Chapter 33 PrepU

A client has been given the diagnosis of diffuse glomerulonephritis. The client asks the nurse what diffuse means. The nurse responds: "Only some of the glomeruli are affected." "All glomeruli and all parts of the glomeruli are involved." "Only one segment of each glomerulus is involved." "The mesangial cells are being affected."

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

What is the most common cause of a lower urinary tract infection? a. Escherichia coli b. Pseudomonas aeruginosa c. Staphylococcus saprophyticus d. Staphylococcus aureus

Escherichia coli

Which diagnostic and assessment results support the diagnosis of chronic pyelonephritis? Select all that apply. a. Blood pressure 140/92 b. Nocturia (voiding at night) c. Severe pain in upper outer quadrant of the abdomen d. Bilateral flank pain e. Polyuria (excess urine output)

-Nocturia (voiding at night) -Polyuria (excess urine output)

The nurse is reviewing glomerular disorders with a group of nursing students. Which lab/diagnostic results will the nurse likely talk about? Select all that apply. a. Protein in the urine b. Epithelial cells in the urine c. Red cells in the urine d. White cells in the urine e. Low serum albumin levels

-Protein in the urine -Red cells in the urine

Which client is displaying manifestations of having a kidney stone? a. Elevation in systemic blood pressure and frequent urination b. A visible abdominal mass and abdominal pain in bilateral lower quadrants c. Increased thirst and urinary output with warm, dry skin d. Acute onset of colicky flank pain radiating to lower abdomen

Acute onset of colicky flank pain radiating to lower abdomen

The nurse suspects that a newborn infant who presents with bilateral flank masses, impaired lung development, and oliguria may be suffering from which disorder? a. Horseshoe kidney abnormality b. Autosomal dominant polycystic kidney disease (ADPKD) c. Simple renal cysts d. Autosomal recessive polycystic kidney disease (ARPKD)

Autosomal recessive polycystic kidney disease (ARPKD)

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? a. Force micturition every 2 hours while awake. b. Continue taking antibiotics for 10 to 14 days even if symptoms of infection disappear. c. Increase intake of cranberry juice to 2 L/day. d. Take prescribed diuretics early in the day to avoid having to get up during the night.

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

Which client clinical manifestation most clearly suggests a need for diagnostic testing to rule out renal cell carcinoma? a. Urinary urgency b. Cloudy urine c. Hematuria d. Oliguria

Hematuria

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? a. Increased urine output b. Increase in blood pressure c. Inability to control urination d. Excretion of dilute urine

Increase in blood pressure

Which assessment finding would lead the nurse to suspect the client has developed nephrotic syndrome? a. Proteinuria and generalized edema b. Hematuria and anemia c. Renal colic and increased serum sodium d. Increased creatinine with normal blood urea nitrogen

Proteinuria and generalized edema

A nurse is caring for a client with renal cell cancer. What is the treatment of choice for this condition? a. Chemotherapy b. Radiation c. Alternative therapy d. Surgical resection

Surgical resection

A nurse observes that a client's urine is cola colored and considers which factor as a possible reason? a. The client's urine contains material from the degradation of red blood cells. b. The client has ingested a dark-colored drink. c. The client's urine has a decrease in the specific gravity. d. The client has an elevation of urine potassium.

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

The nurse caring for an older adult notes a marked decrease in mental acuity over a 24-hour period. What assessment indicates the most likely cause of this change? a. Exacerbation of osteoarthritis b. Hearing aid batteries are run down c. Urine cloudy with strong odor d. No bowel movement in 48 hours

Urine cloudy with strong odor

The nurse recognizes the most common cause of acute postinfectious glomerulonephritis as: a. prolonged blockage of the ureter with a stone. b. a streptococcal infection 7 to 12 days prior to onset. c. drug-induced damage to the renal glomeruli. d. uncontrolled diabetes with increased proteinuria.

a streptococcal infection 7 to 12 days prior to onset.

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? a. specific gravity of 1.025 b. solid formations c. positive glucose d. increased nitrites

increased nitrites

A client has recently undergone diagnostic testing for possible Berger disease. The nurse caring for this client would anticipate the primary clinical manifestations to include which findings? Select all that apply. a. Recent upper respiratory infection b. Gross hematuria c. Elevated ketone levels in the urine d. Fever, chills, and general body aches

-Recent upper respiratory infection -Gross hematuria -Fever, chills, and general body aches

What are appropriate interventions in the care of a client diagnosed with renal calculi? Select all that apply. a. Inserting a Foley catheter b. Straining the client's urine c. Addressing the client's pain d. Keeping track of intake and output e. Restricting the client's oral fluid intake

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

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. a. urinary urgency and frequency b. abrupt onset of fever and chills c. flank pain in the back d. shortness of breath d. heart palpitations

-urinary urgency and frequency -abrupt onset of fever and chills -flank pain in the back

Which statement about the use of angiotensin-converting enzyme (ACE) inhibitors and autosomal recessive polycystic kidney disease (ARPKD) is accurate? a. The ACE inhibitors have been shown to shrink the size of the cysts inside the kidneys. b. ACE inhibitors should be used strictly in those clients who also have an underlying cardiac history. c. ACE inhibitors may interrupt the renin-angiotensin-aldosterone system to reduce renal vasoconstriction. d. The use of ACE inhibitors will increase the vasopressin levels.

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

Hospitalized neonates are at greatest risk of developing septicemia related to which procedure? a. Suctioning of tracheostomy b. Arterial blood gas measurement c. Collection of urine for analysis d. Catheter-associated bacteriuria

Catheter-associated bacteriuria

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? a. Eat plenty of yogurt that contains protein to prevent future infection. b. Include lots of calcium in your diet to promote urinary health. c. Monitor and limit your intake of fats, especially triglycerides in your diet. d. Drink lots of fluids to help relieve the signs/symptoms of UTIs.

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

Which procedure is a nonsurgical method of treatment for renal calculi (kidney stones)? a. Percutaneous ureterolithotomy b. Extracorporeal shock wave lithotripsy (ESWL) c. Percutaneous nephrolithotomy d. Retrograde ureteroscopy

Extracorporeal shock wave lithotripsy (ESWL)

Which of the following clients is at greatest risk for developing a urinary tract infection (UTI)? a. Older adult female client admitted with an indwelling Foley catheter that has been in place for 1 month b. Woman who has just given birth and had a straight urinary catheter inserted prior to delivery c. Middle-aged male client admitted for dehydration due to strenuous exercise in hot weather d. Male client 2 days postoperative hip fracture repair whose Foley catheter was removed on postoperative day 1

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

A client diagnosed with Goodpasture syndrome would require which therapy to remove proteins and autoantibodies from the system? a. Plasmapheresis b. Kidney removal c. Intravenous calcium d. Renal transplant

Plasmapheresis

Which substance would not be found in glomerular filtrate? a. Sodium b. Water c. Potassium d. Protein

Protein

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? a. There is possible obstruction in the urinary tract. b. The woman does not clean herself properly. c. The woman has multiple sexual partners. d. The woman takes too many bubble baths.

There is possible obstruction in the urinary tract.

The nurse is reviewing the lab results of a client with suspected nephrotic syndrome. The nurse anticipates the results to include: a. protein in the urine. b. serum hyperalbuminemia. c. decreased triglycerides. d. decreased low-density lipoproteins. e. abnormal blood clotting factors.

protein in the urine.

A major complication of prolonged bed rest is an increased risk of kidney stones. The nurse knows that this is most likely related to: a. a limited access to fluids while hospitalized. b. frequency of urination. c. saturation of urine with calcium salts. d. increased urine levels of citrate.

saturation of urine with calcium salts.