Chapter 48 Medsurg PrepU Questions
One of the roles of the nurse in caring for clients with chronic kidney disease is to help them learn to minimize and manage potential complications. This would include:
restricting sources of potassium.
A triple-lumen indwelling urinary catheter is inserted for continuous bladder irrigation following a transurethral resection of the prostate. In addition to balloon inflation, the functions of the three lumens include:
continuous inflow and outflow of irrigation solution.
A client with chronic renal failure (CRF) has developed faulty red blood cell (RBC) production. The nurse should monitor this client for:
fatigue and weakness.
An investment banker with chronic renal failure informs the nurse of the choice for continuous cyclic peritoneal dialysis. Which is the best response by the nurse?
"This type of dialysis will provide more independence."
The nurse instructs a client to perform continuous ambulatory peritoneal dialysis correctly at home. Which educational information should the nurse provide to the client?
Use an aseptic technique during the procedure.
Azotemia
(excessive) urea and nitrogenous wastes in the blood
Finasteride (Proscar)
- Do not use with saw palmetto berry - Used to shrink an enlarged prostate
What findings does the nurse assess that are consistent with acute glomerulonephritis?
- Red blood cells in the urine - Proteinuria - White cell casts in the urine
Normal urine output
30 mL/hr
The nurse is able to identify which condition as uremia?
An excess of urea in the blood
The client is admitted to the hospital with a diagnosis of acute glomerulonephritis. Which clinical manifestation would the nurse expect to find?
Cola-colored urine
A patient has been diagnosed with postrenal failure. The nurse reviews the patient's electronic health record and notes a possible cause. Which of the following is the possible cause?
Renal calculi
What is used to decrease potassium level seen in acute renal failure?
Sodium polystyrene sulfonate
A client is admitted with nausea, vomiting, and diarrhea. His blood pressure on admission is 74/30 mm Hg. The client is oliguric and his blood urea nitrogen (BUN) and creatinine levels are elevated. The physician will most likely write an order for which treatment?
Start IV fluids with a normal saline solution bolus followed by a maintenance dose. Explanation: This treatment should rehydrate the client, causing his blood pressure to rise, his urine output to increase, and the BUN and creatinine levels to normalize.
Which nursing assessment finding indicates that the client who has undergone renal transplant has not met expected outcomes?
Fever Explanation: Fever is a sign of infection or transplant rejection
A client with chronic kidney disease reports generalized bone pain and tenderness. Which assessment finding would alert the nurse to an increased potential for the development of spontaneous bone fractures?
Hyperphosphatemia
As renal failure progresses and the glomerular filtration rate (GFR) falls, which of the following changes occur?
Hyperphosphatemia
The nurse is caring for a patient after kidney surgery. What major danger should the nurse closely monitor for?
Hypovolemic shock caused by hemorrhage.
What is a characteristic of the intrarenal category of acute kidney injury (AKI)?
Increased BUN
A client recovering from hepatitis B develops acute nephrotic syndrome. Which treatment will the nurse anticipate being prescribed for this client?
Methylprednisolone
Which of the following nursing assessment findings would be most significant in determining sterility in a male client?
Mumps at age 15 years
A client is receiving hemodialysis for acute kidney failure. Which assessment finding(s) indicates to the nurse that the client is experiencing dialysis disequilibrium? Select all that apply.
Nausea, vomiting, headache, confusion
Which period of acute renal failure is accompanied by an increase in the serum concentration of substances usually excreted by the kidneys?
Oliguria
Which condition is associated with buildup of fibrous plaques in the sheath of the corpus cavernosum, causing curvature of the penis when it is erect?
Peyronie's disease
A nurse is reviewing the history of a client who is suspected of having glomerulonephritis. Which of the following would the nurse consider significant?
Recent history of streptococcal infection
Complications of Chronic Renal Failure
hyperkalemia, hypertension, anemia
A client is diagnosed with polycystic kidney disease. Which of the following would the nurse most likely assess?
hypertension
Which clinical finding should a nurse look for in a client with chronic renal failure?
increased BUN
The nurse performs acute intermittent peritoneal dialysis (PD) on a client who is experiencing uremic signs and symptoms. The peritoneal fluid is not draining as expected. What is the best response by the nurse?
Turn the client from side to side.
A client has a decreased secretion of erythropoietin from the kidneys due to end-stage kidney disease. The nurse explains that the decrease in erythropoietin will have what effect?
anemia
A client with renal failure is undergoing continuous ambulatory peritoneal dialysis. Which nursing diagnosis is the most appropriate for this client?
Risk for infection
A client has undergone a renal transplant and returns to the health care agency for a follow-up evaluation. Which finding would lead the nurse to suspect that the client is experiencing rejection?
Tenderness over transplant site
The nurse is administering calcium acetate (PhosLo) to a patient with end-stage renal disease. When is the best time for the nurse to administer this medication?
With food
A client with chronic renal failure (CRF) is receiving a hemodialysis treatment. After hemodialysis, the nurse knows that the client is most likely to experience:
weight loss.
A client has been diagnosed with acute glomerulonephritis. This condition causes:
proteinuria
Which of the following herbal remedies is used to treat symptoms of benign prostatic hypertrophy (BPH)?
Saw palmetto
The nurse is providing discharge instructions to the client with acute post-streptococcal glomerulonephritis. Which statement by the client indicates a need for further teaching?
"I should drink as much as possible to keep my kidneys working."
The nurse helps a client to correctly perform peritoneal dialysis at home. The nurse must educate the client about the procedure. Which educational information should the nurse provide to the client?
Keep the dialysis supplies in a clean area, away from children and pets