med surg exam 4 ATI questions

A. <0.5 mL/kg of urine output for 12 hr B. no urine output for 12 hr C. no UO without renal replacement therapy D. no UO without renal replacement therapy for more than 3 months ANS: D

a nurse is assessing a client who has AKI. according to the RIFLE classification system, which of the following findings indicates that the client has end stage kidney disease?

A. ureter B. bladder C. renal pelvis D. renal tubules ANS: A

a nurse is assessing a client who has urolithiasis and reports pain in his thigh. this finding indicates the stone is in which of the following structures?

A. elevated BUN B. bradycardia C. headache D. temp of 102.5 ANS: headache **DDS causes HA, NV, decreased LOC, seizures, and restlessness

a nurse is assessing a client who is receiving hemodialysis for the first time. which of the following findings indicates the client is developing dialysis disequilibrium syndrome?

A. difficulty draining the effluent B. redness at the access site C. fluid flowing from the catheter site D. cloudy effluent ANS: D *cloudy or opaque effluent indicates client is at high risk for peritonitis therefor this is priority. A is a result of clamped tubing, fibrin clot, or kinked catheter. B indicates client is at risk for infection but the other one is priority. C indicates at risk for leakage which can create a need for hemodialysis support

a nurse is assessing a client who is receiving peritoneal dialysis. which of the following findings should the nurse report the provider ASAP

A. maintain the child on strict bed rest B. check the child's BP Q 4 hr C. administer albumin to the child Q 8 hr D. provide the child with low carb diet ANS: B *monitor for hypertension. glomerulonephritis does not require strict bed rest. there is no restriction on carb consumption. albumin is to help with edema but this is a mild problem with glomerulonephritis

a nurse is caring for a child who has acute glomerulonephritis. which of the following actions should the nurse take?

A. platelets 120,000 B. sodium 160 C. hgb 9 D. cholesterol 700 ANS: D *a client with nephrotic syndrome will have high cholesterol bc of increase in plasma lipids. they also have increased platelet count (the above number is below normal) bc of hemoconcentration. they also have low sodium levels and hgb will be normal

a nurse is caring for a child who has suspected nephrotic syndrome. which of the following lab values should the nurse expect?

A. hypotension B. elevated serum lipid levels C. decreased serum potassium D. hematuria ANS: D * elevated BP is a manifestation. lipid levels are WNL. potassium are WNL or elevated

a nurse is caring for a child with acute post streptococcal glomerulonephritis. which of the following manifestations should the nurse expect?

A. relieve the client's pain B. encourage the client to increase fluid intake C. monitor the client's I&O D. strain the urine ANS: A

a nurse is caring for a client who has a diagnosis of renal calculi and reports severe flank pain. which of the following is the priority nursing action?

A. hypotension B. diuresis C. increased glucose D. weight gain ANS: B *hypotension is an adverse effect

a nurse is caring for a client who has acute glomerulonephritis and a prescription for furosemide. the nurse should monitor the client for which of the following therapeutic effects of this med?

A. place client in respiratory isolation B. monitor VS Q 2 hr C. assess neuro status Q 4 hr D. maintain the client in modified trendelenburg position E. keep room dark ANS: B,C,E

a nurse is caring for a client who has encephalitis due to west nile. which of the following actions should the nurse take? SATA

A. hemodialysis B. biopsy C. immunosuppression D. balloon angioplasty E. surgical repair ANS: A,B,C

a nurse is caring for a client who has manifestations of acute tubular necrosis following kidney transplant. which of the following interventions should the nurse anticipate for this client? SATA

A. add gestures when speaking with the client B. ask open ended questions C. limit visitors to 3 at a time D. use different words if the client does not understand the statement ANS: A

a nurse is caring for a client who has moderate alzheimers. which of the following actions should the nurse take?

A. administer an analgesic to the client B. check the client's electrolytes C. measure the client's weight D. restrict protein intake ANS: B

a nurse is caring for a client who is in the oliguric stage of AKI. the client reports diarrhea, a dull headache, palpitations, and muscle tingling and weakness. which of the following actions should the nurse take first?

A. diarrhea B. increased albumin C. hypoglycemia D. peritonitis ANS: D diarrhea is not an adverse effect but constipation is. hyperglycemia is an adverse effect

a nurse is caring for a client who is receiving peritoneal dialysis. the nurse should monitor the client for which of the following adverse effects?

A. hypotension B. stomatitis C. bloody diarrhea D. periorbital edema ANS: D

a nurse is caring for an 8 year old child who has acute glomerulonephritis. which of the following findings should the nurse expect?

A. dysrhythmias B. pink tinged urine C. bruising on the flank area D. stone fragments in the urine ANS: A

a nurse is monitoring a client who is undergoing extracorpeal shockwave lithotripsy. the nurse should identify that which of the following findings is the priority?

A. provide thorough skin care B. test for blood type and cross match C. allow ample hydrating fluids D. maintain a low carb diet ANS: A **skin care is important d/t edema and risk for infection. child is not likely to have blood transfusion. fluid restriction may be necessary. diet might require protein, sodium, and fat restrictions but no indication for low carb diet

a nurse is planning care for a 4 year old child who has nephrotic syndrome. which of the following actions should the nurse take?

A. prerenal azotemia begins prior to the onset of symptoms B. interference with renal perfusion causes prerenal azotemia C. prerenal azotemia is irreversible, even in early stages D. infections and tumors cause prerenal azotemia ANS: B *results from interference with renal perfusion such as from heart failure or hypovolemic shocl

a nurse is preparing an in service program about the stages of AKI. which of the following pieces of info should the nurse include about prerenal azotemia?

A. calcium B. phosphorous C. potassium D. sodium ANS: A

a nurse is providing dietary teaching to a client with CKD. which of the following nutrients should the nurse instruct the client to increase in her diet?

A. restrict potassium in diet B. administer acetaminophen to the child twice daily C. weigh the child once each week D. keep the child away from people who have an infection ANS: D *restrict sodium intake and in severe cases, restrict fluids. a child with glomerulonephritis should have restricted potassium intake

a nurse is providing discharge teaching to the parents of a child who has nephrotic syndrome. which of the following instructions should the nurse include in the teaching?

A, drink fruit punch or juice with every meal B. consume 1,000 mg of dietary calcium daily C. take 1 g of vitamin C daily increase your daily bran intake ANS: B

a nurse is providing teaching to a young adult client who has a history of calcium oxalate renal calculi. which of the following instructions should the nurse include?

A. place abstract pictures on the wall in the room B. provide music using headphones C. reorient the client to reality frequently D. limit choices offered to the client ANS: D

a nurse is providing teaching to the family of a client with stage 2 alzheimers. which of the following pieces of info should the nurse include in the teaching?

A. hypernatremia B. hypomagnesemia C. hypercalcemia D. hyperkalemia ANS: D

a nurse is reviewing the labs of a client with CKD. the client reports significant persistent nausea and muscle weakness. which of the following findings should the nurse expect?

A. renal impairment B. ischemic heart disease C. severe osteoporosis D. cirrhosis ANS: B

a nurse is reviewing the medical record for a client who has a migraine and a prescription for sumatriptan. which of the following factors in the client's medical history should the nurse identify as a contraindication to receiving sumatriptan?

A. you should complete the entire cycle of antibiotic therapy B. you should maintain bed rest until manifestations decrease C. you should drink 1,000 mL of fluid per day D. you should avoid using NSAIDS for pain ANS: A *people with acute pyelonephritis can take NSAIDs as needed for pain unless otherwise contraindicated

a nurse is teaching a client who has acute pyelonephritis. which of the following instructions should the nurse include in the teaching?

A. douche after sex B. wipe from front to back after defecation C. avoid foods high in phosphate D. add yogurt to your diet regularly ANS: B

a nurse is teaching a female client who has pyelonephritis about the disorder. which of the following pieces of info should nurse include to help the client prevent a recurrence?

A. a full therapeutic response may take several months to happen B. the med should be taken with high protein foods C. a full therapeutic response might cause vivid dreams D. the med is given at the onset of mild symptoms ANS: A

a nurse is teaching about levodopa with a family member of a client who has parkinsons. which of the following pieces of info should the nurse include?

A. you should chew the med prior to swallowing B. you should take this late in the evening C. you should take with food D. if you miss taking a dose, take 2 doses the following day ANS: B

a nurse is teaching about taking donepezil with a client who was recently diagnosed with alzheimers. which of the instructions should the nurse include in the teaching?