Prep U: Ch 54- Management of Patients With Kidney Disorders

The nurse is caring for a client with chronic kidney disease. The patient has gained 4 kg in the past 3 days. In milliliters, how much fluid retention does this equal? Enter your response as a whole number.

4,000 mL

A nurse is reviewing the history of a client who is suspected of having glomerulonephritis. Which of the following would the nurse consider significant? a. Previous episode of acute pyelonephritis b. History of hyperparathyroidism c. History of osteoporosis d. Recent history of streptococcal infection

d. Recent history of streptococcal infection

The nurse weighs a patient daily and measures urinary output every hour. The nurse notices a weight gain of 1.5 kg in a 74-kg patient over 48 hours. The nurse is aware that this weight gain is equivalent to the retention of: a. 500 mL of fluid b. 1,000 mL of fluid c. 2,000 mL of fluid d. 1,500 mL of fluid

d. 1,500 mL of fluid

At the end of five peritoneal exchanges, a patient's fluid loss was 500 mL. How much is this loss equal to? a. 1.0 lb b. 2 lb c. 1.5 lb d. 0.5 lb

a. 1.0 lb

A history of infection specifically caused by group A beta-hemolytic streptococci is associated with which disorder? a. Acute glomerulonephritis b. Nephrotic syndrome c. Chronic renal failure d. Acute renal failure

a. Acute glomerulonephritis

After teaching a group of students about how to perform peritoneal dialysis, which statement would indicate to the instructor that the students need additional teaching? a. "It is important to use strict aseptic technique." b. "It is appropriate to warm the dialysate in a microwave." c. "The infusion clamp should be open during infusion." d. "The effluent should be allowed to drain by gravity."

b. "It is appropriate to warm the dialysate in a microwave."

The nurse expects which of the following assessment findings in the client in the diuretic phase of acute renal failure? a. Crackles b. Hyperkalemia c. Dehydration d. Hypertension

c. Dehydration

The presence of prerenal azotemia is a probable indicator for hospitalization for CAP. Which of the following is an initial laboratory result that would alert a nurse to this condition? a. BUN of 18 mg/dL. b. Serum creatinine of 1.2 mg/dL. c. Blood urea nitrogen (BUN)-to-creatinine ratio (BUN:Cr) >20. d. Glomerular filtration rate (GFR) of 100 mL/min.

c. Blood urea nitrogen (BUN)-to-creatinine ratio (BUN:Cr) >20.

Diet modifications are part of nutritional therapy for the management of ARF. Select the high-potassium food that should be restricted. a. Butter b. White rice c. Citrus fruits d. Salad oils

c. Citrus fruits

A patient has stage 3 chronic kidney failure. What would the nurse expect the patient's glomerular filtration rate (GFR) to be? a. A GFR of 30-59 mL/min/1.73 m2 b. A GFR of 85 mL/min/1.73 m2 c. A GFR of 90 mL/min/1.73 m2 d. A GFR of 120 mL/min/1.73 m2

a. A GFR of 30-59 mL/min/1.73 m2

What is used to decrease potassium level seen in acute renal failure? a. Sodium polystyrene sulfonate b. IV dextrose 50% c. Sorbitol d. Calcium supplements

a. Sodium polystyrene sulfonate

A client with end-stage renal disease is scheduled to undergo a kidney transplant using a sibling donated kidney. The client asks if immunosuppressive drugs can be avoided. Which is the best response by the nurse? a. "The doctor may decide to delay the use of immunosuppressant drugs." b. "Even a perfect match does not guarantee organ success." c. "Immunosuppressive drugs guarantee organ success." d. "Let's wait until after the surgery to discuss your treatment plan."

b. "Even a perfect match does not guarantee organ success."

A patient with chronic kidney failure experiences decreased levels of erythropoietin. What serious complication related to those levels should the nurse assess for when caring for this client? a. Hyperkalemia b. Anemia c. Pericarditis d. Acidosis

b. Anemia

A client, aged 87, undergoes continuous ambulatory peritoneal dialysis (CAPD) for acute renal failure (ARF). Which task would be most important for the nurse to do? a. Monitor the client for hypoglycemia and hyperglycemia. b. Frequently monitor the client's progress. c. Ensure a diet rich in proteins and potassium. d. Note a color change in the client's eyes, teeth, and nails.

b. Frequently monitor the client's progress.

A client with chronic renal failure complains of generalized bone pain and tenderness. Which assessment finding would alert the nurse to an increased potential for the development of spontaneous bone fractures? a. Elevated urea and nitrogen b. Hyperphosphatemia c. Elevated serum creatinine d. Hyperkalemia

b. Hyperphosphatemia

Which nursing assessment finding indicates that the client who has undergone renal transplant has not met expected outcomes? a. Absence of pain b. Diuresis c. Fever d. Weight loss

c. Fever

What is a hallmark of the diagnosis of nephrotic syndrome? a. Hyperalbuminemia b. Proteinuria c. Hyponatremia d. Hypokalemia

c. Proteinuria

A client with renal failure is undergoing continuous ambulatory peritoneal dialysis. Which nursing diagnosis is the most appropriate for this client? a. Toileting self-care deficit b. Activity intolerance c. Impaired urinary elimination d. Risk for infection

d. Risk for infection

A nurse assesses a client shortly after living donor kidney transplant surgery. Which postoperative finding must the nurse report to the physician immediately? a. Temperature of 99.2° F (37.3° C) b. Serum potassium level of 4.9 mEq/L c. Urine output of 20 ml/hour d. Serum sodium level of 135 mEq/L

c. Urine output of 20 ml/hour

The nurse is providing supportive care to a client receiving hemodialysis in the management of acute renal failure. Which statement from the nurse best reflects the ability of the kidneys to recover from acute renal failure? a. Once on dialysis, the need will be permanent. b. Acute renal failure tends to turn to end-stage failure. c. Kidney function will improve with transplant. d. The kidneys can improve over a period of months.

d. The kidneys can improve over a period of months.