Question 1

A patient with chronic kidney disease is trying to decide between hemodialysis and peritoneal dialysis. What should the nurse encourage the patient to consider as advantages of peritoneal dialysis?

Accepted Answer

A,B,C

Question 2

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 what health problem?

Accepted Answer

Chronic rejection is characterized by a gradual loss of organ function, as evidenced by increasing blood pressure and proteinuria, and can occur years after transplantation.

Question 3

An older 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?

Accepted Answer

Older patients with cardiac complications and diabetes are likely to have compromised renal function, which can affect the metabolism and excretion of medications. Therefore, it is important for nurses to consider the type and amount of medications given, and monitor the patient's renal function regularly to prevent adverse drug reactions. Options B, C, and D are also important considerations; however, A is the best answer given the patient's medical condition.

Question 4

A patient who is recovering from acute kidney injury (AKI) is being discharged. What should the nurse include in this patient's instructions?

Accepted Answer

Alcohol can be harmful to the kidneys, especially in a patient recovering from acute kidney injury (AKI), so avoiding alcohol consumption is important to prevent further kidney damage.

Question 5

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

Accepted Answer

ACE inhibitors are commonly used to treat hypertension in patients with polycystic kidney disease. They work by relaxing the blood vessels, which helps to lower blood pressure. Kidney transplant and dialysis may be considered in later stages of the disease, but medical management with ACE inhibitors is the first line of treatment for hypertension. Peritoneal dialysis is not directly related to controlling blood pressure in this patient.

Question 6

A patient is admitted with signs of chronic kidney disease. What finding should the nurse use to determine whether this patient is developing metabolic acidosis?

Accepted Answer

Kussmaul respirations may indicate metabolic acidosis, as the body attempts to compensate for the increase in acid by increasing the depth and rate of respirations. Low urine output (B) may be a sign of kidney damage, but it does not necessarily indicate metabolic acidosis. Muscle cramps (C) and diarrhea (D) are not specific indications of metabolic acidosis.

Question 7

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?

Accepted Answer

Polycystic kidney disease is a genetic disorder that is inherited in an autosomal dominant pattern, which means that there is a 50% chance that a child of an affected individual will inherit the disease. It is important for the nurse to provide accurate information and not dismiss the patient's concerns. Additionally, the nurse can provide resources for genetic counseling to assist the patient and their partner in making informed decisions about having children.

Question 8

A patient who is diagnosed with renal cancer states, "I only lost a few pounds! I had no other symptoms!" What should the nurse realize as being the only consistent symptom of renal cancer?

Accepted Answer

Hematuria (blood in the urine) is the only consistent symptom of renal cancer. However, it may not always be present or may be intermittent, which is why it is important for routine urine analysis to be conducted. Flank pain, nausea, and vomiting are not consistent symptoms of renal cancer.

Question 9

The nurse is planning care for a patient with kidney disease who is having difficulty maintaining adequate nutrition. Which intervention should the nurse include in this patient's plan of care?

Accepted Answer

Providing mouth care before meals can improve appetite and help the patient maintain adequate nutrition. It can also prevent oral infections, which can be a complication of kidney disease. Scheduling meals for three times each day may not be appropriate for all patients as individual nutrition needs vary. Providing antiemetics after meals may not address the underlying issue of poor appetite and may have side effects. Weighing once per week may be important for monitoring fluid levels in some patients but does not directly address the issue of poor nutrition.

Question 10

A patient with diabetes and heart disease is diagnosed with chronic kidney disease. Which medication order should the nurse question for this patient?

Accepted Answer

The nurse should question the order for the oral antihyperglycemic agent because it may further damage the kidneys and increase the risk of hypoglycemia, especially in patients with chronic kidney disease. The beta-blocker and calcium channel blocker are commonly used in patients with heart disease and do not pose a significant risk to the kidneys. The order for an analgesic should be evaluated based on the patient's pain level and overall health status, but it is not contraindicated in patients with diabetes, heart disease, and chronic kidney disease.

Question 11

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

Accepted Answer

Periorbital edema or swelling around the eyes is a common symptom of acute glomerulonephritis, which presents as inflammation in the kidneys. Hunger, polyuria, and polyphagia are not typically associated with this condition.

Question 12

An older patient is scheduled for a CT scan with and without contrast dye. What should be done prior to this CT scan?

Accepted Answer

Prior to a CT scan with contrast dye, it is important to assess renal function to ensure that the body can properly filter and eliminate the dye. Impaired renal function can lead to the accumulation of the dye in the body, which can cause adverse effects.

Question 13

The nurse is teaching a patient recovering from a nephrectomy for kidney cancer. What should the nurse include in this teaching?

Accepted Answer

Early recognition of a urinary tract infection is important after a nephrectomy as the remaining kidney can be compromised if the infection is not treated promptly. Limiting fluids is not recommended as the remaining kidney needs adequate hydration to function properly. High-impact sports and activities are not recommended until the patient has fully recovered from the surgery. Organ donor information is not relevant to the patient's current situation.

Question 14

The nurse is preparing to assess an older patient with age-related renal dysfunction. What should the nurse include in this assessment?

Accepted Answer

Older patients with age-related renal dysfunction are at increased risk for medication or drug toxicity due to changes in renal function. Therefore, medication review and monitoring are important components of their assessment.

Question 15

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

Accepted Answer

Uncontrolled hypertension can lead to further damage to the kidneys and increase the risk of adverse effects, such as kidney failure or cardiovascular disease, in patients with chronic kidney disease. Therefore, controlling the patient's blood pressure is crucial to prevent these complications.

Question 16

A patient is scheduled to have an arteriovenous (AV) fistula created for hemodialysis. What should the nurse include when teaching the patient about this fistula?

Accepted Answer

B) A functioning AV fistula can be detected by palpating a thrill and auscultating a bruit. This indicates that blood is flowing through the fistula as it should be.
A) Blood pressure should not be taken on an arm with an AV fistula to prevent damage to the site or interference with dialysis.

Question 17

A patient with acute kidney injury (AKI) is prescribed furosemide (Lasix). The nurse realizes that this medication will be helpful to the patient because it will

Accepted Answer

Furosemide is a loop diuretic that promotes the loss of excess fluid and electrolytes, including sodium and potassium. This can help reduce edema in a patient with AKI. It does not preserve protein, as it is not a protein-sparing diuretic. It is not considered the gentlest diuretic to use, as it can cause significant electrolyte imbalances and other side effects if not used carefully.

Question 18

A patient is diagnosed with postrenal acute kidney injury (AKI). The nurse realizes that this type of kidney injury can be caused by what health problem?

Accepted Answer

Postrenal AKI is caused by any obstruction that affects the flow of urine from the renal pelvis through the ureters, bladder, and urethra. Benign prostatic hypertrophy is a common cause of obstruction in males that leads to postrenal AKI. Hypovolemia, sepsis, and drug toxicity can cause prerenal or intrinsic AKI.

Question 19

The nurse is caring for a patient with chronic glomerulonephritis. Which intervention should the nurse add to this patient's plan of care to address excess body fluid?

Accepted Answer

Chronic glomerulonephritis can lead to impaired kidney function, resulting in difficulty regulating body fluid. Weighing the patient daily on the same scale is an important measure to monitor for fluid retention and adjust medication doses accordingly. Documenting energy level, scheduling activities to conserve energy, and assessing for signs of infection are important interventions but are not as directly related to addressing excess body fluid in this patient.

Question 20

The nurse is planning the care of a patient with chronic glomerulonephritis. What should the nurse identify as being the goal of treatment for this patient?

Accepted Answer

The goal of treatment for chronic glomerulonephritis is to maintain renal function, as the disease causes damage to the kidneys over time. Achieving maximum independence and returning to work may be secondary goals, but the primary focus of treatment is on preserving kidney function. Lifestyle changes, while important for overall health, may not be the primary goal of treatment specifically for glomerulonephritis.

Quiz 28: Nursing Care of Patients With Kidney Disorders