Prep U 24,25,26

Lakukan tugas rumah & ujian kamu dengan baik sekarang menggunakan Quizwiz!

A new client on hemodialysis is watching his blood being filtered through a dialyzer. He asks the nurse how much blood typically passes through the kidney every minute? The nurse responds:

1000-1300 mL/minute.

An adult has a serum sample taken to evaluate the BUN-creatinine ratio. Select the result that indicates a normal test.

BUN 10 mg/dL to creatinine 1 mg/dL

The nurse is reviewing the laboratory work of several medical clients. Which laboratory result is most suggestive of abnormalities in kidney function?

Increased creatinine and blood urea nitrogen (BUN) levels

Which client is displaying manifestations of having a kidney stone?

Acute onset of colicky flank pain radiating to lower abdomen.

A 34-year-old woman presents with an abrupt onset of shaking chills, moderate to high fever, and a constant ache in her lower back. She is also experiencing dysuria, urinary frequency, and a feeling of urgency. Her partner states that she has been very tired the last few days and that she looked like she may have the flu. What diagnosis is the most likely?

Acute pyelonephritis

A client with chronic kidney disease (CKD) has developed asterixis. The nurse knows that asterixis is which of the following?

Dorsiflexion of hands and feet

A nurse is teaching a client about the functions of the kidney. Which would be the most appropriate information for the nurse to provide? Select all that apply.

Eliminates metabolic wastes Regulates calcium and phosphorus conservation and elimination Regulates blood pressure through the renin-aldosterone mechanism Regulates pH of body fluids through reabsorption and conservation

Which assessment findings would a clinician consider as most indicative of acute renal failure?

Increased nitrogenous waste levels; decreased glomerular filtration rate (GFR).

A client is to receive a radiocontrast media as part of a diagnostic scan. Which intervention is intended to reduce the nephrotoxic effects of the radiocontrast media?

Increasing the normal saline intravenous infusion rate prior to the exam

A patient sustained acute tubular injury approximately 2 hours ago. Which of the following phases of this disorder does the nurse recognize that the patient is in at this time?

Initiating phase

Neuromuscular disorders can be triggered by CKD. For those clients on dialysis, approximately two thirds suffer from what peripheral neuropathy?

Restless legs syndrome

Acute pyelonephritis is a result of which of the following?

Bacterial infection

A frantic mother reports a large mass in her child's abdomen and after diagnostic testing, the healthcare provider diagnoses a Wilms tumor, Stage IV. After the provider leaves the room, the parents ask the nurse, "What does this mean?" Which response by the nurse is most accurate?

"A cancer of the kidney has most likely spread to their lungs."

A young client has just been diagnosed with acute glomerulonephritis. Which question should the nurse ask this client in attempting to establish a cause?

"Have you had any type of infection within the last 2 weeks?"

A client with a diagnosis of end-stage renal disease received a kidney transplant 2 years ago that was deemed a success. During the most recent follow-up appointment, the nurse should prioritize the client for referral based on which statement?

"I'm feeling a bit under the weather these days and I'm a bit feverish."

A client in hospital is frustrated at the inconvenience of having to collect his urine for an entire day and night as part of an ordered 24-hour urine-collection test. The client asks the nurse why the test is necessary since the client provided a single urine sample two days prior. How could the nurse best respond?

"Often when an abnormal substance shows up in a urine test, a 24-hour urine collection is needed to determine exactly how much is present in your urine."

A patient is scheduled for a creatinine clearance test to measure the glomerular filtration rate (GFR). The patient asks the nurse what this test is used for. Which of the following is the nurse's best response?

"This test provides a gauge of renal function."

A nurse is collecting a urine specimen prior to measuring the albumin level in a client's urine. A colleague states, "I thought albumin was related to liver function, not the kidney." How can the nurse best respond to this statement?

"Urine albumin levels are useful for diagnosing diabetic kidney disease."

A healthcare provider for an obese male, who has a history of diabetes and hypertension, reports that their GFR of 51 mL/min with elevated serum creatinine levels. Which statement by the healthcare provider will likely answer the clients question about the cause of these abnormal results?

"Your chronic kidney disease has likely been caused by your diabetes and high blood pressure."

A client has been taking up to 2400 mg of ibuprofen per day following a motor vehicle for chronic pain. They are diagnosed with chronic analgesic nephritis. The client states, "I thought that taking too many drugs hurt your liver if anything, not your kidneys." What is the most appropriate response to the man's statement?

"Your kidneys are vulnerable to damage because of how much blood flows through them and the fact that they break down many drugs.

A client is suspected to have chronic kidney disease (CKD). The nurse will use which glomerular filtration rate (GFR) to aid in this diagnosis?

60 ml/min/1.73 square meters or less for three months

Urine is a amber, light-yellow fluid that is 5% dissolved solid. What percent of it is water?

95

A geriatric nurse is caring for several clients. Which alterations in clients' health should the nurse attribute to age-related physiologic changes?

A 78-year-old woman's GFR has been steadily declining over several years.

The nurse on a geriatric unit is assessing four clients. Which client is most likely to exhibit pyuria and high counts of urine colony-forming units?

A client who has urinary catheter in place due to confusion

The nurse recognizes that which individuals have the greatest risk for the development of chronic kidney disease (CKD)? Select all that apply.

A client with a recent diagnosis of type 2 diabetes who does not monitor their blood sugar A 42-year-old client with uncontrolled hypertension averaging 170/94

Which diagnostic bloodwork is most suggestive of chronic kidney disease (CKD)?

A client with low vitamin D levels; low calcitrol levels and elevated parathyroid hormone (PTH) levels

The nurse is educating a patient with chronic kidney disease (CKD). What is the recommended daily fluid intake for this patient?

A daily fluid intake of 500 to 800 mL/day to maintain hydration

A client is experiencing an increase in urinary output. Which physiologic response by the body is responsible for how the kidney concentrates urine?

A decrease in antidiuretic hormone

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

A streptococcal infection 7 to 12 days prior to onset

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

Albumin

It is known that high levels of uric acid in the blood can cause gout, while high levels in the urine can cause kidney stones. What medication competes with uric acid for secretion in to the tubular fluid, thereby reducing uric acid secretion?

Aspirin

Which substance released by atrial muscle cells will inhibit sodium and water reabsoption?

Atrial natriuretic peptide (ANP)

The form of polycystic kidney disease (PKD) that first manifests in the early infant period is most commonly characterized as which of the following?

Autosomal recessive

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)

A school nurse is teaching a group of fourth-grade girls about personal hygiene. Important teaching points aimed at reducing the incidence of urinary tract infection (UTI) include which of the following? Select all that apply.

Avoiding bubble baths Wiping from front to back after a bowel movement Careful hand washing

The nurse is caring for a patient who has had acute blood loss from ruptured esophageal varices. Which of the following does the nurse recognize is an early sign of prerenal failure?

Baseline urine output of 50 mL/hr that is now 10 mL/hr

Which clinical manifestations would you expect to see in an infant diagnosed with autosomal recessive polycystic kidney disease (ARPKD)?

Bilateral flank masses and impaired lung development

When caring for a client with dehydration, the nurse anticipates the client will have an alteration in which of these substances in the blood?

Blood urea nitrogen

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

Renal cell carcinoma

Skeletal disorders frequently accompany chronic kidney disease (CKD). The nurse recognizes which statements regarding bone turnover in CKD are correct? Select all that apply.

Both high and low turnover present risk for fracture. In high-bone-turnover, there is both increased bone formation and increased resorption. High-bone-turnover produces porous, coarse-fibered bone.

The nurse is caring for a 76-year-old client with acute glomerulonephritis who develops sudden-onset dyspnea. The client's vital signs are: blood pressure 175/96 mm Hg; heart rate 98 bpm; respiratory rate 22 breaths/min; oxygen saturation 88% on room air. What is the nurse's priority assessment?

Breath sounds

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

Which medication would the nurse anticipate being prescribed for the renal failure client who has hyperphosphatemia?

Calcium carbonate.

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

Catheter-associated bacteriuria

A client is diagnosed with decreased gomerular filtration rate but has no renal damage. The nurse recognizes this can occur with which disease process? Select all that apply.

Cirrhosis Heart failure Removal of one kidney Dehydration

Which clients does the nurse need to monitor for the development of intense intrarenal vasoconstriction that may induce prerenal failure? Select all that apply.

Client undergoing cardiac catheterization Client taking cyclosporine to prevent rejection for a liver transplant Client with an elevated blood urea nitrogen who is taking ibuprofen every 6 hours for back pain

Which client would the nurse consider having the highest risk for developing a urinary tract infection?

Client with obstructed urinary outflow from a kidney stone

An 80-year-old client with diabetes has a GFR of 41 mL/min/1.73 m2. His physical and workup show uremia, azotemia, and elevated BUN. Which action should be done first to slow the decline of his kidney function?

Control blood glucose and blood pressure

What is the action of renin in the renin-angiotensin-aldosterone mechanism?

Converts angiotensinogen to angiotensin I

A nurse is evaluating a patient's morning laboratory values. Which of the following results requires that the nurse notify the health care provider?

Creatinine: 10.6 mg/dL

Which of the following occurrences is most likely to cause increased urination?

Decrease in anti-diuretic hormone

The nurse is preparing to assess a client who has just been admitted to the hospital with a diagnosis of prerenal failure. Which would the nurse expect the client to manifest? Select all that apply.

Decreased urinary output Increased BUN BUN-to-serum creatinine ratio of greater than 20:1

When caring for a client with autosomal dominant polycystic kidney disease (ADPD), which sign/symptom is associated with a complication that requires immediate treatment?

Develops an excruciating headache, the client needs to get to the emergency department right away, because of the possibility of an aneurysm that is bleeding.

A new client presents with elevated BUN, systemic edema, a BP of 145/93 mm Hg, recurrent infections, and a GFR of 51 mL/min/1.73 m2. What treatment should the nurse anticipate?

Dialysis

The nurse is instructing a patient with advanced kidney disease (AKD) about a dietary regimen. Which of the following restrictions should the nurse be sure to include in the treatment plan to decrease the progress of renal impairment in people with AKD?

Dietary protein

The nurse collects a urine sample but forgets the sample in the client's room for several hours. What is the nurse's best action?

Discard the sample and recollect in the morning.

The nurse is teaching a group of nursing students about the major functions of the kidney. Which of these should the nurse include in the discussion? Select all that apply.

Elimination of water, Removal of waste products Removal of excess electrolytes

The nurse is caring for a client with a condition of deficiency of antidiuretic hormone (ADH). When assessing the client, which of these findings does the nurse anticipate?d

Excessive urine output

Which pain descriptions would lead the nurse to suspect the client is experiencing ureteral colic?

Excruciating pain in the flank and upper outer quadrant of abdomen that radiates to bladder area.

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

Extracorporeal shock wave lithotripsy (ESWL)

Which option identifies the function of the kidneys in maintaining normal composition of internal body fluids?

Filtration and reabsorption of physiologically essential substances

Urine specific gravity is normally 1.010 to 1.025 with adequate hydration. When there is loss of renal concentrating ability due to impaired renal function, low concentration levels are exhibited. When would the nurse consider the low levels of concentration to be significant?

First void in morning

A middle-aged female is admitted with acute pyelonephritis. Which assessment findings correlate with this diagnosis?

Flank pain, dysuria and nausea and vomiting are likely assessment findings.

The nurse is caring for a client with a disease causing excess antidiuretic hormone (ADH). When performing the assessment, the nurse should focus on which of these manifestations of excess ADH?

Fluid volume excess

The health care provider is reviewing lab results of a client. Select the diagnostic test that is considered the best measurement of overall kidney function?

Glomerular filtration rate (GFR)

When caring for the client with proteinuria, the nurse recognizes dysfunction in which of these structures of the kidney allows protein to leak into the urine?

Glomerulus

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

A nurse is assessing a client for early manifestations of chronic kidney disease (CKD). Which would the nurse expect the client to display?

Hypertension

A client diagnosed with CKD has begun to experience periods of epistaxis and developed bruising of skin and subcutaneous tissues. The nurse recognizes these manifestations as:

Impaired platelet function

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?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?

Inability to control urination

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?

Increase in blood pressure

Manifestations of polycystic kidney disease include which of the following?

Increase in kidney size bilaterally

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 manifestation?

Increased blood pressure

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.

Which can be said about acute drug-induced interstitial nephritis? Select all that apply.

It may be related to a sensitivity to sulfonamide drugs. It manifests as a fever, hematuria, mild proteinuria, and possibly a rash. It may result in acute renal failure.

To treat enuresis in a young girl, her pediatrician prescribes desmopressin, an antidiuretic hormone (ADH) nasal spray, before bedtime. Which rationale for this treatment is the most likely?

It removes water from the filtrate and returns it to the vascular compartment.

Vitamin D metabolism is deranged in clients with chronic kidney disease (CKD). The nurse recognizes that which of the following statements regarding vitamin D is correct?

Kidneys convert inactive vitamin D to its active form, calcitriol.

Wilms tumor is a tumor of childhood. It is usually an encapsulated mass occurring in any part of the kidney. What are the common presenting signs of a Wilms tumor?

Large asymptomatic abdominal mass and hypertension

The nurse assessing a renal failure client for encephalopathy caused by uremia may observe which clinical manifestations?

Loss of recent memory and inattention.

A nurse is explaining the clinical manifestations of diabetic nephropathy (diabetic glomerulosclerosis) to a client. Which would be the most important information for the nurse to provide?

Microalbuminemia is a predictor of future nephropathies.

A 35-year-old female ultramarathon runner is admitted to hospital following a day-long, 80-km race because her urinary volume is drastically decreased and her urine is dark red. Tests indicate that she is in the initiating phase of acute tubular necrosis. Why is her urine red?

Myoglobinuria

Both type 1 and type 2 diabetes mellitus can cause damage to the glomeruli of the kidneys. What renal disease is diabetic nephropathy associated with?

Nephrotic syndrome

The health care provider has prescribed an aminoglycoside (gentamicin) for a client. The nurse is aware that the client is at risk for:

Nephrotoxic acute tubular necrosis

A 45-year-old client with chronic kidney disease (CKD) voices concern about her dialysis treatment. The client would like to work and spend time with her family. Which type of dialysis will best fit this client's lifestyle?

Nocturnal intermittent peritoneal dialysis (NIPD)

The nurse knows that a patient with chronic kidney disease (CKD) may experience which of the following changes in skin integrity? Select all that apply.

Pale skin Brittle fingernails Decreased perspiration

A patient with stage 5 chronic kidney disease (CKD) is presenting with fever and chest pain, especially when taking a deep breath. The nurse detects a pericardial friction rub on auscultation. Which of the following conditions does the nurse suspect is common with this stage of kidney disease?

Pericarditis

The nurse and nursing student are caring for a client with a condition causing deficiency of ADH. The nurse recognizes that the student understands the origin of this process when the student states ADH is produced in which of these areas?

Pituitary gland

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

Plasmapheresis

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

Polycystic kidney disease

A patient has an obstructive urine outflow related to benign prostatic hyperplasia. Due to the inability to excrete adequate amounts of urine, which of the following types of renal failure should the nurse closely monitor for?

Postrenal failure

A patient in renal failure has marked decrease in renal blood flow caused by hypovolemia, caused by gastrointestinal bleeding. The nurse is aware that this form of renal failure can be reversed if the bleeding is under control. Which of the following forms of acute renal injury does this patient have?

Prerenal failure

The anemia that occurs with end-stage kidney disease is often caused by the kidneys themselves. What loss of function in the kidney results in anemia of end-stage kidney disease?

Produce erythropoietin

The nurse is teaching a group of nursing students about the physiologic consequences of hypotension and reduced perfusion to the kidney. Which of these compensatory mechanisms occurs immediately after renin release from the kidney?

Production of angiotensin I

The nurse caring for four male clients recognizes which client is at highest risk for developing postrenal kidney failure?

Prostatic hyperplasia

When acute tubular necrosis (ATN) is suspected, the nurse will likely see which laboratory findings on the urinalysis report? Select all that apply.

Protein Red blood cells Cast cells

The nurse is reviewing the lab results of a patient with suspected nephrotic syndrome. The nurse anticipates that the results to include:

Protein in the urine

When teaching a pharmacology class the nurse relates that 65 percent of all reabsorptive and secretory processes that occur in the tubular system take place in which of these areas?

Proximal tubules

The nurse recognizes that acute renal injury is characterized by which of the following?

Rapid decline in renal function

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

A 72-year-old patient is scheduled for a kidney transplant. The nurse knows that which aspect of advanced age has a positive effect on the success of kidney transplant survival?

Reduction in T-lymphocyte function

The nurse recognizes the kidney can be considered an endocrine organ as it may exert which of the following actions?

Regulation of red blood cells through manufacture of erythropoietin

An elderly man is brought into the clinic by his daughter who states, "My father hasn't been himself lately. Now I think he looks a little yellow." What test would the nurse expect to have ordered to check this man's creatinine level?

Serum creatinine

The GFR is considered to be the best measure of renal function. What is used to estimate the GFR?

Serum creatinine. In clinical practice, glomerular filtration rate is usually estimated using the serum creatinine concentration.

A young adult with a history of intermittent flank pain, repeated UTIs and hematuria is diagnosed with autosomal dominant polycystic kidney disease (ADPKD). Which pathophysiologic abnormality most likely has contributed to the development of ADPKD?

She has inherited a tendency for epithelial cell in her tubules to proliferate inappropriately.

Drug-related nephropathies involve functional and/or structural changes to the kidney after exposure to a drug. What does the tolerance to drugs depend on?

State of hydration

A nurse is caring for a client who has been diagnosed with kidney colic but has yet passed the stone. Which interventions would the nurse emphasize when planning the care for this client?

Strain the urine.

A client is being treated for calcium oxalate kidney stones. The nurse will include which intervention in the client's care? Select all that apply.

Straining urine Administering calcium carbonate Increasing fluid intake

The nurse teaches the client with end-stage kidney disease who has developed anemia that the reason anemia has developed is which of these?

The damaged kidney is unable to produce erythropoietin.

The nurse is caring for a client with kidney disease who has an estimated glomerular filtration rate of 75 ml/minute. The nurse interprets this data in which of the following way?

The client has reduced glomerular filtration reflecting damage to the kidney.

While assessing a client with urosepsis, the ICU nurse notes the client's BP is 80/54; HR 132; RR 24; pulse Ox 89% on 6 lpm O2. Over the last hour, the clients' urine output is 15 mL. When explaining to a new graduate nurse, the nurse will explain which physiologic principle?

The clients sympathetic nervous system has been stimulated which has resulted in vasoconstriction of the afferent arteriole which causes a decrease in renal blood flow.

Which function of the kidneys helps to maintain the pH balance in the body?

The kidneys conserve base bicarbonate and eliminate hydrogen ions.

The nurse is caring for a client who has produced an average of 20 ml/hour for the previous day. The nurse recognizes this compares in which way to the normal urine output?

The kidneys should produce about 1.5 liters of urine each day.

A 56-year-old woman has been diagnosed with CKD. She first went to the doctor due to complications of hypertension. How are hypertension and CKD related?

The mechanisms that produce hypertension in CKD include an increased vascular volume and increased activity of the renin--angiotensin system.

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 pediatric unit is admitting an eight day-old infant with a suspected congenital renal disorder. What could possibly be the cause of the renal abnormality? Select all that apply.

The upper or lower poles of the two kidneys may be fused. The kidneys may be misshapen and have cysts present. One of the infant's kidneys may have failed to develop normally.

The nurse is teaching a group of nursing students about the mechanism of action of common diuretics. Which of these best reflects the mechanism of these drugs?

They block the reabsorption of sodium and chloride in the nephron.

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

Gout and the development of kidney stones are often attributed to high levels of what compound?

Uric acid

Which substance is most likely to be reabsorbed in the tubular segments of the nephron using passive transport mechanisms?

Water

p. The nurse administers the drug vasopressin to a patient with a pituitary disorder. Based on knowledge of pathophysiology, the nurse anticipates the client will react in which of these ways?

Water will be retained and decreased urine output will result.

Which factor contributes to the development of polycystic kidney disease?

Which factor contributes to the development of polycystic kidney disease? Hereditary mutations in polycystin I and II

A cytotechnologist is performing genetic testing on a series of tissues. One tissue comes back with the WT1 mutation, and it's mapped to chromosome 11. What disease will the client most likely develop?

Wilms tumour

The client with chronic kidney disease asks the nurse why he must take active vitamin D (calcitriol) as a medication. Which of these is the most appropriate response by the nurse?

With renal disease vitamin D is unable to be transformed to its active form.

A client with a history of renal insufficiency is experiencing a flare-up of his arthritis and he has increased his daily dose of ibprofen (an NSAID). Knowing the effect that ibprofen has on prostaglandin synthesis, the nurse should anticipate:

decrease renal blood flow resulting in decrease in urine output.

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.

A client arrives in the emergency department semi-comatose. Her breath has a "fruity" smell. Their initial blood glucose level is >600. Her mouth and mucous membranes are dry. The healthcare providers suspect the client may be experiencing hyperglycemic hyperosmolar syndrome. In this situation, the nurse can expect the client's lab results to reflect:

an increase in glomerular filtration rate [GFR].

A client has been prescribed a drug that is not removed quickly by renal filtration. The drug likely has this quality because it is:

bound to plasma proteins.

The nurse is reviewing the results of a renal client's laboratory results. This client's urine specific gravity allows the nurse to assess the kidneys' ability to:

concentrate urine.

The family asks the nurse what the usual treatment of focal segmental glomerulosclerosis entails. The nurse responds:

corticosteroids.

A client has just been admitted to the emergency department after sustaining severe injuries and massive blood loss following a motor vehicle accident. The nurse predicts that the client's glomerular filtration rate will:

decrease

A patient has passed a kidney stone composed of uric acid (urate). Which of the following pathological conditions is a contributing factor for the development of this type of kidney stone?

gout

In the emergency department, a client arrives following a car accident. His pulse is 122; BP 88/60; respiration is 18 bpm. Urine output is 4 mL over the first hour on arrival. When in shock, this lower urine output is primarily due to:

innervation of the sympathetic nervous system causing constriction of the afferent arteriole.

The nurse is providing dietary instruction for a client with chronic kidney disease who is on hemodialysis. Which would the nurse encourage the client to restrict?

lean meats

A 45-year-old female is being treated for ovarian cancer. Her treatment involves the chemotherapy agent cisplatin. The nurse should monitor the client for signs and symptoms of:

nephrotoxic acute tubular necrosis (ATN).

A client with chronic kidney disease has developed cardiac calcification. On admission the priority assessment would be for the nurse to:

place on a heart monitor to watch for arrhythmias.

The nurse would be most concerned when the glomerular filtrate contains:

protein

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

protein

One form of renal tubular acidosis (RTA) results from aldosterone deficiency or resistance to its action, which leads to impaired reabsorption of which of the following electrolytes?

sodium

A patient is being treated with colchicine (Colcrys) for pain in the big right toe. The patient begins to complain of severe right flank pain and is diagnosed with kidney stones. Which of the following types of kidney stones does the nurse recognize this patient is most likely affected by?

uric acid

The nurse is teaching a group of nursing students about the formation of urine in the nephron. Which of these components does the nurse teach are components of the nephron? Select all that apply.

• Collecting tubule • Proximal convoluted tubule • Distal convoluted tubule • Loop of Henle

A client is diagnosed with chronic kidney disease (CKD). The nurse will monitor this client for which gastrointestinal signs and symptoms? Select all that apply.

• Early morning nausea • Gastrointestinal ulceration • Metallic taste • Anorexia

Which of the following have the potential to cause chronic kidney disease? (Select all that apply.)

• Hypertension • Diabetes • Glomerulonephritis

A nine year-old boy has been diagnosed with the nephritic syndrome. Place the following stages in the development of his health problem in ascending order. Use all the options.

• Hypoalbuminemia • Proteins escape from plasma to glomerular filtrate. • Increased glomerular membrane permeability. • Accumulation of fluid in interstitial tissue (edema). • Decreased colloidal osmotic pressure

A nurse is caring for a child with Wilms tumor, stage I. Which of the following can be said regarding this diagnosis? Select all that apply.

• Prognosis is good with treatment. • The tumor is limited to the kidney and can be excised with the capsular surface intact.

Which of the following are appropriate interventions in the care of a patient diagnosed with renal calculi? Select all that apply.

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


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