Deck 62: Coordinating Care for Patients With Renal Disorders

Question 1

The nurse is providing care for a patient diagnosed with chronic kidney disease who is experiencing hyperkalemia.When planning meals for this patient,which choice would be most appropriate for this patient?

A) Hamburger on a bun,banana
B) Cold cuts with bun with fresh pears
C) Spaghetti and meat sauce,breadsticks
D) Carrots and green,leafy vegetables

Answer 1

Spaghetti and meat sauce,breadsticks

Question 2

The nurse is caring for a patient with chronic kidney disease who is pale and experiencing fatigue.The nurse attributes these symptoms to anemia secondary to chronic kidney disease.The patient's spouse asks why the patient is anemic.Which response by the nurse is the most appropriate?

A) "Your spouse has a genetic tendency for the development of anemia."
B) "The increased metabolic waste products in the body depress the bone marrow and cause anemia."
C) "There is a decreased production by the kidneys of the hormone erythropoietin,which is the cause of anemia."
D) "The patient is not eating enough iron-rich foods,which is causing anemia."

Answer 2

"There is a decreased production by the kidneys of the hormone erythropoietin,which is the cause of anemia."

Question 3

The nurse is providing education to a patient who is 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 most appropriate?

A) "Your cancer is limited to the renal capsule."
B) "Your cancer involves the perirenal fat but is confined to fascia with metastasis to the adrenal gland."
C) "Your cancer involves the regional lymph node,renal vein,and vena cava."
D) "Your cancer involves metastases to other sites in the body."

Answer 3

"Your cancer is limited to the renal capsule."

Question 4

The nurse is planning care for a patient with chronic kidney disease and osteoporosis.After reviewing the patient's medical record,which is the priority nursing diagnosis for this patient?

A) Anxiety
B) Disturbed Body Image
C) Risk for Injury
D) Risk for Bleeding

Question 5

The nurse is providing care to a patient who is diagnosed with renal trauma.The patient has a renal laceration that is greater than 1 cm in depth,but the laceration does not involve the collecting system.Which grade of renal trauma should the nurse document?

A) Grade 1
B) Grade 2
C) Grade 3
D) Grade 4

Question 6

During a home visit,the nurse is concerned that an older adult patient is developing chronic kidney disease.The patient has no history of cardiovascular disease.Which data in the patient's assessment caused the nurse to have this concern?

A) Progressive edema
B) Complaints of hip joint pain
C) Recent increase in hunger and thirst
D) Warm moist skin

Question 7

A young school-age patient is in the hospital with acute kidney injury following a streptococcus infection.The parents are Spanish-speaking and speak little English.The parents,through an interpreter,ask the nurse what mistake they made that caused the child to be so sick.Which response by the nurse is the most appropriate?

A) "Your child does not have enough dietary protein."
B) "Your child has a congenital defect that led to renal failure."
C) "Your child's renal failure has been caused by a low calcium level."
D) "Your child's recent infection may have caused the renal failure."

Question 8

The nurse is providing care to a patient who is diagnosed with renal trauma.The patient is experiencing hematuria and contusions but has normal imaging studies.Which grade of renal trauma should the nurse document?

A) Grade 1
B) Grade 2
C) Grade 3
D) Grade 4

Question 9

The nurse is administering peritoneal dialysis to a patient with acute kidney injury.The nurse notes the presence of a cloudy dialysate return.After notifying the health-care provider,which action by the nurse is the most appropriate?

A) Measure abdominal girth
B) Document the cloudy dialysate
C) Culture the dialysate return
D) Increase dialysate instillation

Question 10

The nurse is preparing to discharge a patient with chronic kidney disease.The nurse is teaching the patient and family about administering calcium acetate tablets by mouth with each meal at home.Which explanation about this medication is the most appropriate?

A) "The calcium acetate will lower your serum phosphate levels."
B) "The calcium acetate helps to neutralize your gastric acids."
C) "The calcium acetate will help to stimulate your appetite."
D) "The calcium acetate will decrease your serum creatinine levels."

Question 11

A nurse evaluating the therapeutic effect of the drug sodium polystyrene sulfonate (Kayexalate)for a patient diagnosed with chronic kidney disease.Which therapeutic effect from the medication does the nurse anticipate?

A) Decreased serum sodium
B) Increased stool excretion
C) Decreased urine specific gravity
D) Decreased serum potassium

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 most appropriate?

A) "Thickening of the kidney structures and gradual death of nephrons has caused this diagnosis."
B) "Cysts compress renal tissue that destroys the kidneys,causing this diagnosis."
C) "High blood pressure reduces renal blood flow and harms the kidney tissue,causing this diagnosis."
D) "Immune complexes form in the kidney tissue that causes inflammation,causing this diagnosis."

Question 13

The nurse is caring for a patient who is diagnosed with acute kidney injury.When reviewing the patient's laboratory data,which finding indicates that a patient has met the expected outcomes?

A) Decreasing serum creatinine
B) Decreasing neutrophil count
C) Decreasing lymphocyte count
D) Decreasing erythrocyte count

Question 14

The nurse is planning care for the patient with acute kidney injury.The nurse plans the patient's care based on the nursing diagnosis of Excess Fluid Volume.Which assessment data supports this nursing diagnosis?

A) Pitting edema in the lower extremities
B) Bowel sounds positive in four quadrants
C) Wheezing in the lungs
D) Generalized weakness

Question 15

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?

A) "No,don't think that.You're going to be fine."
B) "Your condition can be reversed with prompt treatment and usually will not destroy the kidney."
C) "Kidney transplantation is likely,and it would be a good idea to start talking to family members."
D) "When the doctor comes to see you,we can talk about whether you will need a transplant."

Question 16

The nurse is caring for an older adult patient diagnosed with chronic kidney disease.The patient reports no bowel movement in the past two days.Based on this data,which condition is the patient at an increased risk for developing?

A) Metabolic acidosis
B) Hypocalcemia
C) Increased serum creatinine levels
D) Hyperkalemia

Question 17

A patient with renal failure is receiving peritoneal dialysis.The nurse is explaining the process to the patient.Which statement would the nurse include in a discussion with the patient?

A) "The peritoneum is more permeable because of the presence of excess metabolites."
B) "The metabolites will diffuse from the interstitial space to the bloodstream mainly through diffusion and ultrafiltration."
C) "The peritoneum acts as a semipermeable membrane through which wastes move by diffusion and osmosis."
D) "The solutes in the dialysate will enter the bloodstream through the peritoneum."

Question 18

A patient with acute kidney injury is complaining of a metallic taste in the mouth and has no appetite.Based on this data,which intervention by the nurse is the most appropriate?

A) Provide mouth care before meals
B) Administer an antiemetic as prescribed
C) Restrict fluids
D) Encourage the intake of protein,salt,and potassium

Question 19

A patient agrees to receive long-term hemodialysis to treat chronic kidney disease.For which surgical procedure should the nurse instruct this patient?

A) Insertion of a double-lumen catheter into the subclavian artery
B) Placement of a peritoneal catheter
C) Insertion of a subarachnoid-peritoneal shunt
D) Placement of an arteriovenous fistula

Question 20

The nurse is caring for a patient from another country who was admitted with hypertension and chronic kidney disease.The patient is receiving hemodialysis three times a week.The nurse is assessing the client's diet,and the patient reports the use of salt substitutes.When teaching the patient to avoid salt substitute,which rationale supports this teaching point?

A) They will increase the risk of AV fistula infection.
B) They will cause the patient to retain fluid.
C) They will interact with the client's antihypertensive medications.
D) They can potentiate hyperkalemia.

Question 21

A patient with chronic kidney disease is experiencing manifestations of anemia.Based on this data,which treatment does the nurse anticipate for this patient?

A) Begin fluid restriction.
B) Administer intravenous glucose and insulin.
C) Begin a low-sodium diet.
D) Epoetin injections

Question 22

While caring for a patient with chronic kidney disease,the nurse tracks the patient's serum albumin level.For which nursing diagnosis is the action most indicated?

A) Excess Fluid Volume
B) Imbalanced Nutrition: Less Than Body Requirements
C) Risk for Ineffective Perfusion
D) Risk for Infection

Question 23

The nurse instructs a patient with chronic kidney disease on the prescribed medication furosemide (Lasix).Which patient statement indicates that teaching has been effective?

A) "I will take this medication to keep my calcium balance normal."
B) "This medication will make sure I have enough red blood cells in my body."
C) "I will take this pill to keep the protein level in my body stable."
D) "This pill will reduce the swelling in my body and get rid of the extra potassium."

Question 24

The nurse is providing care to a patient who may have polycystic kidney disease.Which is the first symptom the nurse should assess this patient for?

A) Hypertension
B) Hematuria
C) Urinary frequency
D) Urinary calculi

Question 25

The nurse is providing care to a patient diagnosed with polycystic kidney disease.Which assessment finding would indicate to the nurse that the patient is experiencing an infection?

A) Increased temperature
B) Increased blood pressure
C) Decreased white blood cell count
D) Decreased urine output