EAQ chapter 67
What instructions will the nurse provide before the patient with suspected renovascular disease undergoes noninvasive diagnostic imaging? 'A radionuclide scan will evaluate your kidney's vessels.' 'A renal artery bypass will evaluate your kidney's vessels.' 'A kidney, ureter, and bladder (KUB) scan will evaluate your kidney's vessels.' 'A magnetic resonance angiography (MRA) will evaluate your kidney's vessels.'
'A radionuclide scan will evaluate your kidney's vessels.'
A patient, who is a mother of two, has autosomal dominant polycystic kidney disease (ADPKD). Which statement by the patient indicates a need for further education about her disease? 'If my children have the ADPKD gene, they will have cysts by the age of 30.' 'By maintaining a low-salt diet in our house, I can prevent ADPKD in my children.' 'My children have a 50% chance of inheriting the ADPKD gene that causes the disease.' 'Even though my children don't have symptoms at the same age I did, they can still have ADPKD.'
'By maintaining a low-salt diet in our house, I can prevent ADPKD in my children.'
The school nurse is counseling a teenage student about how to prevent kidney trauma. Which statement by the student indicates a need for further teaching? 'I avoid riding motorcycles.' 'I always wear a seat belt in the car.' 'I always wear pads when playing football.' 'I can't play any type of contact sports because my brother had kidney cancer.'
'I can't play any type of contact sports because my brother had kidney cancer.'
A nurse is caring for a male patient with renal cell carcinoma. What statement made by the patient is consistent with his diagnosis? Select all that apply. Some correct answers were not selected 'My urine is cloudy all the time.' 'I feel like my sex drive is decreased.' 'I look more feminine than I used to.' 'My blood pressure is high all the time.' 'I feel cold all the time, even in summer.'
'I feel like my sex drive is decreased.' 'I look more feminine than I used to.' 'My blood pressure is high all the time.'
The nurse is educating a group of individuals at the community center about methods to prevent kidney trauma. Which statement from a member of the group indicates that further teaching is required? 'I should wear a seat belt when riding in the car.' 'I need to use caution when riding a motorcycle.' 'I should quit the soccer team so I don't injure my kidneys.' 'It is important to wear protective gear when participating in kickboxing.'
'I should quit the soccer team so I don't injure my kidneys.'
A patient with renal cell carcinoma is admitted to the hospital due to severe anemia. What statement will the nurse include in the patient's teaching regarding this condition? 'Kidney cancer affects the liver, causing anemia.' 'Kidney cancer damages kidney vessels, causing anemia.' 'Kidney cancer causes bleeding in your urine, causing anemia.' 'Kidney cancer decreases red blood cell production, causing anemia.'
'Kidney cancer decreases red blood cell production, causing anemia.'
The nurse is performing discharge teaching for a patient after a nephrectomy for renal cell carcinoma. Which statement by the patient indicates that teaching has been effective? 'I'll eventually require some type of renal replacement therapy.' 'My remaining kidney will provide me with normal kidney function now.' 'I'll need to decrease my fluid intake to prevent stress to my remaining kidney.' 'Because renal cell carcinoma usually affects both kidneys, I'll need to be watched closely.'
'My remaining kidney will provide me with normal kidney function now.'
A patient is hesitant to talk to the nurse about genitourinary dysfunction symptoms. What is the nurse's best response? 'Why are you hesitant?' 'Don't worry, no one else will know.' 'Take your time. What is bothering you the most?' 'You need to tell me so we can determine what is wrong.'
'Take your time. What is bothering you the most?'
What will the nurse teach a patient with diabetes mellitus with nephropathy and the patient's family about this condition? 'The severity of this condition depends on your average blood glucose level.' 'This condition generally only occurs in patients with type 1 diabetes mellitus.' 'This condition generally only occurs in patients with type 2 diabetes mellitus.' 'The severity of this condition depends on how long you have had diabetes mellitus.'
'The severity of this condition depends on your average blood glucose level.'
A patient with stage II renal cell carcinoma asks the nurse, 'What does stage II mean?' What is the nurse's best response? 'The tumor has metastasized beyond your kidney.' 'The tumor has extended to the renal vein inside your kidney.' 'The tumor is less than 2.5 cm and does not involve your lymph nodes.' 'The tumor is bigger than 2.5 cm but does not involve your lymph nodes.'
'The tumor is bigger than 2.5 cm but does not involve your lymph nodes.'
A nurse is caring for a patient who has sustained trauma to the kidney after being an unrestrained passenger in a motor vehicle accident. The health care provider orders intravenous albumin therapy for the patient. What will the nurse include when teaching the patient about this therapy? 'This medication is used to improve the blood flow to your kidney.' 'This medication is used to decrease the risk of bleeding from your kidney.' 'This medication helps to decrease the risk of developing shock due to your injury.' 'This medication helps to decrease the extra fluid you have accumulated in your lungs due to your injury.'
'This medication helps to decrease the risk of developing shock due to your injury.'
During discharge teaching for a patient with kidney disease, what does the nurse teach the patient to do? 'Weigh yourself and take your blood pressure.' 'Check your blood sugar and do a urine dipstick test.' 'Eat breakfast and go to bed at the same time every day.' 'Drink 2 liters of fluid and urinate at the same time every day.'
'Weigh yourself and take your blood pressure.'
What teaching will the nurse provide to a patient who is recovering from an endovascular renal stent placement with balloon angioplasty procedure? 'You should be able to go home tomorrow.' 'The bypass only fixed one of your kidneys.' 'Your total recovery may take up to 2 months.' 'The synthetic blood vessel graft is a permanent fix.'
'You should be able to go home tomorrow.'
A patient who has recently been diagnosed with renovascular disease asks the nurse, 'What is the cause of this disease?' What are the nurse's best responses? Select all that apply. Some correct answers were not selected -'A blood clot in your vessels may cause this disease.' -'A buildup of plaque in your vessels may cause this disease.' -'The narrowing of your renal vessels may cause this disease.' -'This disease is most likely caused by a genetic malformation.' -'This disease is most likely caused by excess hormone secretion.'
-'A blood clot in your vessels may cause this disease.' '-A buildup of plaque in your vessels may cause this disease.' -'The narrowing of your renal vessels may cause this disease.'
A nurse is providing discharge instructions to a patient who was admitted and treated for a kidney injury sustained from a fall off of a ladder. What statements will the nurse include in the teaching? Select all that apply. Some correct answers were not selected -'Report any discomfort to the health care provider immediately.' -'Urine leakage is a common complication that may occur after this type of injury.' -'Report any cloudy, foul-smelling urine to the health care provider immediately.' -'Delayed bleeding is a common complication that may occur after this type of injury.' -'Increased body temperature is a common complication that may occur after this type of injury.'
-'Urine leakage is a common complication that may occur after this type of injury.' -'Report any cloudy, foul-smelling urine to the health care provider immediately.' -'Delayed bleeding is a common complication that may occur after this type of injury.'
What would be the nursing actions for a patient with kidney trauma? Select all that apply. Some correct answers were not selected -Check for hematuria -Note the frequency of urination -Encourage the intake of excess fluid -Include foods that are high in calcium content in patient's diet -Note if the patient complains of pain and burning on urination
-Check for hematuria -Note the frequency of urination -Note if the patient complains of pain and burning on urination
Which statements about the relationship between hypertension and kidney disease are accurate? Select all that apply. Some correct answers were not selected Hypertension is the leading cause of end-stage kidney disease (ESKD). Maintain a maximum blood pressure of 160/110 mm Hg to prevent hypertensive renal damage. Hypertension is the second leading cause of ESKD, with many patients requiring kidney replacement. Renal artery stenosis can lead to sudden onset of hypertension and usually affects patients over 50 years. People of American-Indian and African-American descent have a higher risk of ESKD from uncontrolled hypertension.
-Hypertension is the second leading cause of ESKD, with many patients requiring kidney replacement. -Renal artery stenosis can lead to sudden onset of hypertension and usually affects patients over 50 years. -People of American-Indian and African-American descent have a higher risk of ESKD from uncontrolled hypertension.
The nurse is caring for a patient who underwent a nephrostomy tube insertion because of a urethral stricture. What assessment findings does the nurse report immediately to the health care provider? Select all that apply. -Some correct answers were not selected Reports of back pain Red-tinged drainage into the collection bag -Leakage of urine from the nephrostomy site -Leakage of blood from the nephrostomy site -Foul-smelling drainage into the collection bag -Increase in urinary output into the drainage bag
-Reports of back pain -Leakage of urine from the nephrostomy site -Leakage of blood from the nephrostomy site -Foul-smelling drainage into the collection bag
Identify the correct order of the pathophysiologic changes that occur with pyelonephritis. 1. Inflammatory response 2. Formation of fibrosis or scar tissue 3. Impairment of kidney function 4. Microbial invasion of the renal pelvis 5. Decrease in tubular reabsorption and secretion
1. Microbial invasion of the renal pelvis 2. Inflammatory response 3. Formation of fibrosis or scar tissue 4. Decrease in tubular reabsorption and secretion 5. Impairment of kidney function
Arrange the tumor descriptions in order from the least advanced to the most advanced stage of renal cell carcinoma. 1. Tumor extends into the renal vein and lymph nodes. 2. Tumor is situated within the capsule of the kidney. 3. Tumor is situated beyond the capsule and within Gerota's fascia. 4. Tumor extends into the adjacent organs.
1. Tumor is situated within the capsule of the kidney. 2. Tumor is situated beyond the capsule and within Gerota's fascia. 3. Tumor extends into the renal vein and lymph nodes. 4. Tumor extends into the adjacent organs.
Which hourly urine output amount is considered acceptable for the patient who has just undergone a radical nephrectomy? 10 mL/hr 20 mL/hr 30 mL/hr 90 mL/hr
30 mL/hr
What amount of urine output is an indicator of adequate perfusion to the remaining kidney after the removal of one of the kidneys? 15-20 mL/hr 20-25 mL/hr 25-30 mL/hr 30-50 mL/hr
30-50 mL/hr
A 60-year-old adult patient presents to the emergency department coughing up blood with difficulty breathing. The patient states, "I had the flu a little over a week ago, and I am a type II diabetic." Upon assessment, the nurse notes that the patient is dyspneic and has generalized edema. The patient's vital signs are temperature 99.9°F, pulse 98 bpm, respiration 26 breaths per minute, blood pressure 158/100 mm Hg, and oxygen saturation 88%. Based on the patient's information and assessment findings, what is most likely the primary pathophysiological disease? Pulmonary edema Pulmonary embolism Congestive heart failure Acute glomerulonephritis
Acute glomerulonephritis
The nurse anticipates that a patient who develops hypotension and oliguria post-nephrectomy may need the addition of which element to the regimen? Increase in analgesics Addition of a corticosteroid Administration of a diuretic Course of antibiotic therapy
Addition of a corticosteroid
When caring for a patient with nephrotic syndrome, which intervention should be included in the plan of care? Providing transfusion of clotting factors Providing antibiotics to decrease infection Administering heparin to prevent deep vein thrombosis (DVT) Administering angiotensin-converting enzyme (ACE) inhibitors to decrease protein loss
Administering angiotensin-converting enzyme (ACE) inhibitors to decrease protein loss
Which patient assessment finding may indicate adrenal insufficiency following radical nephrectomy? Patient report of back pain Metallic taste in the mouth Bleeding at the surgical site Altered level of consciousness
Altered level of consciousness
What cultural factor increases an American Indian patient's risk for developing end-stage kidney disease (ESKD)? American Indian patients do not respond to conventional medicine as do other populations. American Indian patients have greater incidences of hypertension than do other populations. American Indian patients do not respond to changes in electrolyte levels as do other populations. American Indian patients have greater incidences of genetic alterations of the kidney than do other populations.
American Indian patients have greater incidences of hypertension than do other populations.
What is the drug of choice for hypertension in a patient diagnosed with polycystic kidney disease (PKD)? Diuretics Beta-blockers Calcium channel blockers Angiotensin-converting enzyme inhibitors
Angiotensin-converting enzyme inhibitors
The nurse is caring for a patient with polycystic kidney disease (PKD). Which nursing intervention would the nurse perform to provide comfort from flank pain? Administer aspirin. Administer ciprofloxacin as prescribed. Urge the patient to drink at least 2 L of fluid daily. Apply moist heat to the abdomen or flank of the patient.
Apply moist heat to the abdomen or flank of the patient.
A nurse is caring for a patient with a degenerative kidney disorder with chronic hypertension. What action by the nurse best promotes the patient's adherence to therapy for the treatment of this disorder? Determine the patient's financial status. Determine the patient's cultural influences. Teach the patient about complications from the disorder. Assess the patient for knowledge deficit about the disorder.
Assess the patient for knowledge deficit about the disorder.
The nurse is providing postoperative care for a patient who underwent nephrectomy. What actions should the nurse take? Select all that apply. Some correct answers were not selected Assess the urine output every hour. Monitor blood pressure every 4 hours. Monitor the respiratory rate every hour. Monitor the hemoglobin level every 24 hours. Inspect the abdomen for distention every shift.
Assess the urine output every hour. Monitor blood pressure every 4 hours. Inspect the abdomen for distention every shift.
The RN is working with an unlicensed assistive personnel (UAP) in caring for a group of patients. Which action is best for the RN to delegate to the UAP? Assisting a patient who had a radical nephrectomy 2 days ago to turn in bed Palpating for bladder distention on a patient recently admitted with a ureteral stricture Helping the provider with a kidney biopsy for a patient admitted with acute glomerulonephritis Assessing the vital signs of a patient who was just admitted with blunt flank trauma and hematuria
Assisting a patient who had a radical nephrectomy 2 days ago to turn in bed
A patient is recovering in the intensive care unit (ICU) after a nephrectomy due to renal cell carcinoma. What nursing intervention best prevents pulmonary complications that may occur after a nephrectomy? Assisting the patient to a side-lying position Assisting the patient in using an incentive spirometer Encouraging the patient to ambulate without assistance Using a humidifier attachment for the patient's supplemental oxygen
Assisting the patient in using an incentive spirometer
Which action helps prevent kidney trauma in a patient with kidney disease? Avoiding contact sports Eating a protein-rich diet Avoiding the use of seat belts Including adequate salt in the diet
Avoiding contact sports
How are the blood creatinine and blood urea nitrogen (BUN) levels related to reduced glomerular filtration rate (GFR) in patients with obstructive kidney disorders? BUN increases with reduced GFR. BUN decreases with reduced GFR. BUN levels remain unchanged with reduced GFR. BUN levels can either increase or decrease with reduced GFR.
BUN increases with reduced GFR.
The nurse is caring for a patient who has just returned to the surgical unit after a radical nephrectomy. Which assessment information alarms the nurse? Dressing has a 1-cm area of bleeding. Pain is at a level 4 (on a 0 to 10 scale). Urine output over the past hour was 80 mL. Blood pressure is 98/56 mm Hg; heart rate is 118 beats/min.
Blood pressure is 98/56 mm Hg; heart rate is 118 beats/min.
What findings indicate end-stage kidney disease (ESKD) for a patient with diabetes mellitus? Select all that apply. Some correct answers were not selected Proteins in urine: 1 g/day Blood pressure: 150/90 mmHg Low density lipoprotein (LDL): 30 mg/dL Plasma glucose concentration (HbA1c): 7.5% Glomerular filtration rate (GFR): 10 mL/min/1.73 m 2
Blood pressure: 150/90 mmHg Glomerular filtration rate (GFR): 10 mL/min/1.73 m 2
The nurse receives a report on a patient with hydronephrosis. Which laboratory study does the nurse monitor? Lipid levels White blood cell (WBC) count Hemoglobin and hematocrit (H&H) Blood urea nitrogen (BUN) and creatinine
Blood urea nitrogen (BUN) and creatinine
A nurse is performing an assessment on a patient with early renal cell carcinoma. What manifestation will the nurse most likely find on assessment? Gross hematuria Patient complaint of flank pain Mass palpated on patient's kidney Bruit on auscultation of the kidney
Bruit on auscultation of the kidney
When caring for a patient 24 hours after a nephrectomy, the nurse notes that the patient's abdomen is distended. Which action should the nurse perform next? Check vital signs. Notify the surgeon. Continue to monitor. Insert a nasogastric (NG) tube.
Check vital signs
When assessing a patient with acute pyelonephritis, which findings does the nurse anticipate will be present? Select all that apply. Some correct answers were not selected Chills Dysuria Oliguria Vomiting Suprapubic pain
Chills Dysuria Vomiting
The nurse is caring for a 76-year-old patient on prolonged bedrest related to a history of stroke. Which condition is the patient at risk of developing? Renal abscess Acute pyelonephritis Chronic glomerulonephritis Chronic pyelonephritis
Chronic pyelonephritis
The nurse is caring for a patient with pyelonephritis. What does the nurse teach the patient about preventing end-stage kidney disease? Limit fluid intake to 1 L per day. Increase protein intake in the diet. Monitor blood glucose levels regularly. Complete the drug therapy exactly as indicated.
Complete the drug therapy exactly as indicated.
A nurse is caring for a patient who has sustained trauma to the kidney and urethra. When attempting to insert an indwelling urinary catheter, the nurse notes that the patient's urethral opening is bleeding. What is the nurse's priority action? Contact the patient's health care provider. Prepare for an in-and-out catheter placement. Clean the urethral opening prior to insertion of the catheter. Do not wipe the blood in order to maintain sterile technique.
Contact the patient's health care provider.
What is the nurse's priority when caring for a patient with polycystic kidney disease (PKD)? Monitoring fluid balance Controlling hypertension Maintaining electrolyte balance Monitoring for ruptured aneurysms
Controlling hypertension
What priority of care will the nurse focus on when caring for a patient with nephrosclerosis? Select all that apply. Some correct answers were not selected -Reversing the patient's kidney condition -Controlling the patient's blood pressure -Preserving the patient's kidney function -Assessing the patient's blood vessels for hyperplasia -Determining the cause of the patient's kidney condition
Controlling the patient's blood pressure Preserving the patient's kidney function
When assessing a patient with acute glomerulonephritis, which finding causes the nurse to notify the provider? Cola-colored urine History of diabetes Purulent wound on the leg Crackles throughout the lung fields
Crackles throughout the lung fields
Which clinical manifestation in a patient with pyelonephritis indicates that treatment has been effective? Decreased urine output Increased red blood cell count Increased urine specific gravity Decreased white blood cells in urine
Decreased white blood cells in urine
A nurse working in triage at the local emergency department assesses a patient who has sustained a kidney injury. What action by the nurse will best assist the health care provider in determining the severity of the patient's injury? Determining the patient's pain level Checking the patient's urine for blood Documenting the mechanism of injury Assessing the appearance of the flank area
Documenting the mechanism of injury
Which finding is typical of chronic glomerulonephritis? Polyuria Dyspnea Malnutrition Hypotension
Dyspnea
A patient presented with symptoms of acute glomerulonephritis. Which sample of urine is likely to be collected for accurate urinalysis? Daytime sample Late night sample Early morning sample Randomly collected sample
Early morning sample
What is the paraneoplastic syndrome that is common in patients with renal cell carcinoma? Hypotension Erythrocytosis Decreased sedimentation rate Decreased serum calcium level
Erythrocytosis
Which assessment findings does the nurse expect in a patient with kidney cancer? Select all that apply. Some correct answers were not selected Erythrocytosis Hypokalemia Hypercalcemia Hepatic dysfunction Increased sedimentation rate
Erythrocytosis Hypercalcemia Hepatic dysfunction Increased sedimentation rate
What hormonal deficiency may lead to anemia in patients diagnosed with renal cell carcinoma? Renin Erythropoietin Parathyroid hormone Human chorionic gonadotropin
Erythropoietin
A hospitalized patient is 12 hours post nephrostomy. Which clinical manifestations should be assessed for monitoring the complication-like infection? Select all that apply. Some correct answers were not selected Fever Onset of back pain Change in urine character Presence of red-tinged urine in collecting bag Leaking of urine or blood from site of nephrostomy
Fever Change in urine character
A patient is admitted with uremic symptoms secondary to chronic glomerulonephritis. What does the nurse expect to find in the assessment? Select all that apply. Some correct answers were not selected Edema of the foot and ankle Flapping tremor of the fingers Itching and dryness of the skin Presence of an S 3 heart sound Engorgement of the neck veins
Flapping tremor of the fingers Itching and dryness of the skin
Which type of kidney disorder may occur in the patient diagnosed with systemic lupus erythematosus (SLE)? Pyelonephritis Nephrosclerosis Glomerular disease Renovascular disease
Glomerular disease
A 70-year-old patient reports shortness of breath and a decrease in urine output. What else does the nurse include in the assessment in order to differentiate between congestive heart failure and glomerulonephritis? Hematuria Hypotension Pale yellow urine Decrease in body temperature
Hematuria
What finding reflects a desired outcome in the prevention of end-stage kidney disease (ESKD) in a patient with type 2 diabetes mellitus with microalbuminuria? Hemoglobin A1C of 6.3% Fasting glucose of 110 mg/dL Blood pressure of 138/82 mm Hg Low-density lipoprotein of 105 mg/dL
Hemoglobin A1C of 6.3%
Which factor is an indicator for a diagnosis of hydronephrosis? History of nocturia Recent weight loss Urinary incontinence History of urinary stones
History of urinary stones
What should the nurse expect to find in a patient whose ultrasound shows an obstruction in the upper part of the ureter? Pyelonephritis Hydronephrosis Glomerulonephritis Polycystic kidney disease
Hydronephrosis
What condition may occur when a patient with nephrosclerosis takes spironolactone? Hypokalemia Hyperkalemia Hyponatremia Hyperuricemia
Hyperkalemia
What manifestation does the nurse expect to assess in a patient with chronic pyelonephritis? Flank pain Hyperkalemia Fevers and chills Nausea and vomiting
Hyperkalemia
What complication will the nurse observe for in a patient with nephrosclerosis who requires potassium-sparing diuretics? Select all that apply. Some correct answers were not selected Anemia Hypokalemia Hyperkalemia Fluid volume deficit Fluid volume excess
Hyperkalemia Fluid volume deficit
Which disorders can lead to nephrosclerosis? Select all that apply. Some correct answers were not selected Hypertension Nephrolithiasis Atherosclerosis Hydronephrosis Diabetes mellitus
Hypertension Atherosclerosis Diabetes mellitus
What is the primary cause of high blood pressure resulting from trauma and injury to the kidney? Hypertension may result from a blood clot caused by the injury. Hypertension may result from too much fluid being administered. Hypertension may result from a decrease in the level of antidiuretic hormone. Hypertension may result from the activation of the renin-angiotensin-aldosterone system.
Hypertension may result from the activation of the renin-angiotensin-aldosterone system.
A patient is recovering following right radical nephrectomy surgery to address renal cell carcinoma. Which finding is consistent with adrenal insufficiency as a complication of the surgery? Hypokalemia Hyponatremia Very swollen, difficult-to-treat pedal edema Very high, difficult-to-control blood pressure
Hyponatremia
What is an early sign of adrenal insufficiency? Flank pain Proteinuria Hypotension Water retention
Hypotension
The nurse is preparing a patient diagnosed with hydronephrosis for a nephrostomy. Which laboratory order does the nurse anticipate for the patient prior to the procedure? Albumin INR, PT, PTT C-reactive protein BUN and creatinine
INR, PT, PTT
The nurse is teaching a patient with polycystic kidney disease about controlling hypertension. Which instruction would be helpful in slowing the progression of kidney dysfunction? Increase intake of dietary fiber Follow a sodium-restricted diet Monitor the serum creatinine levels Increase the daily fluid intake up to 2 liters/day
Increase the daily fluid intake up to 2 liters/day
What does the nurse expect to find during the assessment of a patient with polycystic kidney disease (PKD)? Anuria Hypotension Pale yellow urine Increased abdominal girth
Increased abdominal girth
Which condition may result due to increased renin in a patient with renal cell carcinoma (RCC)? Decreased libido Decreased hemoglobin Increased calcium levels Increased blood pressure
Increased blood pressure
What clinical manifestations will the nurse expect to find while assessing a patient who has renovascular disease? Select all that apply. Some correct answers were not selected Increased serum creatinine Decreased serum creatinine Increased creatinine clearance Decreased creatinine clearance Low blood pressure that is symptomatic High blood pressure that is difficult to control
Increased serum creatinine Decreased creatinine clearance High blood pressure that is difficult to control
A patient with hydronephrosis is scheduled for a nephrostomy. What diagnostic test is most important for this patient before the procedure? Serum creatinine Renal echography Blood urea nitrogen (BUN) International normalized ratio (INR)
International normalized ratio (INR)
The renal echography for a patient indicates hydronephrosis. What does the nurse tell the patient about this condition? The ureter dilates above the obstruction. It is caused by an obstruction in the renal pelvis. The bladder dilates following urethral obstruction. It is caused by an obstruction in the lower part of the ureter.
It is caused by an obstruction in the renal pelvis.
The nurse is caring for a patient with stage II renal cell carcinoma (RCC). What is the most accurate statement describing the tumor in the patient's kidney? It is within the renal capsule. It is larger than 2.5 cm in size. It has extended beyond Gerota's fascia. It has invaded the renal vein and lymph nodes.
It is larger than 2.5 cm in size.
What is the most accurate statement regarding acute glomerulonephritis (GN)? It is more common in women. It increases serum albumin levels. It may cause edema of the eyelids. It often progresses to end-stage kidney disease.
It may cause edema of the eyelids.
Which statement describing hydronephrosis is correct? It is an enlargement of the ureter above the obstruction. It decreases blood creatinine and blood urea nitrogen levels. It may occur because of an obstruction caused by kidney stones. It occurs before bladder distension in patients with urethral stricture.
It may occur because of an obstruction caused by kidney stones.
Which complication of polycystic kidney disease (PKD) may result in high blood pressure? Kidney calculi Kidney abscess Kidney ischemia Necrosis of the kidney
Kidney ischemia
Which type of intravenous fluid would the nurse expect to be administered to a patient who sustained trauma to the kidneys? Lactated Ringer's 0.45% normal saline D 5 0.9% normal saline Dextrose 5% in water (D5W)
Lactated Ringer's
Which assessment findings would lead the nurse to suspect adrenal insufficiency in a patient who underwent a total nephrectomy secondary to renal carcinoma? Select all that apply. Some correct answers were not selected Lethargy and drowsiness Urine output 500 mL/24 hr Blood pressure 88/50 mm Hg White blood cell count 10.2 cells/mm 3 Scant amount of serosanguinous drainage
Lethargy and drowsiness Urine output 500 mL/24 hr Blood pressure 88/50 mm Hg
The nurse is reviewing the laboratory results of a patient with altered kidney function. What laboratory findings suggest the onset of nephrotic syndrome? Select all that apply. Some correct answers were not selected Lipiduria Severe proteinuria Decreased coagulation Increased serum lipid level Increased serum albumin level
Lipiduria Severe proteinuria Increased serum lipid level
Which medication would the nurse expect the health care provider to prescribe for a patient with polycystic kidney disease (PCKD) and persistent high blood pressure in order to achieve blood pressure control and prevent complications? Losartan Lisinopril Diltiazem Hydralazine
Lisinopril
Where is the obstruction located in the kidney for a patient diagnosed with a hydroureter? Throughout the ureter Upper part of the ureter Lower part of the ureter The ureter is not obstructed; it is dilated.
Lower part of the ureter
The nurse is caring for a patient with acute glomerulonephritis. What instructions does the nurse provide to manage the infection? Select all that apply. Some correct answers were not selected Include protein in the diet. Maintain personal hygiene and handwashing. Restrict potassium and sodium intake in the diet. Monitor weight every week on the same day and same time. Consume a fluid intake equal to 24-hour urine output plus 500 mL.
Maintain personal hygiene and handwashing. Restrict potassium and sodium intake in the diet. Consume a fluid intake equal to 24-hour urine output plus 500 mL.
Which goal for a patient with diabetes mellitus will best help prevent diabetic nephropathy? Maintaining HbA 1C at 7% or less Emptying the bladder regularly Avoiding carbohydrates in the diet Taking insulin at the same time every day
Maintaining HbA 1C at 7% or less
Which teaching points would be helpful in lowering the risk of end-stage kidney disease when instructing a patient about self-management therapies related to polycystic disease? Select all that apply. Some correct answers were not selected Practicing a high-protein diet Allowing 10 g of salt intake per day Measuring the blood pressure daily Regular monitoring of bowel movements Getting medical attention in case of hematuria
Measuring the blood pressure daily Regular monitoring of bowel movements Getting medical attention in case of hematuria
Which statement about autosomal dominant polycystic kidney disease (ADPKD) is correct? In the recessive form, only a few nephrons have cysts. In the dominant form, 100% of the nephrons have cysts. Both parents of the patient have a copy of the mutated allele. Men and women have an equal chance of inheriting the disease.
Men and women have an equal chance of inheriting the disease.
Which signs of uremia would the nurse expect to find when assessing a patient with glomerulonephritis? Select all that apply. Some correct answers were not selected Nausea Vomiting Anorexia Hypotension Hypothermia
Nausea Vomiting Anorexia
What treatment is preferred for a kidney trauma patient with a grade 5 injury? Drug therapy Fluid therapy Nephrectomy Angiographic embolization
Nephrectomy
Which clinical manifestation indicates the inability of the kidneys to concentrate the urine in patients with polycystic kidney disease? Oliguria Nocturia Hematuria Proteinuria
Nocturia
What are the key features of acute pyelonephritis? Select all that apply. Some correct answers were not selected Nocturia Flank pain Hypertension Abdominal discomfort Decreased ability to concentrate urine
Nocturia Flank pain Abdominal discomfort
What signs/symptoms does the nurse expect to find during the assessment of a patient with polycystic kidney disease (PKD)? Select all that apply. Some correct answers were not selected Diarrhea Nocturia Flank pain Hypotension Kidney stones
Nocturia Flank pain Kidney stones
When caring for a patient with hemorrhage secondary to kidney trauma, the nurse provides volume expansion. Which element does the nurse anticipate will be used? Platelet infusions Fresh-frozen plasma 5% dextrose in water Normal saline solution
Normal saline solution
What is the most accurate statement regarding the etiology and genetic risk of polycystic kidney disease (PKD)? PKD can be prevented by adequate control of hypertension. PKD can occur in those with no family history of the disease. Autosomal dominant PKD is rarer than autosomal recessive PKD. Autosomal dominant PKD-1 (ADPKD-1) is less severe than ADPKD-2.
PKD can occur in those with no family history of the disease.
The nurse is caring for a patient with acute pyelonephritis. Which indicator is used to determine adequate fluid intake? Pale yellow urine Urine sample negative for bacteria Urine dipstick negative for leukocytes Patient reports of no pain with urination
Pale yellow urine
A nurse is caring for a patient with renal cell carcinoma who is admitted to the hospital with a cardiac dysrhythmia due to hypercalcemia. What pathophysiological process is the most likely cause of the patient's hypercalcemia? Thyroxin hormone is released by the tumor. Bone resorption occurs because of the tumor. Bone breakdown occurs because of the tumor. Parathyroid hormone is released by the tumor.
Parathyroid hormone is released by the tumor.
After receiving a change-of-shift report on the urology unit, which patient does the nurse assess first? Patient with glomerulonephritis who has cola-colored urine Patient with nephrotic syndrome who has gained 2 kg since yesterday Patient who was involved in a motor vehicle crash and has hematuria Patient with post-radical nephrectomy whose temperature is 99.8° F (37.6° C)
Patient who was involved in a motor vehicle crash and has hematuria
Which kidney disease would have higher incidence of cerebral aneurysms? Pyelonephritis Acute kidney injury Glomerulonephritis Polycystic kidney disease
Polycystic kidney disease
When caring for a patient with polycystic kidney disease, which goal is most important? Performing genetic testing Assessing for related causes Consulting with the dialysis unit Preventing progression of the disease
Preventing progression of the disease
When preparing a patient for a nephrostomy tube insertion, it is essential for the nurse to monitor which factor before the procedure? Intake and output (I&O) Hemoglobin and hematocrit (H&H) Blood urea nitrogen (BUN) and creatinine Prothrombin time (PT) and International Normalized Ratio (INR)
Prothrombin time (PT) and International Normalized Ratio (INR)
A patient presents with hydronephrosis because of a kidney stone. Which procedure does the nurse expect the health care provider to prescribe to remove the kidney stone? Nephrostomy Pyelolithotomy Nephrectomy Ureteroplasty
Pyelolithotomy
Which procedure is preferred for the removal of a large stone from the kidney pelvis? Nephrostomy Ureteroplasty Nephrectomy Pyelolithotomy
Pyelolithotomy
Which staff member should care for a newly admitted patient who is diabetic, has pyelonephritis and prescriptions for intravenous antibiotics, and who needs blood glucose monitoring every 2 hours and insulin administration? RN who is caring for a patient who just returned after having renal artery balloon angioplasty RN who has just completed preoperative teaching for a patient who is scheduled for nephrectomy RN who is currently admitting a patient with acute hypertension and possible renal artery stenosis RN whose other assignments include a patient receiving chemotherapy for renal cell carcinoma
RN who has just completed preoperative teaching for a patient who is scheduled for nephrectomy
When taking the health history of a patient with acute glomerulonephritis, the nurse questions the patient about which related cause of the problem? Hypertension Neoplastic disease Unexplained weight loss Recent respiratory infection
Recent respiratory infection
Which findings indicate that a patient is progressing normally 12 hours after a nephrostomy tube is inserted? Select all that apply. Some correct answers were not selected Red-tinged urine Leakage of urine or blood Complaints of severe back pain Blood pressure of 115/75 mm Hg Minimum urine excretion of 30ml/hr
Red-tinged urine Blood pressure of 115/75 mm Hg Minimum urine excretion of 30ml/hr
Which patient action may cause complications if the patient has polycystic kidney disease? Reducing fluid intake Maintaining healthy weight Performing regular exercise Adhering to a sodium-restricted diet
Reducing fluid intake
The nurse is assessing a patient for early signs of renal cell carcinoma (RCC). What finding does the nurse expect in this patient? Bloody urine Gynecomastia Renal bruit on auscultation Sharp, intermittent flank pain
Renal bruit on auscultation
What does the nurse teach a patient with polycystic kidney disease about managing the disease? Measure and record temperature every day. Report any headache and visual disturbances. Measure and record body weight every month. Monitor bowel movements to prevent diarrhea.
Report any headache and visual disturbances.
The nurse is caring for a patient with kidney trauma. The patient has a considerable loss of blood. What intervention should the nurse perform? Take vital signs every 30 minutes. Measure and record urine output every 30 minutes. Report urethral bleeding prior to urinary catheterization. Monitor the patient for nausea when fluids are administered.
Report urethral bleeding prior to urinary catheterization.
Which laboratory parameter indicates impaired kidney function? Serum creatinine of 3.1 mg/dL Serum calcium of 13.5 mg/dL Serum bicarbonate of 28 mEq/L Blood urea nitrogen (BUN) of 9 mg/dL
Serum creatinine of 3.1 mg/dL
Which are risk factors for renal cell carcinoma? Select all that apply. Some correct answers were not selected Obesity Smoking Older age Male gender Family history
Smoking Older age Family history
Which condition may predispose a patient to chronic pyelonephritis? Hepatic failure Cardiomyopathy Spinal cord injury Glomerulonephritis
Spinal cord injury
Which stage of kidney tumor includes extension into the patient's renal vein, lymph nodes, or both? Stage I Stage II Stage III Stage IV
Stage III
The nurse is caring for a patient with acute glomerulonephritis (GN) who has a total urine output of 350 mL in 24 hours. Which intervention would the nurse include in the plan of care? Teach the patient to limit intake of potassium. Plan a diet that ensures a high protein intake. Advise that the patient takes prescribed antibiotics while symptomatic. Encourage a fluid intake of at least 1200 mL in 24 hours.
Teach the patient to limit intake of potassium.
What drug used to treat renal carcinoma blocks a protein that is needed for cell division? Sorafenib Interleukin-2 Temsirolimus Interferon alpha
Temsirolimus
The nurse assesses a patient who has undergone nephrostomy and determines that the patient's drainage tube has become dislodged. What finding supports the nurse's conclusion? Drainage increases. The drainage is clear. The patient reports increased back pain. Red-tinged urine for the first hour following the patient's surgery.
The patient reports increased back pain.
The nurse caring for a patient with suspected chronic pyelonephritis receives the following laboratory results: creatinine 8 mg/dL, BUN 53 mg/dL, serum sodium 138 mEq/L, potassium 5.5 mEq/L, phosphate 6 mg/dL, calcium 8.0 mg/dL. Based on the laboratory results, what conclusion can the nurse make? The patient's lab work is reflective of renal failure. The patient's lab work reflects normal kidney function. The patient's lab work is reflective of decreased kidney function. The patient's kidney function cannot be determined by the lab results.
The patient's lab work is reflective of decreased kidney function.
The labor and delivery nurse is caring for an obstetric patient who has a newborn with an autosomal-recessive polycystic kidney disease (PKD) trait. What is the nurse's understanding of the future implications for the newborn? The trait is recessive, so no further treatment will be required. There is a higher incidence of death in childhood from the disease. The baby will need to be placed on a waiting list for a kidney transplant. Treatment for the newborn can be started to prevent the disease from occurring.
There is a higher incidence of death in childhood from the disease.
Which sign or symptom when assessed in a patient with chronic glomerulonephritis (GN) warrants a call to the health care provider? Itchy skin Mild proteinuria Third heart sound (S 3) Serum potassium of 5.0 mEq/L
Third heart sound (S 3)
Why is cortisol hormonal replacement required for patients with renal cell carcinoma after the surgical removal of one kidney (nephrectomy)? To manage pain To prevent infections To manage adrenal insufficiency To improve function of second kidney
To manage adrenal insufficiency
When caring for a patient who had a nephrostomy tube inserted 4 hours ago, which is essential for the nurse to report to the health care provider? Dark pink-colored urine Creatinine of 1.8 mg/dL Tube that has stopped draining Small amount of urine leaking around the catheter
Tube that has stopped draining
A patient with a history of diabetes mellitus and cataracts is diagnosed with pyelonephritis. What does the nurse identify as the possible cause of pyelonephritis in the patient? Use of antibiotics Use of antihypertensive drugs Use of oral hypoglycemic drugs Use of nonsteroidal anti-inflammatory drugs
Use of nonsteroidal anti-inflammatory drugs
A 55-year-old patient who presents to the primary care clinic with a sudden onset of hypertension tells the nurse, 'I don't understand why I would have high blood pressure. No one in my family has high blood pressure.' What teaching will the nurse most likely provide to the patient? -Instructions on decreasing overall daily stress -Instructions on increasing overall daily fluid intake -Ways to decrease the development and progression of atherosclerosis -Ways to decrease the development and progression of chronic kidney infection
Ways to decrease the development and progression of atherosclerosis
