ATI GU

A RN is caring for a pt who has manifestations of ATN following a kidney transplantation. Which of the following interventions should the RN anticipate for this pt? A. Hemodialysis B. Biopsy C. Immunosuppression D. Balloon angioplasty E. Surgical repair

A, B, C Pts who develop ATN after transplantation surgery might need dialysis until they have adequate urine output and their BUN and Creatinine levels stabilize. Because the development of ATN after transplantation surgery miicsthe symptoms of rejection, pts have to undergo a biopsy to determine the correct diagnosis. Immunosuppressive medication therapy is essential after kidney transplantation to protect the new kidney.

A RN is providing teaching to a pt who has gout and urolithiasis. The pt asks how to prevent future uric acid stones. Which of the following suggestions should the RN provide? SATA A. Take allopurinol as prescribed B. Exercise several time a week C. Limit intake of foods high in purine D. Decrease daily fluid intake E. Avoid citrus juices

A. B. C. The Rn should inform the pt that allopurinol is an antigout medication that reduces uric acid, which helps prevent stones. Immobility is a risk factor, so they should be encouraged to maintain healthy lifestyle. Purines increase the risk of stones: organ meats, poultry, fish, red wine, and gravy are high in purine.

A RN is assessing a pt who is 1 wk postoperative following a living donor kidney transplant. Which of the following findings indicates the pt is experiencing acute kidney rejection? A. BP 160/90 mm/Hg B. Creatinine 0.8 mg/dL C. Sodium 137 mg/dL D. Urinary output 100mL/hr

A. BP 160/90mm/Hg Due to the kidneys role in fluid and blood regulation, a pt who is experiencing rejection can have hypertension.

A RN is providing dietary teaching to a pt who has late-stage CKD. Which of the following nutrients should the RN instruct the pt to increase in her diet? A. Calcium B. Phosphorus C. Potassium D. Sodium

A. Calcium A pt who has CKD can develop hypocalcemia due to the reduced production of active vitamin D, which is needed for calcium absorption. The pt should supplement dietary calcium.

A RN is monitoring a pt who is undergoing extracorpreal shockwave lithotripsy. The RN should identify that which of the following findings is the priority? A. Dysrhythmias B. Pink-tinged urine C. Bruising on the flank area D. Stone fragments in the urine

A. Dysrhythmias ESWL is the application of sound, laser, or dry shock wave energies to break a kidney stone into small peices. The shock waves are initiated during the R wave of the ECG to prevent dysrhythmias.

A RN is teaching a pt who has CKD. Which of the following instructions should the RN include? A. Limit fluid intake B. Limit caloric intake C. Eat a diet high in phosphorus D. Eat a diet high in protein

A. Limit fluid intake A Pt who has CKD should limit fluid intake to prevent hypervolemia.

A RN is checking the laboratory values of a pt who has CKD. The RN should expect elevations in which of the following values? A. Potassium and Magnesium B. Calcium and bicarbonate. C. Hemoglobin and Hematocrit D. Arterial pH and PaCO2

A. Potassium and Magnesium Pts who have CKD have hyperkalemia, hyperphosphatemia, and hypermagnesemia as well as elevations in creatinine and BUN.

A RN is teaching a pt with CKD about predialysis dietary recommendations. The RN should recommend restricting the intake of which of the following nutrients? A. Protein B. Carbohydrates C. Calcium D. Monounsaturated fats

A. Protein Dietary restrictions for pts who have CKD cary based on the degree of kidney function; however, most pts need protein limitations. Predialysis protein restriction can help preserve some kidney function.

A RN is caring for a pt who has a diagnosis of renal calculi and reports severe flank pain. Which of the following is the priority nursing action. A. Relieve the pts pain. B. Encourage the pt to increase fluid intake. C. Monitor the pts I & O D. Strain the pts urine.

A. Relieve the pts pain. Using the urgent-nonurgent framework, the pain associated with renal calculi is severe and can lead to shock, therefore, this is the priority action.

A RN is assessing a pt who has urolithiasis and reports a pain in his thigh. This finding indicates the stone is in which of the following structures? A. Ureter B. Bladder C. Renal pelvis D. Renal tubules

A. Ureter When stones are in the ureters, pain radiates to the genitalia and the thighs.

A RN is teaching a pt who has acute pyelonephritis. Which of the following instructions should the RN include in the teaching? A. You should complete the entire cycle of ABX therapy B. You should maintain on bedrest until manifestations decrease C. You should drink 1L of fluid per day D. You should avoid NSAIDs for pain

A. You should complete the entire cycle of antibiotic therapy. The pt should take the full Rx of ABX therapy to decrease the chance of regrowth of the causative organism.

A RN is caring for a pt who is in the oliguric-anuric stage of AKI. The pt reports diarrhea, a dull headace, palpitations, and muscle tingling and weakness. Which of the following actions should the nurse take FIRST? A. Adminster an analgesic to the pt B. Check the pts electrolyte values C. Measure the pts weight. D. Restrict the pts protein intake

B. Check the pts electrolyte values The Rn should check the most recent potassium value because these findings are manifestations of hyperkalemia, which can lead to cardiac dysrhythmias.

a RN is conducting a dietary teaching with a pt who has a history of renal calculi. Which of the following instructions should trhe RN include in the teaching? A. Consume foods containing vitamin C. B. Drink 3.8L of water throughout the day. C. Suggest almonds a snack. D. Limit sodium intake to 3g/day

B. Drink 3.8L of water throughout the day. The RN should instruct the pt to drink 3.8L of water per day to keep the urine diluted and decrease the risk of kidney stone formation.

A RN is providing dietary teaching to a pt who has chronic renal failure. Which of the following food choices by the pt indicates an understanding of the teaching? A. Canned Soup B. Grilled Fish C. Pastrami D. Peanut butter

B. Grilled fish Protein choices, such as fresh fish or poultry, can minimize the risk of worsening chronic renal failure.

A RN is reviewing the lab report of a pt who has CKF. The RN finds the following results: Potassium 6.8, Calcium 7.4, Hgb 10.2, Phosphate 4.8. Which of the following is the priority for the RN to report to the provider? A. Hypocalcemia B. Hyperkalemia C. Anemia D. Hypoalbuminemia

B. Hyperkalemia Hyperkalemia, which can cause life-threatening cardiac dysrhythmias, is the priority for the RN to report to the provider.

A female pt who has recurrent cystitis asks the RN about preventing future episodes. For which of the following pt statements should the RN provide further teaching? A. I drink at least 2L of fluid per day B. I prefer taking tub baths to showering C. I urinate before and after sexual relations D. I wipe from front to back after urinating.

B. I prefer taking tub baths to showering. Cystitis is an inflammation of the bladder lining that commonly occurs with a UTI. Women who are at risks for UTIs should avoid tub baths because they increase the risk of infection. The nurs should recommend taking showers instead of tub baths.

A RN is preparing an in-service program about the stages of AKI. Which of the following pieces of information should the RN include about prerenal azotemia? A. Prerenal azotemia begins prior to the onset of symptoms. B. Interference with renal perfusion causes prerenal azotemia. C. Prerenal azotemia is irreversible, even in the early stages. D. Infections and tumors cause prerenal azotemia.

B. Interference with rnal perfusion causes prerenal azotemia. Prerenal azotemia results from interference with renal perfusion, such as from heart failure or hypovolemic shock.

A RN is preparing a pt who is scheduled for an IVP. Which of the following findings should the nurse report to the provider? A Allergy to egg products. B. Vomiting and diarrhea for the last 6 hours. C. Serum Potassium of 3.6mEq/L D. Serum Creatinine of 1.2mg/dL

B. Vomiting and diarrhea for the last 6 hours. Vomiting and diarrhea for 6 hours deplete the pts fluid volume, which results in dehydration that can case renal failure following a procedure that uses contrast dye. Therefor, the RN should notify the provider.

A RN is teaching a newly licensed RN about caring for a pt who has a new left arteriovenous fistula. Which of the following statements should the RN make? A. "Check the fistula site daily for a vibration." B. "Instruct the pt to restrict movement of his left arm." C. "Avoid taking a BP on the pts left arm." D. "Instruct the pt to sleep on his left side."

C. Avoid taking BP on left arm. The Rn should avoid taking BP measurements on the left arm, as this can decrease blood flow and cause clotting.

A RN is caring for a pt who had a nephrostomy tube inserted 8 hours ago. Which of the following actions should the RN include in the pts plan of care. A. Flush the nephrostomy tube every 4 hours with sterile saline B. Clamp the nephrostomy tube intermittently to establish continence C. Check the skin at the nephrostomy site for irritation from urine leakage D. Monitor for an report any blood-tinged drainage to the provider immediately

C. Check the skin at the site for irritation from urine leakage The RN should monitor the pt for complications, impairment of skin integrity and tube obstruction. The RN should use the aseptic technique for dressing changes and encourage oral intake but should never clamp or irrigate the tube without a specific prescription to do so.

A RN is providing teaching to a young pt who has a hx of calcium oxalate renal calculi. Which of the following instructions should the RN include? A. "Drink fruit punch or juice with every meal." B. "Consume 1,000mg of dietary calcium daily." C. "Take 1g of Vitamin C daily. D. "Increase your daily bran intake."

C. Consume 1000mg of dietary calcium daily. Pts who are prone to the development of calcium oxalate stones should consume the recommended daily allowance of calcium for their age.

A RN is caring for a pt who has just returned from the surgical suite following a right nephrectomy. Which of the following indicates that the pt is meeting a successful short-term goal following the procedure? A. The pt request pain medication upon arrival from surgery. B. A CXR shows consolidation in the right lower lobe C. Urinary output is 35 to 50mL/hr consistently D. The pt has slight abd distension

C. Urinary output is 35-50mL/hr consistently

A RN is providing teaching to a pt who is preoperative for renal biopsy. Which of the following statements should the RN make? A. You will be NPO for 8 hours following procedure. B. An allergy to shellfish is a contraindication to the procedure. C. You will be on bedrest following the procedure. D. A creatinine clearance is needed prior to the procedure.

C. You will need to be on bedrest following the procedure. A renal biopsy involves a tissue biopsy through needle insertion into the lower lobe of the kidney. The pt should maintain bed rest in a supine position with a back roll for support for 2-24 hours following the procedure to reduce the risk of bleeding. The RN can elevate the head of the bed.

A RN is teaching a pt who is preoperative for a cystoscopy. Which of the following statements should the RN make? A. You will need to keep the sutures clean after the procedure. B. You will be placed on your left side for this procedure. C. Expect to be on bed rest for 24 hours after this procedure. D. Expect to have pink-tinged urine after this procedure.

D. Expect to have pink-tinged urine after this procedure. A cystoscopy is a procedure in which a scope is inserted into the urethra to diagnose or treat bladder problems. Following the procedure, pink-tinged urine is expected.

A RN is reviewing the lab findings of a pt who has chronic kidney disease. The pt reports significant persistent nausea and muscle weakness. Which of the following findings should the RN expect? A. Hypernatremia B. Hypomagnesemia C. Hypercalcemia D. Hyperkalemia

D. Hyperkalemia A pt who has CKD can have hyperkalemia, which is a potassium level greater than 5.0mEq/L. The expected reference range is 3.5-5.0mEq/L. Other manifestations of hyperkalemia can include palpitations, dysrhythmias, nausea, and muscle weakness.

A RN is assessing a pt who has AKI. According to the RIFLE classification system, which of the following findings indicates that the pt has end-stage kidney disease? A. < 0.5mL/kg of urine for 12 hours. B. No urine output for 12 hours C. No urine output without renal replacement therapy for 4-12 weeks. D. No urine output without renal replacement therapy for more than 3 months.

D. No urine output without renal replacement therapy for more than 3 months. In the RIFLE classification, R stands for Risk, I stands for Injury, F stands for Failure, L stands for Loss, and E stands for End-stage kidney disease. No urine output without renal replacement therapy for more than 3 months indicates end-stage kidney disease.