Deck 67: Care of Patients with Kidney Disorders

Question 1

A nurse cares for a client who has pyelonephritis.The client states,"I am embarrassed to talk about my symptoms." How should the nurse respond?

A) "I am a professional.Your symptoms will be kept in confidence."
B) "I understand.Elimination is a private topic and shouldn't be discussed."
C) "Take your time.It is okay to use words that are familiar to you."
D) "You seem anxious.Would you like a nurse of the same gender to care for you?"

Answer 1

"Take your time.It is okay to use words that are familiar to you."

Question 2

A nurse teaches a client who is recovering from a nephrectomy secondary to kidney trauma.Which statement should the nurse include in this client's teaching?

A) "Since you only have one kidney, a salt and fluid restriction is required."
B) "Your therapy will include hemodialysis while you recover."
C) "Medication will be prescribed to control your high blood pressure."
D) "You need to avoid participating in contact sports like football."

Answer 2

"You need to avoid participating in contact sports like football."

Question 3

A nurse assesses a client who has a family history of polycystic kidney disease (PKD).For which clinical manifestations should the nurse assess? (Select all that apply.)

A) Nocturia
B) Flank pain
C) Increased abdominal girth
D) Dysuria
E) Hematuria

Answer 3

Flank pain
Increased abdominal girth
Hematuria

Question 4

A nurse assesses a client with polycystic kidney disease (PKD).Which assessment finding should alert the nurse to immediately contact the health care provider?

A) Flank pain
B) Periorbital edema
C) Bloody and cloudy urine
D) Enlarged abdomen

Question 5

After teaching a client with hypertension secondary to renal disease,the nurse assesses the client's understanding.Which statement made by the client indicates a need for additional teaching?

A) "I can prevent more damage to my kidneys by managing my blood pressure."
B) "If I have increased urination at night, I need to drink less fluid during the day."
C) "I need to see the registered dietitian to discuss limiting my protein intake."
D) "It is important that I take my antihypertensive medications as directed."

Question 6

A nurse cares for a middle-aged female client with diabetes mellitus who is being treated for the third episode of acute pyelonephritis in the past year.The client asks,"What can I do to help prevent these infections?" How should the nurse respond?

A) "Test your urine daily for the presence of ketone bodies and proteins."
B) "Use tampons rather than sanitary napkins during your menstrual period."
C) "Drink more water and empty your bladder more frequently during the day."
D) "Keep your hemoglobin A1c under 9% by keeping your blood sugar controlled."

Question 7

A nurse teaches a client with polycystic kidney disease (PKD).Which statements should the nurse include in this client's discharge teaching? (Select all that apply.)

A) "Take your blood pressure every morning."
B) "Weigh yourself at the same time each day."
C) "Adjust your diet to prevent diarrhea."
D) "Contact your provider if you have visual disturbances."
E) "Assess your urine for renal stones."

Question 8

After teaching a client with early polycystic kidney disease (PKD)about nutritional therapy,the nurse assesses the client's understanding.Which statement made by the client indicates a correct understanding of the teaching?

A) "I will take a laxative every night before going to bed."
B) "I must increase my intake of dietary fiber and fluids."
C) "I shall only use salt when I am cooking my own food."
D) "I'll eat white bread to minimize gastrointestinal gas."

Question 9

A nurse cares for a client who is recovering after a nephrostomy tube was placed 6 hours ago.The nurse notes drainage in the tube has decreased from 40 mL/hr to 12 mL over the last hour.Which action should the nurse take?

A) Document the finding in the client's record.
B) Evaluate the tube as working in the hand-off report.
C) Clamp the tube in preparation for removing it.
D) Assess the client's abdomen and vital signs.

Question 10

A nurse reviews laboratory results for a client with glomerulonephritis.The client's glomerular filtration rate (GFR)is 40 mL/min as measured by a 24-hour creatinine clearance.How should the nurse interpret this finding? (Select all that apply.)

A) Excessive GFR
B) Normal GFR
C) Reduced GFR
D) Potential for fluid overload
E) Potential for dehydration

Question 11

A nurse assesses a client who is recovering from a radical nephrectomy for renal cell carcinoma.The nurse notes that the client's blood pressure has decreased from 134/90 to 100/56 mm Hg and urine output is 20 mL for this past hour.Which action should the nurse take?

A) Position the client to lay on the surgical incision.
B) Measure the specific gravity of the client's urine.
C) Administer intravenous pain medications.
D) Assess the rate and quality of the client's pulse.

Question 12

After teaching a client with renal cancer who is prescribed temsirolimus (Torisel),the nurse assesses the client's understanding.Which statement made by the client indicates a correct understanding of the teaching?

A) "I will take this medication with food and plenty of water."
B) "I shall keep my appointment at the infusion center each week."
C) "I'll limit my intake of green leafy vegetables while on this medication."
D) "I must not take this medication if I have an infection or am feeling ill."

Question 13

A nurse cares for a client with autosomal dominant polycystic kidney disease (ADPKD).The client asks,"Will my children develop this disease?" How should the nurse respond?

A) "No genetic link is known, so your children are not at increased risk."
B) "Your sons will develop this disease because it has a sex-linked gene."
C) "Only if both you and your spouse are carriers of this disease."
D) "Each of your children has a 50% risk of having ADPKD."

Question 14

An emergency department nurse assesses a client with kidney trauma and notes that the client's abdomen is tender and distended and blood is visible at the urinary meatus.Which prescription should the nurse consult the provider about before implementation?

A) Assessing vital signs every 15 minutes
B) Inserting an indwelling urinary catheter
C) Administering intravenous fluids at 125 mL/hr
D) Typing and crossmatching for blood products

Question 15

A nurse evaluates a client with acute glomerulonephritis (GN).Which manifestation should the nurse recognize as a positive response to the prescribed treatment?

A) The client has lost 11 pounds in the past 10 days.
B) The client's urine specific gravity is 1.048.
C) No blood is observed in the client's urine.
D) The client's blood pressure is 152/88 mm Hg.

Question 16

A nurse provides health screening for a community health center with a large population of African-American clients.Which priority assessment should the nurse include when working with this population?

A) Measure height and weight.
B) Assess blood pressure.
C) Observe for any signs of abuse.
D) Ask about medications.

Question 17

A nurse assesses a client with nephrotic syndrome.For which clinical manifestations should the nurse assess? (Select all that apply.)

A) Proteinuria
B) Hypoalbuminemia
C) Dehydration
D) Lipiduria
E) Dysuria

Question 18

A nurse assesses a client who is recovering from a nephrostomy.Which assessment findings should alert the nurse to urgently contact the health care provider? (Select all that apply.)

A) Clear drainage
B) Bloody drainage at site
C) Client reports headache
D) Foul-smelling drainage
E) Urine draining from site

Question 19

After teaching a client with nephrotic syndrome and a normal glomerular filtration,the nurse assesses the client's understanding.Which statement made by the client indicates a correct understanding of the nutritional therapy for this condition?

A) "I must decrease my intake of fat."
B) "I will increase my intake of protein."
C) "A decreased intake of carbohydrates will be required."
D) "An increased intake of vitamin C is necessary."

Question 20

An emergency department nurse cares for a client who is severely dehydrated and is prescribed 3 L of intravenous fluid over 6 hours.At what rate (mL/hr)should the nurse set the intravenous pump to infuse the fluids? (Record your answer using a whole number.)____ mL/hr