MLQ Ch 54
When caring for the patient with acute glomerulonephritis, which of the following assessment findings should the nurse anticipate? A. Cola-colored urine B. Pyuria C. Left upper quadrant pain D. Low blood pressure
A
Which nursing assessment finding indicates that the client who has undergone renal transplant has not met expected outcomes? A. Fever B. Diuresis C. Absence of pain D. Weight loss
A
What is a characteristic of the intrarenal category of acute kidney injury (AKI)? A. High specific gravity B. Decreased urine sodium C. Increased BUN D. Decreased creatinine
C
A male client has doubts about performing peritoneal dialysis at home. He informs the nurse about his existing upper respiratory infection. Which of the following suggestions can the nurse offer to the client while performing an at-home peritoneal dialysis? A. Auscultate the lungs frequently. B. Wear a mask when performing exchanges. C. Avoid carrying heavy items. D. Perform deep-breathing exercises vigorously.
B
Which clinical finding should a nurse look for in a client with chronic renal failure? A. Metabolic alkalosis B. Uremia C. Polycythemia D. Hypotension
B
A client with renal failure is undergoing continuous ambulatory peritoneal dialysis. Which nursing diagnosis is the most appropriate for this client? A. Toileting self-care deficit B. Impaired urinary elimination C. Activity intolerance D. Risk for infection
D
The nurse expects which of the following assessment findings in the client in the diuretic phase of acute renal failure? A. Hyperkalemia B. Hypertension C. Crackles D. Dehydration
D
What is a hallmark of the diagnosis of nephrotic syndrome? A. Hyponatremia B. Hyperalbuminemia C. Hypokalemia D. Proteinuria
D
Hyperkalemia is a serious side effect of acute renal failure. Identify the electrocardiogram (ECG) tracing that is diagnostic for hyperkalemia. A. Tall, peaked T waves B. Multiple spiked P waves C. Prolonged ST segment D. Shortened QRS complex
A
A patient admitted with electrolyte imbalance has carpopedal spasm, ECG changes, and a positive Chvostek sign. What deficit does the nurse suspect the patient has? A. Sodium B. Magnesium C. Calcium D. Phosphorus
C
What is used to decrease potassium level seen in acute renal failure? A. Sorbitol B. IV dextrose 50% C. Sodium polystyrene sulfonate D. Calcium supplements
C
Patient education regarding a fistulae or graft includes which of the following? Select all that apply. A. No tight clothing. B. Check daily for thrill and bruit. C. Cleanse site b.i.d. D. Avoid compression of the site. E. No IV or blood pressure taken on extremity with dialysis access.
A, B, D, E
A client with acute renal failure progresses through four phases. Which describes the onset phase? A. It is accompanied by reduced blood flow to the nephrons. B. The excretion of wastes and electrolytes continues to be impaired despite increased water content of the urine. C. Fluid volume excess develops, which leads to edema, hypertension, and cardiopulmonary complications. D. Normal glomerular filtration and tubular function are restored.
A
A client with chronic renal failure (CRF) has developed faulty red blood cell (RBC) production. The nurse should monitor this client for: A. fatigue and weakness. B. thrush and circumoral pallor. C. dyspnea and cyanosis. D. nausea and vomiting.
A
A client in chronic renal failure becomes confused and complains of abdominal cramping, racing heart rate, and numbness of the extremities. The nurse relates these symptoms to which of the following lab values? A. Elevated white blood cells B. Elevated urea levels C. Hyperkalemia D. Hypocalcemia
C
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? A. Keep the drainage catheter below the level of insertion. B. Administer isotonic fluid therapy as ordered. C. Encourage use of incentive spirometer every 2 hours. D. Monitor temperature every 4 hours.
C
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? A. Administration of an insulin drip B. Administration of a loop diuretic C. Administration of sodium polystyrene sulfonate [Kayexalate]) D. Administration of sodium bicarbonate
C
The presence of prerenal azotemia is a probable indicator for hospitalization for CAP. Which of the following is an initial laboratory result that would alert a nurse to this condition? A. BUN of 18 mg/dL. B. Serum creatinine of 1.2 mg/dL. C. Blood urea nitrogen (BUN)-to-creatinine ratio (BUN:Cr) >20. D. Glomerular filtration rate (GFR) of 100 mL/min.
C
A client is admitted for treatment of chronic renal failure (CRF). The nurse knows that this disorder increases the client's risk of: A. water and sodium retention secondary to a severe decrease in the glomerular filtration rate. B. a decreased serum phosphate level secondary to kidney failure. C. an increased serum calcium level secondary to kidney failure. D. metabolic alkalosis secondary to retention of hydrogen ions.
A
The nurse helps a client to correctly perform peritoneal dialysis at home. The nurse must educate the client about the procedure. Which educational information should the nurse provide to the client? A. Wear a mask while handling any dialysate solutions B. Clean the catheter insertion site daily with soap C. Keep the dialysis supplies in a clean area, away from children and pets D. Keep the catheter stabilized to the abdomen, below the belt line
A
A client is diagnosed with polycystic kidney disease. Which symptom would the nurse most likely assess? A. Periorbital edema B. Hypertension C. Flank pain D. Fever
B
Which of the following would the nurse expect to find when reviewing the laboratory test results of a client with renal failure? A. Decreased serum potassium level B. Increased serum creatinine level C. Increased red blood cell count D. Increased serum calcium level
B
A client admitted with a gunshot wound to the abdomen is transferred to the intensive care unit after an exploratory laparotomy. IV fluid is being infused at 150 mL/hour. Which assessment finding suggests that the client is experiencing acute renal failure (ARF)? A. Temperature of 100.2° F (37.8° C) B. Serum creatinine level of 1.2 mg/dl C. Blood urea nitrogen (BUN) level of 22 mg/dl D. Urine output of 250 ml/24 hours
D
A client with chronic renal failure complains of generalized bone pain and tenderness. Which assessment finding would alert the nurse to an increased potential for the development of spontaneous bone fractures? A. Elevated serum creatinine B. Elevated urea and nitrogen C. Hyperkalemia D. Hyperphosphatemia
D
At the end of five peritoneal exchanges, a patient's fluid loss was 500 mL. How much is this loss equal to? A. 0.5 lb B. 1.5 lb C. 2 lb D. 1.0 lb
D
Because of difficulties with hemodialysis, peritoneal dialysis is initiated to treat a client's uremia. Which finding during this procedure signals a significant problem? A. Blood glucose level of 200 mg/dl B. Hematocrit (HCT) of 35% C. Potassium level of 3.5 mEq/L D. White blood cell (WBC) count of 20,000/mm3
D
The nurse is caring for a patient after kidney surgery. What major danger should the nurse closely monitor for? A. Abdominal distention owing to reflex cessation of intestinal peristalsis B. Pneumonia caused by shallow breathing because of severe incisional pain C. Paralytic ileus caused by manipulation of the colon during surgery D. Hypovolemic shock caused by hemorrhage
D
Which nursing assessment finding indicates that the client who has undergone renal transplant has not met expected outcomes? A. Diuresis B. Absence of pain C. Weight loss D. Fever
D
Which of the following is a term used to describe excessive nitrogenous waste in the blood, as seen in acute glomerulonephritis? A. Proteinuria B. Bacteremia C. Hematuria D. Azotemia
D
A client has undergone a renal transplant and returns to the health care agency for a follow-up evaluation. Which finding would lead to the suspicion that the client is experiencing rejection? Weight loss Hypotension Tenderness over transplant site Polyuria
C
Which of the following would a nurse classify as a prerenal cause of acute renal failure? A. Polycystic disease B. Ureteral stricture C. Prostatic hypertrophy D. Septic shock
D
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? A. "Immunosuppressive drugs guarantee organ success." B. "Let's wait until after the surgery to discuss your treatment plan." C. "Even a perfect match does not guarantee organ success." D. "The doctor may decide to delay the use of immunosuppressant drugs."
C
The nurse is providing supportive care to a client receiving hemodialysis in the management of acute renal failure. Which statement from the nurse best reflects the ability of the kidneys to recover from acute renal failure? A. The kidneys can improve over a period of months. B. Once on dialysis, the need will be permanent. C. Kidney function will improve with transplant. D. Acute renal failure tends to turn to end-stage failure.
A
Following a nephrectomy, which assessment finding is most important in determining nursing care for the client? A. Blood tinged drainage in Jackson-Pratt drainage tube B. SpO2 at 90% with fine crackles in the lung bases C. Urine output of 35 to 40 mL/hour D. Pain of 3 out of 10, 1 hour after analgesic administration
B
The nurse performs acute intermittent peritoneal dialysis (PD) on a client who is experiencing uremic signs and symptoms. The peritoneal fluid is not draining as expected. What is the best response by the nurse? A. Lower the head of the bed. B. Turn the client from side to side. C. Push the catheter further into the abdomen. D. Notify the health care provider.
B
The nurse cares for a client diagnosed with chronic glomerulonephritis. The nurse will observe the client for the development of A. hypophosphatemia. B. metabolic alkalosis. C. anemia. D. hypokalemia.
C
A client with newly diagnosed renal cancer is questioning why detection was delayed. Which is the best response by the nurse? A. "Very few symptoms are associated with renal cancer." B. "Painless gross hematuria is the first symptom in renal cancer." C. "Squamous cell carcinomas do not present with detectable symptoms." D. "You should have sought treatment earlier."
A
