NCLEX Liver_Kidney Questions
What nursing measure would be included in the plan of care for a client with acute renal failure? 1) Observe for signs of a secondary infection 2) Provide a high protein, low carbohydrate diet 3) In and out catheterization for residual urine 4) Encourage fluids to 2000 mL in 24 hours
1: Secondary infections are the cause of death in 50-90% of clients with acute renal failure. A low protein diet is most often offered. Catheterizations are avoided. Fluids may be limited if the client is in ARF.
A client in renal failure is to have a serum blood urea nitrogen level determined. What will this diagnostic test measure? 1) Concentration of urine osmolarity and electrolytes 2) Serum level of the end products of protein 3) Ability of kidneys to concentrate urine 4) Levels of C-reactive protein to determine inflammation
2: Urea is an end product of protein metabolism. In renal failure, the kidneys cannot clear all of the urea from the blood, and the creatinine and BUN level will be elevated. The C-reactive protein is a diagnostic test used in assessing clients with inflammatory bowel disease, rheumatoid arthritis, autoimmune diseases, and PID. A specific gravity test of the urine would assess the ability of the kidneys to concentrate urine. The urine osmolarity (concentration of particles in urine) and electrolytes assess fluid balance. The kidneys play an important role in the balance of electrolytes and fluids.
The nurse explains that pruritus in the patient with hepatitis is related to: 1. decreased fat intake. 2. poor appetite and therefore poor protein intake. 3. accumulation of bile salts under the skin. 4. altered urinary output of bile.
ANS: 3 Bile salts accumulate under the skin, causing irritation. PTS: 1 DIF: Cognitive Level: Comprehension REF: 805 OBJ: 4 TOP: Hepatitis KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance
Which of the follwing clients is more likely to develop pancreatitis? (1) 59 y/o male w/ a hx of occasional ETOH use (2) Pt. w/ renal probs and hypocalcemia (3) Pt. recovering from MI with hypercholesterolemia (4) A client with a stone lodged in the pancreatic duct
Answer: (4) A client w/ a stone in pancreatic duct Rationale: Stones in the pancreatic duct can cause obsrtuction and lead to inflammation of the pancreas.
A patient with severe heart failure develops elevated BUN and creatinine levels. The nurse plans care for the patient based on the knowledge that collaborative care of the patient will be directed toward the goal of a. preventing hypertension. b. replacing fluid volume. c. diluting nephrotoxic substances. d. maintaining cardiac output.
Answer: D Rationale: The primary goal of treatment for ARF is to eliminate the cause and provide supportive care while the kidneys recover. Because this patient's heart failure is causing ARF, the care will be directed toward treatment of the heart failure. For renal failure caused by hypertension, hypovolemia, or nephrotoxins, the other responses would be correct. Cognitive Level: Application Text Reference: pp. 1201-1202 Nursing Process: Planning NCLEX: Physiological Integrit
You notice your patient is has nephrotic syndrome. The strongest indicator is -- A. Serum Albumin = 4.5 B. 4g of protein in urine C. LDL of 125 D. Decreased coagulation
B
Your patient has nephrotic syndrome. GFR is 35. Your dietary approach would be -- A. Increased fats B. Decreased fats C. Increased proteins D. Decreased proteins
D - if gfr is low, than lower proteins
A client with chronic renal failure has an internal venous access site for hemodialysis on her left forearm. What action will the nurse take to protect this access site? 1) Irrigate with heparin and NS q8 hrs 2) Apply warm moist packs to the area after hemodialysis 3) Do not use the left arm to take blood pressure readings. 4) Keep the arm elevated above the level of the heart.
3: Protect the arm with the functioning shunt. No blood pressure readings should be taken from that arm, and there should be no needle sticks. The access is not irrigated with Heparin.
The nurse assists the client with acute kidney injury (AKI) to modify the diet in which way? Select all that apply: A. Restricted protein B. Liberal sodium C. Fluid restriction D. Low potassium E. Low fat
A, C, and D: Restricted protein (Breakdown of protein leads to azotemia and increased blood urea nitrogen (BUN). Fluid is restricted during the oliguric phase of acute renal failure. Potassium intoxication may occur; dietary potassium is restricted.
Which clinical manifestation indicates the need for increased fluids in the client with kidney failure? A. Increased blood urea nitrogen B. Increased creatinine C. Pale urine D. Decreased sodium
A. Increased blood urea nitrogen: An increase in blood urea nitrogen can be an indication of dehydration, and an increase in fluids is needed. Increased creatinine indicates kidney impairment.
The sign that would be a contraindication for the need of increased fluid intake for the patient with a hepatic disorder is: 1. low blood pressure. 2. increased urinary output. 3. signs of edema. 4. bradycardia.
ANS: 3 Edema may indicate fluid overload; therefore, question intake as well as electrolyte and cardiac status. PTS:
A patient with acute renal failure (ARF) has an arterial blood pH of 7.30. The nurse will assess the patient for a. tachycardia. b. rapid respirations. c. poor skin turgor. d. vasodilation.
Answer: B Rationale: Patients with metabolic acidosis caused by ARF may have Kussmaul respirations as the lungs try to regulate carbon dioxide. Tachycardia and vasodilation are not associated with metabolic acidosis. Because the patient is likely to have fluid retention, poor skin turgor would not be a finding in ARF. Cognitive Level: Application Text Reference: pp. 1200-1201 Nursing Process: Assessment NCLEX: Physiological Integrity
A nurse is assigned to care for a client with nephrotic syndrome. The nurse assesses which important parameter on a daily basis? a) weight b) albumin levels c) activity tolerance d) blood urea nitrogen (BUN) level
a) weight
A cllient with chronic renal failure has been prescribed calcium carbonate. What is the rationale for this particular medication? 1) Diminishes incidence of gastric ulcer formation 2) Alleviates constipation 3) Binds with phosphorus to lower concentration 4) Increase tubular reabsorption of sodium
3: Clients with ARF have hyperphosphatemia. Clients are prescribed calcium-based phosphate binders to improve excretion of phosphorus.
A client with acute renal failure develops sever hyperkalemia. What would the nurse anticipate to be used to treat this imbalance? 1) Furosemide (Lasix) 2) Amphojel (aluminum hydroxide) 3) 50% glucose and regular insulin 4) Epoetin (Procrit)
3: Hyperkalemia can develop into an emergency situation (Cardia Arrest). It is important to quickly move the potassium back into the cells by administering 50% glucose and regular insulin, usually in conjunction with some type of base to correct the acidosis, such as sodium bicarbonate or calcium gluconate given IV. Insulin assists in the movement of potassium into the cells and helps to reduce the serum potassium level. Amphojel is used for the treatment of hyperphosphatemia that occurs with ARF. Procrit is used for the treatment of anemia caused by a decrease in erythropoietin production by the kidneys. A diuretic, such as Lasix, may lead to a loss of potassium, but the rate is too slow.
The client with chronic kidney disease reports chest pain. The nurse notes tachycardia and low-grade fever. Which additional assessment is warranted? A. Auscultate for pericardial friction rub B. Assess for crackles C. Monitor for decreased peripheral pulses D. Determine whether the client is able to ambulate
A. Auscultate for pericardial friction rub The client with uremia is prone to pericarditis; symptoms include inspiratory chest pain, low-grade fever, and ST segment elevation. Crackles and tachycardia are symptomatic of fluid overload; fever is not present.
The nurse teaches the client recovering from acute kidney disease to avoid which of these? A. Nonsteroidal anti-inflammatory drugs B. Angiotensin-converting enzyme (ACE) inhibitors C. Opiates D. Acetaminophen
A. Non-steroidal anti-inflammatory drugs (NSAIDs): Nonsteroidal anti-inflammatory drugs may be nephrotoxic. ACE inhibitors are used for treatment of hypertension and to protect the kidneys, especially in the diabetic client, from progression of kidney disease. Opiates may be used by clients with kidney disease if severe pain is present; however, excretion may be delayed. Acetaminophen is hepatotoxic, not generally nephrotoxic.
Which of these interventions is essential for the client in the oliguric phase of acute kidney injury (AKI)? A. Restrict fluids B. Replace potassium C. Administer blood transfusions D. Monitor arterial blood gases (ABGs)
A. Restrict fluids: During the oliguric phase of AKI, the client will be at risk for fluid overload; fluid restriction is necessary to limit this problem. Hyperkalemia results from kidney injury; do not replace potassium unless clearly decreased. Blood transfusions replace the oxygen-carrying capacity of the blood and are used for shortness of breath or chest pain; use is not specific to the oliguric phase.
The young woman with severe jaundice has a nursing diagnosis of altered body image re- lated to jaundice. When the patient says, "Will I always be this horrible color?" the nurse replies: 1. "Yes, but your sclera will return to their previous white color." 2. "No. The color will fade gradually as liver inflammation decreases." 3. "Yes, but cosmetics can disguise the color." 4. "No, the color will change to freckles."
ANS: 2 Jaundice causes patients to be self-conscious and reclusive because of the change in physical appearance. Patients can be reassured that the color improves as liver function improves, usually in 2 to 4 weeks
The complication that the nurse would monitor for after a liver biopsy is: 1. headache. 2. muscle cramps. 3. bleeding. 4. respiratory distress.
ANS: 3 Liver biopsy is a vascular process and, if liver disease is present, there may be an interfer-ence with clotting factors that were not noted on the workup. PTS: 1 DIF: Cognitive Level: Application REF: 800 OBJ: 2 TOP: Liver Biopsy KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
To prevent complications in a hepatitis patient on bed rest, the nurse would plan to: 1. raise the knee gatch to prevent the patient from sliding down in bed. 2. provide undisturbed periods of 6 hours to encourage rest. 3. restrict fluids. 4. encourage turning, coughing, and deep breathing every 2 hours.
ANS: 4 The nurse must encourage measures that will prevent pneumonia and impaired skin integrity because of the increased risk factors associated with bed rest.
What laboratory test is a common measure of renal function? (1) CBC (2) BUN/CREATININE (3) Glucose (4) ALT- alanine amino transferase
Answer (2) BUN/Creatinine Rationale: The blood urea nitrogen is promarily used as an indicator of kidney funciton because most renal diseases interere with its excretion and cause blood levels to rise. Creatinine is produced in relatively constant amounts, according to the amount of muscle mass and is excreted entirely by the kidneys making it a good indicator of renal function.
Which of the following should the nurse suspect as an iatrogenic cause of acute renal failure? (1) ETOH (2) Diet (3) Nephrotoxic meds (4) Exercise
Answer (3) Nephrotoxic meds Rationale: Iatrogenic causes result from tx. from a physician or other caure provider. Some examples include: nephrotoxic meds, radiologic contrast dye, and shock after surgery.
When doing discharge teaching to a client with chronic cirrhosis, why is it important to put emphasis on bleeding percautions? (1) Because of the cirrhosis, the liver is unable to produce clotting factors (2) the low protein diet will result in reduced clotting factors (3) The increased production of bile decreases clotting factors. (4) The required medications reduce clotting factors.
Answer: (1) B/c of the cirrhosis, the liver is unable to produce clotting factors. Rationale: When bile productions is reduced, the body has reduced ability to absorb fat-soluble vitamins. W/o adequate Vit K absorption, clotting factors II, VII, IX, and X are not produced in sufficient amounts.
The physical assessment findings of spider angiomas, palmar erythema, peropheral edema, ascities, and change in mental status are consistent with which of the following d/o? (1)Cirrhosis (2)Pancreatitis
Answer: (1) Cirrhosis Rationale: Portal hypertension and liver dailure contribute to the late manifestationso f cirrhosis. Pancreatitis presents with pain radiating to the back, mild cardiovascular changes, and hypocalcemia.
The physical assessment of a 55 y/o female with end-stage cirrhosis reveals a protuberant abdomen with bulging flanks and dullness to the dependent side while lying on the right. The appropriate terminology for documentation of this assessment is what? (1) Fluid overload (2) Ascities (3) Distension
Answer: (2) Ascities Rational: In a person who has cirrhosis, fibrous tissue develops among the parenchymal cells preventing the production of adequate plasma proteins. The consequence of low plasms proteins leads to a decrease in colloid osmotic pressure and generalized edema. When combined with high portal capillary pressures, larga amounts of fluid and protein can form in the abd. cavity, which is called ascities.
Which of the following findings would strongly indicate the possibility of cirrhosis? (1) Dry skin (2) Hepatomegaly (3) Peripheral edema (4) Pruritus
Answer: (2) hepatomegaly Rationale: Although option 4 is correct, it is not a strong indicator of cirrhosis. Pruritus can occur for many reasons. Options 1 and 3 are incorrect, fluid accumulation is usually in the form of ascites in the abdomen. Hepatomegaly is an enlarged liver. The spleen may also be enlarged.
A 45 y/o female hospitalized with acute pancreatitis has orders for meperidine (Demerol) 50 mg IM Q 4 hrs PRN as needed for pain. Demerol has been ordered rather than morphine for this client because it: (1) Has a faster onset of action than morphine (2) Is less addictive than morphine. (3) Causes fewer spasms in the sphincter of Oddi (4) Has fewer cognitive side effects
Answer: (3) Causes fewer spasms in the sphincter of Oddi. Rationale: The onset of action for meperidine is 10-15 minutes and the onset of morphine is 20-60 minutes. Both drugs are equal in the potential for addiction. Demerol is less sedating than morphine. The most important difference is that the meperidine causes fewer spasms of the sphincter of Oddi, which contributes to the goal of giving the pancreas a rest.
A client with a hx. of renal calculi has progressively lost renal fx. and is admitted to the unit w/ a dx. of chronic renal failure. The physician has prescribed polystyrene sulfonate (Kayexalate). Which of the following is the best reason to use this drug in renal failure? (1)to lower serum phosphat elevels (2) To correct acidosis (3) To exchange potassium for sodium
Answer: (3) to exchange potassium for sodium. Rationale: In renal failure, clients become hyperkalemic b/c they can't excrete potassium into urine. Kayaxelate provides the mechanism for potassium excretion by pulling potassium into the bowels andexchanging it for sodium. The potassium is then excreted in the feces. Phosphate binders, such as aluminum hydroxide gel, are given to lower phophate levels. Diet changes, sodium bicarbonate, or dialysis might be used to help control acidosis. Kayaxelate can cause constipation and MUST be given with a laxatve such as sorbitol.
A 65 y/o F w/ a hx of hepatic encephalopathy is hospitalized for pneumonia and dehydration. When she complains to the nurse about the small portions of meat ordered by the dietitian, the best response would be: (1) Ask your doc. about it (2) The amount of meat on the tray is dictated by certain blood test results. (3) Your protein is being limited, but you can have more food from another group.
Answer: (4) Protein is being limited, can pick from another group. Rationale: The client is at inc. risk for a return of encephalopathy b/c of the dx. of penumonia and dehydration. She has vol. depletion and the potential for electrolyte imbalance, both of whic can contribute to the development of encephalopathy. Dietary protein intake must be controlled (or eliminated) in order to minimize the ammonia levels in the blood stream.
When reviewing the laboratory values for a patient admitted with a severe crushing injury after an industrial accident, the nurse will be most concerned about levels of a. creatinine. b. potassium. c. white blood cells (WBCs). d. BUN.
Answer: B Rationale: The hyperkalemia associated with crushing injuries may cause cardiac arrest and should be treated immediately. The nurse will also review the other laboratory values, but abnormalities in these are not immediately life threatening. Cognitive Level: Application Text Reference: p. 1200
A patient admitted with severe dehydration has a urine output of 380 ml over the next 24 hours and elevated blood urea nitrogen (BUN) and creatinine levels. A finding that the nurse would expect when reviewing the patient's urinalysis is a. proteinuria. b. bacteriuria. c. high specific gravity. d. tubular casts.
Answer: C Rationale: The patient's renal failure has been caused by the prerenal problem of hypovolemia. Prerenal oliguria is characterized by the ability of the kidneys to concentrate urine, resulting in a high urine specific gravity. The urinalysis in intrarenal failure would show proteins and tubular casts. Bacteriuria would be typical of a urinary tract infection (UTI), not renal failure. Cognitive Level: Application Text Reference: pp. 1198-1199 Nursing Process: Assessment NCLEX: Physiological Integrity
A client with chirrhosis may have alterations in what lab values? (1) CO2 level (2) pH (3) prothrombin time (PT) (4) WBC
Answer: prothrombin time (PT) Rationale: Clients with cirrhosis have used their clotting factors, and their liver is unalbe to provide enough clotting factors. A PT time is an indication of the time needed for blood to clot. If clotting factorsa ren't present, bleeding is more likely.
Your patient has nephrotic syndrome and has problems breathing. You would assess for -- A. Fluid accumulation in the lungs B. Ascites C. Venous return from the feet D. Serum protein levels
B - makes it harder to breathe
When caring for the client with a left forearm arteriovenous (AV) fistula created for hemodialysis, the nurse must do which of these? Select all that apply. A. Check brachial pulses daily B. Auscultate for a bruit each shift C. Teach the client to palpate for a thrill over the site D. Elevate the arm above heart level E. Ensure that no blood pressures are taken in that arm
B. Auscultate for a bruit each shift, C. Teach the client to palpate for a thrill over the site, and E. Ensure that no blood pressures are taken in that arm
Which teaching by the nurse will help the client prevent renal osteodystrophy? A. Low-calcium diet B. Avoiding peas, nuts, and legumes C. Drinking cola beverages only once daily D. Avoiding dairy enriched with vitamin D
B. Kidney failure causes hyperphosphatemia. Client must restrict phosphorus-containing foods such as beans, peas, nuts (peanut butter), and legumes. Kidney failure decreases serum calcium, resulting in demineralization of the bone; do not restrict calcium in the diet. Cola beverages are high in phosphorus and are to be avoided. Dairy products are high in phosphorus, contributing to hypocalcemia and bone breakdown.
When administering medications to the client with chronic kidney disease, the nurse recognizes that which of these medications is most effective in slowing the progression of kidney failure? A. Diltiazem (Cardizem) B. Lisinopril (Zestril) C. Clonidine (Catapres) D. Doxazosin (Cardura)
B. Lisinopril (Zestril): Angiotensin-converting enzyme (ACE) inhibitors appear to be the most effective drugs to slow the progression of kidney failure. Calcium channel blockers (diltiazem/Cardizem) may indirectly prevent kidney disease by controlling hypertension but are not specific to slowing progression of kidney disease.
When caring for the client with acute kidney injury and a temporary subclavian hemodialysis catheter, which of these should the nurse report to the provider? A. Crackles at lung bases B. Temperature of 100.8 F C. +1 ankle edema D. Anorexia
B. Temperature of 100.8 F: Infection is a major complication of temporary catheters. Report all symptoms of infection, including fever, to the provider. The catheter may have to be removed. Some degree of fluid retention is expected. Rising blood urea nitrogen (BUN) may result in anorexia, nausea, and vomiting.
The nurse carefully observes for toxicity of drugs excreted through the kidney. Which of these represents a sign or symptom of digoxin toxicity? A. Serum digoxin level of 1.2 ng/mL B. Polyphagia C. Anorexia D. Serum potassium of 5.0 mEq/L
C. Anorexia: Anorexia, nausea, and vomiting are symptoms of digoxin toxicity.
The nurse recognizes that the client with end-stage kidney disease has difficulty adhering to the fluid restriction when which of these is found? A. Blood pressure 118/78 B. Weight loss of 3 lbs during hospitalization C. Dyspnea and anxiety at rest D. Central venous pressure (CVP) of 6 mm Hg
C. Dyspnea and anxiety at rest: Dyspnea is a sign of fluid overload and possible pulmonary edema; the nurse assists the client in correlating symptoms of fluid overload with nonadherence to fluid restriction. Excess fluid intake and fluid retention are manifested by elevated CVP (>8 mm Hg). Excess fluid intake and fluid retention are manifested by weight gain, not loss. Nonadherence to fluid restriction results in fluid volume excess and higher blood pressures; 118/78 is a normal blood pressure.
Which of the following represents a positive response to administration of erythropoietin (Epogen, Procrit)? A. Hematocrit of 26.7% B. Potassium within normal range C. Free from spontaneous fractures D. Less fatigue
D. Less fatigue: Treatment of anemia with erythropoietin will result in increased (H&H) and decreased shortness of breath (SOB) and fatigue.
The client with chronic renal failure has an indwelling abdominal catheter for peritoneal dialysis. The client spills water on the catheter dressing while bathing. The nurse should immediately: a) change the dressing b) reinforce the dressing c) flush the peritoneal dialysis catheter d) scrub the catheter with povidine-iodine
a) change the dressing - Clients with peritoneal dialysis catheters are at high risk for infection. A wet dressing is a conduit for bacteria to reach the catheter insertion site. The nurse ensures that the dressing is kept dry at all times. Reinforcing the dressing is not a safe practice to prevent infection in this circumstance. Flushing the catheter is not indicated. Scrubbing the catheter with povidone-iodine is done at the time of connection or disconnection of peritoneal dialysis.
The client hemodialyzed suddenly becomes short of breath and complains of chest pain. The client is tachycardic, pale and anxious. The nurse suspects air embolism. The priority action for the nurse is to: a) discontinue dialysis and notify the physician b) monitor vital signs every 15 minutes for the next hour c) continue dialysis at a slower rate after checking the lines for air d) bolus the client with 500 ml of normal saline to break up the air embolus
a) discontinue dialysis and notify the physician
A client with renal failure is receiving epoetin alfa (Epogen) to support erythropoiesis. The nurse questions the client about compliance with taking which of the following medications that supports red blood cell (RBC) production? a) iron supplement b) zinc supplement c) calcium supplement d) magnesium supplement
a) iron supplement
Which of the following should be considered in the diet of the client with end-stage-renal-disease (ESRD)? a) limit fluid intake during anuric phase b) limit phosphorus and vitamin D-rich food c) limit calcium-rich food d) limit carbohydrates
a) limit fluid intake during anuric phase during ESRD, fluid intake of the client should be limited during anuric phase to prevent fluid overload. Fluid overload increases renal workload, pulmonary edema, and congestive heart failure.
The client who has a history of gout also is diagnosed with urolithisis and the stones are determined to be of uric acid type. The nurse gives the client instructions in which foods to limit, including: a) milk b) liver c) apples d) carrots
b) liver
The client with acute renal failure has a serum potassium of 6.0 mEq/L. The nurse would plan which of the following as a priority action? a) check the sodium level b) place the client on a cardiac monitor c) encourage increased vegetables in the diet d) allow an extra 500 ml of fluid intake to dilute the electrolyte concentration
b) place the client on a cardiac monitor
A client who has a renal mass asks the nurse why an ultrasound has been scheduled, as opposed to other diagnostic tests that may be ordered. The nurse formulates a response based on the understanding that: a) all other tests are more invasive than an ultrasound b) all other tests require more elaborate postprocedure care c) an ultrasound can differentiate a solid mass from a fluid-filled cyst d) an ultrasound is much more cost effective than other diagnostic tests
c) an ultrasound can differentiate a solid mass from a fluid-filled cyst
The home care nurse is making follow-up visits to a client following renal transplant. The nurse assesses the client for which signs of acute graft rejection? a) hypotension, graft tenderness, and anemia b) hypertension, oliguria, thirst, and hypothermia c) fever, hypertension, graft tenderness, and malaise d) fever, vomiting, hypotension, and copious amounts of dilute urine
c) fever, hypertension, graft tenderness, and malaise
A client has an arteriovenous (AV) fistula in place in the right upper extremity for hemodialysis treatments. When planning care for this client, which of the following measures should the nurse implement to promote client safely? a) take blood pressures only on the right arm to ensure accuracy b) use the fistula for all venipunctures and intravenous infusions c) ensure that small clamps are attached to the AV fistula dressing d) assess the fistula for the presence of a bruit and thrill every 4 hours
d) assess the fistula for the presence of a bruit and thrill every 4 hours
The client with an external arteriovenous shunt in place for hemodialysis is at risk for bleeding. The priority nurse action would be to: a) check the shunt for the presence of bruit and thrill b) observe the site once as time permits during the shift c) check the results of the prothrombin time as they are determined d) ensure that small clamps are attached to the arteriovenous shunt dressing
d) ensure that small clamps are attached to the arteriovenous shunt dressing - An arteriovenous shunt is a less common form of access site but carries a risk for bleeding when it is used because two ends of an external cannula are tunneled subcutaneously into an artery and a vein, and the ends of the cannula are joined. If accidental disconnection occurs, the client could lose blood rapidly. For this reason, small clamps are attached to the dressing that covers the insertion site for use if needed. The shunt site also should be assessed at least every 4 hours.
The client with chronic renal failure who is scheduled for hemodialysis this morning is due to receive a daily dose of enalapril (Vasotec). The nurse should plan to administer this medication: a) during dialysis b) just before dialysis c) the day after dialysis d) on return form dialysis
d) on return form dialysis
A client has been admitted to the hospital with a diagnosis of acute glomerulonephritis. During history-taking the nurse first asks the client about a recent history of: a) bleeding ulcer b) deep vein thrombosis c) myocardial infarction d) streptococcal infection
d) streptococcal infection
