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The nursing instructor who is teaching about incontinence in older adults recognizes a need for further instruction when a student makes which statement? "Many factors can contribute to incontinence." "A number of factors that contribute to incontinence can be altered." "Incontinence can increase social isolation in the elderly." "Frequency is not a major problem for the elderly."
"Frequency is not a major problem for the elderly."
The client has just been diagnosed with bladder cancer and asks the nurse what causes it. What would be the nurse's best response to the client? "The cause is unknown." "It is usually inherited." "You should not worry about its cause." "It is due to something outside the body."
"The cause is unknown."
A geriatric nurse is caring for several clients. Which alterations in health should the nurse attribute to age-related physiologic changes? A 78-year-old woman's GFR has been steadily declining over several years. A 90-year-old woman's blood urea nitrogen (BUN) is rising. A dipstick of an 80-year-old man's urine reveals protein is present. An 81-year-old man's serum creatinine level has increased sharply since his last blood work.
A 78-year-old woman's GFR has been steadily declining over several years.
The physician suspects that a client with kidney stones has developed magnesium ammonium phosphate (struvite) stones based on which urinalysis results? Select all that apply. High urine phosphate level Alkaline urine pH Presence of cystine particles High bacterial count Elevated uric acid levels
Alkaline urine pH High urine phosphate level High bacterial count
The nurse is performing palpation of the kidney during assessment of the client on the urology unit. The nurse plans to palpate in which area? Upper abdomen, under the costal margins Between the 12th thoracic and 3rd lumbar vertebrae Right costal margin, anterior abdomen Lower abdomen in the suprapubic area SUBMIT ANSWER
Between the 12th thoracic and 3rd lumbar vertebrae
The nurse caring for four male clients recognizes which client is at highest risk for developing postrenal kidney failure? Client with intratubular obstruction Client with prostatic hyperplasia Client with acute pyelonephritis Client with severe hypovolemia
Client with prostatic hyperplasia
Which dermatologic problem most often accompanies chronic kidney disease (CKD)? Dry skin and pruritus Alopecia and fungal rashes Hirsutism and psoriasis Petechiae and purpura
Dry skin and pruritus
The nurse is caring for a client with Addison disease. For which complication should the nurse monitor the client? Increased carbon dioxide Elevations in potassium levels Renin-angiotensin-aldosterone production Hyperuricemia
Elevations in potassium levels
What is the most common cause of a lower urinary tract infection? Pseudomonas aeruginosa Staphylococcus saprophyticus Staphylococcus aureus Escherichia coli
Escherichia coli
The nurse is caring for a client with a condition of deficiency of antidiuretic hormone (ADH). When assessing the client, which finding does the nurse anticipate? Excessive urine output Retention of sodium Retention of chloride Low blood pressure
Excessive urine output
Which procedure is a nonsurgical method of treatment for renal calculi (kidney stones)? Percutaneous nephrolithotomy Percutaneous ureterolithotomy Extracorporeal shock wave lithotripsy (ESWL) Retrograde ureteroscopy
Extracorporeal shock wave lithotripsy (ESWL)
Which option identifies the function of the kidneys in maintaining normal composition of internal body fluids? Production of erythropoietin for red blood cell production Excretion of the renin-angiotensin mechanism Conversion of vitamin D to active form Filtration and reabsorption of physiologically essential substances
Filtration and reabsorption of physiologically essential substances
Which assessment indicates to the nurse that a client may have a spastic bladder dysfunction? Distended abdominal area Incontinence Failure to void for 8 or more hours Severe cramping
Incontinence
Which condition/disorder would the nurse see as being likely to cause the most serious long-term problems? Simple renal cyst Horseshoe kidney Unilateral renal agenesis Polycystic kidney disease
Polycystic kidney disease
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 Produce renin Produce angiotensin Inactivate vitamin D
Produce erythropoietin
The GFR is considered to be the best measure of renal function. What is used to estimate the GFR? Serum protein Serum creatinine Albumin level BUN
Serum creatinine
The nurse caring for clients who have bladder cancer identifies which treatments to be acceptable for this cancer? Select all that apply. Hypnosis Surgical removal Herbal therapy Chemotherapy Radiation therapy
Surgical removal Radiation therapy Chemotherapy
A client has experienced severe hemorrhage and is in prerenal failure. The nurse anticipates the client's blood urea nitrogen (BUN) and serum creatinine laboratory results will be in which range? The BUN-to-creatinine ratio is 10:1. BUN elevates above 60 mg/dL (21.4 mmol/L) and creatinine decreases to <0.3 mg/dL (<27 µmol/L). Creatinine level increase to 5 mg/dL (442 µmol/L) and BUN decreases to 4 mg/dL (1.4 mmol/L). The BUN-to-creatinine ratio is 20:1.
The BUN-to-creatinine ratio is 20:1.
The nurse understands that medications, although very beneficial to clients, can have harmful effects. When working with older adult clients the nurse should recognize that which outcome is a common result of potent, fast-acting diuretics? No untoward effects Increased potassium levels Urge incontinence Decreased urine output
Urge incontinence
The nurse administers the drug vasopressin to a client with a pituitary disorder. Based on knowledge of pathophysiology, the nurse anticipates the client will react in which way? Water loss with dehydration will result. Water will be retained and decreased urine output will result. Water will be lost through the kidney. Decreased renal blood flow and urine output will occur.
Water will be retained and decreased urine output will result.
A client has been given the diagnosis of diffuse glomerulonephritis. The client asks the nurse what diffuse means. The nurse responds: "All glomeruli and all parts of the glomeruli are involved." "Only one segment of each glomerulus is involved." "Only some of the glomeruli are affected." "The mesangial cells are being affected."
"All glomeruli and all parts of the glomeruli are involved."
The nursing instructor who is teaching about disorders of the lower urinary tract realizes a need for further instruction when one of the students makes which statement? "Alterations in bladder function can include urinary incontinence with involuntary loss of urine." "Alterations in bladder function occurs frequently in the elderly." "Alterations in bladder function can include urinary obstruction with retention or stasis of urine." "Alterations in bladder function can only occur when there is incontinence."
"Alterations in bladder function can only occur when there is incontinence."
A young adult client is currently in a rehabilitation facility following a spinal cord injury at level T2. The nurse and client are discussing long-term options for continence management. Which statement demonstrates the client has a clear understanding of the issue? "It is critical that intermittent catheterization be performed using sterile technique." "An indwelling catheter certainly would work well, but it comes with a number of risks and possible complications." "An indwelling urethral catheter is the option that best minimizes my chance of a urinary tract infection." "Self-catheterization can limit the recovery of my neural pathways that control my voiding if I do it too often."
"An indwelling catheter certainly would work well, but it comes with a number of risks and possible complications."
A client has been diagnosed with having calcium oxalate kidney stones following intravenous pyelography. Which teaching points about the treatment of the condition are justifiable? Select all that apply. "It is important that you avoid high-calcium foods like milk, cheese and yogurt." "Extracorporeal shock-wave lithotripsy treatment may be used to fragment larger stones." "You may need to cut out cocoa, chocolate and some nuts from your diet." "Most likely your stones can be dissolved by medications over the next several days." "We will come up with a plan to safely limit your fluid intake over the next few weeks."
"Extracorporeal shock-wave lithotripsy treatment may be used to fragment larger stones." "You may need to cut out cocoa, chocolate and some nuts from your diet."
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've noticed that my urine is a bit more concentrated than usual the last few days." "I've decided to try eating less fat and carbohydrates than I have been." "I'm feeling a bit under the weather these days and I'm a bit feverish." "The scarring on my flank where the surgery was done doesn't seem to be fading."
"I'm feeling a bit under the weather these days and I'm a bit feverish."
A nurse's neighbor is experiencing some odd symptoms, and asks the nurse about them. The neighbor states having blood in the urine intermittently and thinks there is a lump in the back (where kidney is located). What advice is most appropriate for the nurse to relay to this neighbor? "Do you think you might have a kidney infection?" "Try drinking more water and see if the symptoms go away." "Make an appointment with your health care provider immediately." "See if your health care provider will prescribe some antibiotics for you."
"Make an appointment with your health care provider immediately."
Following a health promotion class, which statement by a participant demonstrates an accurate understanding of the risk factors for bladder cancer? "More than ever, I guess it would be worthwhile for me to quit smoking." "I suppose I should listen to my health care provider and drink more cranberry juice." "I can see that preventing bladder cancer is one more benefit of a healthy diet." "I think I should be okay because there's no history of bladder cancer in my family that I'm aware of."
"More than ever, I guess it would be worthwhile for me to quit smoking."
In anatomy class, the instructor asks, "Explain how urine is expelled from the bladder during voiding." Which student has given the most accurate response? "The detrusor muscle contracts down on the urine and the ureteral orifices are forced shut. The external sphincter relaxes as urine moves out of the bladder." "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." "The beginning of micturition occurs when neurons send messages down to the pudendal nerve." "The urothelium acts as a barrier to prevent urine from seeping into capillaries."
"The detrusor muscle contracts down on the urine and the ureteral orifices are forced shut. The external sphincter relaxes as urine moves out of the bladder."
A nurse is teaching a client scheduled for a cystoscopy about the procedure. Which statement made by the client verifies that the teaching has been successful? "The doctor will insert a lighted tube through my urethra into my bladder in order to inspect the inside of the bladder." "The doctor will inject a radioactive solution into my vein. The dye will distribute through my body and can be monitored by x-ray as it travels through my kidneys to my bladder." "The doctor will insert a lighted tube into the bladder, and little catheters will be inserted through the tube into my kidney." "The doctor will place a catheter into an artery in my groin and inject a dye that will visualize the blood supply to the kidneys."
"The doctor will insert a lighted tube through my urethra into my bladder in order to inspect the inside of the bladder."
A client is scheduled for a creatinine clearance test to measure the glomerular filtration rate (GFR). The client asks the nurse what this test is used for. What is the nurse's best response? "This test measures circulating antidiuretic hormone levels." "This test measures the volume of urine output." "This test measures urine specific gravity." "This test provides a gauge of renal function."
"This test provides a gauge of renal function."
A client has a postvoid residual (PVR) volume of 250 mL. Which information would the nurse tell the client? "This test indicates you do not have adequate bladder control." "This value indicates you are emptying your bladder too completely." "This is a normal value." "This value indicates you are having difficulty emptying your bladder."
"This value indicates you are having difficulty emptying your bladder."
A mother asks, "Why can't my 1-year-old go to the bathroom by himself?" What is the nurse's best response? "Young children are very manipulative." "Does he wear diapers during the day?" "Your child is too young to begin toilet training." "How long have you been trying to train him?"
"Your child is too young to begin toilet training."
Which client is likely at the greatest risk of developing a urinary tract infection? A pregnant woman who has been experiencing urinary frequency A client with a diagnosis of chronic kidney disease who requires regular hemodialysis A 79-year-old client with an indwelling catheter A confused, 81-year-old client who is incontinent of urine SUBMIT ANSWER
A 79-year-old client with an indwelling catheter
Which individual likely faces the greatest risk for the development of chronic kidney disease? A first-time mother who recently lost 1.5 L of blood during a postpartum hemorrhage A client with a recent diagnosis of type 2 diabetes who does not monitor blood sugars or control diet A client who experienced a hemorrhagic stroke and now has sensory and motor deficits A client whose diagnosis of thyroid cancer necessitated a thyroidectomy
A client with a recent diagnosis of type 2 diabetes who does not monitor blood sugars or control diet
The nurse is educating a client with chronic kidney disease (CKD). What is the recommended daily fluid intake for this client? Intake equal to daily urine output to maintain hydration No oral intake of fluids A daily fluid intake of 500 to 800 mL/day to maintain hydration A minimum of 2000 mL/day to flush out the kidneys
A daily fluid intake of 500 to 800 mL/day to maintain hydration
Which statement about the use of angiotensin-converting enzyme (ACE) inhibitors and autosomal recessive polycystic kidney disease (ARPKD) is accurate? ACE inhibitors may interrupt the renin-angiotensin-aldosterone system to reduce renal vasoconstriction. ACE inhibitors should be used strictly in those clients who also have an underlying cardiac history. The use of ACE inhibitors will increase the vasopressin levels. The ACE inhibitors have been shown to shrink the size of the cysts inside the kidneys.
ACE inhibitors may interrupt the renin-angiotensin-aldosterone system to reduce renal vasoconstriction.
The nurse caring for clients with chronic kidney disease (CKD) assesses for signs of renal osteodystrophy (skeletal damage). Which manifestations are characteristic of both high-bone-turnover and low-bone-turnover osteodystrophy? Select all that apply. Defective bone remodeling Normal osteoblast and osteoclast numbers Abnormal bone resorption Bone marrow fibrosis Decreased osteoblast and elevated osteoclast proliferation
Abnormal bone resorption Defective bone remodeling
A client asks the nurse what may have caused elevation in urinary protein levels (proteinuria) on a urine test. The best response by the nurse would be: Poor fluid intake Abnormal glomerular filtration Decrease in antidiuretic hormone Urinary tract infection
Abnormal glomerular filtration
In addition to regulating body fluids and electrolytes, the kidneys' endocrine function in maintaining bone calcium levels consists of what process? Synthesizing erythropoietin Excreting bicarbonate Activating vitamin D Stimulating bone marrow
Activating vitamin D
A warehouse worker is experiencing trouble with incontinence, especially when lifting heavy objects. What intervention is most appropriate for this client's needs? Intermittent catheterization Administration of diuretics as ordered to promote frequent bladder emptying Bladder ultrasonography two to three times daily Administration of alpha-adrenergic agonist drugs as ordered
Administration of alpha-adrenergic agonist drugs as ordered
When caring for the client in a shock state, the nurse recognizes that which compensatory substance may produce vasoconstriction of renal vessels? Select all that apply. Angiotensin II Prostaglandins Nitric oxide Antidiuretic hormone Endothelins
Angiotensin II Antidiuretic hormone Endothelins
A client who suffers from spastic bladder has been catheterized to promote bladder emptying. Which medication should the nurse plan on the physician ordering to also treat this problem? Calcium channel blocker Cholinergic Anticholinergic medication Skeletal muscle relaxant
Anticholinergic medication
A client who suffers from spastic bladder has been catheterized to promote bladder emptying. Which medication should the nurse plan on the physician ordering to also treat this problem? Skeletal muscle relaxant Calcium channel blocker Cholinergic Anticholinergic medication
Anticholinergic medication
Which type of pharmacologic therapy does the nurse anticipate administering to a client for treatment of a spastic bladder in order to decrease bladder hyperactivity? Antibiotics Biofeedback Anticholinergic medications Calcium channel blockers
Anticholinergic medications
A client has been diagnosed with chronic kidney disease (CKD). Which drug category is usually administered to treat coexisting conditions that manifest early in CKD? Nonsteroidal anti-inflammatory drugs (NSAIDs) Antihypertensive medications Opioid analgesics Antiarrhythmic medications
Antihypertensive medications
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 into the tubular fluid, thereby reducing uric acid secretion? Aspirin Naproxen Acetaminophen Ibuprofen
Aspirin
The form of polycystic kidney disease (PKD) that first manifests in the early infant period is most commonly characterized as: Autosomal dominant Autosomal recessive Simple Acquired
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 disorder? Simple renal cysts Autosomal dominant polycystic kidney disease (ADPKD) Autosomal recessive polycystic kidney disease (ARPKD) Horseshoe kidney abnormality
Autosomal recessive polycystic kidney disease (ARPKD)
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 (3.57 mmol/L) to creatinine 1 mg/dL (88.40 µmol/L) BUN 40 mg/dL (14.28 mmol/L) to creatinine 2 mg/dL (176.80 µmol/L) BUN 25 mg/dL (8.92 mmol/L) to creatinine 1 mg/dL (88.40 µmol/L) BUN 30 mg/dL (10.71 mmol/L) to creatinine 2.5 mg/dL (221.0 µmol/L)
BUN 10 mg/dL (3.57 mmol/L) to creatinine 1 mg/dL (88.40 µmol/L)
The nurse is caring for a client who has had acute blood loss from ruptured esophageal varices. What does the nurse recognize is an early sign of prerenal failure? Baseline urine output of 50 mL/hr that is now 10 mL/hr Baseline heart rate of 100 bpm that has increased to 120 bpm Foul smelling, cloudy urine Baseline blood pressure of 150/90 mm Hg that is now 130/80 mm Hg
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 Ascending urinary tract infection and vomiting Elevated systemic blood pressure and severe pain Gross hematuria and massive generalized edema
Bilateral flank masses and impaired lung development
A nurse is caring for a client with systemic lupus erythematosis (SLE). The client asks why a urinalysis is necessary. The best answer is that a urinalysis would determine whether which factor was present in the urine? Cancer cells Blood or protein Sugar Potassium
Blood or protein
When caring for a client with dehydration, the nurse anticipates the client will have an alteration in which substance in the blood? Iric acid Erythropoietin Blood urea nitrogen Bicarbonate
Blood urea nitrogen
A client with a history of chronic kidney disease (CKD) is experiencing increasing fatigue, lethargy, and activity intolerance. The care team has established that the client's glomerular filtration rate (GFR) remains at a low, but stable, level. Which laboratory assessments will mostlikely be prescirbed to help determine the cause of these new symptoms? Blood work for hemoglobin, red blood cells, and hematocrit Assessment of pancreatic exocrine and endocrine function Blood work for white cells and differential Cystoscopy and ureteroscopy
Blood work for hemoglobin, red blood cells, and hematocrit
Hospitalized neonates are at greatest risk of developing septicemia related to which procedure? Catheter-associated bacteriuria Collection of urine for analysis Arterial blood gas measurement Suctioning of tracheostomy
Catheter-associated bacteriuria
The nurse is assigned multiple clients with anemia. Which client may be experiencing a failure of the body to produce erythropoietin and thus may require supplemental injections of this hormone? Client who recently had surgery and is scheduled for a follow-up visit Client with history of chronic kidney failure Client with a recent wound that bled a large amount but is now healing well Client with impaired oxygenation related to chronic obstructive pulmonary disease (COPD) Client living at a high altitude
Client with history of chronic kidney failure
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? Increase intake of cranberry juice to 2 L/day. Continue taking antibiotics for 10 to 14 days even if symptoms of infection disappear. Force micturition every 2 hours while awake. 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.
The family asks the nurse what the usual treatment of focal segmental glomerulosclerosis entails. What is the nurse's best response? Corticosteroids Antibiotics Pain medications Antiviral medications
Corticosteroids
A client asks, "Why did my provider order a glomerular filtration rate (GFR) to my usual blood work?" The nurse's best response is based on the fact that GFR can estimate serum levels of which substance? Myoglobin Protein Urea Creatinine
Creatinine
A nurse is evaluating a client's morning laboratory values. Which result requires that the nurse notify the health care provider? Sodium: 148 mEq/L (148 mmol/L) Potassium: 3.4 mEq/L (3.4 mmol/L) Creatinine: 10.6 mg/dL (937.04 µmol/L) Blood urea nitrogen: 20.0 mg/dL (7.14 mmol/L)
Creatinine: 10.6 mg/dL (937.04 µmol/L)
Which diagnostic study would be effective in determining direct visualization of the bladder and ureters? Ultrasonography Cystoscope MRI Renal angiography
Cystoscope
When the urologist wants to directly visualize the bladder, urethra, and ureteral orifices, what diagnostic test would he use? Echocardiogram Laparoscopy Cystoscopy Ultrasonography
Cystoscopy
A nursing instructor who is teaching students about urinary incontinence in older adults suggests that an easy and effective way to remember the transient and treatable causes of urinary incontinence is to use which acronym? FACES SBAR CBC DIAPPERS
DIAPPERS
A client is experiencing an increase in urinary output. Which physiologic response by the body is responsible for how the kidney concentrates urine? Decrease in antidiuretic hormone Excessive secretion of aldosterone Activation of the angiotensin system Reduction in glomerular filtration rate
Decrease in antidiuretic hormone
Which occurrence is most likely to cause increased urination? Increased secretion of aldosterone Decrease in antidiuretic hormone Activation of angiotensin Decrease in glomerular filtration rate
Decrease in antidiuretic hormone
A client's most recent blood work reveals a blood urea nitrogen (BUN) level of 36 mg/dL (12.85 mmol/L). Which factor may have contributed to this finding? Increased salt intake Action of antdiuretic hormone Parasympathetic nervous system stimulation Dehydration
Dehydration
While studying about the process of urination, the nursing student learns that which muscle is known as the "muscle of micturition"? Trigone muscle Detrusor muscle External sphincter muscle Internal sphincter muscle
Detrusor muscle
the parents of a child who has been diagnosed with chronic kidney disease (CKD) ask the nurse about manifestations of the disease. Which information is the most appropriate information to provide these parents? Select all that apply. Growth impairment Accelerated sexual maturation Developmental delay Delayed cognitive development Secondary hyperparathyroidism Early-onset puberty
Developmental delay Delayed cognitive development Secondary hyperparathyroidism Growth impairment
The nurse is instructing a client with advanced kidney disease (AKD) about a dietary regimen. Which restriction should the nurse be sure to include in the treatment plan to decrease the progress of renal impairment in people with AKD? Dietary protein Carbohydrates Fats Foods high in calcium
Dietary protein
Several urine tests can be useful in establishing a diagnosis of acute renal failure (ARF). The nurse must consider that fractional excretion of sodium can be particularly affected by administration of which type of drug? Diuretics Beta-adrenergic blockers (beta-blockers) Calcium channel blockers Sulfonylureas
Diuretics
A client with chronic kidney disease (CKD) has developed asterixis. The nurse knows that asterixis is: Unsteady gait Demyelination of nerve fibers Dorsiflexion of hands and feet Burning sensation in feet
Dorsiflexion of hands and feet
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 mostaccurate? Monitor and limit your intake of fats, especially triglycerides in your diet. Eat plenty of yogurt that contains protein to prevent future infection. Include lots of calcium in your diet to promote urinary health. Drink lots of fluids to help relieve the signs/symptoms of UTIs.
Drink lots of fluids to help relieve the signs/symptoms of UTIs.
A child is diagnosed with chronic kidney disease (CKD). The nurse knows that which statements regarding supportive renal therapy in children are true? Select all that apply. Corticosteroid therapy reduces the risk of growth retardation in children. Peritoneal dialysis is generally most appropriate for children younger than 6. Early transplantation is the preferred treatment when considering long-term effects. Less immune system suppression is needed in children than in adults. Children older than 12 years will benefit from hemodialysis.
Early transplantation is the preferred treatment when considering long-term effects. Children older than 12 years will benefit from hemodialysis. Peritoneal dialysis is generally most appropriate for children younger than 6.
Which laboratory findings would the nurse anticipate in a client diagnosed with nephritic syndrome? Low triglycerides (<150 mg/dL; 1.69 mmol/L]) and elevated sodium levels Elevated urine protein level (>3.5 g/day) and hypoalbuminemia Decreased high-density lipoproteins (HDL) and increased iron levels (Hgb >18 g/dL; 180 g/L). Low platelet level (<20 ×103/µL; 20 ×109/L) and elevated blood pressure
Elevated urine protein level (>3.5 g/day) and hypoalbuminemia
An older male comes to the clinic with the chief report of having difficulty voiding. The physician diagnoses him with a lower urinary tract obstruction and stasis. What should the nurse suspect to be the most frequent cause of this client's problem? Kidney infection Bladder tumor Enlargement of prostate gland Gonorrhea
Enlargement of prostate gland
Urinary incontinence can be a problem with older adults. One method of treatment is habit training, or bladder training. When using this treatment with an older adult, how frequently should he or she be voiding? Every 1 to 3 hours Every 2 to 4 hours Every 3 to 5 hours Every 4 to 6 hours
Every 2 to 4 hours
People with chronic kidney disease (CKD) have impaired immune responses due to high levels of urea and metabolic wastes in the blood. What is one thing missing in the immune response when a person with CKD is exposed to sick people? Failure to mount a fever with infection Impaired humoral immunity response with infection Failure of a phagocytic response with infection Decrease in granulocyte count
Failure to mount a fever with infection
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? At noon Last void at night After a nap First void in morning
First void in morning
Several clients in clinic today are reporting urinary signs/symptoms. Which reported manifestation(s) leads the health care provider to suspect acute pyelonephritis? Select all that apply. Flank pain in the back Shortness of breath Urinary urgency and frequency Heart palpitations Abrupt onset of fever and chills
Flank pain in the back Abrupt onset of fever and chills Urinary urgency and frequency
A client has developed gout and is experiencing a "flare-up" with excruciating pain in the feet and toes. The client provides a list of recent new medications to treat worsening heart failure. The nurse's concern is that one may cause retention of uric acid. Which drug should the nurse ask the health care provider about? Spironolactone, an aldosterone receptor antagonist Furosemide, a loop diuretic Lisinopril, an ACE-inhibitor Isosorbide mononitrate, a nitrate SUBMIT ANSWER
Furosemide, a loop diuretic
The health care provider is reviewing laboratory results of a client. Select the diagnostic test that is considered the best measurement of overall kidney function. Serum creatinine levels Glomerular filtration rate (GFR) Blood urea nitrogen (BUN) Urine albumin levels
Glomerular filtration rate (GFR)
A client informs the nurse that she is afraid of developing bladder cancer because her mother had it. She asks the nurse what signs and symptoms are present with this cancer. What does the nurse tell the client is the most common sign of bladder cancer? Frequent urination Pus in urine Gross hematuria Amber-colored urine
Gross hematuria
When assessing a client with acute pyelonephritis, the nurse would expect the client to exhibit which clinical manifestations? Select all that apply. Chills High fever Nausea and vomiting Flank tenderness
High fever Flank tenderness Nausea and vomiting Chills
A nurse is assessing a client for early manifestations of chronic kidney disease (CKD). Which would the nurse expect the client to display? Asterixis Terry nails Hypertension Impotence
Hypertension
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. Proteins escape from plasma to glomerular filtrate. Hypoalbuminemia Accumulation of fluid in interstitial tissue (edema). Decreased colloidal osmotic pressure Increased glomerular membrane permeability.
Hypoalbuminemia Increased glomerular membrane permeability. Decreased colloidal osmotic pressure Proteins escape from plasma to glomerular filtrate. Accumulation of fluid in interstitial tissue (edema).
The client with chronic kidney disease asks the nurse why he must take active vitamin D (calcitriol) as a medication. What is the most appropriate response by the nurse? In renal disease, vitamin D is unable to be transformed to its active form. Vitamin D can no longer be released from the exocrine glands. The skin is no longer able to activate vitamin D for use. The bones no longer respond to vitamin D and demineralize.
In renal disease, vitamin D is unable to be transformed to its active form.
A nurse advises a client with recurring UTIs to drink large amounts of water. What normal protective action is the nurse telling the client to utilize? Decrease acidity of urine Increase washout of urine Thin mucus to prevent bacterial adherence Increase immune availability
Increase washout of urine
The nurse is planning care for a client with a urinary tract obstruction. The nurse includes assessment for which possible complication? Increased blood pressure Polyuria Decreased blood pressure Diluted urine
Increased blood pressure
Unilateral obstruction of the urinary tract may result in renin secretion, thereby leading to which manifestation? Increased urinary output Decreased sodium retention Decreased heart rate Increased blood pressure
Increased blood pressure
The nurse is reviewing the laboratory work of several medical clients. Which laboratory result is most suggestive of abnormalities in kidney function? An absolute absence of protein in a urine sample Normal creatinine levels and elevated blood urea nitrogen (BUN) Increased creatinine and blood urea nitrogen (BUN) levels Urine gravity of 1.030 and normal serum creatinine levels
Increased creatinine and blood urea nitrogen (BUN) levels
When teaching the client with gout about the cause of the disease, which cause should the nurse relate? High blood pressure causes gout. Increased levels of uric acid in the blood cause gout. Retention of sodium can cause gout. Urea, in the form of blood urea nitrogen, causes gout.
Increased levels of uric acid in the blood cause gout.
A client is diagnosed with chronic kidney disease (CKD). The nurse will monitor for which manifestations of this disorder? Select all that apply. Increased nitrogenous waste in blood Osteodystrophy Anemia Hypercalcemia Right ventricular dysfunction
Increased nitrogenous waste in blood Anemia Osteodystrophy
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 Having the client take nothing by mouth Administering ibuprofen 600 mg prior to the procedure Administering one unit of packed red blood cells
Increasing the normal saline intravenous infusion rate prior to the exam
Magnesium renal stones are associated with which medical problem? Hypercalcemia Infection Gout Azotemia
Infection
What is the usual cause of acute pyelonephritis? Reflux Obstruction Autoimmunity Infection
Infection
The filtration of blood undergoes several steps between the entry of blood into the kidney and the accumulation of urine. Which anatomical location begins the process of delivering blood for the filtration of blood and the flow of filtrate? Afferent arteriole Interlobular artery Glomerulus Ascending loop of Henle
Interlobular artery
A client sustained acute tubular injury approximately 2 hours ago. Which cause of acute kidney injury (AKI) would the nurse suspect the client is experiencing? Prerenal Intrarenal Postrenal Systemic
Intrarenal
According to the Kidney Disease Outcome Quality Initiative (KDOQI) guidelines, in the first stage of kidney disease, the nurse will assess which finding? Kidney damage with normal glomerular filtration rate (GFR) Kidney failure requiring dialysis Removal of one kidney GFR of 60-89 mL/min with no renal damage
Kidney damage with normal glomerular filtration rate (GFR)
Vitamin D metabolism is deranged in clients with chronic kidney disease (CKD). The nurse recognizes that which statement regarding vitamin D is correct? Suppression of parathyroid hormone release is characteristic of CKD. Calcitriol stimulates release of parathyroid hormone (PTH). Calcitriol blocks gastrointestinal absorption of calcium. Kidneys convert inactive vitamin D to its active form, calcitriol.
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? Hypotension and a large abdominal mass Abdominal pain and diarrhea Vomiting and oliguria Large asymptomatic abdominal mass and hypertension
Large asymptomatic abdominal mass and hypertension
A nurse is reviewing the mechanisms of action of diuretics. Which diuretic is the mosteffective? Loop diuretics Aldosterone agonists Thiazide diuretics Osmotic diuretics
Loop diuretics
An older adult presents to the primary health care provider's office with a report of bladder leakage. Which assessment correlates with a diagnosis of stress incontinence? Complete bladder emptying when the first sensation of fullness is felt Loss of small amounts of urine when laughing or sneezing Urinary retention followed by overflow and incomplete emptying Large amount of urine leakage during a hyperglycemic episode
Loss of small amounts of urine when laughing or sneezing
If a client is in the early phases of nephrotic syndrome, which area of the body will likely have the initial presence of edema? Hands Lower extremities Eyelids Abdomen
Lower extremities
A nurse suspects a client may be experiencing flaccid bladder dysfunction based on 24-hour intake and output. Which diagnostic method is most likely to confirm or rule out whether the client is retaining urine? Routine urinalysis Measurement of postvoid residual (PVR) by ultrasound Blood test for creatinine, blood urea nitrogen, and glomerular filtration rate Urine test for culture and sensitivity
Measurement of postvoid residual (PVR) by ultrasound
The health care provider has prescribed an aminoglycoside (gentamicin) for a client. The nurse is aware that the client is at risk for: Ischemic acute tubular necrosis Chronic kidney disease Nephrotoxic acute tubular necrosis Postrenal failure
Nephrotoxic acute tubular necrosis
The client with substance use disorder was found unconscious after overdosing on heroin 2 days prior. Because of prolonged pressure on the muscles the client has developed myoglobinuria, causing which complication? Obstruction of the renal tubules with myoglobin and damaged tubular cells Hypokalemia and metabolic acidosis Development of renal stones due to stasis Compartment syndrome in the lower extremities
Obstruction of the renal tubules with myoglobin and damaged tubular cells
The nurse has delegated obtaining a urine specimen for testing to the nursing assistant. What does the nurse emphasize the assistant should do to ensure accuracy of testing? Record the volume of urine obtained in the medical record. Encourage the client to drink water prior to obtaining the specimen. Obtain a freshly voided specimen. Teach the client the purpose of the test. SUBMIT ANSWER
Obtain a freshly voided specimen.
A nurse is caring for a client in spinal shock. Which intervention is appropriate in relation to the client's urinary status? Perform a urine culture Palpate the lower abdomen Assess bowel sounds Perform intermittent catheterization
Perform intermittent catheterization
While assessing a peritoneal dialysis client in the home, the nurse notes that the fluid draining from the abdomen is cloudy, is white in color, and contains a strong odor. The nurse suspects this client has developed a serious complication known as: Peritonitis Bowel perforation Too much sugar in the dialysis solution Bladder erosion
Peritonitis
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 area? Adrenal gland Osmoreceptors Renal cortex Pituitary gland
Pituitary gland
The initiating event in the development of nephrotic syndrome is a derangement in the glomerular membrane that causes increased permeability to which substance? Plasma proteins Antibody complexes Inflammatory cells Red blood cells
Plasma proteins
A client diagnosed with Goodpasture syndrome would require which therapy to remove proteins and autoantibodies from the system? Intravenous calcium Renal transplant Plasmapheresis Kidney removal
Plasmapheresis
A nurse is administering furosemide to a client with heart failure. Which electrolytes should the nurse monitor when giving this medication? Select all that apply. Potassium Calcium Magnesium Phosphorus Sodium SUBMIT ANSWER
Potassium Magnesium Sodium Calcium
An 86-year-old client is being treated for dehydration and hyponatremia after curtailing fluid intake to prevent urinary incontinence. Given these findings, the nurse recognizes that this client is likely in what phase of acute kidney injury? Prerenal Intrinsic Postrenal Intrarenal
Prerenal
Which substance would not be found in glomerular filtrate? Sodium Protein Water Potassium
Protein
Which assessment finding would lead the nurse to suspect the client has developed nephrotic syndrome? Hematuria and anemia Increased creatinine with normal blood urea nitrogen Renal colic and increased serum sodium Proteinuria and generalized edema
Proteinuria and generalized edema
The nurse is teaching a group of nursing students about the formation of urine in the nephron. Which component does the nurse teach is a component of the nephron? Select all that apply. Loop of Henle Renal pelvis Distal convoluted tubule Proximal convoluted tubule Collecting tubule
Proximal convoluted tubule Loop of Henle Distal convoluted tubule Collecting tubule
When teaching a pharmacology class the nurse relates that 65% of all reabsorptive and secretory processes that occur in the tubular system take place in which area? Efferent arteriole Proximal tubules Afferent arteriole Bowman's capsule
Proximal tubules
The nurse recognizes that acute renal injury is characterized by which of the following? Irreversible damage to nephrons Low incidence of mortality Rapid decline in renal function Decreased blood urea nitrogen (BUN)
Rapid decline in renal function
An older adult client has been hospitalized for the treatment of acute pyelonephritis. Which characteristic of the client is most likely implicated in the etiology of this current health problem? Recently had a urinary tract infection Takes a diuretic and an ACE inhibitor each day for the treatment of hypertension Has peripheral vascular disease Was diagnosed with type 2 diabetes several years earlier
Recently had a urinary tract infection
The nurse reviews the lab results for a client who has advanced autosomal dominant polycystic kidney disease (ADPKD). The client 's hemoglobin is 8.8 g/dL (88 g/L). The nurse suspects this lab value is related to which cause? Hemorrhage Poor dietary intake of iron Low calcium levels Reduced production of erythropoietin
Reduced production of erythropoietin
A client diagnosed with chronic kidney disease (CKD) is experiencing nausea and vomiting. Which intervention would be most appropriate for the nurse to provide? Increase intake of carbohydrates Increase intake of fruit juice Restrict intake of dietary protein Restrict intake of dietary fat
Restrict intake of dietary protein
The edema that develops in persons with glomerulonephritis and nephrotic syndrome reflects which physiologic principle? Inability to concentrate urine Obstruction and reflux Decreased glomerular permeability Salt and water tubular reabsorption
Salt and water tubular reabsorption
An older adult 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? BUN level 24-hour urine test Serum creatinine Urine test, first void in morning
Serum creatinine
An 86-year-old female client has been admitted to the hospital for the treatment of dehydration and hyponatremia after she curtailed her fluid intake to minimize urinary incontinence. The client's admitting laboratory results are suggestive of prerenal failure. The nurse should be assessing this client for which early sign of prerenal injury? Excessive voiding of clear urine Intermittent periods of confusion Sharp decrease in urine output Acute hypertensive crisis
Sharp decrease in urine output
The nurse is performing a history and physical on a client with diabetic nephropathy. Findings include BP 124/80; smokes two packs of cigarettes/day; diet high in saturated fats and sodium. Which intervention can help prevent the progression of the diabetic nephropathy? DASH diet with limited caloric intake Increase dietary sodium intake Smoking cessation program Walking program
Smoking cessation program
When the glomerular transport maximum for blood glucose is exceeded and its renal threshold has been reached, what happens to the excess glucose? Reabsorbs quickly Attaches to protein carriers Countertransports sodium Spills into the urine
Spills into the urine
Which factor is likely to result in decreased renal blood flow? Action of dopamine Release of nitric oxide Action of prostaglandins Stimulation of the sympathetic nervous system
Stimulation of the sympathetic nervous system
A client who has a problem with incontinence loses a small amount of urine every time she coughs or sneezes. This type of incontinence is known as: Overflow Stress Urge Functional
Stress
A 40-year-old mother of three reports incontinence. Her physician suggests Kegel exercises because they strengthen the pelvic floor muscles. Kegel exercises are most likely to help which type of incontinence? Urge incontinence Overflow incontinence Mixed incontinence Stress incontinence
Stress incontinence
A female teenager has experienced three uncomplicated urinary tract infections in the past 3 months. Which action should the nurse include in education for this teenager? Wearing gloves when wiping perineum after defecation to prevent Staphylococcus aureus infection Taking antimicrobials to treat Escherichia coli while forcing fluids Proper handwashing to decrease amount of Pseudomonas growing on the hands Washing hands prior to inserting a tampon to minimize the risk of group B Streptococcus
Taking antimicrobials to treat Escherichia coli while forcing fluids
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 way? The client's low blood pressure is causing the reduced glomerular filtration rate. The client has reduced glomerular filtration, reflecting damage to the kidney. The rate is normal. The client's diabetes is causing the reduced glomerular filtration rate.
The client has reduced glomerular filtration, reflecting damage to the kidney.
An older adult states that he awakens at least three times each night to void. When assessing the client, what potential causative factor should the nurse prioritize? The client takes his prescribed beta-blocker and diuretic each evening at bedtime. The client's father was diagnosed with bladder cancer when he was in his 60s. The client takes over-the-counter glucosamine supplements for the treatment of arthritis. The client states that the majority of his fluid intake during the day is tea or coffee.
The client takes his prescribed beta-blocker and diuretic each evening at bedtime.
A nurse observes that a client's urine is cola colored and considers which factor as a possible reason? The client has ingested a dark-colored drink. The client has an elevation of urine potassium. The client's urine has a decrease in the specific gravity. The client's urine contains material from the degradation of red blood cells.
The client's urine contains material from the degradation of red blood cells.
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 L of urine each day. The normal kidney produces an average 3000 mL of urine daily. This represents normal urinary output for 24 hours. The kidneys should produce a minimum of 10 mL/hr over one day.
The kidneys should produce about 1.5 L of urine each day.
Urinary obstruction in the lower urinary tract triggers changes to the urinary system to compensate for the obstruction. What is an early change the system makes in its effort to cope with an obstruction? Bladder contraction weakens. The bladder begins to shrink. The stretch receptors in the bladder wall become hypersensitive. Ability to suppress urination is increased.
The stretch receptors in the bladder wall become hypersensitive.
A nurse is caring for a child with Wilms tumor, stage I. Which statements are true regarding this diagnosis? Select all that apply. The tumor has undergone hematogenous metastasis, most commonly involving the lung. Prognosis is poor even with treatment. The tumor is limited to the kidney and can be excised with the capsular surface intact. Prognosis is good with treatment.
The tumor is limited to the kidney and can be excised with the capsular surface intact.
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? There is possible obstruction in the urinary tract. The woman has multiple sexual partners. The woman takes too many bubble baths. The woman does not clean herself properly.
There is possible obstruction in the urinary tract.
Which medication may be responsible for a client developing increased uric acid levels by decreasing ECF volume? Penicillin antibiotics Antacids Thiazide diuretics Vitamin C
Thiazide diuretics
An older adult client who recently started taking furosemide tells the nurse about now experiencing problems with urine incontinence. Which type of incontinence is this client likely experiencing? Overflow Transient Stress Neurogenic
Transient
The older adult client tells the health care provider about experiencing incontinence ever since starting diuretic therapy 2 weeks ago. What term should the provider document in the medical record related to the type of incontinence? Stress Chronic Transient Neurogenic
Transient
The older adult client tells the health care provider about experiencing incontinence ever since starting diuretic therapy 2 weeks ago. What term should the provider document in the medical record related to the type of incontinence? Transient Neurogenic Chronic Stress
Transient
A client with chronic kidney disease (CKD) will be managed with peritoneal dialysis. Which description of this type of dialysis is most accurate? The dialyzer is usually a hollow cylinder composed of bundles of capillary tubes. Treatments typically occur three times each week for 3 to 4 hours. Treatment involves the introduction into the peritoneum of a sterile dialyzing solution, which is drained after a specified time. Vascular access is achieved through an internal arteriovenous fistula or an external arteriovenous shunt.
Treatment involves the introduction into the peritoneum of a sterile dialyzing solution, which is drained after a specified time.
A client tells the nurse that he is experiencing involuntary loss of urine associated with a strong desire to void (urgency). The nurse would recognize this as: Urge incontinence Overflow incontinence Transient incontinence Stress incontinence
Urge incontinence
A client is being treated with colchicine for pain in the big right toe. The client begins to complain of severe right flank pain and is diagnosed with kidney stones. Which type of kidney stone does the nurse recognize this client is most likely affected by? Calcium Cystine Uric acid Magnesium ammonium phosphate
Uric acid
The nurse is caring for a client who is diagnosed with gout. Which laboratory study does the nurse monitor to monitor this condition? Bicarbonate levels Uric acid levels Potassium levels Urea nitrogen levels
Uric acid levels
An obese client with a history of gout and a sedentary lifestyle has been advised by the primary health care provider to avoid organ meats, certain fish, and other foods that are high in purines. The care provider is demonstrating an awareness of the client's susceptibility to which type of kidney stones? Cystine stones Calcium stones Magnesium ammonium phosphate stones Uric acid stones
Uric acid stones
One of the most damaging effects of urinary obstruction on kidney structures is which effect? Concentrated urine Kidney hyperplasia Urinary stasis Renal hypertension
Urinary stasis
One of the most reliable predictors for worsening autosomal dominant polycystic kidney disease includes which diagnostic procedure? Urine albumin excretion (UAE) Blood urea nitrogen (BUN) level Serum creatinine levels Urine specific gravity
Urine albumin excretion (UAE)
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? No bowel movement in 48 hours Hearing aid batteries are run down Urine cloudy with strong odor Exacerbation of osteoarthritis
Urine cloudy with strong odor
A client has a routine urine sample during an annual checkup. Which result is an expected finding in a healthy individual? Presence of moderate amounts of albumin with the absence of other proteins Urine specific gravity of 1.020 Presence of urinary casts Low to moderate amount of glucose in the urine
Urine specific gravity of 1.020
A teenager has been admitted with the diagnosis of Alport syndrome. The client has been passing large amounts of blood in the urine. Knowing that this disorder is inherited and associated with other abnormalities, the nurse should focus assessment on which area? Cardiac problems associated with dysrhythmias Liver enlargement and ascites Visual disturbances and hearing loss Cognitive imbalance
Visual disturbances and hearing loss
Which clinical manifestations would tell a nurse that a client is having progressive decompensation related to obstruction of urinary outflow? When tested for residual urine volume, 1400 mL of urine is obtained when client is catheterized. Client states that he or she is incontinent. Client complains of urinary urgency. Client complains of waking up several times in the night to void.
When tested for residual urine volume, 1400 mL of urine is obtained when client is catheterized.
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 mostlikely develop? Alport syndrome Pyelonephritis Wilms tumor Renal cell carcinoma
Wilms tumor
The primary care provider for a newly admitted hospital client has added the glomerular filtration rate (GFR) to the blood work scheduled for this morning. The client's GFR results return as 50 mL/minute/1.73 m2. The nurse explains to the client that this result represents: a need to increase water intake. a loss of over half the client's normal kidney function. concentrated urine. that the kidneys are functioning normally.
a loss of over half the client's normal kidney function.
A client has been prescribed a drug that is not removed quickly by renal filtration. The drug likely has this quality because it is: water soluble. a hydrophilic weak base. a hydrophilic weak acid. bound to plasma proteins.
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: excrete potassium. concentrate urine. concentrate protein. excrete excess hydrogen ions.
concentrate urine.
A 65-year-old female who smokes presents with increased urinary frequency, dysuria, and sporadic, painless hematuria. The client's follow-up will likely include: lithotripsy. cystoscopy. bladder retraining. long-term intermittent catheterization.
cystoscopy.
A 9-year-old boy has just been diagnosed with the nephritic syndrome. The first stage of his disease will result in: decreased plasma oncotic pressure. glomerular damage. increased permeability to proteins. hypoproteinemia.
glomerular damage.
A 25-year-old man of Asian ancestry arrives in the emergency room in a panic. Except for a bout with bronchitis a week earlier, he has been healthy his entire life; today he has blood in his urine. He is eventually told that his kidney disease has no known treatment and results in protein deposits accumulating in the glomerulus. The client has likely been diagnosed with: Goodpasture syndrome. membranous glomerulonephritis. Kimmelstiel-Wilson syndrome. immunoglobulin A nephropathy.
immunoglobulin A nephropathy.
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: high filtration rates in the glomerulus. obstruction in the glomerular capillaries due to overabundance of large molecules being released. innervation of the sympathetic nervous system, causing constriction of the afferent arteriole. parasympathetic stimulation, causing the renal arteries to constrict in response to pain.
innervation of the sympathetic nervous system, causing constriction of the afferent arteriole.
The nurse is reviewing the lab results of a client with suspected nephrotic syndrome. The nurse anticipates the results to include: decreased low-density lipoproteins. abnormal blood clotting factors. decreased tryglycerides. serum hyperalbuminemia. protein in the urine.
protein in the urine.
Prior to undergoing diagnostic testing with contrast, it is recommended that older adult clients have their creatinine level checked. The rationale for this is to ensure the client: will not undergo an acute kidney injury by decreasing renal blood flow. is in good enough health to withstand a walking on a treadmill. is not allergic to shell fish or iodine. does not have a kidney stone obstructing the urethra.
will not undergo an acute kidney injury by decreasing renal blood flow.
The nurse is providing dietary instruction for a client with chronic kidney disease (CKD) who is on hemodialysis. Which food would the nurse encourage the client to restrict? Whole grains Fresh apples Raw carrots Lean meats
Lean meats
Chronic kidney disease impacts many systems in the body. What is the most common hematologic disorder caused by CKD? Erythrocythemia Leukocytosis Anemia Polycythemia
Anemia
Following kidney transplantation, the client is prescribed maintenance immunosuppressive therapy consisting of prednisone, azathioprine, and cyclosporine. While educating the client about the immunosuppressive therapy, which side effects should the nurse include in the teaching plan? Select all that apply. Cardiovascular complications Development of metabolic dysfunction Nephrotoxicity of newly transplanted kidney Ringing or buzzing in the ears Increased risk of developing cancer
Cardiovascular complications Increased risk of developing cancer Development of metabolic dysfunction
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. Which treatment should the nurse anticipate? Dialysis Kidney transplant Intravenous antibiotics Bone marrow transplant
Dialysis
Which client clinical manifestation most clearly suggests a need for diagnostic testing to rule out renal cell carcinoma? Hematuria Cloudy urine Oliguria Urinary urgency
Hematuria
A client reports urinary incontinence, specifically not feeling the urge to urinate until the bladder voids uncontrollably. Client history shows type 1 diabetes of 40+ years and compliance with medication and diet. What is the most likely diagnosis? Incontinence related to neuropathy causing overactive bladder Incontinence related to having large volumes stored in the bladder Incontinence caused by stress on the bladder Incontinence caused by a physical block in the urethra
Incontinence related to neuropathy causing overactive bladder
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? Excretion of dilute urine Inability to control urination Increased urine output Increase in blood pressure
Increase in blood pressure
A client in renal failure has marked decrease in renal blood flow caused by hypovolemia, the result of gastrointestinal bleeding. The nurse is aware that this form of renal failure can be reversed if the bleeding is under control. Which form of acute renal injury does this client have? Postrenal failure Prerenal failure Intrarenal failure Chronic renal failure
Prerenal failure
The nurse would be most concerned when the glomerular filtrate contains: Water Protein Potassium Sodium
Protein
The nurse recognizes the kidney can be considered an endocrine organ as it may exert which action? Activation of vitamin D Synthesis of potassium Synthesis of renin-angiotensin-aldosterone Protein and albumin synthesis Regulation of red blood cells through manufacture of erythropoietin
Regulation of red blood cells through manufacture of erythropoietin
An athlete has become dehydrated during a long race in hot weather. Which physiologic process will occur in an attempt to protect the athlete's extracellular fluid volume? Release of antidiuretic hormone from the posterior pituitary Increased water reabsorption in the ascending limb of the loop of Henle Dilation of the afferent and efferent arterioles Increased water reabsorption in the distal convoluted tubule
Release of antidiuretic hormone from the posterior pituitary
What is the most common cancer of the kidney? Renal cell carcinoma Wilms tumor Lymphoma Transitional cell carcinoma SUBMIT ANSWER
Renal cell carcinoma
The kidney assists in blood pressure regulation by releasing which substance from the juxtaglomerular cells in response to decreased renal blood flow, causing efferent arteriole vasoconstriction? Angiotensin I Aldosterone Angiotensin II Renin
Renin
What are appropriate interventions in the care of a client diagnosed with renal calculi? Select all that apply. Restricting the client's oral fluid intake Straining the client's urine Keeping track of intake and output Inserting a Foley catheter Addressing the client's pain SUBMIT ANSWER
Straining the client's urine Addressing the client's pain Keeping track of intake and output
A 56-year-old client reports urinary incontinence when laughing. The nurse documents this as which type of incontinence? Overflow Stress Overactive Urge
Stress
The nurse is providing care for a client newly diagnosed with a spinal cord injury. When the client asks why she can no longer control her bladder, which response by the nurse is the bestexplanation? Select all that apply. You have a condition known as a relaxed bladder. You have a condition known as detrusor-sphincter dyssynergia. You will always have to wear an internal catheter. Your spinal cord injury has disrupted the control your brain has over your bladder. You will have to learn how to in-and-out catheterize yourself.
Your spinal cord injury has disrupted the control your brain has over your bladder. You will have to learn how to in-and-out catheterize yourself. You have a condition known as detrusor-sphincter dyssynergia.
The nurse recognizes the most common cause of acute postinfectious glomerulonephritis as: prolonged blockage of the ureter with a stone. a streptococcal infection 7 to 12 days prior to onset. uncontrolled diabetes with increased proteinuria. drug-induced damage to the renal glomeruli.
a streptococcal infection 7 to 12 days prior to onset.
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: kidney stones. acute postinfectious glomerulonephritis. acute renal failure. nephrotic syndrome.
acute postinfectious glomerulonephritis.
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: chronic renal failure (CRF). anemia. glomerulonephritis. nephrotoxic acute tubular necrosis (ATN).
nephrotoxic acute tubular necrosis (ATN).
A nursing student studying pharmacology is learning how angiotensin converting enzyme inhibitors (ACE) work. The student is correct when stating that the mechanism of action of ACE inhibitors is to: promote osmotic diuresis. prevent conversion of angiotensin I to II. prevent reabsorption of sodium in the distal tubules. block aldosterone.
prevent conversion of angiotensin I to II.
Clients with CKD are at risk for demineralization of their bones since they are no longer able to: excrete bicarbonate effectively. transform vitamin D to its active form. stimulate bone osteoclastic production. synthesize erythropoietin.
transform vitamin D to its active form.
One of the many tests done during urodynamic studies is the sphincter electromyelogram. What does this test study? Activity of the voluntary muscles of the perineal area Pressure of the bladder during filling and emptying Ability of the bladder to store urine Flow rate during urination
Activity of the voluntary muscles of the perineal area
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: 1700-2000 mL/minute. 500-800 mL/minute. 100-300 mL/minute. 1000-1300 mL/minute.
1000-1300 mL/minute.
Accumulation of nitrogenous wastes such as urea in the circulatory system is an early sigh of chronic kidney disease (CKD). The nurse knows that normal levels of urea in blood are approximately: 80 mg/dL (28.56 mmol/L) 100 mg/dL (35.70 mmol/L) 20 mg/dL (7.14 mmol/L) 60 mg/dL (21.42 mmol/L)
20 mg/dL (7.14 mmol/L)
The nurse is educating a client about renal disease. Which percentage of cardiac output perfuses the kidneys? 27% to 30% 10% to 15% 22% to 25% 15% to 20%
22% to 25%
Which client is displaying manifestations of having a kidney stone? A visible abdominal mass and abdominal pain in bilateral lower quadrants Elevation in systemic blood pressure and frequent urination Acute onset of colicky flank pain radiating to lower abdomen Increased thirst and urinary output with warm, dry skin
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 is the most likely diagnosis? Acute pyelonephritis Renal cell carcinoma Renal calculi Acute renal failure
Acute pyelonephritis
In women, stress incontinence is a common problem. The loss of the angle between the urethrovesical junction and the bladder contributes to stress incontinence. What is the normal angle between the bladder and the urethrovesical junction? 95 to 105 degrees 80 to 90 degrees 90 to 100 degrees 100 to 110 degrees
90 to 100 degrees
