Porth's PrepU: Chapter 41: Disorders of Renal Function

Which of the following is a nonsurgical method of treatment for renal calculi (kidney stones)?

Extracorporeal shock wave lithotripsy (ESWL)

The nurse is planning care for a patient with a urinary tract obstruction. The nurse includes assessment for which of the following possible complications?

Increased blood pressure

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

Increased blood pressure

Which one of the following would the nurse see as being liable to cause the most serious long-term problems?

Polycystic kidney disease

Which of the following substances would not be found in glomerular filtrate?

Protein

Which of the following is the most common cancer of the kidney?

Renal cell carcinoma

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

Escherichia coli

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

A 79-year-old patient with an indwelling catheter

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

A streptococcal infection 7 to 12 days prior to onset

Which of the following statements about the use of angiotensin-converting enzyme inhibitor medications and autosomal recessive polycystic kidney disease (ARPKD) is accurate?

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

A nurse is caring for a patient with diabetic glomerulosclerosis. The analysis is reviewed for the presence of which of the following manifestations?

Albumin

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

All glomeruli and all parts of the glomeruli are involved

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

Autosomal recessive polycystic kidney disease (ARPD)

Acute pyelonephritis is a result of which of the following?

Bacterial infection

A nurse is caring for a patient with systemic lupus erythematosis (SLE). The patient asks why a urinalysis is necessary. The best answer is that a urinalysis would determine whether which of the following factors was present in the urine?

Blood or protein

An adult female patient has been diagnosed with cystitis. The patient informs the nurse that this is has been occurring with some frequency and she recognized the symptoms. Which of the following symptoms reported by the patient does the nurse recognize are significant for cystitis? Select all that apply.

Burning and pain with urination Frequency of urination Lower abdominal and back discomfort

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

Calcium

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

Catheter-associated bacteriuria

What is the most common cause of a lower urinary tract infection?

Escherichia coli

Which laboratory findings should you expect to see in a patient diagnosed with nephritic syndrome?

Elevated urine protein and hypoalbuminemia

The nurse is caring for a patient with cystitis. Which of the following 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

Which of the following client clinical manifestations most clearly suggests a need for diagnostic testing to rule out renal cell carcinoma?

Hematuria

Which signs and symptoms would you expect to see in a patient diagnosed with acute nephritic syndrome?

Hematuria and azotemia

A nurse is caring for a patient who has a recent history of passing calcium urinary stones. Which of the following is a priority nursing consideration for this patient?

Hydration

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 patient is to receive a radiocontrast media as part of a diagnostic scan. Which of the following is intended to reduce the nephrotoxic effects of the radiocontrast media?

Increasing the normal saline intravenous infusion rate to 125 mL/hour

A nurse is giving discharge instructions for a patient who was diagnosed with acute pyelonephritis 3 days previously. Which of the following is important for the nurse to discuss when instructing the patient?

It is important that the patient take the prescribed antibiotic for the duration of the prescription

The nurse should assess which of the following when assessing for the initial presence of edema in a patient with nephrotic syndrome?

Lower extremities

The nurse is evaluating her patient's risk for an urinary tract infection. Which of the following patients has the highest risk?

Patient with obstructed urinary outflow from the kidney

A patient diagnosed with Goodpasture's syndrome would require which of the therapies to remove proteins and autoantibodies from the system?

Plasmapheresis

The nurse reviews the lab results for a patient who has advanced autosomal dominant polycystic kidney disease (ADPKD). The patient 's hemoglobin is 8.8 g/dL. The nurse suspects this lab value is related to which of the following causes?

Reduced production of erythropoietin

The nurse is assessing a patient with diabetic nephropathy whose blood pressure is 124/80. The patient smokes two packs of cigarettes a day and consumes a diet high in saturated fats and sodium. The nurse's plan of care should focus on which of the following to decrease the patient's risk for progression of the diabetic nephropathy?

Smoking cessation program

A nurse observes that a patient's urine is cola colored and considers which of the following as a possible reason?

The patient's urine contains material from the degradation of red blood cells

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

One of the complications of asymptomatic urinary tract infection (UTI) during pregnancy is the risk of preterm birth.

True

The family members of a client who has been diagnosed with autosomal dominant polycystic kidney disease (ADPKD) asks the nurse what they should do to find out if they have this disease. The nurse will respond that they should visit with their healthcare provider and ask about having which lab/diagnostic test to screen for the disease?

Ultrasound of the kidney

Prior to undergoing diagnostic testing with contrast, it is recommended that older adult clients have their creatinine level checked. The rationale for this is to ensure the client:

Will not undergo an acute kidney injury by decreasing renal blood flow

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 give antibiotics for 3 days for the throat to be better." The nurse should suspect the child has developed:

acute postinfectious glomerulonephritis

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

plasma proteins