Ch. 25 Prep U

A patient has just been diagnosed with acute glomerulonephritis. Which question should the nurse ask this client in attempting to establish a cause?

"Have you had any type of infection within the last 2 weeks?"

A 34 year-old man has been taking up to 2400 mg of ibuprofen per day following a motor vehicle several months ago and consequent chronic pain. He has recently been diagnosed with chronic analgesic nephritis as a result of his high analgesic intake. The man is surprised at the diagnosis, stating, "I thought that taking too many drugs hurt your liver if anything, not your kidneys." What is the most appropriate response to the man's statement?

"Your kidneys are vulnerable to damage because of how much blood flows through them and the fact that they break down many drugs."

The nurse on a geriatric unit is assessing four clients. Which client is most likely to exhibit pyuria (pus in urine) and high counts of urine colony-forming units?

A client who has urinary catheter in place due to confusion

The nurse recognizes the most common cause of acute postinfectious glomerulonephritis as:

A streptococcal infection 7 to 12 days prior to onset

A patient is being evaluated for kidney stones. The nurse anticipates the patient will manifest:

Acute onset of colicky or dull and achy intermittent flank pain

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 diagnosis is the most likely?

Acute pyelonephritis

A client is concerned that medication may damage his kidneys. Which factor(s) place the client at most risk for developing a drug-related nephropathy? Select all that apply.

Age/elderly Nonsteroidal anti-inflammatory drugs (NSAIDs) Diuretics Prescription methicillin and other synthetic antibiotics Procedures involving radiocontrast media

The nurse suspects that a newborn infant who presents with bilateral flank masses, impaired lung development, and oliguria may be suffering from which of the following disorders?

Autosomal recessive polycystic kidney disease (ARPD)

Acute pyelonephritis is a result of which of the following?

Bacterial infection

A patient who has had an intestinal bypass has developed a kidney stone. Which of the following types of kidney stone does the nurse recognize that this patient will most likely be treated for?

Calcium

Hospitalized patients are at the greatest risk of developing septicemia related to which procedure?

Catheter-associated bacteriuria

Which laboratory findings should you expect to see in a patient diagnosed with nephritic syndrome?

Elevated urine protein and hypoalbuminemia

A patient has passed a kidney stone composed of uric acid (urate). Which of the following pathological conditions is a contributing factor for the development of this type of kidney stone?

Gout

The nurse is assessing a patient who has a unilateral obstruction of the urinary tract. The nurse anticipates the patient may develop:

Increase in blood pressure

A nurse advises a client with recurring UTIs to drink large amounts of water. What normal protective action is the nurse telling the client to utilize?

Increase washout of urine

Unilateral obstruction of the urinary tract may result in renin secretion, thereby leading to which of the following?

Increased blood pressure

Which one of the following is the usual cause of acute pyelonephritis?

Infection

A nurse is giving discharge instructions for a patient who was diagnosed with acute pyelonephritis 3 days previously. Which of the following is important for the nurse to discuss when instructing the patient?

It is important that the patient take the prescribed antibiotic for the duration of the prescription.

The nurse should assess which of the following when assessing for the initial presence of edema in a patient with nephrotic syndrome?

Lower extremities

A nurse is caring for a client who is diagnosed with acute poststreptococcal glomerulonephritis. Which renal disorder is most commonly associated with acute poststreptococcal glomerulonephritis?

Nephritic syndrome

The nurse is evaluating her patient's risk for an urinary tract infection. Which of the following patients has the highest risk?

Patient with obstructed urinary outflow from the kidney

Which one of the following would the nurse see as being liable to cause the most serious long-term problems?

Polycystic kidney disease

Which of the following substances would not be found in glomerular filtrate?

Protein

The nurse is reviewing the lab results of a patient with suspected nephrotic syndrome. The nurse anticipates that the results to include:

Protein in the urine

The nurse reviews the lab results for a patient who has advanced autosomal dominant polycystic kidney disease (ADPKD). The patient 's hemoglobin is 8.8 g/dL. The nurse suspects this lab value is related to which of the following causes?

Reduced production of erythropoietin

A nurse is caring for a patient with hematuria. The nurse understands this may be a clinical manifestation of which renal conditions? Select all that apply.

Renal cell carcinoma Renal calculi Acquired renal cyst

The nurse is assessing a patient with diabetic nephropathy whose blood pressure is 124/80. The patient smokes two packs of cigarettes a day and consumes a diet high in saturated fats and sodium. The nurse's plan of care should focus on which of the following to decrease the patient's risk for progression of the diabetic nephropathy?

Smoking cessation program

A client is being treated for calcium oxalate kidney stones. The nurse will include which intervention in the client's care? Select all that apply.

Straining urine Administering calcium carbonate Increasing fluid intake

A nurse observes that a patient's urine is cola colored and considers which of the following as a possible reason?

The patient's urine contains material from the degradation of red blood cells.

A young woman presents with signs and symptoms of urinary tract infection (UTI). The nurse notes that this is the fifth UTI in as many months. What would this information lead the nurse to believe?

There is possible obstruction in the urinary tract.

A patient is being treated with colchicine (Colcrys) for pain in the big right toe. The patient begins to complain of severe right flank pain and is diagnosed with kidney stones. Which of the following types of kidney stones does the nurse recognize this patient is most likely affected by?

Uric acid

A child has been brought to an urgent care clinic. The parents state that the child is "not making water." When taking a history, the nurse learns the child had a sore throat about 1 week ago but seems to have gotten over it. "We [parents] only had to give antibiotics for 3 days for the throat to be better." The nurse should suspect the child has developed:

acute postinfectious glomerulonephritis.

A 25-year-old man of Asian ancestry arrives in the emergency room in a panic. Except for a bout with bronchitis a week earlier, he has been healthy his entire life; today he has blood in his urine. He is eventually told that his kidney disease has no known treatment and results in protein deposits accumulating in the glomerulus. The client has likely been diagnosed with:

immunoglobulin A nephropathy