NRS233 Exam 1-Chapter 33 PrepU

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

Increased blood pressure

The nurse is evaluating the urinalysis results of a client presenting with polyuria and lower abdominal pain due to a suspected urinary tract infection. Which finding should the nurse expect?

Increased nitrates

A client has been given the diagnosis of diffuse glomerulonephritis. The client asks the nurse what diffuse means. The nurse responds:

"All glomeruli and all parts of the glomeruli are involved."

What is the usual cause of acute pyelonephritis?

Infection

The most recent assessment of a client with type 1 diabetes indicates a heightened risk of diabetic nephropathy. Which assessment finding is most suggestive of this increased risk?

Microalbuminuria

A nurse is explaining the clinical manifestations of diabetic nephropathy (diabetic glomerulosclerosis) to a client. Which statement would be the most important information for the nurse to provide?

Microalbuminuria is a predictor of future nephropathies.

The nurse is reviewing the lab results of a client with suspected nephrotic syndrome. The nurse anticipates the results to include:

protein in the urine.

The nurse is planning care for a client with a urinary tract obstruction. The nurse includes assessment for which possible complication?

Increased blood pressure

What is a common cause of acute pyelonephritis, an infection of the renal parenchyma and renal pelvis?

Pseudomonas species

A client suffering from chronic hypertension is beginning to show the symptoms of glomerular disease. This client's kidney damage is due to what phenomenon?

The higher pressures force protein and cells through the glomerular membrane, resulting in glomerular inflammation

A client experienced asymptomatic UTIs while pregnant. The client asks the nurse if this places her at any risk for complications. Which would be the best response by the nurse?

"You are at risk for developing acute pyelonephritis."

Which client is likely at the greatest risk of developing a urinary tract infection?

A 79-year-old client with an indwelling catheter

The nurse on a geriatric unit is assessing four clients. Which client is most likely to exhibit bacteriuria?

A client who has a urinary catheter in place due to confusion

The nurse recognizes the most common cause of acute postinfectious glomerulonephritis as:

A streptococcal infection 7 to 12 days prior to onset.

Which statement about the use of angiotensin-converting enzyme (ACE) inhibitors and autosomal recessive polycystic kidney disease (ARPKD) is accurate?

ACE inhibitors may interrupt the renin-angiotensin-aldosterone system to reduce renal vasoconstriction.

A child has been brought to an urgent care clinic. The parents state that the child is "not making water." When taking a history, the nurse learns the child had a sore throat about 1 week ago but seems to have gotten over it. "We [parents] only had to gave antibiotics for 3 days for the throat to be better." The nurse should suspect the child has developed which complication?

Acute postinfectious glomerulonephritis

A 34-year-old client presents with an abrupt onset of shaking chills, moderate to high fever, and a constant ache in the lower back. The client is also experiencing dysuria, urinary frequency, and a feeling of urgency. The client's partner states that the client has been very tired the last few days and that the client looked like they may have the flu. What is the most likely condition?

Acute pyelonephritis

A nurse is caring for a client with diabetic glomerulosclerosis. The presence of which substance in the urine would be used in diagnosing this condition?

Albumin

The form of polycystic kidney disease (PKD) that first manifests in the early infant period is most commonly characterized as:

Autosomal recessive

The nurse suspects that a newborn infant who presents with bilateral flank masses, impaired lung development, and oliguria may be suffering from which disorder?

Autosomal recessive polycystic kidney disease (ARPKD)

Which clinical manifestations would you expect to see in an infant diagnosed with autosomal recessive polycystic kidney disease (ARPKD)?

Bilateral flank masses and impaired lung development

A client who has had an intestinal bypass has developed a kidney stone. Which type of kidney stone does the nurse recognize that this client will most likely be treated for?

Calcium

Hospitalized neonates are at greatest risk of developing septicemia related to which procedure?

Catheter-associated bacteriuria

Which disorder of renal function primarily affects the proximal and distal tubules?

Chronic pyelonephritis

A client with a history of chronic pyelonephritis has been admitted several times with recurrent bacterial infection of the urinary tract. The nurse should anticipate educating this client with regard to which common treatment regimen?

Continue taking antibiotics for 10 to 14 days even if symptoms of infection disappear.

The family asks the nurse what the usual treatment of focal segmental glomerulosclerosis entails. What is the nurse's best response?

Corticosteroids

The nurse is caring for a client with recurring urinary tract infections (UTIs). The client asks, "Other than taking antibiotics, what else can I do?" Which response by the nurse is most accurate?

Drink lots of fluids to help relieve the signs/symptoms of UTIs.

The nurse is reviewing the laboratory results for a client. Which laboratory findings would the nurse correlate with nephrotic syndrome?

Elevated urine protein level (>3.5 g/day) and hypoalbuminemia

An newborn has been diagnosed with renal agenesis. Which characteristics should the nurse mention to the parents as it correlates to this diagnosis? Select all that apply.

Epicanthic folds (skin of the upper eyelid) are present Low-set ears Receding chin

Most common uncomplicated urinary tract infections are caused by ____ that enter through the urethra.

Escherichia coli

The nurse assesses a client in an ambulatory care facility. Which manifestation(s) leads the nurse to advocate for investigation of possible acute pyelonephritis? Select all that apply.

Flank pain in the back Abrupt onset of fever and chills Urinary urgency and frequency

The nurse is caring for a client with cystitis. Which sign/symptom is most characteristic of the urine associated with cystitis?

Foul smell

Acute postinfectious glomerulonephritis, as its name implies, follows an acute infection somewhere else in the body. What is the most common cause of acute postinfectious glomerulonephritis?

Group A β-hemolytic streptococci

While taking a history from an adult client newly diagnosed with renal cell cancer, the nurse can associate which high-risk factor with the development of this cancer?

Heavy smoking

Which client clinical manifestation most clearly suggests a need for diagnostic testing to rule out renal cell carcinoma?

Hematuria

A client has been diagnosed with an uncomplicated urinary tract infection (UTI) for the second time in a year. Which teaching will the nurse include to prevent the most common cause of recurrent uncomplicated UTIs?

Hygiene practices to reduce exposing the urethral meatus to Escherichia coli

A client is diagnosed with renal calcium stone formation. Which endocrine imbalances could contribute to this condition?

Hyperparathyroidism

The nurse is assessing a client who has a unilateral obstruction of the urinary tract. Which clinical finding by the nurse correlates to this diagnosis?

Increase in blood pressure

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.

Wilms tumor is a tumor of childhood. It is usually an encapsulated mass occurring in any part of the kidney. What are the common presenting signs of a Wilms tumor?

Large asymptomatic abdominal mass and hypertension

If a client is in the early phases of nephrotic syndrome, which area of the body will likely have the initial presence of edema?

Lower extremities

Following the diagnosis of nephrotic syndrome, the nurse knows the clinical manifestations occur as a result of a decreased plasma colloidal osmotic pressure. Therefore, the nurse should assess the client for which signs? Select all that apply.

Moist crackles in both lung fields Areas of diminished breath sounds due to pleural effusions Increased circumference in the abdomen related to fluid excess

Which of the following clients is at greatest risk for developing a urinary tract infection (UTI)?

Older adult female client admitted with an indwelling Foley catheter that has been in place for 1 month

The initiating event in the development of nephrotic syndrome is a derangement in the glomerular membrane that causes increased permeability to which substance?

Plasma proteins

A client diagnosed with Goodpasture syndrome would require which therapy to remove proteins and autoantibodies from the system?

Plasmapheresis

Which substance would not be found in glomerular filtrate?

Protein

Which of the following are NOT found in the glomerular filtrate?

Protein (should have potassium, sodium, and water)

An older adult client has been hospitalized for the treatment of acute pyelonephritis. Which characteristic of the client is most likely implicated in the etiology of this current health problem?

Recently had a urinary tract infection

What is the most common cancer of the kidney?

Renal cell carcinoma

One form of renal tubular acidosis (RTA) results from aldosterone deficiency or resistance to its action, which leads to impaired reabsorption of which electrolyte?

Sodium

A nurse is caring for a client who has been diagnosed with kidney colic but has yet passed the stone. Which interventions would the nurse emphasize when planning the care for this client?

Strain the urine.

What are appropriate interventions in the care of a client diagnosed with renal calculi? Select all that apply.

Straining the client's urine Addressing the client's pain Keeping track of intake and output

A young woman presents with signs and symptoms of urinary tract infection (UTI). The nurse notes that this is the fifth UTI in as many months. What would this information lead the nurse to believe?

There is possible obstruction in the urinary tract.

Which signs and symptoms in a 2-year-old child should prompt assessment for a urinary tract infection?

Unexplained fever and anorexia

A client is being treated with colchicine for pain in the big right toe. The client begins to complain of severe right flank pain and is diagnosed with kidney stones. Which type of kidney stone does the nurse recognize this client is most likely affected by?

Uric acid

An obese client with a history of gout and a sedentary lifestyle has been advised by the primary health care provider to avoid organ meats, certain fish, and other foods that are high in purines. This treatment would be advised for which type of kidney stones?

Uric acid stones

A cytotechnologist is performing genetic testing on a series of tissues. One tissue comes back with the WT1 mutation, and it's mapped to chromosome 11. What disease will the client most likely develop?

Wilms tumor

A child is recovering from a bout with group A beta-hemolytic Streptococcus infection. The child returns to the clinic 1 week later reporting decrease in urine output with puffiness and edema in the face and hands. The health care provider suspects the child has developed which condition?

acute postinfectious glomerulonephritis

Which factor contributes to the development of polycystic kidney disease?

hereditary mutations in polycystin I and II

Acute pyelonephritis is a result of:

bacterial infection.

A 9-year-old child has been diagnosed with the nephrotic syndrome. Place the following stages in the development of this health problem in ascending order. Use all the options.

1. Hypoalbuminemia 2. Increased glomerular membrane permeability 3. Proteins escape from plasma to glomerular filtrate 4. Decreased colloidal osmotic pressure 5. Accumulation of fluid in interstitial tissue (edema).

Urinary tract infections (UTIs) in children do not generally present as they do in adults. What are the signs and symptoms of a UTI in a toddler? Select all that apply. -Frequency -Diarrhea -Abdominal pain -Poor growth -Burning

-Diarrhea -Abdominal pain -Poor growth

Which pathophysiologic changes are associated with nephrotic syndrome? Select all that apply. -Glomerular damage -Increased plasma oncotic pressure -Hypoproteinemia -Compensatory synthesis of proteins by the liver -Hypolipidemia

-Glomerular damage -Hypoproteinemia -Compensatory synthesis of proteins by the liver

A major complication of prolonged bed rest is an increased risk of kidney stones. The nurse knows that this is most likely related to what?

saturation of urine with calcium salts.

Select the manifestations of renal cell carcinoma. Select all that apply. -Often silent in the early stages -Hematuria -Palpable flank mass -Does not metastasize

-Often silent in the early stages -Hematuria -Palpable flank mass

Which condition/disorder would the nurse see as being likely to cause the most serious long-term problems?

Polycystic kidney disease

Which assessment finding would lead the nurse to suspect the client has developed nephrotic syndrome?

Proteinuria and generalized edema

Manifestations of polycystic kidney disease include which of the following?

Increase in kidney size bilaterally

A nurse advises a client with recurring UTIs to drink large amounts of water. What normal protective action is the nurse telling the client to utilize?

Increase washout of urine

A female client with suspected glomerular disease has been referred to a nephrologist by her family physician. Which finding would help the specialist rule out glomerular disease?

Podocytes encircle the outer surface of glomerular capillaries and connect to the epithelial cells.