GU Questions Chapters 53 & 54

Treatment of metabolic acidosis in chronic renal failure includes: Hemodialysis No treatment Peritoneal dialysis Sodium bicarbonate supplements

No treatment

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

Urine output of 20 ml/hour

A client presents to the emergency department complaining of a dull, constant ache along the right costovertebral angle along with nausea and vomiting. The most likely cause of the client's symptoms is: acute prostatitis. interstitial cystitis. an overdistended bladder. renal calculi.

renal calculi.

The client with polycystic kidney disease asks the nurse, "Will my kidneys ever function normally again?" The best response by the nurse is: "Dietary changes can reverse the damage that has occurred in your kidneys." "As the disease progresses, you will most likely require renal replacement therapy." "Genetic testing will determine the best treatment for your condition." "Draining of the cysts and antibiotic therapy will cure your disease."

"As the disease progresses, you will most likely require renal replacement therapy."

The nurse is providing instructions to the client prior to an intravenous pyelogram. Which statement by the client indicates teaching was effective? "I should let the staff know if I feel claustrophobic." "I will feel a warm sensation as the dye is injected." "I should remove all jewelry before the test." "I will need to drink all of the dye as quickly as possible."

"I will feel a warm sensation as the dye is injected."

The nurse is explaining the steps for collecting a clean catch urine specimen to a client. Which statement by the client indicates effective teaching? "After I clean the area, I can let go of my labia to hold the container." "I'll start to urinate for a few seconds and then start to collect the specimen." "I need to use one antiseptic wipe to clean the sides and down the middle." "I need to collect at least 100 mL of urine for the specimen."

"I'll start to urinate for a few seconds and then start to collect the specimen."

A client with chronic renal failure comes to the clinic for a visit. During the visit, he complains of pruritus. Which suggestion by the nurse would be most appropriate? "Liberally apply alcohol to the areas of your skin where you itch the most." "Try washing clothes with a strong detergent to ensure that all impurities are gone." "Keep your showers brief, patting your skin dry after showering." "When you shower, use really warm water and an antibacterial soap."

"Keep your showers brief, patting your skin dry after showering."

When fluid intake is normal, the specific gravity of urine should be 1.000 Less than 1.010 Greater than 1.025 1.010 to 1.025

1.010 to 1.025

A nurse is assisting the physician conducting a cystogram. The client has an intravenous (IV) infusion of D5W at 40 ml/hr. The physician inserts a urinary catheter into the bladder and instills a total of 350 ml of a contrast agent. The nurse empties 500 ml from the urinary catheter drainage bag at the conclusion of the procedure. How many milliliters does the nurse record as urine? ml ______________________________

150ML

The nurse is completing a full exam of the renal system. Which assessment finding best documents the need to offer the use of the bathroom? A dull sound when percussing over the bladder Tenderness over the kidneys Bruits noted over the abdominal area The ingestion of 8 oz of water

A dull sound when percussing over the bladder

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

Acute glomerulonephritis

The nurse is reviewing the potassium level of a patient with kidney disease. The results of the test are 6.5 mEq/L, and the nurse observes peaked T waves on the ECG. What priority intervention does the nurse anticipate the physician will order to reduce the potassium level? Administration of an insulin drip Administration of sodium bicarbonate Administration of sodium polystyrene sulfonate [Kayexalate]) Administration of a loop diuretic

Administration of sodium polystyrene sulfonate [Kayexalate])

Which hormone causes the kidneys to reabsorb sodium? Antidiuretic hormone Prostaglandins Aldosterone Growth hormone

Aldosterone

A client is undergoing diagnostics due to a significant drop in renal output. The physician has scheduled an angiography. What postprocedural assessment will the nurse perform on the client? Monitor hypersensitivity response. Palpate pedal pulses. All options are correct. Monitor site condition.

All options are correct.

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 patient? Anemia Pericarditis Hyperkalemia Acidosis

Anemia

A patient has undergone a renal biopsy. After the test, while the patient is resting, the patient complains of severe pain in the back, arms, and shoulders. Which of the following appropriate nursing interventions should be offered by the nurse? Enable the patient to sit up and ambulate. Distract the patient's attention from the pain. Asses the patient's back and shoulder areas for signs of internal bleeding. Provide analgesics to the patient.

Asses the patient's back and shoulder areas for signs of internal bleeding.

Following a renal biopsy, a client reports severe pain in the back, the arms, and the shoulders. Which intervention should be offered by the nurse? Distract the client's attention from the pain. Enable the client to sit up and ambulate. Provide analgesics to the client. Assess the patient's back and shoulder areas for signs of internal bleeding.

Assess the patient's back and shoulder areas for signs of internal bleeding.

Which of the following is a term used to describe excessive nitrogenous waste in the blood, as seen in acute glomerulonephritis? Proteinuria Hematuria Azotemia Bacteremia

Azotemia

Question 3 of 10 A client has undergone diagnostic testing that involved the insertion of a lighted tube with a telescopic lens. The nurse identifies this test as which of the following? A. Excretory urogram B.Cystoscopy C.Renal angiography D. Intravenous pyelography

B.Cystoscopy

The nurse is caring for a client prescribed gentamicin 110 mg every 8 hours for 10 days. Which laboratory study is anticipated to monitor medication side effects? Creatinine clearance test BUN and serum creatinine Urine osmolality Blood chemistry

BUN and serum creatinine

The nurse is providing care to a client who has had a kidney biopsy. The nurse would need to be alert for signs and symptoms of which of the following? Infection Allergic reaction Dehydration Bleeding

Bleeding

The nurse is providing care to a client who has had a renal biopsy. The nurse would need to be alert for signs and symptoms of which of the following? Dehydration Infection Bleeding Allergic reaction

Bleeding

A client with chronic renal failure (CRF) is admitted to the urology unit. Which diagnostic test results are consistent with CRF? Increased serum levels of potassium, magnesium, and calcium Increased pH with decreased hydrogen ions Blood urea nitrogen (BUN) 100 mg/dl and serum creatinine 6.5 mg/dl Uric acid analysis 3.5 mg/dl and phenolsulfonphthalein (PSP) excretion 75%

Blood urea nitrogen (BUN) 100 mg/dl and serum creatinine 6.5 mg/dl

The client is admitted to the hospital with a diagnosis of acute pyelonephritis. Which clinical manifestations would the nurse expect to find? A. Pain after voiding B. Suprapubic pain C.Costovertebal angle tenderness D. Perineal pain

C.Costovertebal angle tenderness

When preparing a client for hemodialysis, which of the following would be most important for the nurse to do? Warm the solution to body temperature. Check for thrill or bruit over the access site. Add the prescribed drug to the dialysate. Inspect the catheter insertion site for infection.

Check for thrill or bruit over the access site.

The nurse reviews a client's history and notes that the client has a history of hyperparathyroidism. The nurse would identify that this client most likely would be at risk for which of the following? Fistula Chronic renal failure Neurogenic bladder Kidney stones

Kidney stones

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

Citrus fruits

Which nursing assessment finding indicates the client with renal dysfunction has not met expected outcomes? Client reports increasing fatigue. Client denies frequency and urgency. Urine output is 100 ml/hr. Client rates pain at a 3 on a scale of 0 to 10.

Client reports increasing fatigue.

The nurse is assessing a client at the diagnostic imaging center. For which diagnostic test would the client assess for an allergy to shellfish? Computed tomography with contrast Cystoscopy Bladder ultrasonography Radiography

Computed tomography with contrast

A patient is being seen in the clinic for possible kidney disease. What major sensitive indicator of kidney disease does the nurse anticipate the patient will be tested for? Blood urea nitrogen level Serum potassium level Uric acid level Creatinine clearance level

Creatinine clearance level

A nurse is reviewing the laboratory test results of a client with renal disease. Which of the following would the nurse expect to find? A. Decreased potassium B.Decreased blood urea nitrogen (BUN) C. Increased serum albumin D.Increased serum creatinine

D.Increased serum creatinine

A client who suffered hypovolemic shock during a cardiac incident has developed acute renal failure. Which is the best nursing rationale for this complication? Blood clot formed in the kidneys interfered with the flow Obstruction of urine flow from the kidneys Structural damage occurred in the nephrons of the kidneys Decrease in the blood flow through the kidneys

Decrease in the blood flow through the kidneys

An elderly client is being evaluated for suspected pyelonephritis and is ordered kidney, ureter, and bladder (KUB) x-ray. The nurse understands the significance of this order is related to which rationale? If risk for chronic pyelonephritis is likely Detects calculi, cysts, or tumors Shows damage to the kidneys Reveals causative microorganisms

Detects calculi, cysts, or tumors

An appropriate nursing intervention for the client following a nuclear scan of the kidney is to: Encourage high fluid intake. Strain all urine for 48 hours. Monitor for hematuria. Apply moist heat to the flank area.

Encourage high fluid intake.

Following a voiding cystogram, the client has a nursing diagnosis of risk for infection related to the introduction of bacterial following manipulation of the urinary tract. An appropriate nursing intervention for the client is to: Strain all urine for 48 hours. Encourage high fluid intake. Apply moist heat to the flank area. Monitor for hematuria.

Encourage high fluid intake.

A nurse identifies a nursing diagnosis of risk for ineffective breathing pattern related to incisional pain and restricted positioning for a client who has had a nephrectomy. Which of the following would be most appropriate for the nurse to include in the client's plan of care? Monitor temperature every 4 hours. Administer isotonic fluid therapy as ordered. Encourage use of incentive spirometer every 2 hours. Keep the drainage catheter below the level of insertion.

Encourage use of incentive spirometer every 2 hours.

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? "Even a perfect match does not guarantee organ success." "Let's wait until after the surgery to discuss your treatment plan." "The doctor may decide to delay the use of immunosuppressant drugs." "Immunosuppressive drugs guarantee organ success

Even a perfect match does not guarantee organ success."

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

Fever

Which of the following causes should the nurse suspect in a client is diagnosed with intrarenal failure? Dysrhythmia Ureteral calculus Hypovolemia Glomerulonephritis

Glomerulonephritis

The nurse recognizes which condition as an integumentary manifestation of chronic renal failure? Seizures Tremors Asterixis Gray-bronze skin color

Gray-bronze skin color

The nurse is caring for a patient after kidney surgery. What major danger should the nurse closely monitor for? Pneumonia caused by shallow breathing because of severe incisional pain Paralytic ileus caused by manipulation of the colon during surgery Hypovolemic shock caused by hemorrhage Abdominal distention owing to reflex cessation of intestinal peristalsis

Hypovolemic shock caused by hemorrhage

A client has end-stage renal failure. Which of the following should the nurse include when teaching the client about nutrition to limit the effects of azotemia? Eliminate fat intake and increase protein intake. Increase carbohydrates and limit protein intake. Increase fat intake and limit carbohydrates. Increase protein, carbohydrates, and fat intake.

Increase carbohydrates and limit protein intake.

A client reports urinary frequency, urgency, and dysuria. Which of the following would the nurse most likely suspect? Infection Nephrotic syndrome Acute renal failure Obstruction of the lower urinary tract

Infection

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? "The infusion clamp should be open during infusion." "It is appropriate to warm the dialysate in a microwave." "The effluent should be allowed to drain by gravity." "It is important to use strict aseptic technique."

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

When assessing the impact of medications on the etiology of ARF, the nurse recognizes which of the following as the drug that is not nephrotoxic? Penicillin Neomycin Gentamicin Tobramycin

Penicillin

After teaching a group of students about urolithiasis, the instructor determines that additional teaching is needed when the students identify which of the following as a possible risk factor? Diabetes Prolonged exercise Decreased intake of Vitamin D Gout

Prolonged exercise

What is a hallmark of the diagnosis of nephrotic syndrome? Hyponatremia Hypokalemia Proteinuria Hypoalbuminemia

Proteinuria

A client is scheduled for a renal arteriogram. When the nurse checks the chart for allergies to shellfish or iodine, she finds no allergies recorded. The client is unable to provide the information. During the procedure, the nurse should be alert for which finding that may indicate an allergic reaction to the dye used during the arteriogram? Increased alertness Hypoventilation Pruritus Unusually smooth skin

Pruritus

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? Acute pyelonephritis Renal calculi Osmotic dieresis. Dysrhythmias

Renal calculi

The nurse is caring for a client who is brought to the emergency department after being found unconscious outside in hot weather. Dehydration is suspected. Baseline lab work including a urine specific gravity is ordered. Which relation between the client's symptoms and urine specific gravity is anticipated? The specific gravity will be high. The specific gravity will be low The specific gravity will be inversely proportional The specific gravity will equal to one

The specific gravity will be high. p. 1520.

A client comes to the Emergency Department complaining of a sudden onset of sharp, severe flank pain. During the physical examination, the client indicates that the pain, which comes in waves, travels to the suprapubic region. He states, "I can even feel the pain at the tip of my penis." Which of the following would the nurse suspect? Acute glomerulonephritis Ureteral stricture Renal cell carcinoma Urinary calculi

Urinary calculi

The most frequent reason for admission to skilled care facilities includes which of the following? Stroke Myocardial infarction Congestive heart failure Urinary incontinence

Urinary incontinence

A client admitted with a gunshot wound to the abdomen is transferred to the intensive care unit after an exploratory laparotomy. I.V. fluid is being infused at 150 ml/hour. Which assessment finding suggests that the client is experiencing acute renal failure (ARF)? Blood urea nitrogen (BUN) level of 22 mg/dl Urine output of 250 ml/24 hours Temperature of 100.2° F (37.8° C) Serum creatinine level of 1.2 mg/dl

Urine output of 250 ml/24 hours

A client is scheduled for a renal ultrasound. Which of the following would the nurse include when explaining this procedure to the client? a. "A contrast medium will be used to help see the structures better." b. "An x-ray will be done to view your kidneys, ureters, and bladder." c. "You'll have a pressure dressing on your groin after the test." d."You don't need to do any fasting before this noninvasive test."

d."You don't need to do any fasting before this noninvasive test."

When the bladder contains 400 to 500 mL of urine, this is referred to as functional capacity. specific gravity. renal clearance. anuria.

functional capacity.

A client is experiencing some secretion abnormalities, for which diagnostics are being performed. Which substance is typically reabsorbed and not secreted in urine? glucose chloride creatinine potassium

glucose

One of the roles of the nurse in caring for clients with chronic renal failure is to help them learn to minimize and manage potential complications. This would include: eating protein liberally. restricting sources of potassium usually found in fresh fruits and vegetables. allowing liberal use of sodium. limiting iron and folic acid intake.

restricting sources of potassium usually found in fresh fruits and vegetables.

A nurse receives her client care assignment. Following the report, she should give priority assessment to the client: with pinkish mucus discharge in the appliance bag 2 days after an ileal conduit. who is experiencing mild pain from urolithiasis. who has a sodium level of 135 mEq/L and a potassium level of 3.7 mEq/L 7 days after a kidney transplant. who, following a kidney transplant, has returned from hemodialysis with a sodium level of 110 mEq/L and a potassium level of 2.0 mEq/L.

who, following a kidney transplant, has returned from hemodialysis with a sodium level of 110 mEq/L and a potassium level of 2.0 mEq/L.

The nurse observes the color of the client's urine which appears pale blue-green. The nurse obtains a drug history from the client based on the understanding that drugs used by the client may affect which of the following? Urine specific gravity Amount of urine produced Size of the urinary bladder Urinary tract tests

Urinary tract tests