Deck 62: Coordinating Care for Patients With Renal Disorders

Question 1

What grade of renal trauma does the nurse document in the patient experiencing hematuria and contusions, but with normal imaging studies?
1)Grade 1
2)Grade 2
3)Grade 3
4)Grade 4

Answer 1

1

Question 2

A patient with chronic kidney disease is experiencing manifestations of anemia. Based on this data, which treatment does the nurse anticipate for this patient?
1)Begin fluid restriction.
2)Administer intravenous glucose and insulin.
3)Begin a low-sodium diet.
4)Administer erythropoietin (Epoetin) injections.

Answer 2

4

Question 3

Which statement by the patient diagnosed with pyelonephritis indicates the need for further teaching?
1)"I will urinate every 3 to 4 hours during the day."
2)"I will report pain in my back to my provider if it occurs again."
3)"I will take my entire course of phenazopyridine to treat future UTIs."
4)"I will empty my bladder before and after sexual intercourse to decrease my risk for UTIs."

Answer 3

3

Question 4

Which medication prescription for the patient with chronic kidney disease needs to be questioned by the nurse?
1)Acetaminophen
2)Demerol
3)Morphine
4)Oxycodone

Question 5

The nurse is caring for a patient admitted with a diagnosis of acute kidney injury. The patient asks the nurse, "Are my kidneys failing? Will I need a kidney transplant?
" Which response by the nurse is the most appropriate?
1)"No, don't think that. You're going to be fine."
2)"Your condition can be reversed with prompt treatment and usually will not destroy the kidney."
3)"Kidney transplantation is likely, and it would be a good idea to start talking to family members."
4)"When the doctor comes to see you, we can talk about whether you will need a transplant."

Question 6

Which statement by the patient diagnosed with polycystic kidney disease (PKD) indicates the need for further teaching?
1)"I will have prunes for breakfast each day."
2)"I will use frozen vegetables to decrease my intake of salt."
3)"I will notify my provider if I experience burning when I urinate."
4)"I will monitor my fluid intake daily."

Question 7

In providing care to the patient who may have polycystic kidney disease, the nurse recognizes which finding as the first clinical manifestation of this disease process?
1)Hypertension
2)Hematuria
3)Urinary frequency
4)Urinary calculi

Question 8

The nurse monitors for which therapeutic effect in the patient receiving sodium polystyrene sulfonate (Kayexalate) for the treatment of chronic kidney disease?
1)Decreased serum sodium
2)Decreased serum phosphorus
3)Decreased urine specific gravity
4)Decreased serum potassium

Question 9

What grade of renal trauma does should the nurse document in the patient who has a renal laceration that is greater than 1 cm in depth but does not involve the collecting system?
1)Grade 1
2)Grade 2
3)Grade 3
4)Grade 4

Question 10

The nurse is caring for a patient who is pale and experiencing fatigue secondary to anemia related to chronic kidney disease. When the patient's spouse asks why the patient is anemic, what response by the nurse is the best?
1)"Your spouse has a genetic tendency for the development of anemia."
2)"The increased metabolic waste products in the body depress the bone marrow and cause anemia."
3)"There is a decreased production by the kidneys of the hormone erythropoietin, which is the cause of anemia."
4)"The patient is not eating enough iron-rich foods, which is causing anemia."

Question 11

Which statement by the patient after radical nephrectomy for renal cancer indicates the need for further teaching?
1)"I will notify you if my urine is pink tinged."
2)"I will notify you if my drain no longer has output."
3)"I will drink at least the prescribed amount of fluid each day."
4)"I will change positions in the bed frequently to decrease my risk for pneumonia."

Question 12

A patient with a history of hypertension is diagnosed with chronic kidney disease. When the patient asks the nurse how this occurred, which response by the nurse is the best?
1)"Thickening of the kidney structures and gradual death of nephrons has caused this diagnosis."
2)"Cysts compress renal tissue, which destroy the kidneys, causing this diagnosis."
3)"High blood pressure reduces renal blood flow and harms the kidney tissue, causing this diagnosis."
4)"Immune complexes form in the kidney tissue and produce inflammation, causing this diagnosis."

Question 13

In providing education to a patient diagnosed with renal carcinoma, the patient states, "My doctor says I am a stage I. What does that mean? " Which response by the nurse is best?
1)"Your cancer is limited to the renal capsule."
2)"Your cancer involves the perirenal fat but is confined to fascia with metastasis to the adrenal gland."
3)"Your cancer involves the regional lymph node, renal vein, and vena cava."
4)"Your cancer involves metastases to other sites in the body."

Question 14

Which statement by the patient diagnosed with chronic kidney disease who is prescribed furosemide (Lasix) indicates that teaching about this medication was effective?
1)"I will take this medication to keep my calcium balance normal."
2)"This medication will make sure I have enough red blood cells in my body."
3)"I will take this pill to keep the protein level in my body stable."
4)"This pill will reduce the swelling in my body and get rid of the extra potassium."

Question 15

The nurse correlates which disorder to the development of intrarenal renal failure?
1)Prolonged hypotension
2)Glomerulonephritis
3)Renal calculi
4)Hypovolemia

Question 16

The nurse is planning care for the patient with acute kidney injury. Which assessment data best supports the nursing diagnosis Excess Fluid Volume?
1)Pitting edema in the lower extremities
2)Bowel sounds positive in four quadrants
3)Wheezing in the lungs
4)Fatigue

Question 17

Which statement by the patient being discharged after treatment for acute glomerulonephritis indicates the need for further teaching?
1)"I am at risk for developing acute kidney disease."
2)"I have to decrease my salt intake so that I will not retain fluid."
3)"Elevated blood pressure is a clinical manifestation of my condition."
4)"I will increase the protein in my diet to help me heal."

Question 18

The nurse monitors for which electrocardiogram change as the first indication of hyperkalemia in the patient with acute kidney disease?
1)Absence of P waves
2)Tall T waves
3)Long PR intervals
4)Wide QRS complexes

Question 19

Which nursing diagnosis is the priority in the patient diagnosed with chronic kidney disease?
1)Anxiety
2)Disturbed Body Image
3)Risk for Injury-Fractures
4)Risk for Bleeding

Question 20

When teaching the patient with chronic kidney disease and hypertension to avoid salt substitute, the nurse bases this instruction on which rationale?
1)They interfere with antihypertensive medications.
2)They will cause the patient to retain fluid.
3)They will interact with the patient's antihypertensive medications.
4)They can potentiate hyperkalemia.

Question 21

Which data in an older adult's history does the nurse correlate as risk factors for developing acute kidney injury? Select all that apply.
1)Diagnosed with hypotension
2)Recent aortic valve replacement surgery
3)Prescribed high doses of intravenous antibiotics
4)Total hip replacement surgery 5 years ago
5)Taking medication for type 2 diabetes mellitus

Question 22

The nurse monitors for which clinical manifestations in the patient diagnosed with acute glomerulonephritis? Select all that apply.
1)Hematuria
2)Proteinuria
3)Serum BUN 8.0 mg/dL
4)Serum creatinine 2.4 mg/dL
5)Increased urine output

Question 23

The nurse is preparing to discharge a patient with chronic kidney disease. In teaching the patient about calcium acetate tablets, which explanation by the nurse is best?
1)"The calcium acetate will lower your serum phosphate levels."
2)"The calcium acetate helps to neutralize your gastric acids."
3)"The calcium acetate will help to stimulate your appetite."
4)"The calcium acetate will decrease your serum creatinine levels."

Question 24

The nurse is administering peritoneal dialysis to a patient with acute kidney injury and notes the presence of a cloudy dialysate return. After notifying the healthcare provider, which action by the nurse is best?
1)Measure abdominal girth
2)Document the cloudy dialysate
3)Culture the dialysate return
4)Increase dialysate instillation

Question 25

The nurse correlates which clinical manifestations in the patient diagnosed with a grade 1 renal trauma? Select all that apply.
1)Contusion
2)Hematuria
3)Superficial laceration
4)Injury to the renal artery
5)Nonexpanding hematoma

Question 26

What laboratory values does the nurse need to assess before a patient receives a hemodialysis treatment? Select all that apply.
1)Increased blood urea nitrogen (BUN)
2)Decreased potassium
3)Decreased phosphorus
4)Increased urine osmolality
5)Increased creatinine

Question 27

During a home visit, the nurse is concerned that an older adult patient is developing chronic kidney disease. Because the patient has no history of cardiovascular disease, what data requires further consideration by the nurse?
1)Progressive edema
2)Complaints of hip joint pain
3)Recent increase in hunger and thirst
4)Warm moist skin

Question 28

When planning meals for the patient with chronic kidney disease, which dietary choices are best for this patient?
1)Hamburger on a bun, banana
2)Cold cuts with bun with fresh pears
3)Spaghetti and meat sauce, breadsticks
4)Carrots and green, leafy vegetables

Question 29

In providing an educational inservice to the nursing staff about peritoneal dialysis, which information does the nurse include in this presentation?
1)"The peritoneum is more permeable because of the presence of excess metabolites."
2)"The metabolites will diffuse from the interstitial space to the bloodstream mainly through diffusion and ultrafiltration."
3)"The peritoneum acts as a semipermeable membrane through which wastes move by diffusion and osmosis."
4)"The solutes in the dialysate will enter the bloodstream through the peritoneum."

Question 30

The nurse correlates which data in a patient's medical history as risk factors for acute kidney injury? Select all that apply.
1)Dehydration
2)Renal calculi
3)Ineffective wound healing
4)Low serum albumin
5)Hypertension