Chapter 25- Disorders of Renal Function

21. If a client with a kidney stone has the "classic" ureteral colic, the client will describe his pain as: Select all that apply. A) Acute, intermittent B) Diffuse over the entire lower back and legs C) Excruciating D) In the flank and upper outer quadrant of the abdomen

A) Acute, intermittent C) Excruciating D) In the flank and upper outer quadrant of the abdomen

11. A client has been recently undergone diagnostic testing for possible Berger disease. The nurse caring for this client would anticipate the primary clinical manifestations include which of the following? Select all that apply. A) Gross hematuria B) Recent upper respiratory infection C) Elevated ketone levels in the urine D) Fever, chills, and general body aches

A) Gross hematuria B) Recent upper respiratory infection D) Fever, chills, and general body aches

24. While taking a history from an adult client newly diagnosed with renal cell cancer, the nurse can associate which of the following high-risk factors with the development of this cancer? A) Heavy smoking B) Inherited renal disease C) Adrenal medulla tumors D) Anorexia/bulimia disorder

A) Heavy smoking

22. A client has recently undergone successful extracorporeal shock wave lithotripsy (ESWL) for the treatment of renal calculi. Which of the following measures should the client integrate into his lifestyle to reduce the risk of recurrence? A) Increased fluid intake and dietary changes B) Weight loss and blood pressure control C) Regular random blood glucose testing D) Increased physical activity and use of over-the-counter diuretics

A) Increased fluid intake and dietary changes

13. The most recent assessment of a client with a diagnosis of type 1 diabetes indicates a heightened risk of diabetic nephropathy. Which of the following assessment findings is most suggestive of this increased risk? A) Microalbuminuria B) Hematuria C) Orthostatic hypotension D) Diabetic retinopathy

A) Microalbuminuria

10. Following the diagnosis of nephrotic syndrome, the nurse knows the clinical manifestations occur as a result of a decreased plasma colloidal osmotic pressure. Therefore, the nurse should assess the client for: Select all that apply. A) Moist crackles in both lung fields B) Areas of diminished breath sounds due to pleural effusions C) Liver enlargement D) Kidneys palpable to deep palpation E) Increased circumference in the abdomen related to fluid excess

A) Moist crackles in both lung fields B) Areas of diminished breath sounds due to pleural effusions E) Increased circumference in the abdomen related to fluid excess

8. Following an episode of strep throat, the school nurse notices the fourth grade child has not recovered from this illness a week later. Upon further investigation, the nurse notices that the child has developed water retention. Which of the following assessments support this conclusion? Select all that apply. A) Periorbital edema B) BP 100/70 C) Swelling of the hands and fingers D) Vomiting after intake of any solid food E) Dizziness and right ear pain

A) Periorbital edema B) BP 100/70

14. Which of the following diagnostic and assessment results support the diagnosis of chronic pyelonephritis? Select all that apply. A) Polyuria (excess urine output) B) Nocturia (voiding at night) C) Bilateral flank pain D) Blood pressure 140/92 E) Severe pain in upper outer quadrant of the abdomen

A) Polyuria (excess urine output) B) Nocturia (voiding at night)

18. The most damaging effects of urinary obstruction are the result unrelieved obstruction of urine outflow and: A) Urinary stasis B) Concentrated urine C) Kidney hyperplasia D) Renal hypertension

A) Urinary stasis

3. Which of the following statements about the use of angiotensin-converting enzyme inhibitor medications and autosomal recessive polycystic kidney disease (ARPKD) is accurate? A) The use of ACE inhibitors will increase the vasopressin levels. B) ACE inhibitors may interrupt the renin-angiotensin-aldosterone system to reduce renal vasoconstriction. C) The ACE inhibitors have been shown to shrink the size of the cysts inside the kidneys. D) ACE inhibitors should be used strictly in those clients who also have an underlying cardiac history.

B) ACE inhibitors may interrupt the renin-angiotensin-aldosterone system to reduce renal vasoconstriction.

19. The physician suspects that a client with kidney stones has developed magnesium ammonium phosphate (struvite) stones based on which of the following urinalysis results? Select all that apply. A) Elevated uric acid levels B) Alkaline urine pH C) High urine phosphate level D) High bacterial count E) Presence of cystine particles

B) Alkaline urine pH C) High urine phosphate level D) High bacterial count

16. A client with a history of chronic pyelonephritis has been admitted several times with recurrent bacterial infection of the urinary tract. The nurse should anticipate educating this client with regard to which common treatment regimen? A) Increase intake of cranberry juice to 2 L/day. B) Continue taking antibiotics for full 10 to 14 days even if symptoms of infection disappear. C) Force micturition every 2 hours while awake. D) Take prescribed diuretics early in the day to avoid having to get up during the night.

B) Continue taking antibiotics for full 10 to 14 days even if symptoms of infection disappear.

25. Which of the following client clinical manifestations most clearly suggests a need for diagnostic testing to rule out renal cell carcinoma? A) Urinary urgency B) Hematuria C) Oliguria D) Cloudy urine

B) Hematuria

12. A 43-year-old female has recently been diagnosed with systemic lupus erythematosus (SLE) glomerulonephritis. She has presented to the out-client department to have a renal biopsy. Knowing the usual treatment options, the nurse should anticipate educating the client (who has a positive biopsy result) on which of the following medications being prescribed? Select all that apply. A) Lasix, a diuretic B) Prednisone, a corticosteroid C) Captopril, an ACE inhibitor D) Ampicillin, an antibiotic

B) Prednisone, a corticosteroid C) Captopril, an ACE inhibitor

9. Which of the following assessment findings would lead the nurse to suspect the client has nephrotic syndrome? A) Hematuria and anemia B) Proteinuria and generalized edema C) Renal colic and increased serum sodium D) Increased creatinine with normal blood urea nitrogen

B) Proteinuria and generalized edema

2. While taking a client history, which of the following assessments lead the nurse to suspect the client may have polycystic kidney disease? Select all that apply. A) Massive proteinuria on dipstick urine specimen B) Renal colic with flank pain C) Bright red blood in urine sample D) Elevated blood pressure of 180/94 E) Shortness of breath (SOB) with loud rhonchi and wheezes heard on auscultation

B) Renal colic with flank pain C) Bright red blood in urine sample D) Elevated blood pressure of 180/94

17. Prior to undergoing diagnostic testing with contrast, it is recommended that older adult clients have their creatinine level checked. The rationale for this is to ensure the client: A) Is not allergic to shell fish or iodine B) Will not undergo an acute kidney injury by decreasing renal blood flow C) Does not have a kidney stone obstructing the urethra D) Is in good enough health to withstand a walking on a treadmill

B) Will not undergo an acute kidney injury by decreasing renal blood flow

1. An adult client has been diagnosed with polycystic kidney disease. Which of the client's following statements demonstrates an accurate understanding of this diagnosis? A) "I suppose I really should have paid more attention to my blood pressure." B) "I've always been prone to getting UTIs, and now I know why." C) "I suppose I should be tested to see if my children might inherit this." D) "I had a feeling that I was taking too many medications, and now I know the damage they can do."

C) "I suppose I should be tested to see if my children might inherit this."

7. A child is recovering from a bout with group A β-hemolytic Streptococcus infection. They return to the clinic a week later complaining of decrease in urine output with puffiness and edema noted in the face and hands. The health care provider suspects the child has developed: A) Autosomal recessive polycystic kidney disease B) Adult-onset medullary cystic disease C) Acute postinfectious glomerulonephritis D) Acute nephritic syndrome

C) Acute postinfectious glomerulonephritis

5. Glomerulonephritis is usually caused by: A) Vesicoureteral reflux B) Catheter-induced infection C) Antigen-antibody complexes D) Glomerular membrane viruses

C) Antigen-antibody complexes

15. An elderly female client has been hospitalized for the treatment of acute pyelonephritis. Which of the following characteristics of the client is most likely implicated in the etiology of her current health problem? The client: A) Has been diagnosed with type 2 diabetes several years earlier B) Takes a diuretic and an ACE inhibitor each day for the treatment of hypertension C) Recently had a urinary tract infection D) Has peripheral vascular disease

C) Recently had a urinary tract infection

20. An obese, male client with a history of gout and a sedentary lifestyle has been advised by his primary care provider to avoid organ meats, certain fish, and other foods that are high in purines. The care provider is demonstrating an awareness of the client's susceptibility to which of the following types of kidney stones? A) Calcium stones B) Magnesium ammonium phosphate stones C) Uric acid stones D) Cystine stones

C) Uric acid stones

6. A client has been given the diagnosis of diffuse glomerulonephritis. They ask the nurse what diffuse means. The nurse responds: A) Only some of the glomeruli are affected. B) Only one segment of each glomerulus is involved. C) That the mesangial cells are being affected. D) All glomeruli and all parts of the glomeruli are involved.

D) All glomeruli and all parts of the glomeruli are involved.

23. A young child has been diagnosed with Wilms tumor after his mother discovered an unusual mass, prompting a diagnostic workup. Which of the following characteristics is typical of Wilms tumor? The tumor is usually: A) Asymptomatic B) Self-limiting C) A secondary neoplasm D) Encapsulated

D) Encapsulated

4. An infant has been diagnosed with autosomal recessive polycystic kidney disease (ARPKD). Which of the following treatment goals would be considered the priority in the care of this child? A) Rehydration therapy B) Total parenteral nutrition C) Prophylactic antibiotics D) Respiratory support

D) Respiratory support