Module 9A - Edge Questions

A nursing student is studying the progression of acute kidney injury. What is the proper order for the progression of acute kidney injury? Kidney function decreases Oliguria develops Initial insult or injury to the kidney Diuresis with reduced concentrating ability by kidney Recovery with return to normal urine concentration

1. Initial insult or injury to the kidney 2. Kidney function decreases 3. Oliguria develops 4. Diuresis with reduced concentrating ability by kidney 5. Recovery with return to normal urine concentration

A patient's chart shows blood urea nitrogen (BUN) is 22 mg/dL and creatinine is 2.0 mg/dL. The nurse is asked to report the BUN-to-creatinine level. What is the correct response for the nurse to make, expressed as a ratio? Enter numeral online.

11

A patient passes a kidney stone. What is the most likely composition of the stone? Cystine Uric acid Calcium Magnesium

Calcium

A renal patient presents with edema. What may be the primary cause of this edema? Urinary stone causing backup Decreased serum albumin due to renal loss Increased gluconeogenesis by the kidney Decreased erythropoietin synthesis

Decreased serum albumin due to renal loss

For which disorder may a nurse suggest Kegel exercises? Stress incontinence Asymptomatic bacteriuria Urinary tract infection (UTI) Overactive bladder

Stress incontinence

Which of the following substances may be needed as a supplement for a patient suffering renal osteodystrophy? Iron Vitamin D Glucosamine Vitamin E

Vitamin D

True or False? One of the main causes of nephrotic syndrome is post streptococcal infection.

false

A nurse is providing teaching to a client who has frequent kidney stones. Which of the following instructions should the nurse NOT include in the teaching? •A. "Drink lots of fluid to help flush your kidneys." •B. "Increase the amount of protein in your diet." •C. "Strain your urine and bring the stone in for analysis." •D. "If pain persists, return for medical treatment."

B

Question 7 of 15 Glomerular filtration rate (GFR) is recorded as 12 ml/min. What is the correct interpretation by the nurse? Renal function has returned to normal. The patient is ready to be discharged. Renal function is not normal, as the patient is in stage 3 chronic renal failure (CRF). Renal function is above normal levels. Renal function indicates stage 5 CRF.

Renal function indicates stage 5 CRF.

A patient's glomerular filtration rate (GFR) is 110 ml/min. Which of the following interpretations is correct? Renal function is normal. The value is too high; the kidneys are not concentrating the urine. This value is too low; the patient is retaining fluids. The value is too low due to decreased renal perfusion.

Renal function is normal.

Which of the following bacterial infections is most worrisome to the clinician in regards to glomerular damage? Staphylococcal Clostridial Neisseria Streptococcal

Streptococcal

The following assessment results for a patient are reviewed: urine culture revealed a high level of colony-forming units. Urine was cloudy in appearance and the patient reports pain with urination. No fever or other symptoms are present. What conclusion may the clinician make? Interstitial cystitis Asymptomatic bacteriuria Urinary tract infection (UTI) Bladder cancer

Urinary tract infection (UTI)

The most common early sign of kidney disease is: •A. Sodium retention •B. Elevated BUN and creatinine levels •C. Development of metabolic acidosis •D. Inability to dilute or concentrate urine

B

Which of the following symptoms do you expect to see in a patient diagnosed with acute pyelonephritis? •A. Jaundice and flank pain •B. Costovertebral angle tenderness and chills •C. Burning sensation on urination •D. Polyuria and nocturia

B

Select the most common type of medications that may be ordered by a physician to treat nephrotic syndrome: A. Cardiac glycosides B. Corticosteroids C. Antibiotics D. Antihypertensives E. Diuretics F. Anticholinergics

B, E

A patient is suspected of having nephrotic syndrome due to a health history of lupus. As the nurse you know that what substance(s) will be present in the urine to confirm this diagnosis? A. Red blood cells and mild protein B. Massive red blood cells and moderate pain C. Massive protein D. Elevated potassium and sodium

C

An 18 y.o. student is admitted with dark urine, fever, and flank pain and is diagnosed with acute glomerulonephritis. Which would most likely be in this student's health history? •A. Renal calculi •B. Renal trauma •C. Recent sore throat •D. Family history of acute glomerulonephritis

C

A patient is diagnosed with nephrotic syndrome. What signs and symptoms below are common in this condition? Select all that apply. A. Hypertension B. Decreased glomerular filtration rate C. Foamy, frothy urine D. Massive proteinuria E. Hyperlipidemia F. Edema G. Hematuria H. Hypoalbuminemia

C, D, E, F, H

A patient has unexplained hematuria with no pain. Which diagnostic follow-through may be most helpful? IV pyelogram procedure Postvoid volume measurement Straining the urine Cystoscopy

Cystoscopy

A nurse is providing teaching to a client who has nephrotic syndrome. The nurse should recognize that which of the following client statements indicates a need for further teaching? •A. "I can expect to have swelling in my face." •B. "I will lose protein in my urine." •C. "I should expect my provider to prescribe a kidney biopsy." •D. "I should increase my sodium intake."

D

A patient wants to know how he can prevent future kidney stones. Which of the following is an appropriate recommendation? Drink at least 3/L per day. Take calcium supplements. Maintain current dietary choices. Take a daily prophylactic antibiotic.

Drink at least 3/L per day.

A patient with chronic renal failure reports that he is feeling like his skin is "itching." What is an appropriate response by the nurse? Suggest that the patient switch to a different cream or lotion. Suggest that the patient switch laundry detergents. Evaluate laboratory values to assess toxin levels in the blood. Suggest the patient may be developing a sensitivity to the bed linen.

Evaluate laboratory values to assess toxin levels in the blood.

A patient is diagnosed with nephrotic syndrome. Which of the following does the nurse expect to observe? Decreased serum blood urea nitrogen (BUN) Fatty casts in urine Absence of edema Patient in severe pain due to stone formation

Fatty casts in urine

A patient is recommended for a urodynamic study. Which of the following pieces of information can be learned from this study? Select all that apply. Functioning of the bladder Postvoid volume Pyelonephritis Stones in the ureters Bladder filling and emptying

Functioning of the bladder Postvoid volume Bladder filling and emptying

Question 7 of 15 A patient has polycystic kidney disease. The nurse correctly determines which of the following is the cause? Bacterial infection Autoimmune disorder Genetic disorder Too much calcium in the diet

Genetic disorder

Which of the following findings may encourage a clinician to begin considering discussing the possibility of a need for a kidney transplant? Damage to 50% of the nephrons Presence of periorbital edema Glomerular filtration rate (GFR) < 12 ml/min Protein in urine

Glomerular filtration rate (GFR) < 12 ml/min

Plasmapheresis would be a treatment option for a patient with which of the following conditions? Acute kidney injury End-stage renal disease Pyelonephritis Goodpasture's syndrome

Goodpasture's syndrome

For which of the following would antibiotics be appropriate as the primary treatment? Select all that apply. Group A beta-hemolytic streptococci (GABHS) glomerulonephritis Nephrotic syndrome Pyelonephritis Goodpasture's syndrome Polycystic kidney disease

Group A beta-hemolytic streptococci (GABHS) glomerulonephritis Pyelonephritis

A patient is to undergo renal ultrasound. Which of the following is the test most likely used to assess? Glomerular filtration rate (GFR) Hydronephrosis Casts Azotemia

Hydronephrosis

A clinician needs to be able to assess a patient's suspected renal calculi. What diagnostic tools may aid the clinician? Select all that apply. IV pyelogram (IVP) procedure Cystoscopy Cough test Computed tomography (CT) scan Urinalysis

IV pyelogram (IVP) procedure Computed tomography (CT) scan

A nurse is speaking to a patient with nephrotic syndrome. Which recommendations will be helpful for the patient? Ingest a high protein diet (3 to 4 g/kg/day) Ingest a low-sodium diet (< 1500 g/day) Encourage overhydration Ingest a low-calorie/restrictive diet

Ingest a low-sodium diet (< 1500 g/day)

A patient complains that she feels she must urinate three times an hour or more. She says urinating helps relieve the discomfort she feels. But she says this is disrupting her life. Which of the following disorders is most likely present? Renal calculi Asymptomatic bacteriuria Interstitial cystitis Pyelonephritis

Interstitial cystitis

A patient is taking a nephrotoxic drug. Which type of renal dysfunction is the nurse most likely concerned about developing? Prerenal Intrarenal Postrenal Juxtarenal

Intrarenal

A nurse is reviewing urinalysis results. Which factors does she review to see whether the patient has a urinary tract infection? Select all that apply. Glucose Bilirubin Albumin Leukocyte esterase Nitrite

Leukocyte esterase Nitrite

A woman is diagnosed with stress incontinence. Which of the following are risk factors for this disorder? Select all that apply. Multiple childbirths Low estrogen levels Female sex Young age Postmenopausal

Multiple childbirths Low estrogen levels Female sex Postmenopausal

A patient mentions that bladder cancer runs in his family. Which signs and symptoms may appear in this cancer? Blood in the urine with severe pain upon urination Increased urge to urinate No pain with urination, but blood appears in urine Urinating up to 50 times per day

No pain with urination, but blood appears in urine

A nursing educator is discussing that urinary incontinence is often under-reported. What is the primary reason for this under-reporting that nursing students should know? Urinary incontinence is extremely rare. Patients may be embarrassed to share details of incontinence. Most patients do not know what urinary incontinence is. No documentation system tracks urinary incontinence.

Patients may be embarrassed to share details of incontinence.

For a confirmative diagnosis of Goodpasture's disease, the nurse anticipates which of the following? Glomerular filtration rate (GFR) measurement decreases. Positive immunoglobulin results. Intravenous pyelogram (IVP) shows obstruction. Urinalysis shows the presence of casts.

Positive immunoglobulin results.

A nursing student suspects that a patient has a lower urinary tract infection (UTI). The nursing educator, however, believes that the patient may have pyelonephritis. Which of the following signs or symptoms did the nursing educator notice that may indicate pyelonephritis? Presence of leukocyte esterase in the urinalysis results Level of pain the patient is self-reporting Presence of fever Patient's past medical history

Presence of fever

The urinalysis results of a patient in the end stage of chronic renal failure is likely to show which of the following? Presence of white blood cells (WBCs), red blood cells (RBCs), and protein Elevated leukocyte esterase Elevated ketones Elevated nitrite

Presence of white blood cells (WBCs), red blood cells (RBCs), and protein

Which of the following would alert the clinician that the patient may have acute glomerulonephritis? Select all that apply. Pain with urination Protein in urine Oliguria Blood in urine Fluid accumulation in renal pelvis

Protein in urine Blood in urine

A patient states that she once took a medication that turned her urine red. What medication does the nurse think the patient is referring to? Pyridium Fluconazole Methicillin Lasix

Pyridium

A patient arrives in the emergency department complaining of a kidney stone. Which of the following is the appropriate nursing intervention? Restrict all fluids. Withhold pain medications until the stone is passed. Strain urine. Offer sedative.

Strain urine.

A patient's urinalysis reveals the presence of glucose. Which of the following should be considered first? The patient is eating too many carbohydrates. Decreased glomerular filtration rate (GFR) is concentrating the urine too much The patient may have diabetes mellitus. The patient has kidney failure.

The patient may have diabetes mellitus.

A critical care patient is to receive continual renal replacement therapy (CRRT). What is an appropriate description to share with family members of the patient? The patient's blood will be purified over 24 hours. CRRT is a form of hemodialysis and is done every three days. CRRT is a form of plasmapheresis and removes antibodies from the plasma. CRRT provides IV infusions due to fluid loss.

The patient's blood will be purified over 24 hours.

A patient has oliguria. Which of the following interpretations by the nurse is correct? The patient has increased urine output compared to normal. The patient has a urinary stone. The patient's urine output is less than 400 ml/day. The patient's glomerular filtration rate (GFR) must be elevated.

The patient's urine output is less than 400 ml/day.

True or False? Hypertension occurs in acute glomerulonephritis and is not a common finding with nephrotic syndrome.

True

For which of the following conditions would the clinician need to recommend straining of the urine? Urinary tract infection (UTI) Asymptomatic bacteriuria Urosepsis Urolithiasis

Urolithiasis

A patient is suffering declining kidney function due to an autoimmune disease. The patient asks the nurse how much of his kidney must suffer damage to lead to end stage renal disease (ESRD). Which of the following is the appropriate response by the nurse? Usually ESRD develops when less than 10% of the nephrons are damaged. Usually ESRD develops when 10% to 20% of the nephrons are damaged. Usually ESRD develops when 65% to 75% of the nephrons are damaged. Usually ESRD develops when 90% to 95% of the nephrons are damaged.

Usually ESRD develops when 90% to 95% of the nephrons are damaged.

Which of the following comments by a patient shows understanding of the dietary changes that may help in interstitial cystitis? "I should probably give up or limit my morning cup of coffee." "I need to become a vegetarian." "I need to drink less water each day in order to urinate less." "Spicy food may help alleviate my symptoms."

"I should probably give up or limit my morning cup of coffee."

A patient is unable to pass a renal calculi. Which of the following treatment options may the clinician consider? Insertion of medications in the bladder Lithotripsy Ingestion of a beverage formulation designed to break up the stone Immediate surgery

Lithotripsy

A nurse is planning care for a client who has acute glomerulonephritis. Which of the following interventions should the nurse include in the plan? •A. Administer antibiotics. •B. Encourage increased fluid intake. •C. Obtain weight weekly. •D. Encourage frequent ambulation.

A

In patients who are experiencing acute glomerulonephritis, the glomerulus is permeable to what substances? A. Red blood cells and protein B. Protein and white blood cells C. Red blood cells, protein, and lipids D. Proteins

A

A nurse is evaluating a patient's risk for renal disorders. Which of the following increase the risk for renal dysfunction? Select all that apply. A patient with diabetes mellitus A patient with severe hypertension A patient with systemic lupus erythematosus A patient with cirrhosis A patient with peptic ulcer disease

A patient with diabetes mellitus A patient with severe hypertension A patient with systemic lupus erythematosus

A 5-year old male patient is experiencing acute glomerulonephritis. What signs and symptoms may you observe with this condition? A. Swelling in the face B. Hyperlipidemia C. Tea-colored urine D. Elevated BUN and creatinine levels E. >3 grams of protein loss in the urine per day

A, C, D

A nurse is treating a patient with kidney dysfunction. She notices that serum albumin levels are 2.8 g/dl. Which of the following is the appropriate interpretation by the nurse? Albumin levels are normal. Albumin levels are increased. Glomerular filtration rate (GFR) must be reduced. Albumin levels are decreased, due to loss in urine. Albumin levels are unaffected by renal function; thus, this value is not helpful.

Albumin levels are decreased, due to loss in urine.

A nurse is working with a patient who finds her incontinence to be very embarrassing. She is wondering if any medications are available that could help her. What class of medications does the clinician consider? Angiotensin receptor blockers Corticosteroids Anticholinergic Antileukotrienes

Anticholinergic

You expect a patient in the oliguricphase of renal failure to have a 24 hour urine output less than: •A. 200ml •B. 400ml •C. 800ml •D. 1000ml

B

Which cause of hypertension is the most common in acute renal failure? •A. Pulmonary edema •B. Anemia •C. Hypovolemia •D. Hypervolemia

D

A patient's chart lists the presence of incontinence. With no further information provided, which type of the incontinence is the nurse most likely to encounter in the patient? Overflow Stress Neurogenic Functional

Stress