Deck 54: Renal Dysfunction: Nursing Management

Question 1

The nurse is caring for a client diagnosed with chronic renal failure. Which of the following would be considered expected manifestations of this disorder? (Select all that apply.)

A) Left ventricular dysfunction
B) Anemia
C) Diarrhea
D) Constipation
E) Prickly burning sensation of the extremities
F) Restless legs

Answer 1

Left ventricular dysfunction
Anemia
Constipation
Prickly burning sensation of the extremities
Restless legs

Question 2

The nurse would expect that a client recovering from a kidney transplant would be prescribed all the following medications EXCEPT:

A) prednisone.
B) cyclosporine.
C) azathioprine.
D) vancomycin.

Answer 2

vancomycin.

Question 3

A client is diagnosed with rhabdomyolysis. The nurse realizes that an emergency condition that may occur with this diagnosis would be:

A) shortness of breath.
B) joint aches.
C) pulmonary hemorrhage.
D) compartment syndrome.

Answer 3

compartment syndrome.

Question 4

A client is being prescribed medication to treat polycystic kidney disease. Which of the following medications would be indicated for this client?

A) Cephalosporin
B) Antifungal
C) Antihypertensive
D) Antiarrhythmic

Question 5

A client diagnosed with chronic renal failure asks the nurse, "What's the difference between hemodialysis and peritoneal dialysis?" Which of the following statements best explains the difference?

A) "Hemodialysis is done three times a week and lasts 3 to 4 hours; peritoneal dialysis is done daily."
B) "Hemodialysis uses a graft or fistula and pumps blood through a semipermeable membrane in a hemodialyzer as the filter. Peritoneal dialysis uses the peritoneal lining of the abdominal cavity as the filter."
C) "Hemodialysis and peritoneal dialysis use different equipment."
D) "There are different dietary requirements for hemodialysis and peritoneal dialysis."

Question 6

The nurse, caring for a client diagnosed with pyelonephritis, realizes that common risk factors for the development of this disorder include all of the following EXCEPT:

A) urinary retention.
B) urinary calculi.
C) prostate gland hypertrophy.
D) orthostatic hypotension.

Question 7

During the admitting assessment process, a client asks, "What is oliguria?" Based on the nurse's knowledge, the best response would be:

A) "Oliguria is a urine output less than 50 mL in 24 hours."
B) "Oliguria is a urine output less than 250 mL in 24 hours."
C) "Oliguria is a urine output less than 400 mL in 24 hours."
D) "Oliguria is a decreased urine output indicative of disease."

Question 8

During discharge teaching with a client diagnosed with autosomal dominant polycystic kidney disease, the nurse should stress which of the following points? (Select all that apply.)

A) Take more tub baths.
B) Void frequently.
C) Practice good perineal hygiene.
D) Void after intercourse.
E) Take showers.
F) Limit fluids.

Question 9

A client is diagnosed with acute renal failure. Which of the following diagnostic studies will the nurse be most concerned with?

A) Blood glucose and HbA_1c
B) Toxicology screening and chloride level
C) Potassium and digitalis levels
D) Chest x-ray study and magnesium level

Question 10

A client is diagnosed with Wegener's granulomatosis. Which of the following will the nurse most likely assess in this client? (Select all that apply.)

A) Shortness of breath and cough
B) Tinnitus
C) Abdominal pain
D) Conjunctivitis
E) Muscle aches
F) Vomiting

Question 11

The nurse is assessing circulation through a client's arteriovenous shunt. Which of the following are signs of a patent site? (Select all that apply.)

A) Normal blood pressure
B) Positive bruit
C) Pulse present distal to the site
D) Dry dressing
E) Palpable thrill
F) Good skin turgor

Question 12

The nurse is caring for a client diagnosed with pyelonephritis. Which of the following are appropriate interventions that the nurse should perform? (Select all that apply.)

A) Ensure adequate hydration.
B) Monitor vital signs and fluid balance.
C) Insert a urinary catheter.
D) Provide urinary antiseptics.
E) Monitor electrolytes and creatinine level.
F) Monitor hemoglobin level.

Question 13

A client has been prescribed a restricted potassium diet. An appropriate snack for the client would be:

A) banana.
B) applesauce.
C) orange juice.
D) dried dates.

Question 14

A client diagnosed with acute renal failure has a magnesium level of 1.0 mg/dL Which of the following will the nurse most likely assess in this client?

A) Broad, flat T-waves
B) ST depression
C) Prolonged QT
D) No clinical signs

Question 15

A client diagnosed with acute renal failure from an intrarenal cause should be instructed to:

A) expect blood in the urine.
B) avoid using NSAIDs.
C) increase fluids.
D) maintain a normal activity schedule.

Question 16

After the nurse provides a client diagnosed with acute renal failure with Kayexalate 30 grams by mouth, the client begins to experience frequent loose bowel movements. Which of the following does this client's response indicate to the nurse?

A) The client needs to be treated with insulin and dextrose.
B) The client needs to receive sodium bicarbonate.
C) The client needs an additional dose of Kayexalate.
D) The client is experiencing a response that is indicative of successful treatment.

Question 17

A client is diagnosed with resistant polycystic kidney disease. The medications which may be indicated for this client would be:

A) penicillin and aminoglycosides.
B) clindamycin and gentamicin.
C) metolazone and amiloride.
D) pyridium and urogesic.

Question 18

For a client to be diagnosed with Anti-Glomerular Basement Membrane disease, the nurse realizes that which of the following characteristics must be present? (Select all that apply.)

A) Anti-glomerular basement membrane (GBM) antibodies
B) Sinus infection
C) Pulmonary hemorrhage
D) Proliferative glomerulonephritis
E) Increased heart rate
F) Rapidly dropping blood pressure

Question 19

A client is diagnosed with autosomal dominant polycystic kidney disease. During data collection, which assessment finding would the nurse expect to discover?

A) Decreasing abdominal girth and proteinuria
B) Urinary tract infection and hypotension
C) Pain and hematuria
D) Irregularly shaped kidney and glucosuria

Question 20

A client diagnosed with chronic renal failure is prescribed a diet low in protein. The rationale for this diet is that:

A) protein sources are broken down and converted to urea, which is then filtered by the kidney.
B) protein sources are of low biological value.
C) protein increases calcium and sodium levels.
D) deficit protein metabolism breaks down muscle tissue.