Question 1

The nurse is caring for a client newly admitted to the medical-surgical unit with glomerulonephritis. Which classic manifestations of this disorder should the nurse expect to assess in this client? Select all that apply.

Accepted Answer

A)Hematuria, proteinuria, and edema are the classic signs of glomerulonephritis, because this disorder affects the structure and function of the glomeruli, disrupting glomerular filtration. This increased permeability in the glomeruli leads to plasma proteins and red blood cells being lost in the urine. Edema occurs because of the loss of plasma proteins, namely albumin. Acute flank pain is often more characteristic of renal calculi. Weight loss is a nonspecific symptom that can occur with many disorders, but not typically with glomerulonephritis.
B)Hematuria, proteinuria, and edema are the classic signs of glomerulonephritis, because this disorder affects the structure and function of the glomeruli, disrupting glomerular filtration. This increased permeability in the glomeruli leads to plasma proteins and red blood cells being lost in the urine. Edema occurs because of the loss of plasma proteins, namely albumin. Acute flank pain is often more characteristic of renal calculi. Weight loss is a nonspecific symptom that can occur with many disorders, but not typically with glomerulonephritis.
C)Hematuria, proteinuria, and edema are the classic signs of glomerulonephritis, because this disorder affects the structure and function of the glomeruli, disrupting glomerular filtration. This increased permeability in the glomeruli leads to plasma proteins and red blood cells being lost in the urine. Edema occurs because of the loss of plasma proteins, namely albumin. Acute flank pain is often more characteristic of renal calculi. Weight loss is a nonspecific symptom that can occur with many disorders, but not typically with glomerulonephritis.
D)Hematuria, proteinuria, and edema are the classic signs of glomerulonephritis, because this disorder affects the structure and function of the glomeruli, disrupting glomerular filtration. This increased permeability in the glomeruli leads to plasma proteins and red blood cells being lost in the urine. Edema occurs because of the loss of plasma proteins, namely albumin. Acute flank pain is often more characteristic of renal calculi. Weight loss is a nonspecific symptom that can occur with many disorders, but not typically with glomerulonephritis.
E)Hematuria, proteinuria, and edema are the classic signs of glomerulonephritis, because this disorder affects the structure and function of the glomeruli, disrupting glomerular filtration. This increased permeability in the glomeruli leads to plasma proteins and red blood cells being lost in the urine. Edema occurs because of the loss of plasma proteins, namely albumin. Acute flank pain is often more characteristic of renal calculi. Weight loss is a nonspecific symptom that can occur with many disorders, but not typically with glomerulonephritis.

Question 2

The nurse is assessing an older adult client with suspected acute interstitial nephritis. When gathering this client's health history, the nurse should be sure to ask the client which of the following questions?

Accepted Answer

A)The nurse should inquire whether the client is taking any medications for the treatment of indigestion, because many cases of acute interstitial nephritis in older adults are due to use of proton pump inhibitors. Although the client will require urinalysis, the timing of the client's last urine test is not important. Angiotensin-converting enzyme (ACE)inhibitors do not contribute to a client's likelihood of acute interstitial nephritis, and protein intake is also unrelated to this diagnosis.
B)The nurse should inquire whether the client is taking any medications for the treatment of indigestion, because many cases of acute interstitial nephritis in older adults are due to use of proton pump inhibitors. Although the client will require urinalysis, the timing of the client's last urine test is not important. Angiotensin-converting enzyme (ACE)inhibitors do not contribute to a client's likelihood of acute interstitial nephritis, and protein intake is also unrelated to this diagnosis.
C)The nurse should inquire whether the client is taking any medications for the treatment of indigestion, because many cases of acute interstitial nephritis in older adults are due to use of proton pump inhibitors. Although the client will require urinalysis, the timing of the client's last urine test is not important. Angiotensin-converting enzyme (ACE)inhibitors do not contribute to a client's likelihood of acute interstitial nephritis, and protein intake is also unrelated to this diagnosis.
D)The nurse should inquire whether the client is taking any medications for the treatment of indigestion, because many cases of acute interstitial nephritis in older adults are due to use of proton pump inhibitors. Although the client will require urinalysis, the timing of the client's last urine test is not important. Angiotensin-converting enzyme (ACE)inhibitors do not contribute to a client's likelihood of acute interstitial nephritis, and protein intake is also unrelated to this diagnosis.

Question 3

The nurse is planning a teaching session for older community members about the risks for peptic ulcer disease (PUD)in this age group. Which of the following pieces of information should the nurse include when teaching this group?

Accepted Answer

A)H. pylori infection is a major factor in the development of ulcers, and prevalence increases with the age of the client. Seventy to 90% of persons with gastric ulcers and 90 to 100% of clients with duodenal ulcers are found to have this infection. Older clients tend to experience more bleeding and often have less pain than younger clients with PUD. Bleeding may be the initial symptom experienced by older clients. Clients with peptic ulcers should have upper GI endoscopy performed to diagnose the problem with visualization and biopsy, not colonoscopy.
B)H. pylori infection is a major factor in the development of ulcers, and prevalence increases with the age of the client. Seventy to 90% of persons with gastric ulcers and 90 to 100% of clients with duodenal ulcers are found to have this infection. Older clients tend to experience more bleeding and often have less pain than younger clients with PUD. Bleeding may be the initial symptom experienced by older clients. Clients with peptic ulcers should have upper GI endoscopy performed to diagnose the problem with visualization and biopsy, not colonoscopy.
C)H. pylori infection is a major factor in the development of ulcers, and prevalence increases with the age of the client. Seventy to 90% of persons with gastric ulcers and 90 to 100% of clients with duodenal ulcers are found to have this infection. Older clients tend to experience more bleeding and often have less pain than younger clients with PUD. Bleeding may be the initial symptom experienced by older clients. Clients with peptic ulcers should have upper GI endoscopy performed to diagnose the problem with visualization and biopsy, not colonoscopy.
D)H. pylori infection is a major factor in the development of ulcers, and prevalence increases with the age of the client. Seventy to 90% of persons with gastric ulcers and 90 to 100% of clients with duodenal ulcers are found to have this infection. Older clients tend to experience more bleeding and often have less pain than younger clients with PUD. Bleeding may be the initial symptom experienced by older clients. Clients with peptic ulcers should have upper GI endoscopy performed to diagnose the problem with visualization and biopsy, not colonoscopy.

Question 4

A nurse caring for a pediatric client with inflammatory bowel disease (IBD)understands that there are variances in the presentation of IBD between children and adults. Which variances should the nurse anticipate for this pediatric client? Select all that apply.

Accepted Answer

A)The pediatric etiology of IBD differs from that of adult-onset IBD. For example, IBD is more common in males than females in the pediatric population, whereas equal numbers of adult males and females have IBD. In addition, children suffer from Crohn disease more frequently than ulcerative colitis; the opposite is true of adults. Adults with Crohn disease usually present with terminal ileal disease without colonic involvement, whereas the majority of pediatric clients have ileocolonic or colonic disease. Children with Crohn disease usually present with inflammatory disease; adults often present with fistulizing or stricturing disease. Similarly, children with ulcerative colitis usually present with pancolitis, whereas adults more often present with left-sided colitis.
B)The pediatric etiology of IBD differs from that of adult-onset IBD. For example, IBD is more common in males than females in the pediatric population, whereas equal numbers of adult males and females have IBD. In addition, children suffer from Crohn disease more frequently than ulcerative colitis; the opposite is true of adults. Adults with Crohn disease usually present with terminal ileal disease without colonic involvement, whereas the majority of pediatric clients have ileocolonic or colonic disease. Children with Crohn disease usually present with inflammatory disease; adults often present with fistulizing or stricturing disease. Similarly, children with ulcerative colitis usually present with pancolitis, whereas adults more often present with left-sided colitis.
C)The pediatric etiology of IBD differs from that of adult-onset IBD. For example, IBD is more common in males than females in the pediatric population, whereas equal numbers of adult males and females have IBD. In addition, children suffer from Crohn disease more frequently than ulcerative colitis; the opposite is true of adults. Adults with Crohn disease usually present with terminal ileal disease without colonic involvement, whereas the majority of pediatric clients have ileocolonic or colonic disease. Children with Crohn disease usually present with inflammatory disease; adults often present with fistulizing or stricturing disease. Similarly, children with ulcerative colitis usually present with pancolitis, whereas adults more often present with left-sided colitis.
D)The pediatric etiology of IBD differs from that of adult-onset IBD. For example, IBD is more common in males than females in the pediatric population, whereas equal numbers of adult males and females have IBD. In addition, children suffer from Crohn disease more frequently than ulcerative colitis; the opposite is true of adults. Adults with Crohn disease usually present with terminal ileal disease without colonic involvement, whereas the majority of pediatric clients have ileocolonic or colonic disease. Children with Crohn disease usually present with inflammatory disease; adults often present with fistulizing or stricturing disease. Similarly, children with ulcerative colitis usually present with pancolitis, whereas adults more often present with left-sided colitis.
E)The pediatric etiology of IBD differs from that of adult-onset IBD. For example, IBD is more common in males than females in the pediatric population, whereas equal numbers of adult males and females have IBD. In addition, children suffer from Crohn disease more frequently than ulcerative colitis; the opposite is true of adults. Adults with Crohn disease usually present with terminal ileal disease without colonic involvement, whereas the majority of pediatric clients have ileocolonic or colonic disease. Children with Crohn disease usually present with inflammatory disease; adults often present with fistulizing or stricturing disease. Similarly, children with ulcerative colitis usually present with pancolitis, whereas adults more often present with left-sided colitis.

Question 5

The nurse is caring for an African American client with nephritis. When planning this client's care, the nurse should include interventions aimed at preventing which of the following long-term complications?

Accepted Answer

A)African Americans have an increased risk of progressing to end-stage renal disease after nephritis. Thus, the nurse should plan interventions to prevent the development of this long-term complication. African Americans are not at increased risk of developing congestive heart failure, diabetes mellitus, or hypertension after nephritis.
B)African Americans have an increased risk of progressing to end-stage renal disease after nephritis. Thus, the nurse should plan interventions to prevent the development of this long-term complication. African Americans are not at increased risk of developing congestive heart failure, diabetes mellitus, or hypertension after nephritis.
C)African Americans have an increased risk of progressing to end-stage renal disease after nephritis. Thus, the nurse should plan interventions to prevent the development of this long-term complication. African Americans are not at increased risk of developing congestive heart failure, diabetes mellitus, or hypertension after nephritis.
D)African Americans have an increased risk of progressing to end-stage renal disease after nephritis. Thus, the nurse should plan interventions to prevent the development of this long-term complication. African Americans are not at increased risk of developing congestive heart failure, diabetes mellitus, or hypertension after nephritis.

Question 6

A client is experiencing weight gain and foamy dark urine 4 weeks after being treated with antibiotics for a sore throat. Which client statement, made during the health history assessment, suggests that the nurse should provide the client with further instruction?

Accepted Answer

A)The client probably had strep throat and did not take the full course of antibiotics, which accounts for the current symptoms that indicate glomerulonephritis. The nurse should teach this client about the importance of taking all medications as prescribed to prevent further complications of a disease. Resting when ill is appropriate, as is changing to a more nutritious diet. Gaining weight would support the nurse's suspicion that the client has glomerulonephritis.
B)The client probably had strep throat and did not take the full course of antibiotics, which accounts for the current symptoms that indicate glomerulonephritis. The nurse should teach this client about the importance of taking all medications as prescribed to prevent further complications of a disease. Resting when ill is appropriate, as is changing to a more nutritious diet. Gaining weight would support the nurse's suspicion that the client has glomerulonephritis.
C)The client probably had strep throat and did not take the full course of antibiotics, which accounts for the current symptoms that indicate glomerulonephritis. The nurse should teach this client about the importance of taking all medications as prescribed to prevent further complications of a disease. Resting when ill is appropriate, as is changing to a more nutritious diet. Gaining weight would support the nurse's suspicion that the client has glomerulonephritis.
D)The client probably had strep throat and did not take the full course of antibiotics, which accounts for the current symptoms that indicate glomerulonephritis. The nurse should teach this client about the importance of taking all medications as prescribed to prevent further complications of a disease. Resting when ill is appropriate, as is changing to a more nutritious diet. Gaining weight would support the nurse's suspicion that the client has glomerulonephritis.

Question 7

A client is being scheduled for diagnostic tests to determine the presence of ulcerative colitis. For which diagnostic tests should the nurse plan to provide teaching? Select all that apply.

Accepted Answer

A)Tests to diagnose ulcerative colitis include upper and lower barium studies and colonoscopy. An intravenous pyelogram is used to diagnose kidney disorders. An upper endoscopy is used to diagnose disorders of the esophagus and stomach.
B)Tests to diagnose ulcerative colitis include upper and lower barium studies and colonoscopy. An intravenous pyelogram is used to diagnose kidney disorders. An upper endoscopy is used to diagnose disorders of the esophagus and stomach.
C)Tests to diagnose ulcerative colitis include upper and lower barium studies and colonoscopy. An intravenous pyelogram is used to diagnose kidney disorders. An upper endoscopy is used to diagnose disorders of the esophagus and stomach.
D)Tests to diagnose ulcerative colitis include upper and lower barium studies and colonoscopy. An intravenous pyelogram is used to diagnose kidney disorders. An upper endoscopy is used to diagnose disorders of the esophagus and stomach.
E)Tests to diagnose ulcerative colitis include upper and lower barium studies and colonoscopy. An intravenous pyelogram is used to diagnose kidney disorders. An upper endoscopy is used to diagnose disorders of the esophagus and stomach.

Question 8

The nurse conducts an evaluation after completing a training session for community members on ways to prevent nephritis. When evaluating the success of this session, what responses from the community members would indicate that learning has been successful? Select all that apply.

Accepted Answer

A)The exact cause of nephritis is unknown, but preventing viral infections through practicing good hygiene habits, not smoking, maintaining a healthy body weight, and controlling high blood pressure reduces the risk of developing this disease. Limiting alcohol intake will not affect the development of nephritis.
B)The exact cause of nephritis is unknown, but preventing viral infections through practicing good hygiene habits, not smoking, maintaining a healthy body weight, and controlling high blood pressure reduces the risk of developing this disease. Limiting alcohol intake will not affect the development of nephritis.
C)The exact cause of nephritis is unknown, but preventing viral infections through practicing good hygiene habits, not smoking, maintaining a healthy body weight, and controlling high blood pressure reduces the risk of developing this disease. Limiting alcohol intake will not affect the development of nephritis.
D)The exact cause of nephritis is unknown, but preventing viral infections through practicing good hygiene habits, not smoking, maintaining a healthy body weight, and controlling high blood pressure reduces the risk of developing this disease. Limiting alcohol intake will not affect the development of nephritis.
E)The exact cause of nephritis is unknown, but preventing viral infections through practicing good hygiene habits, not smoking, maintaining a healthy body weight, and controlling high blood pressure reduces the risk of developing this disease. Limiting alcohol intake will not affect the development of nephritis.

Question 9

The nurse has identified the diagnosis Excess Fluid Volume as appropriate for a client with acute glomerulonephritis. What should the nurse assess to obtain the most accurate indication of this client's fluid balance?

Accepted Answer

A)Daily weight provides the most accurate indication of fluid balance because of the pathophysiology of acute glomerulonephritis. Albumin is lost, causing decreased osmotic pressure and fluid shifting into the interstitial spaces. Accurate weights will provide data to indicate that treatments are effective in pulling fluids from interstitial spaces into the vascular system and then out via kidneys. Intake and output records, serum sodium levels, and vital signs will all provide data indicating fluid balance; however, they are not as accurate as daily weight for determining fluid balance.
B)Daily weight provides the most accurate indication of fluid balance because of the pathophysiology of acute glomerulonephritis. Albumin is lost, causing decreased osmotic pressure and fluid shifting into the interstitial spaces. Accurate weights will provide data to indicate that treatments are effective in pulling fluids from interstitial spaces into the vascular system and then out via kidneys. Intake and output records, serum sodium levels, and vital signs will all provide data indicating fluid balance; however, they are not as accurate as daily weight for determining fluid balance.
C)Daily weight provides the most accurate indication of fluid balance because of the pathophysiology of acute glomerulonephritis. Albumin is lost, causing decreased osmotic pressure and fluid shifting into the interstitial spaces. Accurate weights will provide data to indicate that treatments are effective in pulling fluids from interstitial spaces into the vascular system and then out via kidneys. Intake and output records, serum sodium levels, and vital signs will all provide data indicating fluid balance; however, they are not as accurate as daily weight for determining fluid balance.
D)Daily weight provides the most accurate indication of fluid balance because of the pathophysiology of acute glomerulonephritis. Albumin is lost, causing decreased osmotic pressure and fluid shifting into the interstitial spaces. Accurate weights will provide data to indicate that treatments are effective in pulling fluids from interstitial spaces into the vascular system and then out via kidneys. Intake and output records, serum sodium levels, and vital signs will all provide data indicating fluid balance; however, they are not as accurate as daily weight for determining fluid balance.

Question 10

Which of the following drugs used in the treatment of peptic ulcer disease (PUD)works by both binding to proteins in the ulcer base and stimulating the secretion of mucus?

Accepted Answer

A)All of the medications listed can be used to treat PUD, but they work in different ways. Sucralfate binds to proteins in the ulcer base, forming a protective barrier against acid, bile, and pepsin. Sucralfate also stimulates the secretion of mucus, bicarbonate, and prostaglandin. Omeprazole is a proton-pump inhibitor (PPI). Bismuth compounds stimulate mucosal bicarbonate and prostaglandin production to promote ulcer healing and suppress Helicobacter pylori. Misoprostol promotes ulcer healing by stimulating mucus and bicarbonate secretions and inhibiting acid secretion.
B)All of the medications listed can be used to treat PUD, but they work in different ways. Sucralfate binds to proteins in the ulcer base, forming a protective barrier against acid, bile, and pepsin. Sucralfate also stimulates the secretion of mucus, bicarbonate, and prostaglandin. Omeprazole is a proton-pump inhibitor (PPI). Bismuth compounds stimulate mucosal bicarbonate and prostaglandin production to promote ulcer healing and suppress Helicobacter pylori. Misoprostol promotes ulcer healing by stimulating mucus and bicarbonate secretions and inhibiting acid secretion.
C)All of the medications listed can be used to treat PUD, but they work in different ways. Sucralfate binds to proteins in the ulcer base, forming a protective barrier against acid, bile, and pepsin. Sucralfate also stimulates the secretion of mucus, bicarbonate, and prostaglandin. Omeprazole is a proton-pump inhibitor (PPI). Bismuth compounds stimulate mucosal bicarbonate and prostaglandin production to promote ulcer healing and suppress Helicobacter pylori. Misoprostol promotes ulcer healing by stimulating mucus and bicarbonate secretions and inhibiting acid secretion.
D)All of the medications listed can be used to treat PUD, but they work in different ways. Sucralfate binds to proteins in the ulcer base, forming a protective barrier against acid, bile, and pepsin. Sucralfate also stimulates the secretion of mucus, bicarbonate, and prostaglandin. Omeprazole is a proton-pump inhibitor (PPI). Bismuth compounds stimulate mucosal bicarbonate and prostaglandin production to promote ulcer healing and suppress Helicobacter pylori. Misoprostol promotes ulcer healing by stimulating mucus and bicarbonate secretions and inhibiting acid secretion.

Question 11

A nurse is receiving a client from the emergency department who was diagnosed with an acute exacerbation of ulcerative colitis. The nurse anticipates that the client may present with which clinical characteristics? Select all that apply.

Accepted Answer

A)With both ulcerative colitis and Crohn disease, the client experiences periods of symptom-free remissions with sporadic periods of active disease (flares). However, each condition also has unique clinical characteristics. With ulcerative colitis, the client may have 5-30 diarrhea stools per day with blood and mucus. In addition, the pain associated with ulcerative colitis presents with cramping in the left lower quadrant which is relieved by defecation. All other clinical manifestations listed here are unique to Crohn disease.
B)With both ulcerative colitis and Crohn disease, the client experiences periods of symptom-free remissions with sporadic periods of active disease (flares). However, each condition also has unique clinical characteristics. With ulcerative colitis, the client may have 5-30 diarrhea stools per day with blood and mucus. In addition, the pain associated with ulcerative colitis presents with cramping in the left lower quadrant which is relieved by defecation. All other clinical manifestations listed here are unique to Crohn disease.
C)With both ulcerative colitis and Crohn disease, the client experiences periods of symptom-free remissions with sporadic periods of active disease (flares). However, each condition also has unique clinical characteristics. With ulcerative colitis, the client may have 5-30 diarrhea stools per day with blood and mucus. In addition, the pain associated with ulcerative colitis presents with cramping in the left lower quadrant which is relieved by defecation. All other clinical manifestations listed here are unique to Crohn disease.
D)With both ulcerative colitis and Crohn disease, the client experiences periods of symptom-free remissions with sporadic periods of active disease (flares). However, each condition also has unique clinical characteristics. With ulcerative colitis, the client may have 5-30 diarrhea stools per day with blood and mucus. In addition, the pain associated with ulcerative colitis presents with cramping in the left lower quadrant which is relieved by defecation. All other clinical manifestations listed here are unique to Crohn disease.
E)With both ulcerative colitis and Crohn disease, the client experiences periods of symptom-free remissions with sporadic periods of active disease (flares). However, each condition also has unique clinical characteristics. With ulcerative colitis, the client may have 5-30 diarrhea stools per day with blood and mucus. In addition, the pain associated with ulcerative colitis presents with cramping in the left lower quadrant which is relieved by defecation. All other clinical manifestations listed here are unique to Crohn disease.

Question 12

A client being discharged after treatment for nephritis is concerned about having adequate stamina to care for her children after discharge. Which statement made by the nurse would be most appropriate to address the client's concern?

Accepted Answer

A)The client will be easily fatigued and will need assistance after treatment for nephritis. The nurse should not assume that the client has a spouse. Also, the client might not have family nearby or neighbors who are available to care for her children for a few weeks. Thus, the nurse should contact Social Services to obtain support for the client.
B)The client will be easily fatigued and will need assistance after treatment for nephritis. The nurse should not assume that the client has a spouse. Also, the client might not have family nearby or neighbors who are available to care for her children for a few weeks. Thus, the nurse should contact Social Services to obtain support for the client.
C)The client will be easily fatigued and will need assistance after treatment for nephritis. The nurse should not assume that the client has a spouse. Also, the client might not have family nearby or neighbors who are available to care for her children for a few weeks. Thus, the nurse should contact Social Services to obtain support for the client.
D)The client will be easily fatigued and will need assistance after treatment for nephritis. The nurse should not assume that the client has a spouse. Also, the client might not have family nearby or neighbors who are available to care for her children for a few weeks. Thus, the nurse should contact Social Services to obtain support for the client.

Question 13

Which of the following lab values increases in the presence of renal impairment?

Accepted Answer

A)Serum creatinine is excreted entirely by the kidneys, making it a good indicator of kidney function. Elevations in serum creatinine levels indicate impairment of renal function. In contrast, creatinine clearance, urine creatinine, and total urine output typically decrease in the presence of renal impairment.
B)Serum creatinine is excreted entirely by the kidneys, making it a good indicator of kidney function. Elevations in serum creatinine levels indicate impairment of renal function. In contrast, creatinine clearance, urine creatinine, and total urine output typically decrease in the presence of renal impairment.
C)Serum creatinine is excreted entirely by the kidneys, making it a good indicator of kidney function. Elevations in serum creatinine levels indicate impairment of renal function. In contrast, creatinine clearance, urine creatinine, and total urine output typically decrease in the presence of renal impairment.
D)Serum creatinine is excreted entirely by the kidneys, making it a good indicator of kidney function. Elevations in serum creatinine levels indicate impairment of renal function. In contrast, creatinine clearance, urine creatinine, and total urine output typically decrease in the presence of renal impairment.

Question 14

A child who is hospitalized with acute glomerulonephritis experiences blurred vision and headache while in the playroom. Which action by the nurse is the most appropriate?

Accepted Answer

A)Blurred vision and headache may be signs of encephalopathy, a complication of acute glomerulonephritis. The nurse should obtain a blood pressure reading and notify the physician. The physician may decide to order an antihypertensive to bring down the blood pressure. This is a serious complication, and delay in treatment could mean lethargy and seizures. Therefore, the other options (checking urine for hematuria, encouraging bed rest, and obtaining serum electrolytes)do not directly address the potential problem of encephalopathy.
B)Blurred vision and headache may be signs of encephalopathy, a complication of acute glomerulonephritis. The nurse student should obtain a blood pressure reading and notify the physician. The physician may decide to order an antihypertensive to bring down the blood pressure. This is a serious complication, and delay in treatment could mean lethargy and seizures. Therefore, the other options (checking urine for hematuria, encouraging bed rest, and obtaining serum electrolytes)do not directly address the potential problem of encephalopathy.
C)Blurred vision and headache may be signs of encephalopathy, a complication of acute glomerulonephritis. The nurse should obtain a blood pressure reading and notify the physician. The physician may decide to order an antihypertensive to bring down the blood pressure. This is a serious complication, and delay in treatment could mean lethargy and seizures. Therefore, the other options (checking urine for hematuria, encouraging bed rest, and obtaining serum electrolytes)do not directly address the potential problem of encephalopathy.
D)Blurred vision and headache may be signs of encephalopathy, a complication of acute glomerulonephritis. The nurse should obtain a blood pressure reading and notify the physician. The physician may decide to order an antihypertensive to bring down the blood pressure. This is a serious complication, and delay in treatment could mean lethargy and seizures. Therefore, the other options (checking urine for hematuria, encouraging bed rest, and obtaining serum electrolytes)do not directly address the potential problem of encephalopathy.

Question 15

A client being treated for nephrotic syndrome is a vegetarian and has recently experienced poor oral intake. Which action should the nurse take to meet this client's nutritional needs?

Accepted Answer

A)The client is being treated for nephrotic syndrome, which could impact the amount of protein permitted to be eaten each day. The client should discuss dietary preferences with a dietitian so that the client's nutritional needs will be met. An appetite stimulant is not going to improve the client's appetite if foods are provided that the client does not eat. The nurse should not encourage the client to eat foods that do not support the client's vegetarian diet. The nurse needs to help the client now and not have the client wait to go to home before having foods that the client wants to eat.
B)The client is being treated for nephrotic syndrome, which could impact the amount of protein permitted to be eaten each day. The client should discuss dietary preferences with a dietitian so that the client's nutritional needs will be met. An appetite stimulant is not going to improve the client's appetite if foods are provided that the client does not eat. The nurse should not encourage the client to eat foods that do not support the client's vegetarian diet. The nurse needs to help the client now and not have the client wait to go to home before having foods that the client wants to eat.
C)The client is being treated for nephrotic syndrome, which could impact the amount of protein permitted to be eaten each day. The client should discuss dietary preferences with a dietitian so that the client's nutritional needs will be met. An appetite stimulant is not going to improve the client's appetite if foods are provided that the client does not eat. The nurse should not encourage the client to eat foods that do not support the client's vegetarian diet. The nurse needs to help the client now and not have the client wait to go to home before having foods that the client wants to eat.
D)The client is being treated for nephrotic syndrome, which could impact the amount of protein permitted to be eaten each day. The client should discuss dietary preferences with a dietitian so that the client's nutritional needs will be met. An appetite stimulant is not going to improve the client's appetite if foods are provided that the client does not eat. The nurse should not encourage the client to eat foods that do not support the client's vegetarian diet. The nurse needs to help the client now and not have the client wait to go to home before having foods that the client wants to eat.

Question 16

The nurse is caring for a client who receives H?-receptor antagonists for the treatment of peptic ulcer disease. Based on the nursing diagnosis Risk for Bleeding, which assessment finding should the nurse report immediately to the healthcare provider?

Accepted Answer

A)Melena could indicate GI bleeding and should be reported to the physician immediately. The client may still experience pain for several days with this type of medication. Taking Tums antacids with an H?-receptor antagonist will cause deceased absorption of the H?-receptor antagonist, but this does not need to be reported to the healthcare provider; rather, the nurse should educate the client. Constipation is a common side effect that does not need to be immediately reported to the healthcare provider.
B)Melena could indicate GI bleeding and should be reported to the physician immediately. The client may still experience pain for several days with this type of medication. Taking Tums antacids with an H?-receptor antagonist will cause deceased absorption of the H?-receptor antagonist, but this does not need to be reported to the healthcare provider; rather, the nurse should educate the client. Constipation is a common side effect that does not need to be immediately reported to the healthcare provider.
C)Melena could indicate GI bleeding and should be reported to the physician immediately. The client may still experience pain for several days with this type of medication. Taking Tums antacids with an H?-receptor antagonist will cause deceased absorption of the H?-receptor antagonist, but this does not need to be reported to the healthcare provider; rather, the nurse should educate the client. Constipation is a common side effect that does not need to be immediately reported to the healthcare provider.
D)Melena could indicate GI bleeding and should be reported to the physician immediately. The client may still experience pain for several days with this type of medication. Taking Tums antacids with an H?-receptor antagonist will cause deceased absorption of the H?-receptor antagonist, but this does not need to be reported to the healthcare provider; rather, the nurse should educate the client. Constipation is a common side effect that does not need to be immediately reported to the healthcare provider.

Question 17

Which of the following is the essential and most reliable diagnostic procedure for glomerular disorders?

Accepted Answer

A)Biopsy is the essential and most reliable diagnostic procedure for glomerular disorders. Biopsy helps determine the type of nephritis, the prognosis, and the appropriate treatment. Kidney scan allows visualization of the kidney after IV administration of a radioisotope, but the results are not as definitive as with biopsy. KUB (kidney, ureter, bladder)abdominal x-ray may be done to evaluate kidney size and to rule out other causes of the patient's manifestations, but not to definitively diagnose glomerular disorders. ASO titers and similar blood tests detect streptococcal exoenzymes that stimulate the immune response in acute postinfection glomerulonephritis, but again, they cannot provide a clear diagnosis of glomerular dysfunction.
B)Biopsy is the essential and most reliable diagnostic procedure for glomerular disorders. Biopsy helps determine the type of nephritis, the prognosis, and the appropriate treatment. Kidney scan allows visualization of the kidney after IV administration of a radioisotope, but the results are not as definitive as with biopsy. KUB (kidney, ureter, bladder)abdominal x-ray may be done to evaluate kidney size and to rule out other causes of the patient's manifestations, but not to definitively diagnose glomerular disorders. ASO titers and similar blood tests detect streptococcal exoenzymes that stimulate the immune response in acute postinfection glomerulonephritis, but again, they cannot provide a clear diagnosis of glomerular dysfunction.
C)Biopsy is the essential and most reliable diagnostic procedure for glomerular disorders. Biopsy helps determine the type of nephritis, the prognosis, and the appropriate treatment. Kidney scan allows visualization of the kidney after IV administration of a radioisotope, but the results are not as definitive as with biopsy. KUB (kidney, ureter, bladder)abdominal x-ray may be done to evaluate kidney size and to rule out other causes of the patient's manifestations, but not to definitively diagnose glomerular disorders. ASO titers and similar blood tests detect streptococcal exoenzymes that stimulate the immune response in acute postinfection glomerulonephritis, but again, they cannot provide a clear diagnosis of glomerular dysfunction.
D)Biopsy is the essential and most reliable diagnostic procedure for glomerular disorders. Biopsy helps determine the type of nephritis, the prognosis, and the appropriate treatment. Kidney scan allows visualization of the kidney after IV administration of a radioisotope, but the results are not as definitive as with biopsy. KUB (kidney, ureter, bladder)abdominal x-ray may be done to evaluate kidney size and to rule out other causes of the patient's manifestations, but not to definitively diagnose glomerular disorders. ASO titers and similar blood tests detect streptococcal exoenzymes that stimulate the immune response in acute postinfection glomerulonephritis, but again, they cannot provide a clear diagnosis of glomerular dysfunction.

Question 18

A home health nurse is evaluating a client who had a colostomy placed 6 weeks ago for the treatment of ulcerative colitis. Which assessment would cause the nurse to conclude that teaching goals for this client have been met?

Accepted Answer

A)Stoma care is taught to the client after surgery, and the goal is for the stoma to be pink with intact skin. It is not as critical that the ostomy pouch be clean and dry, particularly if the client has passed a stool. A normal temperature would not be a particular goal for a client 6 weeks postoperatively. Patients with ulcerative colitis are going to have pain when they eat foods that irritate the bowel, but this is not a goal.
B)Stoma care is taught to the client after surgery, and the goal is for the stoma to be pink with intact skin. It is not as critical that the ostomy pouch be clean and dry, particularly if the client has passed a stool. A normal temperature would not be a particular goal for a client 6 weeks postoperatively. Patients with ulcerative colitis are going to have pain when they eat foods that irritate the bowel, but this is not a goal.
C)Stoma care is taught to the client after surgery, and the goal is for the stoma to be pink with intact skin. It is not as critical that the ostomy pouch be clean and dry, particularly if the client has passed a stool. A normal temperature would not be a particular goal for a client 6 weeks postoperatively. Patients with ulcerative colitis are going to have pain when they eat foods that irritate the bowel, but this is not a goal.
D)Stoma care is taught to the client after surgery, and the goal is for the stoma to be pink with intact skin. It is not as critical that the ostomy pouch be clean and dry, particularly if the client has passed a stool. A normal temperature would not be a particular goal for a client 6 weeks postoperatively. Patients with ulcerative colitis are going to have pain when they eat foods that irritate the bowel, but this is not a goal.

Question 19

The healthcare provider prescribes misoprostol (Cytotec)for a female client for the treatment of peptic ulcer disease. What should the nurse ask the client prior to administration of this medication?

Accepted Answer

A)Misoprostol (Cytotec)is contraindicated during pregnancy; in fact, it is sometimes used to terminate pregnancies. There is no contraindication for misoprostol (Cytotec)in a client with irregular menstrual cycles. Misoprostol (Cytotec)is safe as long as the client is not pregnant. Asking if client is sexually active could be appropriate, but the nurse would also ask if the client is using birth control.
B)Misoprostol (Cytotec)is contraindicated during pregnancy; in fact, it is sometimes used to terminate pregnancies. There is no contraindication for misoprostol (Cytotec)in a client with irregular menstrual cycles. Misoprostol (Cytotec)is safe as long as the client is not pregnant. Asking if client is sexually active could be appropriate, but the nurse would also ask if the client is using birth control.
C)Misoprostol (Cytotec)is contraindicated during pregnancy; in fact, it is sometimes used to terminate pregnancies. There is no contraindication for misoprostol (Cytotec)in a client with irregular menstrual cycles. Misoprostol (Cytotec)is safe as long as the client is not pregnant. Asking if client is sexually active could be appropriate, but the nurse would also ask if the client is using birth control.
D)Misoprostol (Cytotec)is contraindicated during pregnancy; in fact, it is sometimes used to terminate pregnancies. There is no contraindication for misoprostol (Cytotec)in a client with irregular menstrual cycles. Misoprostol (Cytotec)is safe as long as the client is not pregnant. Asking if client is sexually active could be appropriate, but the nurse would also ask if the client is using birth control.

Question 20

A client is being treated with blood transfusions for a large peptic ulcer in the duodenum. Which information in the client's history should the nurse suspect as a potential cause of this health problem?

Accepted Answer

A)Clients who are taking high doses of nonsteroidal anti-inflammatory agents (NSAIDs)such as naproxen sodium and aspirin are predisposed to developing large ulcers that do not cause pain. The first symptom the client often experiences is a significant bleeding episode. Concurrent use of NSAIDs and aspirin should therefore be avoided. Allergies to penicillin and morphine sulfate, history of atrial fibrillation, and recent eye surgery are not relevant to the client's bleeding incident.
B)Clients who are taking high doses of nonsteroidal anti-inflammatory agents (NSAIDs)such as naproxen sodium and aspirin are predisposed to developing large ulcers that do not cause pain. The first symptom the client often experiences is a significant bleeding episode. Concurrent use of NSAIDs and aspirin should therefore be avoided. Allergies to penicillin and morphine sulfate, history of atrial fibrillation, and recent eye surgery are not relevant to the client's bleeding incident.
C)Clients who are taking high doses of nonsteroidal anti-inflammatory agents (NSAIDs)such as naproxen sodium and aspirin are predisposed to developing large ulcers that do not cause pain. The first symptom the client often experiences is a significant bleeding episode. Concurrent use of NSAIDs and aspirin should therefore be avoided. Allergies to penicillin and morphine sulfate, history of atrial fibrillation, and recent eye surgery are not relevant to the client's bleeding incident.
D)Clients who are taking high doses of nonsteroidal anti-inflammatory agents (NSAIDs)such as naproxen sodium and aspirin are predisposed to developing large ulcers that do not cause pain. The first symptom the client often experiences is a significant bleeding episode. Concurrent use of NSAIDs and aspirin should therefore be avoided. Allergies to penicillin and morphine sulfate, history of atrial fibrillation, and recent eye surgery are not relevant to the client's bleeding incident.

Quiz 10: Inflammation