan with and without contrast dye. Which of the following should be done prior to this CT scan?

A)Monitor renal function.
B)Assess for level of responsiveness.
C)Assess vital signs.
D)Keep the patient n.p.o.

Question 21

Nursing responsibilities when giving osmotic diuretics include which of the following? Select all that apply.

A)Check mannitol (Osmitrol) solution for crystallization prior to IV administration.
B)Evaluate urine output after test dose is given.
C)Assess for signs of worsening heart failure
D)Assess for orthostatic hypotension.
E)Monitor patient for signs of ototoxicity.

Question 22

The nurse, teaching a patient about the concept of hemodialysis, would include that dialysis is a process that

A)moves blood through a semipermeable membrane into a dialyzer that is used to remove waste products as well as correct fluid and electrolyte imbalances.
B)allows a choice of either diffusion osmosis or ultrafiltration to remove excess water from the body.
C)increases potassium and calcium to the blood when passing through the dialyzer and works on the principle of diffusion.
D)will add electrolytes and water to the blood when passing through a semipermeable membrane to correct electrolyte imbalances.

Question 23

Which of the following is an example of correct maintenance of fluid intake for a patient with acute renal failure (ARF) who is on fluid restriction?

A) 11ea992e_0a36_cbd4_9f38_3721038aa8b0
B) 11ea992e_0a36_f2e5_9f38_4326e115aef4
C) 11ea992e_0a36_f2e6_9f38_df4924c3c2bc
D) 11ea992e_0a37_19f7_9f38_3148bf9bea19

Question 24

A patient is told that a horseshoe kidney was a coincidental finding on a recent x-ray. He asks if this will create problems in the future. What is the nurse's best response?

A)"This does not necessarily affect kidney function but increases the risk of kidney infection."
B)"You can ignore this information."
C)"No, it's just something to be aware of and won't cause you any problems."
D)"I'll give you specific instructions on how to prevent kidney stone formation."

Question 25

Place an "X" on the area of the body where a nurse would assess the peritoneal dialysis catheter insertion site.

Question 26

A patient with polycystic kidney disease is planning to be married and asks the nurse if his children could inherit this disorder. What is the nurse's best response?

A)"Yes, this condition can be inherited."
B)"Yes, but this condition is so rare that you shouldn't worry about it."
C)"No, polycystic kidney disease occurs because of spontaneous mutations."
D)"You should ask your fiancée to come with you to your next office visit so we can discuss this."

Question 27

Which of the following indicates that a patient with chronic renal failure understands the dietary regimen?

A)The patient had an apple and oatmeal for breakfast, peanut butter sandwich for lunch, and pasta with fish for dinner.
B)Breakfast included bacon and eggs; lunch was a hot dog with sauerkraut; dinner consisted of baked canned ham with green peas.
C)The patient reported eating two bananas for breakfast, rice and beans for lunch, and fruit salad, green beans and an 8-ounce steak for dinner.
D)The patient related eating half a cantaloupe and three eggs for breakfast, a baked potato with processed cheese spread and broccoli for lunch, and chicken, pinto beans, squash, and pecan pie for dinner.

Question 28

The nurse reviews the patient's clinical record. Based on the above data, what is the correct interpretation of this information? 11ea992e_0a36_56a2_9f38_6b551aee5ed7

A)acute proliferative glomerulonephritis
B)azotemia
C)azotemia acute renal failure
D)kidney trauma

Question 29

Risk factors for renal cancer include which of the following? Select all that apply.

A)obesity
B)over 55 years of age
C)genetic predisposition
D)female
E)bladder calculi

Question 30

Place an "X" on the diagram below where a nurse would palpate for a donor kidney in a recipient patient.

Question 31

Place an "X" over the area of the body where the nurse would assess for characteristic severe edema in a patient with nephrotic syndrome.

Question 32

The nurse is completing the instructions to a patient who underwent a cadaver kidney transplant and is ready for discharge from the hospital. Which of the following statements by the patient would indicate that further teaching is needed?

A)"I'm glad I won't have to take immunosuppressants any longer."
B)"I know to check my weight on a regular basis."
C)"I'll call my doctor if I notice any decrease in my urine output."
D)"I'll tell my friends to stay away from if they have colds or the flu."

Question 33

The nurse assesses the patient's arm for the presence of which of the following? 11ea992e_0a36_7db3_9f38_256965bfdc5a

A)a bruit upon auscultation
B)a thrill upon auscultation
C)a bruit upon palpation
D)a thrill upon inspection

Question 34

Home care teaching for the patient after a radical nephrectomy should include which of the following? Select all that apply.

A)Avoid contact sports and falls.
B)Older males should schedule routine screening exams for prostatic hypertrophy.
C)Monitor weight.
D)Monitor for signs of rejection.
E)Maintain prescribed fluid restrictions.

Question 35

The patient with chronic renal failure who is scheduled for dialysis this morning is due to receive a daily dose of enalapril (Vasotec). The nurse should plan to administer this medication

A)on return from dialysis.
B)during dialysis.
C)just before dialysis.
D)the day after dialysis.

Question 36

In reviewing the report of laboratory results (see diagram) for a newly admitted patient, the nurse can anticipate that 11ea992e_0a34_a8ef_9f38_99b498116348

A)the patient will probably need to undergo additional testing to validate a diagnosis of acute proliferative glomerulonephritis.
B)no further testing will be needed.
C)the patient probably has prerenal acute renal failure (ARF).
D)the patient will be classified as being in end stage renal disease.

Question 37

The nurse, administering epoetin alfa (Epogen) to a patient on dialysis, understands the therapeutic outcome of this medication is to do which of the following?

A)treat the anemia seen in chronic renal failure patients on dialysis
B)combat the effects of dialysis on bone marrow
C)promote elimination of nephrotoxic drugs from the body
D)enhance absorption of iron and folate in the intestinal tract

Question 38

The nurse is caring for a patient receiving peritoneal dialysis. After completing the exchange and draining the dialysate, the nurse observes the dialysate is cloudy. The nurse interprets this finding as which of the following?

A)a sign of infection
B)a sign of vascular access occlusion
C)the normal appearance of dialysate
D)a sign of possible bowel perforation

Question 39

The nurse instructs a patient in acute renal failure that the expected result of taking sodium polystyrene sulfonate (Kayexalate) is which of the following?

A)removing excess potassium
B)replacing sodium
C)replacement of magnesium
D)exchanging calcium for sodium

Question 40

The nurse recognizes that the risk for dehydration in the elderly increases significantly due to which age-related change in renal function?

A)the decreased ability of the kidney to concentrate urine
B)hypoplasia
C)the presence of renal cysts
D)the reduced clearance of drugs excreted by the kidney