Patho Chapter 26 Review Questions

A client is being treated for chronic kidney disease (CKD). One of the nurse's responsibilities is to explain to the client the need to keep her blood pressure under control. Why is blood pressure control so important in CKD clients?

Elevated blood pressure will exacerbate nephron loss and accelerate renal failure.

A 35-year-old client is diagnosed with acute kidney injury (AKI) and is started on hemodialysis. The client is concerned with the diagnosis and wants to know what to expect in the progression of this disorder. Which statement best addresses the client's concern?

"Acute kidney injury is abrupt in onset and often reversible if recognized early and treated appropriately."

The nurse knows that a patient with chronic kidney disease (CKD) may experience which of the following changes in skin integrity? Select all that apply.

- decreased perspiration - brittle fingernails - pale skin

Which of the following have the potential to cause chronic kidney disease? Select all that apply

- hypertension - diabetes - glomerulonephritis

Which clinical finding among older adults is most likely to be viewed as a normal part of age-related changes?

78 year-old female whose GFR has been steadily declining over several years.

The primary care provider for a newly admitted hospital client has added the glomerular filtration rate (GFR) to the blood work scheduled for this morning. The client's GFR results return as 50 mL/minute/1.73 m2. The nurse explains to the client that this result represents:

A loss of over half the client's normal kidney function

A client with a history of chronic kidney disease (CKD) is experiencing increasing fatigue, lethargy, and activity intolerance. The care team has established that the client's glomerular filtration rate (GFR) remains at a low, but stable, level. Which laboratory assessments will most likely be prescirbed to help determine the cause of these new symptoms?

Blood work for hemoglobin, red blood cells, and hematocrit

An 80-year-old client with diabetes has a GFR of 41 mL/min/1.73 m2. His physical and workup show uremia, azotemia, and elevated BUN. Which action should be done first to slow the decline of his kidney function?

Control blood glucose and blood pressure

Which dermatological problems most often accompanies chronic kidney disease (CKD)?

Dry skin and pruritus

A client with chronic kidney disease (CKD) has developed asterixis. The nurse knows that asterixis is which of the following?

Dorsiflexion of hands and feet

The health care provider is reviewing laboratory results of a client. Select the diagnostic test that is considered the best measurement of overall kidney function.

Glomerular filtration rate (GFR)

A client sustained acute tubular injury approximately 2 hours ago. Which cause of acute kidney injury would the nurse suspect the client is experiencing?

Intrarenal

Vitamin D metabolism is deranged in clients with chronic kidney disease (CKD). The nurse recognizes that which of the following statements regarding vitamin D is correct?

Kidneys convert inactive vitamin D to its active form, calcitriol

The nurse assessing a renal failure client for encephalopathy caused by uremia may observe which clinical manifestations?

Loss of recent memory and inattention

The health care provider has prescribed an aminoglycoside (gentamicin) for a client. The nurse is aware that the client is at risk for:

Nephrotoxic acute tubular necrosis

The client with substance use disorder was found unconscious after overdosing on heroin 2 days prior. Because of prolonged pressure on the muscles the client has developed myoglobinuria causing which complication?

Obstruction of the renal tubules with myoglobin and damage tubular cells

A client with postrenal acute kidney injury (AKI) exhibits oliguria and edema with laboratory results revealing increased levels of urea, potassium, and creatinine. Based on these data, which phase of AKI is this client most likely experiencing?

Oliguric phase

A client is diagnosed with a tumor in the urinary bladder. The nurse will monitor the client for which of the following?

Postrenal failure

The nurse recognizes that acute renal injury is characterized by which of the following?

Rapid decline in renal function

The GFR is considered to be the best measure of renal function. What is used to estimate the GFR?

Serum creatinine

A 45-year-old female is being treated for ovarian cancer. Her treatment involves the chemotherapy agent cisplatin. The nurse should monitor the client for signs and symptoms of:

nephrotoxic acute tubular necrosis (ATN)