Chapter 33 Pathophysiology NCLEX-Style Review Questions

A nurse is assessing a client's risk for developing a hospital-acquired urinary tract infection (UTI) and determines that which of the following places the client at greatest risk? -Increased sexual activity -Prostate enlargement -Indwelling urinary catheter -Impaired bladder emptying

Indwelling urinary catheter

Several clients in clinic today are reporting urinary signs/symptoms. Which reported manifestation(s) leads the health care provider to suspect acute pyelonephritis? Select all that apply. -Shortness of breath -Urinary urgency and frequency -Heart palpitations -Abrupt onset of fever and chills -Flank pain in the back

Urinary urgency and frequency, Abrupt onset of fever and chills, Flank pain in the back

A nurse's neighbor is experiencing some odd symptoms, and asks the nurse about them. The neighbor states having blood in the urine intermittently and thinks there is a lump in the back (where kidney is located). What advice is most appropriate for the nurse to relay to this neighbor? -"Try drinking more water and see if the symptoms go away." -"See if your health care provider will prescribe some antibiotics for you." -"Make an appointment with your health care provider immediately." -"Do you think you might have a kidney infection?"

"Make an appointment with your health care provider immediately."

A 34-year-old woman presents with an abrupt onset of shaking chills, moderate to high fever, and a constant ache in her lower back. She is also experiencing dysuria, urinary frequency, and a feeling of urgency. Her partner states that she has been very tired the last few days and that she looked like she may have the flu. What is the most likely diagnosis? -Renal calculi -Acute renal failure -Renal cell carcinoma -Acute pyelonephritis

Acute pyelonephritis

Which clinical manifestations would you expect to see in an infant diagnosed with autosomal recessive polycystic kidney disease (ARPKD)? -Elevated systemic blood pressure and severe pain -Ascending urinary tract infection and vomiting -Bilateral flank masses and impaired lung development -Gross hematuria and massive generalized edema

Bilateral flank masses and impaired lung development

A school nurse is teaching a group of fourth-grade girls about personal hygiene. Important teaching points aimed at reducing the incidence of urinary tract infection (UTI) include which of the following? Select all that apply. -Daily tub baths -Careful hand washing -Wiping from front to back after a bowel movement -Avoiding bubble baths

Careful hand washing, Wiping from front to back after a bowel movement, Avoiding bubble baths

Which factor contributes to the development of polycystic kidney disease? -A reduction in prerenal blood flow to the kidneys -Enlargement in the basement membrane of the kidney -Hereditary mutations in polycystin I and II -Multiple recurrent urinary tract infections

Hereditary mutations in polycystin I and II

A nurse is caring for a client who has a recent history of passing calcium urinary stones. Which of the following is a priority nursing consideration for this client? -Bowel elimination -Bed rest -Skin care -Hydration

Hydration

The nurse is planning care for a client with a urinary tract obstruction. The nurse includes assessment for which possible complication? -Increased blood pressure -Diluted urine -Decreased blood pressure -Polyuria

Increased blood pressure

The nurse is evaluating the urinalysis results of a client presenting with polyuria and lower abdominal pain due to a suspected urinary tract infection. Which finding should the nurse expect? -Increased nitrates -Solid formations -Positive glucose -Specific gravity of 1.025

Increased nitrates

Wilms tumor is a tumor of childhood. It is usually an encapsulated mass occurring in any part of the kidney. What are the common presenting signs of a Wilms tumor? -Vomiting and oliguria -Large asymptomatic abdominal mass and hypertension -Hypotension and a large abdominal mass -Abdominal pain and diarrhea

Large asymptomatic abdominal mass and hypertension

A nurse is caring for a client diagnosed with nephrotic syndrome. The nurse is aware that the client may manifest which of the following? Select all that apply. -Lipiduria -Hyperlipidemia -Hyperalbuminemia -Generalized edema -Massive proteinuria (>3.5 g/day)

Lipiduria, Hyperlipidemia, Generalized edema, Massive proteinuria (>3.5 g/day)

A client admitted with acute pyelonephritis has shaking chills and acute pain. What other clinical manifestations will the nurse likely assess for this diagnosis? Select all that apply. -Pale skin and dry mucous membranes -Moderate to high fever -Change in level of consciousness and hallucinations -Shallow breathing and expiratory wheezes -Frequency, urgency, and dysuria

Moderate to high fever, Frequency, urgency, and dysuria

A client diagnosed with Goodpasture syndrome would require which therapy to remove proteins and autoantibodies from the system? -Kidney removal -Plasmapheresis -Intravenous calcium -Renal transplant

Plasmapheresis

A client has recently been diagnosed with systemic lupus erythematosus (SLE) glomerulonephritis. Knowing the treatment options, the nurse should anticipate educating the client (who has a positive renal biopsy result) on which medications usually prescribed? Select all that apply. -Prednisone, a corticosteroid -Captopril, an ACE inhibitor -Ampicillin, an antibiotic -Furosemide, a diuretic

Prednisone, a corticosteroid, Captopril, an ACE inhibitor

A nurse is caring for a child with Wilms tumor, stage I. Which statements are true regarding this diagnosis? Select all that apply. -Prognosis is good with treatment. -Prognosis is poor even with treatment. -The tumor is limited to the kidney and can be excised with the capsular surface intact. -The tumor has undergone hematogenous metastasis, most commonly involving the lung.

Prognosis is good with treatment., The tumor is limited to the kidney and can be excised with the capsular surface intact.

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

Respiratory support

One form of renal tubular acidosis (RTA) results from aldosterone deficiency or resistance to its action, which leads to impaired reabsorption of which electrolyte? -Potassium -Sodium -Hydrogen -Glucose

Sodium

The nurse is reviewing the lab results of a client with suspected nephrotic syndrome. The nurse anticipates the results to include: -serum hyperalbuminemia. -decreased tryglycerides. -decreased low-density lipoproteins. -protein in the urine. -abnormal blood clotting factors.

protein in the urine.

The nurse recognizes the most common cause of acute postinfectious glomerulonephritis as: -uncontrolled diabetes with increased proteinuria. -drug-induced damage to the renal glomeruli. -a streptococcal infection 7 to 12 days prior to onset. -prolonged blockage of the ureter with a stone.

a streptococcal infection 7 to 12 days prior to onset.