Nephritis NCLEX Practice Questions
Which assessment finding should alert the nurse to a possible client diagnosis of nephritis? (Select all that apply.) Complaint of cough Complaint of weight loss Presence of infection Presence of facial edema History of diabetes
Complaint of cough Presence of infection Presence of facial edema History of diabetes Facial edema is a manifestation of nephritis due to the retention of sodium and water. A client complaint of cough may indicate Goodpasture syndrome, a rare genetic disorder that causes nephritis and may cause a cough due to antibody destruction of alveoli. Infection may cause nephritis. A client with diabetes is more prone to developing nephritis due to vascular damage to the glomerulus. Weight loss is not a manifestation of nephritis.
The nurse teaches a client diagnosed with nephritis about risk factors for the disease. Which disease should the nurse list as being likely to cause nephritis? Congestive heart failure Celiac disease Asthma Graves disease
Congestive heart failure Congestive heart failure can damage the kidneys due to hypoxia and hypoperfusion, thereby causing nephritis. None of the other diseases listed in this question causes nephritis.
The community health nurse discusses the risk factors for nephritis with a group of community members. Which risk factor should the nurse include in the teaching? (Select all that apply) Diabetes Drug abuse Hypotension Hypothyroidism Overuse of over-the-counter painkillers
Diabetes Drug abuse Overuse of over-the-counter painkillers Diabetes causes damage to the fragile vessels of the nephron that can result in nephritis. Drug abuse and the chronic overuse of over-the-counter painkillers increase the risk. Hypertension, not hypotension, damages the nephron to cause nephritis. Hypothyroidism is not a risk factor for nephritis.
A client is suspected of having acute postinfectious glomerulonephritis. Which test result, if elevated, should lead the nurse to determine that the suspected diagnosis is correct? Creatinine clearance Antistreptolysin O (ASO) titer Blood urea nitrogen (BUN) Erythrocyte sedimentation rate (ESR)
Erythrocyte sedimentation rate (ESR) The ESR is a general indicator of inflammatory response and may be elevated in acute postinfectious glomerulonephritis and in lupus nephritis. BUN measures urea nitrogen, the end product of protein metabolism, created by the breakdown and metabolism of dietary and body proteins. Creatinine clearance is a specific indicator of renal function used to evaluate the glomerular filtration rate (GFR). The ASO titer detects streptococcal exoenzymes.
The nurse assesses a client suspected of having glomerulonephritis. Which assessment finding should indicate to the nurse that the suspected diagnosis is correct? Peripheral and central cyanosis Facial and peripheral edema Decreased bowel sounds Prolonged capillary refill
Facial and peripheral edema Because renal function is impaired in glomerulonephritis, the client will exhibit facial, periorbital, and peripheral edema. Peripheral cyanosis indicates hypoxia and is a respiratory problem. Prolonged capillary refill and decreased bowel sounds are not signs of glomerulonephritis.
The nurse is caring for a client in the acute phase of postinfectious glomerulonephritis. Which intervention should the nurse implement? (Select all that apply.) Fluid restriction Parenteral nutrition Protein restriction Chest physiotherapy Bedrest
Fluid restriction Protein restriction Bedrest A client in the acute phase of postinfectious glomerulonephritis is placed on bedrest, so the body can conserve energy. Only sensible fluid loss is replaced until the renal status is known. Because of the azotemia, protein consumption is limited. Chest physiotherapy is used to clear the lungs of secretions in pulmonary diseases. Parenteral nutrition is not necessary with glomerulonephritis, as the client will still be able to eat.
A client is admitted with acute postinfectious glomerulonephritis. Which medication should the nurse expect to be prescribed for the client to reduce inflammation? Angiotensin-converting enzyme (ACE) Inhibitor Antihypertensive Glucocorticoid Immunosuppressant
Immunosuppressant To control inflammation caused by acute postinfectious glomerulonephritis, the nurse will administer an immunosuppressant. A glucocorticoid also decreases inflammation. However, this medication is contraindicated in acute postinfectious glomerulonephritis. An ACE inhibitor is used in the management of this condition; however, it is used to reduce proteinuria and slow the progression of renal failure. An antihypertensive is also used in the management of this condition; however, it is used to treat hypertension.
Which problem is a priority for the nurse to address when caring for a client with acute glomerulonephritis? Impaired fluid balance Fatigue Impaired skin integrity Impaired nutrition
Impaired fluid balance While all choices are problems that should be addressed in planning care for the client diagnosed with nephritis, impaired fluid balance is a priority as this problem may be life-threatening if not addressed.
A client suspected of having nephritis is scheduled for a test at the nuclear medicine department. The client asks the nurse, "What test am I having?" Which test should the nurse identify? Renal ultrasound Renal biopsy Kidney scan Kidney, ureter, bladder (KUB)
Kidney scan The kidney scan uses nuclear medicine to visualize the kidney after intravenous administration of a radioisotope. The KUB (kidney, ureter, bladder) is an abdominal x-ray that evaluates kidney size and may rule out other causes. The renal ultrasound does not use nuclear medicine. The renal biopsy is a microscopic examination of kidney tissue and does not use nuclear medicine.
The nurse is discussing ways to prevent the development of nephritis with a client. Which strategy should the nurse include? Cutting down on smoking Maintaining blood pressure control Maintaining good dental hygiene Practicing stress-reduction techniques
Maintaining blood pressure control While the exact cause of nephritis is unknown, maintaining good blood pressure control (controlling hypertension) is one way to prevent damage to the kidneys and reduce the incidence of nephritis. Quitting smoking, not cutting down, is recommended. Good dental hygiene and reducing stress are not associated with the risk of developing nephritis.
When planning care for a client with acute glomerulonephritis, the nurse should prioritize which intervention? (Select all that apply.) Maintaining fluid balance Promoting an adequate sleep pattern Using standard precautions Maintaining skin integrity Promoting nutritional balance
Maintaining fluid balance Using standard precautions Maintaining skin integrity Promoting nutritional balance Interventions for a client with acute glomerulonephritis primarily focus on preventing infection, maintaining skin integrity, promoting nutritional balance, and maintaining fluid balance. Promoting an adequate sleep pattern may be an appropriate intervention; however, this is not a primary focus for this client.
The nurse planning care for a client diagnosed with nephritis assigns a goal of maintaining fluid volume balance. Which intervention should the nurse include in the client's plan of care? (Select all that apply.) Measuring abdominal girth Providing a low-sodium diet Encouraging fluid intake Offering ice chips frequently Keeping sheets tight and wrinkle-free
Measuring abdominal girth Providing a low-sodium diet Offering ice chips frequently The client diagnosed with nephritis will be on a fluid restriction diet. Fluids are restricted, not pushed. Measuring abdominal girth allows the nurse to monitor the degree of ascites. Offering frequent ice chips is a means to relieve thirst. Providing a low-sodium diet will decrease fluid retention by the kidneys. Keeping sheets tight and without wrinkles helps to promote skin integrity.
The nurse instructs a pregnant client diagnosed with nephritis about the possible effects of nephritis on the pregnancy. Which should the nurse include in the teaching? (Select all that apply.) Preeclampsia Abruptio placenta Preterm delivery Fetal loss Infant with low birthweight
Preeclampsia Preterm delivery Fetal loss
The nurse admits a client diagnosed with glomerulonephritis. The nurse should identify which characteristic that occurs with glomerulonephritis? (Select all that apply.) Slow, progressive destruction of the glomeruli Surfaces of the kidneys becoming soft and boggy Symmetrical decrease in the size of the kidneys Entire nephrons eventually being lost Gradual decline in renal function
Slow, progressive destruction of the glomeruli Symmetrical decrease in the size of the kidneys Entire nephrons eventually being lost Gradual decline in renal function Characteristics of chronic glomerulonephritis include a slow, progressive destruction of the glomeruli, a gradual decline in renal function, a symmetrical decrease in the size of the kidneys, and an eventual loss of the entire nephron. The surfaces of the kidneys become granular or roughened, not soft and boggy.
The nurse is caring for a client diagnosed with nephritis. Which assessment finding on discharge leads the nurse to determine that treatment was successful? The client's temperature is 101.5°F. The client has regained urine output. The client has gained less than 5 pounds. The client's sodium level is 150 mEq/L.
The client has regained urine output. Successful treatment of nephritis is evidenced by the client maintaining or regaining a normal urine output. The client's weight should return to the pre-admission weight as all retained fluid is excreted. An elevated temperature indicates that the client might be experiencing an infection. The client's sodium level should return to normal levels (135-145 mEq/L).
The nurse is screening a client for the risk of nephritis. Which question should the nurse ask? (Select all that apply.) "Do you have a history of diabetes?" "Does your family have a history of kidney disease?" "Do you have a history of low blood pressure?" "Do you have a history of bladder infections?" "Does your family have a history of gastric reflux?
"Do you have a history of diabetes?" "Does your family have a history of kidney disease?" "Do you have a history of bladder infections?" Diabetes and hypertension (not low blood pressure) can cause damage to the fragile vessels of the nephron, thereby putting the client at greater risk for nephritis. A family history of kidney disease also predisposes the client to developing nephritis. Infections can travel from the bladder to the kidney, thereby damaging the kidney. Gastric reflux is not related to nephritis.
The client diagnosed with nephritis states, "No one in my family has ever had any kidney disease. Where do you think this nephritis came from?" Which response by the nurse is most accurate? "I think your celiac disease must have damaged your kidneys." "The fact that you have thyroid disease probably caused damage to your kidneys." "It is possible that your history of arthritis caused the nephritis." "Your congestive heart failure might have damaged your kidneys."
"Your congestive heart failure might have damaged your kidneys." While the cause of nephritis is unknown, many diseases can damage the kidneys and cause nephritis. Congestive heart failure is one of them due to poor perfusion to the kidneys. Thyroid disease, celiac disease, and arthritis do not.
The nurse admits a hypertensive client diagnosed with glomerulonephritis. Which medication should the nurse expect to be ordered for the client? Angiotensin-converting enzyme (ACE) inhibitor Antibiotic Glucocorticoid Beta blocker
Angiotensin-converting enzyme (ACE) inhibitor ACE inhibitors or angiotensin receptor blockers (ARBs) are the first choice for antihypertensive agents in glomerulonephritis. These medications slow the progression of renal failure. They also reduce protein loss associated with nephrotic syndrome. Beta blockers are not indicated in glomerulonephritis; they are used to reduce hypertension and cardiac workload. Antibiotics are used to treat infections and glucocorticoids reduce inflammation.
The community health nurse speaks with a group of older adult community members about reasons they are at a higher risk for nephritis. Which reason should the nurse include? Higher incidence of cardiac problems Lower risk of developing chronic kidney disease Long-term use of proton pump inhibitors (PPIs) Long-term use of antihypertensives
Long-term use of proton pump inhibitors (PPIs) Medications such as PPIs and certain antibiotics (not antihypertensives) are associated with an increase in nephritis. Older adults have a higher risk of developing chronic kidney disease. Cardiac problems are not shown to increase the risk of nephritis.
The nurse is caring for a client with suspected acute glomerulonephritis. Which clinical manifestation supports this suspicion? (Select all that apply.) Tea-colored urine Microscopic hematuria Weight loss Crackles auscultated in lungs Low blood pressure
Tea-colored urine Microscopic hematuria Crackles auscultated in lungs Manifestations of acute glomerulonephritis include crackles in the lungs, tea-colored urine, microscopic hematuria, high blood pressure, and weight gain.
