In class test questions Exam 4

Mr. K has been admitted with a potential diagnosis of Nephritic Syndrome. Prednisone is prescribed for Mr. K. The nurse can evaluate its effectiveness by which of the following interventions?

Checking his urine for increased protein

The nurse is educating a client who is required to restrict potassium intake. What foods would the nurse suggest the client eliminate that are rich in potassium?

Citrus fruits

A client has undergone creation of an ileal conduit. Which of the following instructions to the client about urostomy care would be appropriate to include in the teaching plan?

Cleanse the skin around the stoma using gentle soap and water, rinse and dry well

Which of the following would the nurse expect to find when reviewing the laboratory test results of a client with renal failure?

Increased serum creatinine level

A client on your unit with Chronic Renal Failure has been prescribed Calcium Carbonate. What rationale is correct for why the patient is being given this medication?

It is a phosphate binder

A client with chronic renal failure comes to the clinic for a visit. During the visit, he complains of pruritus. Which suggestion by the nurse would be most appropriate?

Keep your showers brief, patting your skin dry after showering."

You are caring for a patient with acute renal failure. What is the most common clinical manifestation of acute renal failure?

Oliguria

What disease of the kidney is genetic in nature and leads to kidney failure?

Polycystic kidney disease

A client is scheduled for a CT scan of the abdomen with contrast. The client has a baseline creatinine level of 2.3 mg/dL (203 µmol/L). In preparing this client for the procedure, the nurse anticipates what orders?

Preprocedure hydration and administration of acetylcysteine

A nurse is caring for a client who has received hemodialysis. The nurse should identify that which of the following findings places the client at risk for seizures?

hypokalemia

The nurse is planning client teaching for a client with end-stage kidney disease who is scheduled for the creation of a fistula. The nurse should teach the client what information about the fistula?

"A vein and an artery in your arm will be attached surgically."

A 45-year-old man with diabetic nephropathy has end-stage renal disease and is starting dialysis. What should the nurse teach the client about hemodialysis?

"Hemodialysis is a treatment option that is usually required three times a week."

A patient is receiving patient education prior to beginning continuous ambulatory peritoneal dialysis. What would the nurse teach the patient that the most common complication associated with this procedure is?

-Blood Loss -Dehydration

The nurse is caring for a patient with a medical history of untreated CKD that has progressed to ESKD. Which of the following serum values and associated signs and symptoms will the nurse expect the patient to exhibit? Select all that apply.

-Calcium 7.5 mg/dL; hypotension and irritability -Potassium 6.4 mEq/L; dysrhythmias and abdominal distention -Phosphate 5.0 mg/dL; tachycardia and nausea and emesis

1 L of D5NS is to be infused in 6 hours by infusion pump. At what hourly rate will the nurse set the infusion pump?

167

The critical care nurse is monitoring her patient's urine output and drainage from tubes inserted intraoperatively two hours prior. What would the nurse promptly report to the physician?

Absent drainage

In chronic renal failure (end stage renal disease), decreased glomerular filtration leads to which of the following?

All of the above (Increased UN, decreased creatinine clearance, increased urine pH)

A client is admitted to the hospital with a prerenal disorder, a nonurologic condition that disrupts renal blood flow to the nephrons, affecting their filtering ability. One cause of prerenal acute kidney injury is:

Anaphylaxis

Which of the following is an expected finding in the client with chronic renal failure?

Anemia

Which of the following problems is expected in a client who is in end-stage renal failure?

Anemia

A client was playing softball and was hit in the right ankle by the ball sustaining a contusion. What is the first action taken to help alleviate pain and swelling?

Apply a cold pack to the ankle

A 52-year-old patient is scheduled to undergo ileal conduit surgery. The patient has several appropriate questions. What would be the most appropriate nursing diagnosis for this patient?

Deficient knowledge related to care of the ileal conduit

The nurse is caring for acutely ill client. What assessment finding should prompt the nurse to inform the physician that the client may be exhibiting signs of acute kidney injury (AKI)?

The client's average urine output has been 10 mL/hr for several hours.

A client on the medical unit has a documented history of polycystic kidney disease (PKD). What principle should guide the nurse's care of this client?

The client's disease is incurable and the nurse's interventions will be supportive

A nurse is caring for an 85-year-old patient experiencing urinary incontinence. This nurse is aware that:

Urinary incontinence is not a consequence of aging

The nurse is working on the renal transplant unit. To reduce the risk of infection in a client with a transplanted kidney, it is imperative for the nurse to do what?

Wash hands carefully and frequently

A nurse is caring for a client who has acute glomerulonephritis. The nurse should plan to provide which of the following interventions?

Weigh the client daily

Which of the following is the most accurate indicator of fluid loss or gain?

Weight

You are the nurse working with a patient who has been told they have end stage renal disease. They have voiced wishes to not be treated with dialysis. Which of the following would be an important question to ask them early in the planning phase?

Where would you prefer to receive your careee, and symptom management support

The nurse is caring for a client with a history of systemic lupus erythematosus who has been recently diagnosed with end-stage kidney disease (ESKD). The client has an elevated phosphorus level and has been prescribed calcium acetate to bind the phosphorus. The nurse should teach the client to take the prescribed medication at what time?

With each meal

Which of the following anti-hypertensive medications is contraindicated for clients with renal insufficiency?

angiotensin-converting enzyme inhibitors

the client with chronic renal failure is undergoing peritoneal dialysis. He asks why the nurse monitors his blood glucose levels. Which of the following will be the most appropriate response by the nurse?

the dialysate contains glucose

A client is admitted to the ICU after a motor vehicle accident. On the second day of the hospital admission, the client develops acute kidney injury. The client is hemodynamically unstable, and renal replacement therapy is needed to manage the client's hypervolemia and hyperkalemia. Which of the following therapies will the client's hemodynamic status best tolerate?

Continuous venovenous hemodialysis (CVVHD)

Which term refers to a blunt force injury to soft tissue?

Contusion

Which of the following labs is a major sensitive indicator of kidney disease?

Creatinine Clearance

A client has presented with signs and symptoms that are characteristic of acute kidney injury, but preliminary assessment reveals no obvious risk factors for this health problem. The nurse should recognize the need to interview the client about what topic?

Current medication use

A client with end-stage kidney disease is scheduled to begin hemodialysis. The nurse is working with the client to adapt the client's diet to maximize the therapeutic effect and minimize the risks of complications. The client's diet should include which of the following modifications? Select all that apply.

Decreased protein intake Decreased sodium intake Fluid restriction

A nurse is caring for a renal patient in the diuresis period of ARF. What must the patient be observed closely for during this phase?

Dehydration

During hemodialysis, toxins and wastes in the blood are removed by which of the following?

Diffusion

The client with chronic renal failure is exhibiting signs of anemia. Which is the best nursing rationale for this symptom?

Diminished erythropoietin production

A nurse is inspecting the area of contusion and notes numerous areas of bruising. How would the nurse document this finding?

Ecchymosis

The nurse is caring for a patient with an indwelling urinary catheter. The nurse is aware that what nursing action helps prevent infection in a patient with an indwelling catheter?

Empty the drainage bag at least every 8 hours

A client is being treated for AKI and the client daily weights have been ordered. The nurse notes a weight gain of 3 pounds (1.4 kg) over the past 48 hours. What nursing diagnosis is suggested by this assessment finding?

Excess fluid volume

A client admitted with nephrotic syndrome is being cared for on the medical unit. When writing this client's care plan, based on the major clinical manifestation of nephrotic syndrome, what nursing diagnosis should the nurse include?

Excess fluid volume related to generalized edema

The nurse is caring for a female patient who underwent a kidney transplant. The patient appears anxious and tearful and states "My body is going to reject the new kidney; I know I'm going to die." Which of the following is the best response by the nurse?

"I understand your concerns, let's talk about them."

An 84-year-old woman diagnosed with cancer is admitted to the oncology unit for surgical treatment. The client has been on chemotherapeutic agents to decrease the tumor size prior to the planned surgery. The nurse caring for the client is aware that what precipitating factors in this client may contribute to AKI? Select all that apply.

-Age-related physiologic changes -Chronic systemic disease

The nurse is caring for a client who has just returned to the postsurgical unit following renal surgery. When assessing the client's output from surgical drains, the nurse should assess what parameters? Select all that apply

-Hyperkalemia -Anemia -Hypocalcemia

The nurse is caring for a postoperative kidney surgery patient. The nurse is aware that bleeding is a major complication of kidney surgery, and that if it goes undetected and untreated the result can be hypovolemia and hemorrhagic shock in the patient. What assessment parameters are necessary to assess for bleeding in this postoperative patient?

-LOC -Skin Condition -Urinary Drainage system

The RICE acronym is helpful for remembering treatment interventions for musculoskeletal injuries. Which of the following are components of the RICE acronym? Select all that apply.

-Rest -Ice -Compression -Elevation

A patient with cancer of the bladder has just returned to the unit from the PACU after surgery to create an ileal conduit. The nurse is monitoring the patient's urine output hourly and notifies the physician when the hourly output is less than what?

30 mL/hr

Order: Rocephin 1 g IV every 12 hours over 30 minutesAvailable: Rocephin 1 g in 150 mL NS.At what rate would you set your pump?_______________

300

Administer an IV piggyback of 150 mL over 30 minutes. The drip factor is 10 gtt/mL. How many gtt/min will you infuse?_

50

A nurse is discussing dialysis with the students. The nurse should identify that hemodialysis is contraindicated for which of the following clients?

A client who cannot receive anticoagulants

The nurse coming on shift on the medical unit is taking a report on four clients. What client does the nurse know is at the greatest risk of developing ESKD?

A client with diabetes mellitus and poorly controlled hypertension

Which nursing diagnosis is the most appropriate for a client with a strained ankle?

Impaired physical mobility

A client with end-stage renal disease receives continuous ambulatory peritoneal dialysis. The nurse observes that the dialysate drainage fluid is cloudy. What is the nurse's most appropriate action?

Inform the health care provider and assess the client for signs of infection.

The nurse is teaching the client to perform peritoneal dialysis. The nurse reviews in detail which essential action that will help to prevent the major complication of peritoneal dialysis?

Maintain strict aseptic technique during connection and disconnection

The kidneys are responsible for performing all of the following functions EXCEPT?

Maintaining cortisol production

A nurse is assessing a client who has chronic kidney disease and has completed her third peritoneal dialysis treatment. Which of the following should the nurse report to the provider?

Cloudy dialysate

In a client with a dislocation, the nurse should initially perform neurovascular assessments a minimum of every 15 minutes until stable. Which complication does the assessments help the nurse to monitor?

Compartment syndrome

A newly licensed nurse and a preceptor are caring for a client who has just had a shunt placed in their left arm. Which of the following actions by the new nurse requires intervention by the preceptor?

Measuring the blood pressure in the shunted arm every 4 hours

The emergency department nurse teaches clients with sports injuries to remember the acronym PRICE. This acronym stands for which combination of treatments?

Protection, rest, ice, compression, elevation

A 55-year-old male patient is admitted to the medical-surgical unit with a presumptive diagnosis of renal stones. While assessing the patient you note increased tenderness over the costovertebral area. The patient complains of increased pain and nausea, and then has an episode of vomiting. You know that these symptoms are indicative of what?

Renal Colic

A client sprains an ankle while playing tennis and is brought to the emergency department. What is the priority action by the nurse?

Rest, ice, compression, and elevation

The nurse would evaluate serum and urine levels of glucose because diabetes is the primary cause of renal failure

Serum glucose

The nurse is providing a health education workshop to a group of adults focusing on cancer prevention. The nurse should emphasize what action in order to reduce participants' risks of renal carcinoma?

Smoking cessation

A client has a glomerular filtration rate (GFR) of 43 mL/min/1.73 m2. Based on this GFR, the nurse interprets that the client's chronic kidney disease is at what stage?

Stage 3

A nurse is caring for a patient following lithotripsy to treat their chronic kidney stones. Which of the following actions is appropriate for the nurse to take?

Strain all of the clients urine

A 15-year-old is admitted to the renal unit with a diagnosis of postinfectious glomerular disease. The nurse should recognize that this form of kidney disease may have been precipitated by what event?

Streptococcal infection

A 42-year-old woman comes to the clinic complaining of intermittent urinary incontinence when she sneezes. The clinic nurse is aware this is what type of incontinence?

Stress incontinence

Your Patient is being discharged on Fosomax, a Biophosphonate. During Discharge teaching, you know that the most important instruction to give the patient is:

Take in the morning with a full glass off water

The nurse is caring for a client receiving hemodialysis three times weekly. The client has had surgery to form an arteriovenous fistula. What is most important for the nurse to be aware of when providing care for this client?

Taking a BP reading on the affected arm can damage the fistula.

The nurse is caring for a patient receiving hemodialysis treatments. The patient has had surgery to form an arteriovenous fistula. What is most important for the nurse to be aware of when providing care for this patient?

Taking blood pressure reading on the affected arm can cause clotting of the fistula

A client who has suffered a compound fracture is preparing for discharge to home. During the teaching session, the client asks why he needs antibiotics for a broken bone. Which response by the nurse is most appropriate?

"Antibiotic therapy has been prescribed as a precaution because your bone was exposed to the environment at the time of your injury."

Mrs. M has been admitted to the medical unit with a tentative diagnosis of Nephrotic Syndrome. Mrs. M's potential for impairment of skin integrity is related to

Bilirubin excess and jaundice

The nurse is caring for a client with acute glomerular inflammation. When assessing for the characteristic signs and symptoms of this health problem, the nurse should include which assessments? Select all that apply.

Assess the client's BP Assess for the presence of peripheral edema

The nurse is caring for a client postoperative day 4 following a kidney transplant. When assessing for potential signs and symptoms of rejection, what assessment should the nurse prioritize?

Assessment of the quantity of the client's urine output

Which of the following is a term used to describe excessive nitrogenous waste in the blood, as seen in acute glomerulonephritis?

Azotemia

An 82-year-old female is brought to the clinic by her daughter for transient episodes of incontinence. While assessing this patient, what question should be a priority for the nurse to ask the patient and the family?

Has there been a change in other systems of the body?

The nurse is caring for a client whose acute kidney injury has prerenal cause. What most likely caused this client's health problem?

Heart failure

A nursing instructor is talking with her clinical group about patients with acute glomerulonephritis. The instructor tells the students that the patient may exhibit which of the following clinical manifestations?

Hematuria

The nurse is assessing a client suspected of having developed acute glomerulonephritis. The nurse should expect to address what clinical manifestation that is characteristic of this health problem?

Hematuria

A football player is thought to have sustained an injury to his kidneys from being tackled from behind. The ER nurse caring for the client reviews the initial orders and notes an order to collect all voided urine and send it to the laboratory for analysis. The nurse understands that this nursing intervention is important for what reason?

Hematuria is the most common manifestation of renal trauma and blood losses may be microscopic, so laboratory analysis is essential.

A patient with ESRD is scheduled for his first hemodialysis treatment. The patient asks the nurse what common complications may occur from the treatment. What would be the nurse's best reply?

High blood sugar levels and low protein levels may occur."

The nurse coming on shift is taking a report on four patients. What patient does the nurse know is at the greatest risk of developing end-stage renal disease (ESRD)?

History of diabetes with poorly controlled hypertension

The nurse is caring for a client in acute kidney injury. Which of the following complications would most clearly warrant the administration of polystyrene sulfonate?

Hyperkalemia

The nurse is caring for a patient in acute renal failure. The nurse should expect hypertonic glucose, insulin infusions, and sodium bicarbonate to be used to treat:

Hyperkalemia

A client is diagnosed with polycystic kidney disease. Which symptom would the nurse most likely assess?

Hypertension

The major danger after renal surgery is:

Hypovolemic shock caused by hemorrhage

A nurse is providing discharge teaching for a client who has chronic kidney disease. Which of the following statements by the client indicates an understanding of the teaching?

I will decrease my intake of foods high in phosphorus