Real Quiz 3

Which of the following individuals likely faces the greatest risk for the development of chronic kidney disease? A. A client with a recent diagnosis of type 2 diabetes who does not monitor his blood sugars or control his diet B. A first-time mother who recently lost 1.5 L of blood during a postpartum hemorrhage C. A client who experienced a hemorrhagic stroke and now has sensory and motor deficits D. A client whose diagnosis of thyroid cancer necessitated a thyroidectomy

A client with a recent diagnosis of type 2 diabetes who does not monitor his blood sugars or control his diet

A client has recently undergone successful extracorporeal shock wave lithotripsy (ESWL) for the treatment of renal calculi. Which of the following measures should the client integrate into his lifestyle to reduce the risk of recurrence? A. Regular random blood glucose testing B. Increased fluid intake and dietary changes C. Increased physical activity and use of over-the-counter diuretics D. Weight loss and blood pressure control

Increased fluid intake and dietary changes

Which of the following assessment findings would lead the nurse to suspect the client has nephrotic syndrome? A. Hematuria and anemia B. Proteinuria and generalized edema C. Renal colic and increased serum sodium D. Increased creatinine with normal blood urea nitrogen

Proteinuria and generalized edema

A neighbor is complaining to a friend (who happens to be a nurse) about several changes in their body. Which of the following complaints raises a "red flag" because it could be a sign of epithelial cell bladder cancer? A. "Sometimes I get a sharp pain in my side while exercising." B. "I noticed my urine is pinkish red, but I'm not having any pain when I pee." C. "Seems like I'm holding onto more water these days." D. "Every now and then, I have urine leak when I cough."

"I noticed my urine is pinkish red, but I'm not having any pain when I pee."

An adult client has been diagnosed with polycystic kidney disease. Which of the client's following statements demonstrates an accurate understanding of this diagnosis? A. "I had a feeling that I was taking too many medications, and now I know the damage they can do." B. "I've always been prone to getting UTIs, and now I know why." C. "I suppose I should be tested to see if my children might inherit this." D. "I suppose I really should have paid more attention to my blood pressure."

"I suppose I should be tested to see if my children might inherit this."

A public health nurse is conducting a health promotion class for a group of older adults. Which of the participants' following statements demonstrates an accurate understanding of the risk factors for bladder cancer? A. "I think I should be okay because there's no history of bladder cancer in my family that I'm aware of." B. "I suppose I should listen to my doctor and drink more cranberry juice." C. "I can see that preventing bladder cancer is one more benefit of a healthy diet." D. "More than ever, I guess it would worthwhile for me to quit smoking."

"More than ever, I guess it would worthwhile for me to quit smoking."

In anatomy class, the instructor asks, "Explain how urine is expelled from the bladder during voiding." The student with the most accurate response would be: A. "The beginning of micturition occurs when neurons send messages down to the pudendal nerve." B. "It's really the external sphincter muscle that controls urination. The somatic nervous system innervates the muscles of the external sphincter and the pelvic floor muscles that together control the outflow of urine." C. "The urothelium acts as a barrier to prevent urine from seeping into capillaries." D. "The detrusor muscle contract down on the urine and the ureteral orifices are forced shut. The external sphincter relaxes as urine moves out of the bladder."

"The detrusor muscle contract down on the urine and the ureteral orifices are forced shut. The external sphincter relaxes as urine moves out of the bladder."

A child is recovering from a bout with group A β-hemolytic Streptococcus infection. They return to the clinic a week later complaining of decrease in urine output with puffiness and edema noted in the face and hands. The health care provider suspects the child has developed: A. Autosomal recessive polycystic kidney disease B. Acute nephritic syndrome C. Acute post infectious glomerulonephritis D. Adult-onset medullary cystic disease

Acute post infectious glomerulonephritis

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

All glomeruli and all parts of the glomeruli are involved

Glomerulonephritis is usually caused by: A. Glomerular membrane viruses B. Catheter-induced infection C. Antigen-antibody complexes D. Vesicoureteral reflux

Antigen-antibody complexes

If a CKD client is developing uremic encephalopathy, the earliest manifestations may include: Select all that apply. A. Decreased alertness B. Diminished awareness C. New-onset seizures D. Delirium and hallucinations

Decreased alertness Diminished awareness

A client is beginning to recover from acute tubular necrosis. The nurse would likely be assessing which of the following manifestations of the recovery phase of ATN? A. Proteinuria B. Edema C. Hypokalemia D. Diuresis

Diuresis

While taking a history from an adult client newly diagnosed with renal cell cancer, the nurse can associate which of the following high-risk factors with the development of this cancer? A. Anorexia/bulimia disorder B. Adrenal medulla tumors C. Inherited renal disease D. Heavy smoking

Heavy smoking

The nurse is providing care for a client who has a diagnosis of kidney failure. Which of the following laboratory findings is consistent with this client's diagnosis? A. Hypophosphatemia B. Elevation in vitamin D levels C. Hypocalcemia D. Hypokalemia

Hypocalcemia

The most recent assessment of a client with a diagnosis of type 1 diabetes indicates a heightened risk of diabetic nephropathy. Which of the following assessment findings is most suggestive of this increased risk? A. Microalbuminuria B. Orthostatic hypotension C. Diabetic retinopathy D. Hematuria

Microalbuminuria

A drug abuser was found unconscious after shooting up heroin 2 days prior. Because of the pressure placed on the hip and arm, the client has developed rhabdomyolysis. The nurse knows this can: A. Be cured by administering an anticoagulant immediately B. Cause compartment syndrome in the lower extremities C. Cause the kidney to develop renal stones due to stasis D. Obstruct the renal tubules with myoglobin and damage tubular cells

Obstruct the renal tubules with myoglobin and damage tubular cells

A client had excessive blood loss and prolonged hypotension during surgery. His postoperative urine output is sharply decreased, and his blood urea nitrogen (BUN) is elevated. The most likely cause for the change is acute: A. Intrarenal nephrotoxicity B. Bladder outlet obstruction C. Tubular necrosis D. Prerenal inflammation

Tubular necrosis

Many factors contribute to the incontinence that is common among the elderly. A major factor is increased A. Intake of liquids and water B. Use of multiple medications C. Detrusor muscle function D. Urethral closing pressure

Use of multiple medications

A female client asks, "Why do I leak urine every time I cough or sneeze?" The health care worker's response is based on which physiologic principle? A. Involuntary bladder continence during filling B. A pressure difference between the urethra and bladder C. When intravesical pressure exceeds maximal urethral closure pressure D. A decrease in bladder distensibility

When intravesical pressure exceeds maximal urethral closure pressure

A female teenager has experienced three uncomplicated urinary tract infections in the last 3 months. Knowing the anatomical location of the urethra, the nurse should educate this teenager about: A. Proper handwashing to decrease amount of Pseudomonas growing on the hands B. Wiping from front to back to prevent Escherichia coli contamination of the urethra C. Wearing gloves when wiping perineum after defecation to prevent Staphylococcus aureus infection D. Washing hands prior to inserting a tampon to minimize the risk of group B Streptococcus

Wiping from front to back to prevent Escherichia coli contamination of the urethra