Prep U Renal questions for Exam 2
What is the most common gram-negative bladder infection found in hospitalized clients?
Catheter-induced infection
A client diagnosed with chronic kidney disease (CKD) is experiencing nausea and vomiting. Which intervention would be most appropriate for the nurse to provide?
Restrict intake of dietary protein
Client reports that he occasionally has blood in his urine but has no pain with it.
"Frequency is not a major problem for the elderly."
A client with a diagnosis of end-stage renal disease received a kidney transplant 2 years ago that was deemed a success. During the most recent follow-up appointment, the nurse should prioritize the client for referral based on which statement?
"I'm feeling a bit under the weather these days and I'm a bit feverish."
A client is in cardiogenic shock following a massive myocardial infarction. The client's family asks the nurse, "Why are the health care providers recommending dialysis since its the heart that is sick?" Which response by the nurse is most appropriate at this time?
"When a person has a large heart attack and goes into shock due to heart failure, there is a decrease in renal perfusion which allows toxins to increase in the blood."
A client has been diagnosed with having calcium oxalate kidney stones following intravenous pyelography. Which teaching points about the treatment of the condition are justifiable? Select all that apply.
"You may need to cut out cocoa, chocolate and some nuts from your diet." "Extracorporeal shock-wave lithotripsy treatment may be used to fragment larger stones."
A client has undergone a kidney transplant and voices concerns about organ rejection to the nurse. The most appropriate response by the nurse would be:
"You will be given medication to decrease the likelihood of your immune system attacking your new kidney."
A new client on hemodialysis is watching his blood being filtered through a dialyzer. He asks the nurse how much blood typically passes through the kidney every minute? The nurse responds:
1000-1300 mL/minute
A geriatric nurse is caring for several clients. Which alterations in health should the nurse attribute to age-related physiologic changes?
A 78-year-old woman's GFR has been steadily declining over several years.
Which client is displaying manifestations of having a kidney stone?
Acute onset of colicky flank pain radiating to lower abdomen
A warehouse worker is experiencing trouble with incontinence, especially when lifting heavy objects. What intervention is most appropriate for this client's needs?
Administration of alpha-adrenergic agonist drugs as ordered
A client with a traumatic amputation of the lower leg has lost >40% of blood volume and is currently not producing any urine output. The nurse bases this phenomena on which humoral substance that is responsible for causing severe vasoconstriction of the renal vessels?
Angiotensin II and antidiuretic hormone
The nurse is caring for a client who has had acute blood loss from ruptured esophageal varices. What does the nurse recognize is an early sign of prerenal failure?
Baseline urine output of 50 mL/hr that is now 10 mL/hr
A client is concerned about the possibility of having bladder cancer after his brother was diagnosed with it 2 years ago. Which assessment data obtained by the nurse would indicate that the client should be screened for this disease?
Client reports that he occasionally has blood in his urine but has no pain with it.
A new client presents with elevated BUN, systemic edema, a BP of 145/93 mm Hg, recurrent infections, and a GFR of 51 mL/min/1.73 m2. Which treatment should the nurse anticipate?
Dialysis
The nurse is instructing a client with advanced kidney disease (AKD) about a dietary regimen. Which restriction should the nurse be sure to include in the treatment plan to decrease the progress of renal impairment in people with AKD?
Dietary protein
A client with chronic kidney disease (CKD) has developed asterixis. The nurse knows that asterixis is:
Dorsiflexion of hands and feet
Which procedure is a nonsurgical method of treatment for renal calculi (kidney stones)?
Extracorporeal shock wave lithotripsy (ESWL)
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 informs the nurse that she is afraid of developing bladder cancer because her mother had it. She asks the nurse what signs and symptoms are present with this cancer. What does the nurse tell the client is the most common sign of bladder cancer?
Gross hematuria
Which client's laboratory result would be associated with abnormalities in kidney function? Select all that apply.
Increased creatinine levels Detectable levels of glucose in a urine sample Elevated cystatin C level
In hemodialysis, access to the vascular system is most commonly through:
Internal arteriovenous fistula
Vitamin D metabolism is deranged in clients with chronic kidney disease (CKD). The nurse recognizes that which statement regarding vitamin D is correct?
Kidneys convert inactive vitamin D to its active form, calcitriol.
The nurse is providing dietary instruction for a client with chronic kidney disease (CKD) who is on hemodialysis. Which food would the nurse encourage the client to restrict?
Lean Meats
The nurse assesses a client with renal failure for encephalopathy caused by uremia. Which clinical manifestation will the nurse likely find?
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
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 diagnosed with Goodpasture syndrome would require which therapy to remove proteins and autoantibodies from the system?
Plasmapheresis
A client has an obstructive urine outflow related to benign prostatic hyperplasia. Due to the inability to excrete adequate amounts of urine, which type of renal failure should the nurse closely monitor for?
Postrenal failure
A client in renal failure has marked decrease in renal blood flow caused by hypovolemia, the result of gastrointestinal bleeding. The nurse is aware that this form of renal failure can be reversed if the bleeding is under control. Which form of acute renal injury does this client have?
Prerenal 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 nurse observes that a client's urine is cola colored and considers which factor as a possible reason?
The client's urine contains material from the degradation of red blood cells.
The nurse is caring for a client who has produced an average of 20 mL/hour for the previous day. The nurse recognizes this compares in which way to the normal urine output?
The kidneys should produce about 1.5 L of urine each day.
In the emergency department, a client arrives following a car accident. His pulse is 122; BP 88/60; respiration is 18 bpm. Urine output is 4 mL over the first hour on arrival. When in shock, this lower urine output is primarily due to:
innervation of the sympathetic nervous system, causing constriction of the afferent arteriole.
