Exam 3 Prep U

Glomerular filtration rate (GFR) is the best indicator of renal function. The nurse knows that GFR can vary with which factors? Select all that apply.

Gender Age Body size Ethnicity

Which physiologic process is performed by the kidneys and contributes to increased blood pressure?

Production and release of renin

The nurse is caring for a female client with cholelithiasis. When teaching the client about the disease, the nurse includes which of these points?

"Gallstones have developed, which are typically composed of cholesterol."

A hospitalized older adult asks the nurse how he acquired Clostridium difficile while taking an antibiotic medication. Which is the best response by the nurse?

"The administration of broad-spectrum antibiotics can disrupt the normal microbial balance and allow overgrowth of species."

Following a history of gastric pain and an endoscopy, a client has been diagnosed with a duodenal peptic ulcer. Which teaching point should his caregiver provide?

"Your family history, your smoking history, and NSAID use may all have contributed to this problem."

The nurse is working in a pediatric clinic. Which child would the nurse recognize as having isosexual precocious puberty?

A 5-year-old black female with developing breasts and pubic hair

Which client is displaying manifestations of having a kidney stone?

Acute onset of colicky flank pain radiating to lower abdomen

A client has been diagnosed with dysfunction of the anterior pituitary gland. The nurse is aware that which hormones will likely be affected? Select all that apply.

Adrenocorticotropic hormone (ACTH) Thyroid-stimulating hormone (TSH) Growth hormone (GH) Luteinizing hormone (LH)

A client newly diagnosed with glomerulonephritis asks the nurse, "What caused me to get this disease?" Which response by the nurse is most accurate?

Antigen-antibody complexes

A client develops interstitial edema as a result of decreased:

Colloidal osmotic pressure

What is the action of renin in the renin-angiotensin-aldosterone mechanism?

Converts angiotensinogen to angiotensin I

Anemia frequently occurs in clients with chronic kidney disease (CKD). The nurse will monitor these clients for which contributors to anemia? Select all that apply.

Decreased erythropoietin production Anorexia Bone marrow suppression Chronic blood loss

Manifestations of childhood renal disease are varied and may differ from adult-onset renal failure. A school-aged child with chronic kidney disease may exhibit which manifestation?

Developmental delays such as uncoordinated gait and minimal fine motor skills

A client goes to the health care provider following several days of nausea/vomiting and abdominal pain. After assessment, the provider thinks the client has Helicobacter pylori (H. pylori) infection. Which complications of H. pylori should the client be educated about if this infection is not eradicated? Select all that apply.

GI bleeding due to peptic ulcer formation Gastric cancer due to metaplasia changes in the cells

A client is hospitalized and being treated for an acute kidney injury. Which information is most useful to the nurse while evaluating for improvement in kidney function?

Glomerular filtration rate (GFR)

When the nurse is performing a health history for a client who is being admitted for hyperthyroidism, what symptom does the client report that the nurse would find associated with this disorder?

Increase in appetite

Following a needlestick injury, a nurse develops hepatitis C that eventually developed into a chronic infection. The health care provider counsels the nurse to assess for which major complications that can result from this chronic condition? Select all that apply.

Progressive liver fibrosis Liver Cancer

A client comes to the clinic with fatigue and muscle weakness. The client also states she has been having diarrhea. The nurse observes the skin of the client has a bronze tone and when asked, the client says she has not had any sun exposure. The mucous membranes of the gums are bluish-black. When reviewing laboratory results from this client, what does the nurse anticipate seeing?

Increased levels of ACTH

Which statements are true regarding a Wilms tumor? Select all that apply.

It is the most common childhood malignant tumor. It presents with an abdominal mass. Treatment includes chemotherapy, radiation and surgery.

Diverticulitis is the herniation of tissue of the large intestine through the muscularis layer of the colon. It is often asymptomatic and is found in approximately 80% of people over the age of 85. Diverticulitis is often asymptomatic, but when symptoms do occur, what is the most common complaint of the client?

Lower left quadrant pain with nausea and vomiting

Staghorn kidney stones, or struvite stones, are usually located in the renal pelvis. These stones are made from:

Magnesium ammonium phosphate

A client is diagnosed with chronic kidney disease (CKD). The nurse recognizes that which statements regarding CKD are correct? Select all that apply.

Nephron destruction takes place over many months. Signs and symptoms develop gradually. Functioning nephrons compensate for those that are damaged. There is a reduction in glomerular filtration rate (GFR) as nephrons are destroyed.

The client with ulcerative colitis should be assessed by the health care provider for which clinical manifestations associated with this disease? Select all that apply.

Persistent diarrhea Stool containing blood (hematochezia)

The hallmark manifestations of Cushing syndrome are a moon face, a "buffalo hump" between the shoulder blades, and a protruding abdomen. What other manifestations of Cushing syndrome occur?

Thin extremities and muscle weakness

A client with a history of an endocrine disorder exhibits signs and symptoms of hormone deficiency. Which process would the client's care team most likely rule out first as a contributing factor?

Up-regulation has increased the sensitivity of the body to particular hormone levels.

Clients with which medical history will have an increased risk for developing urinary tract infections? Select all that apply.

Urinary obstruction Neurogenic disorders Elderly Prostate disease

A teenager has been admitted with the diagnosis of Alport syndrome. The client has been passing large amounts of blood in the urine. Knowing that this disorder is inherited and associated with other abnormalities, the nurse should focus assessment on which area?

Visual disturbances and hearing loss

The nurse is assessing a male client and finds abnormally large hands and feet, a bulbous nose, and a broad face with a protruding jaw. Based on these findings, which endocrine abnormality is most likely the cause for these physical changes?

acromegaly

Which enzyme is found in the mouth and is the first to initiate the breakdown of starches?

amylase

The nurse teaches the client with hyperparathyroidism that he is at risk for:

developing kidney stones.

The nurse is planning an education seminar on polycystic kidney disease. Which topic should the nurse include as a key indicator of both autosomal dominant and autosomal recessive polycystic kidney disease?

hypertension

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

increase blood pressure

A client is diagnosed with syndrome of inappropriate antidiuretic hormone as a result of an inoperable brain tumor. When assessing the laboratory results for this client, which finding does the nurse anticipate?

increase in urine osmolality

When caring for the client with hepatic failure, the nurse recognizes that which problem places the client at increased risk for bleeding?

increased prothrombin time

A client tells the nurse that he experiences diarrhea after eating ice cream or cheese. The nurse tells the client he may have a deficiency of:

lactase

While teaching a family member about the development of hepatic encephalopathy, which cause is likely to be mentioned?

neurotoxin accumulation

The prostate gland functions in the elimination of urine. The nurse knows that the prostate gland if enlarged can cause which dysfunction of the urinary system?

obstruction

The nurse cares for a client with type 2 diabetes. The nurse determines the client is at highest risk for foot ulcer formation based on which assessment findings?

report of decreased sensation and cool, pale feet

Helicobacter pylori proteobacteria cause peptic ulceration by producing which substance that interferes with local protection of gastric acid?

toxins

An older male client is experiencing difficulty initiating urination, and notes that the force and volume of the stream is reduced. What assessment data indicates benign prostatic hyperplasia (BPH)?

weak urinary stream