Care of Patients with Kidney Disorders SG
Which clinical manifestation in a patient with an obstruction in the urinary system is associated specifically with a hydronephrosis? A. Flank asymmetry B. Chills and fever C. Urge incontinence D. Bladder distention
A. Flank asymmetry
The patient with acute glomerulonephritis is required to provide 24 hour urine specimen. What does the nurse expect to see when looking at the specimen? A. Smoky or cola colored urine B. Clear and very dilute urine C. Urine that is full of pus and very thick D. Bright orange colored urine
A. Smoky or cola colored urine
Insertion of an indwelling urinary catheter increases the patient's risk for developing what type of kidney disorder? A. Polycystic kidney disease B. Acute pyelonephritis C. Renal stenosis D. Nephrosclerosis
B. Acute pyelonephritis
What change in diabetic therapy may be needed for a patient who has diabetic nephropathy? A. Fluid restriction B. Decreased activity level C. Decreased insulin dosages D. Increased caloric intake
C. Decreased insulin dosages
A patient with polycystic kidney disease reports nocturia. What is the nocturia caused by? A. Increased fluid intake in the evening B. Increased hypertension C. Decreased urine-concentrating ability D. Detrusor irritability
C. Decreased urine-concentrating ability
A patient has renal cell carcinoma that has metastasized to the lungs what stage is the cancer? A. I B. II C. III D. IV
D. IV
A patient has a family history of the autosomal-dominant form of polycystic kidney disease and has been advised to monitor for and report symptoms. What is an early symptom of PKD? A.Headache B. Pruritus C. Edema D. Nocturia
D. Nocturia
A patient is diagnosed with chronic glomerulonephritis. The patients spouse reports that the patient is irritable, forgetful, and has trouble concentrating. Which assessment finding does the nurse expect on further examination? A. Increased respiratory rate B. Elevated blood urea nitrogen C. Hypokalemia D. Low blood pressure
B. Elevated blood urea nitrogen
After a nephrectomy, a patient has a large urine output because of adrenal insufficiency. What does the nurse anticipate the priority intervention for this patient will be? A. Ace inhibitor to control hypertension and decrease protein loss in urine B. Straight catheterization or bedside bladder scan to measure residual urine C. IV fluid replacement because of subsequent hypotension and oliguria D. IV infusion of temsirolimus, to inhibit cell division and cell cycle progression
C. IV fluid replacement because of subsequent hypotension and oliguria
The nurse is interviewing a patient with suspected polycystic kidney disease. What questions does the nurse asked the patient? SATA A. "Is there any family history of PKD or kidney disease?" B. "Do you have a history of sexually transmitted disease?" C. "Have you had any constipation or abdominal discomfort?" D. "Have you noticed a change in urine color of frequency?" E. "Have you had any problems with headaches? F. "Have you had any problems with muscles aches or joint pain?"
A. "Is there any family history of PKD or kidney disease?" C. "Have you had any constipation or abdominal discomfort?" D. "Have you noticed a change in urine color of frequency?" E. "Have you had any problems with headaches?
For the patient with polycystic kidney disease, which type of antihypertensive medication may be used because it helps control the cell growth aspects of PKD and reduce microalbuminuria? A. Ace inhibitors B. Beta blockers C. Calcium channel blockers D. Vasodilators
A. Ace inhibitors
The healthcare team is using a collaborative and interdisciplinary approach to design a treatment plan for a patient with polycystic kidney disease. What is the top priority? A. Controlling hypertension B. Preventing rupture of cysts C. Providing genetic counseling D. Identifying community resources
A. Controlling hypertension
A patient is diagnosed with hydronephrosis. What is the primary complication that could result from this condition? A. Damage to blood vessels in kidney tubules B. Kidney stone disease with retained stones C. Hypertension and diabetic neuropathy D. Pyelonephritis with vesicoureteral reflux
A. Damage to blood vessels in kidney tubules
The nurse is caring for a patient with kidney cell carcinoma. What does the nurse expect to find documented about the patients initial assessment? A. Flank pain, gross hematuria, palpable kidney mass, and renal bruit B. Gross hematuria, hypertension diabetes and oliguria C. Dysuria, polyuria, dehydration and probable kidney mass D. Nocturia and urinary retention with difficulty starting stream
A. Flank pain, gross hematuria, palpable kidney mass, and renal bruit
The nurse is developing a teaching plan for a patient with polycystic kidney disease. Which topics does the nurse include? Select all that apply. A. Instruct how to measure and record blood pressure B. Assist to develop a schedule for self administering drugs C. Teach about daily weights, same time of day, and same amount of clothing. D. Review the potential side effects of the drugs. E. Explain high protein, low fat diet plan. F. Teach to take pulse before and after taking medications.
A. Instruct how to measure and record blood pressure B. Assist to develop a schedule for self administering drugs C. Teach about daily weights, same time of day, and same amount of clothing. D. Review the potential side effects of the drugs.
The nurse is reviewing the laboratory results of a patient with chronic glomerulonephritis. The phosphorus level is 5.3 mg/dL. What else does a nurse expect to see? A. Serum calcium level below the normal range. B. Serum potassium level below the normal range. C. Falsely elevated serum sodium level. D. Elevated serum levels for all other electrolytes.
A. Serum calcium level below the normal range.
A 53-year-old patient is newly diagnosed with renal artery stenosis. Which clinical manifestation is the nurse most likely to observe when the patient first seeks healthcare? A. Sudden onset of hypertension B. Urinary frequency and dysuria C. Nausea and vomiting D. Flank pain and hematuria
A. Sudden onset of hypertension
A patient reports training to pass very small amounts of urine today, despite a normal fluid intake, and reports having the urge to urinate. The nurse palpates the bladder and finds that it is distended. Which condition is most likely to be associated with these findings? A. Urethral stricture B. Hydroureter C. Hydronephrosis D. Polycystic kidney disease
A. Urethral stricture
A patient has late stage chronic glomerulonephritis. Which educational brochure would be the most appropriate to prepare for the patient? A. "How to take your anti-infective medications" B. "Important points to know about dialysis" C. "What are the side effects of radiation therapy?" D. "Precautions to take during immunosuppressive therapy"
B. "Important points to know about dialysis"
The student nurse is assisting in the post operative care of a patient who had a recent nephrectomy. The student demonstrates a reluctance to move the patient to change the linens because "the patient seem so tired". The nurse reminds the student that a priority assessment for this patient is to assess for which factor? A. Skin breakdown on the patients back. B. Blood on the linens beneath the patient C. Urinary incontinence and moisture D. The patient's ability to move self in bed
B. Blood on the linens beneath the patient
What are the key features associated with chronic pyelonephritis? SATA A. Abscess formation B. Hypertension C. Inability to conserve sodium D. Decreased urine-concentrating ability, resulting in nocturia E. Tendency to develop hyperkalemia and acidosis F. Sudden onset of massive proteinuria
B. Hypertension C. Inability to conserve sodium D. Decreased urine-concentrating ability, resulting in nocturia E. Tendency to develop hyperkalemia and acidosis
In polycystic kidney disease, the affects on the renin-angiotensin system in the kidney has which results? A. Adrenal insufficiency B. Increased blood pressure C. Increase urine output D. Oliguria
B. Increased blood pressure
What might the nurse notice if the patient is experiencing problems with urinary illumination as a result of acute pyelonephritis? SATA A. Patient urinates large amounts of dilute urine. B. Patient reports pain and burning on urination. C. Patient reports back or flank pain. D. Urine is cloudy and foul smelling. E. Urine may be darker or smoky or have obvious blood in it. F. Patient reports nocturia.
B. Patient reports pain and burning on urination. C. Patient reports back or flank pain. D. Urine is cloudy and foul smelling. E. Urine may be darker or smoky or have obvious blood in it. F. Patient reports nocturia.
A patient returning to the unit after a left radical nephrectomy for kidney cell carcinoma reports having some soreness on the right side. What does the nurse tell the patient? A. "The right kidney was repositioned to take over the function of both kidneys." B. "I'll call your doctor for an order to increase your pain medication." C. "The soreness is likely to be from being positioned on your right side during surgery." D. "You are having referred pain. It's expected, but you can take mild pain medication."
C. "The soreness is likely to be from being positioned on your right side during surgery."
An older adult male patient calls the clinic because he has "not passed any urine all day long." What is the nurses best response? A. "Try drinking several large glasses of water and waiting a few more hours" B. "If you develop flank pain or fever, then you should probably come in" C. "You could have an obstruction, so you should come in to be checked" D. "I am sorry, but I really can't comment about your problem over the phone"
C. "You could have an obstruction, so you should come in to be checked"
The healthcare provider writes an order to give the patient a fluid allowance equal to the 24 hour urine output plus 500 to 600 ML. Urine output was 60 ML at 8 AM; 260 ML at 12 PM; 200 ML at 4 PM; 280 ML at 8 PM; 100 ML at 12 AM; 100 ML at 4 AM; and 50 ML at 7 AM. How much fluid can the patient have over the next 24 hours? A. 500 to 600 ML B. 1050 to 1060 ML C. 1550 to 1650 ML D. 2500 to 2600 ML
C. 1550 to 1650 ML
Which patient has the greatest risk for developing acute pyelonephritis? A. 80-year-old woman who takes diuretics for mild heart failure. B. 80-year-old man who drinks four cans of beer per day C. 36-year-old woman with diabetes mellitus who is pregnant D. 36-year-old man with diabetes insipidus
C. 36-year-old woman with diabetes mellitus who is pregnant
A patient with polycystic kidney disease is at risk for a berry aneurysm and reports a severe headache. What is the nurses priority action? A. Assess the pain and give a PRN pain medication B. Reassure her that this is an expected symptom of the disease C. Assess for a neurologic changes and check vital signs D. Monitor for hematuria and decreased urinary output.
C. Assess for a neurologic changes and check vital signs
A 22-year-old patient comes to the clinic for a wellness check up. History reveals that the patient's parents has the autosomal dominant form of polycystic kidney disease. Which vital sign suggest that the patient should be evaluated for PKD? A. Pulse of 95 bpm B. Temperature of 100.6°F C. Blood pressure of 136/88 mm Mg D. Respiratory rate of 26 per minute
C. Blood pressure of 136/88 mm Mg
The nurse is caring for a patient after a nephrectomy. The nurse notes that the urine flow was 50 mL per hour at the beginning of the shift but several hours later has dropped to 30 mL. What would the nurse do first? A. Notify the healthcare provider for an order for an IV fluid bolus. B. Document the finding and continue to monitor for downward trend. C. Check the drainage system for kinks or obstructions to flow D. Obtain a patient's weight and compare it to baseline
C. Check the drainage system for kinks or obstructions to flow
What are key features of renovascular disease? Select all that apply. A. Sodium wasting B. Flank pain C. Decreased glomerular filtration rate D. Elevated serum creatinine E. Poorly controlled diabetes or sustained hyperglycemia F. Significant, difficult to control high blood pressure
C. Decreased glomerular filtration rate D. Elevated serum creatinine E. Poorly controlled diabetes or sustained hyperglycemia F. Significant, difficult to control high blood pressure
The patient sustained traumatic injury and needs the best diagnostic test to determine the extent of injury to the kidney. What does the nurse do? A. Obtain a clean catch urine specimen for urinalysis B. Give an IV fluid bolus before renal arteriography C. Explain computed tomography D. Obtain a sample a blood sample for hemoglobin and hematocrit
C. Explain computed tomography
A patient is newly admitted with nephrotic syndrome and has proteinuria, edema, hyperlipidemia, and hypertension. What is the priority for nursing care? A. Consult the dietitian to provide adequate nutritional intake B. Prevent kidney and urinary track infection C. Monitor fluid volume and the patients hydration status D. Prepare the patient for a renal biopsy
C. Monitor fluid volume and the patients hydration status
A patient is admitted to the medical-surgical unit for acute pyelonephritis. What is the priority concept to consider in the immediate nursing care of this patient? A. oxygenation B. Acid-base balance C. Pain D. Cellular regulation
C. Pain
The emergency department nurse is preparing a patient with kidney trauma for emergency surgery. What is the best task to delegate to UAP? A. Set the automated blood pressure machine to cycle every two hours. B. Inform the family about surgery and assist them to the surgery waiting area. C. Pick up the units of packed red cells from the blood bank. D. Insert a urinary catheter if there is no gross bleeding at the urethra.
C. Pick up the units of packed red cells from the blood bank.
The healthcare provider advise the patient that diagnostic testing is needed to identify the possible presence of a renal abscess. Which test does the nurse prepare the patient for? A. Renal arteriography B. Cystourethrogram C. Renal scan D. Urodynamic flow studies
C. Renal scan
A patient is suspected of having polycystic kidney disease. Which diagnostic study has minimal risks and is used to provide initial screening for PKD? A. Kidneys-ureters-bladder x-ray B. Computer tomography with angiography C. Renal ultrasonography D. Renal biopsy
C. Renal ultrasonography
A patient with chronic pyelonephritis returns to the clinic for follow-up. Which behavior indicates that patient is performing these self care measures to conserve existing kidney function? A. Drinks a liter of fluid every day. B. Considers buying a home blood pressure cuff. C. Reports taking antibiotics as prescribed. D. Takes pain medication on a regular basis.
C. Reports taking antibiotics as prescribed.
The health care provider tells the nurse that the patient with polycystic kidney disease has salt wasting. Which intervention is the nurse likely to use related to nutrition therapy? A. Talk to the patient about seasonings that are alternatives for salt B. Help the patient select a lunch tray with low-sodium items C. Obtain an order for fluid restriction to prevent loss of sodium during urination D. Advise that a low sodium diet is not currently necessary
D. Advise that a low sodium diet is not currently necessary.
Which pain management strategy does the nurse teach a patient with polycystic kidney disease who has chronic pain related to the kidney cysts? A. Rest and sleep in a prone position B. Increase dosage of non-steroid all anti-inflammatory C. Gently rub or massage the flank area D. Apply dry heat to the abdomen or flank
D. Apply dry heat to the abdomen or flank
Which nursing intervention is applicable for a patient with acute glomerulonephritis? A. Restricting visitors who have infections B. Assessing the incision site C. Inspecting the vascular access D. Measuring weight daily
D. Measuring weight daily
What is the main concern for patients who have hydronephrosis, hydroureter, or urethral stricture? A. Dilute urine B. Pain on urination C. Dehydration D. Obstruction
D. Obstruction
The nurse is taking a history on patient with chronic glomerulonephritis. What is the patient most likely to report? A. History of antibiotic allergy B. Intense flank pain C. Poor appetite and weight loss D. Occasional edema and fatigue
D. Occasional edema and fatigue
The off going nurse is giving shift report to the oncoming nurse about the care of a patient who had a nephrostomy tube placed 12 hours ago. What is the most important point to clearly communicate about the urine drainage? A. "Urine is draining only into the collection bag, not the bladder; therefore the amount of drainage must be assessed hourly for the first 24 hours." B. "The intake and urinary output have been monitored hourly and the patient has not shown any signs/symptoms of dehydration." C. The surgeon placed ureteral tubes so all of the urine will pass through the bladder; therefore please perform hourly bladder scans to measure residual." D. "The nephrostomy site has not been leaking any blood or urine and you should continue to monitor the site for leakage."
A. "Urine is draining only into the collection bag, not the bladder; therefore the amount of drainage must be assessed hourly for the first 24 hours."
A patient had a nephrostomy and a nephrostomy tube is in place. What is included in the postoperative care of this patient? A. Assess the amount of drainage in the collection bag. B. Irrigate the tube until the return drainage is clear. C. Keep the patient NPO for 6 to 8 hours. D. Instruct to sleep with operative side downward.
A. Assess the amount of drainage in the collection bag.
A patient has come to the clinic for follow-up of acute pyelonephritis. Which action does the nurse reinforced to the patient? A. Complete all antibiotic regimens. B. Report episodes of nocturia. C. Wash hands to prevent spreading infection. D. Avoid taking any over the counter drugs.
A. Complete all antibiotic regimens.
What laboratory values would the nurse observe in a patient experiencing problems with urinary elimination as a result of acute pyelonephritis? SATA A. Complete blood count for elevation of differentials B. Blood urea nitrogen and serum creatinine levels for elevation C. Electrolyte deficiencies, such as hypokalemia and hyponatremia D. Urine culture to identify specific organisms causing infection E. Urinalysis for bacteria, leukocyte esterase, nitrate, or red blood cells F. C-reactive protein and erythrocyte sedimentation rate for immune response
A. Complete blood count for elevation of differentials B. Blood urea nitrogen and serum creatinine levels for elevation D. Urine culture to identify specific organisms causing infection E. Urinalysis for bacteria, leukocyte esterase, nitrate, or red blood cells F. C-reactive protein and erythrocyte sedimentation rate for immune response
A patient with polycystic kidney disease reports nocturia and cloudy urine. What does the nurse encourage patient to do? A. Drink at least 2 L of fluid daily B. Restrict fluids to decrease urination C. Drink 1000 mL early in the morning D. Add a pinch of salt to water in the evenings
A. Drink at least 2 L of fluid daily
A patient is very ill and is admitted to the intensive care unit with rapidly progressing glomerulonephritis. The nurse monitors for manifestations of which prognosis? A. End stage kidney disease B. Gradual improvement after IV fluids C.Stroke due to malignant hypertension D. Full recovery if aggressively treated
A. End stage kidney disease
Which diagnostic test results does the nurse expect to see with acute glomerulonephritis? SATA A. Hematuria B. Proteinuria C. Microscopic red blood cell casts in urine D. Serum albumin level decreased E. Serum potassium decreased F. Serum phosphorus decreased
A. Hematuria B. Proteinuria C. Microscopic red blood cell casts in urine D. Serum albumin level decreased
The health care provider informs the nurse that the patient has acute pyelonephritis that appears to have been caused by a bacterial infection in the blood. For this patient, what is the priority concept? A. Immunity B. Elimination C. Fluid and electrolyte imbalance D. Cellular regulation
A. Immunity
A patient with polycystic kidney disease usually experiences constipation. What does the nurse recommend? A. Increased dietary fiber and increased fluids B. Drinking water until constipation resolves C. Daily laxatives and increased exercise D. Tap water enemas and fiber supplements
A. Increased dietary fiber and increased fluids
The nurse is reviewing arterial blood gas results of a patient with acute glomerulonephritis. The pH of the sample is 7.35. As acidosis is like likely to be present because of hydrogen ion retention and loss of bicarbonate, how does the nurse interpret is data? A. Normal pH with respiratory compensation B. Acidosis with failure of respiratory compensation C. Alkalosis with failure of metabolic compensation D. Normal pH with metabolic compensation
A. Normal pH with respiratory compensation
A patient is diagnosed with nephrosclerosis. Which factors would promote long-term adherence to the prescribed anti-hypertensive medication therapy? SATA A. Once a day dosing B. Annual reminders C. Minimal side effects D. Eliminating dietary restrictions E. Low-cost F. Drug brochures
A. Once a day dosing C. Minimal side effects E. Low-cost
Which patient has the greatest risk for developing chronic pyelonephritis? A. Patient is bedridden and has prostate enlargement with reflux. B. Patient has hematuria and dysuria related to a urinary tract infection. C. Patient had a nephrectomy secondary to severe kidney trauma D. Patient reports limiting fluids in the evening to control nocturia
A. Patient is bedridden and has prostate enlargement with reflux.
Which patient has the greatest risk of developing a kidney abscess? A. Patient is diagnosed with acute pyelonephritis B. Patient has flank asymmetry related to hydronephrosis C. Patient developed a urinary tract infection secondary to a urinary catheter D. Patient is diagnosed with hypertension and nephrosclerosis
A. Patient is diagnosed with acute pyelonephritis
Why may a patient with polycystic kidney disease experience constipation? A. Polycystic kidneys enlarge and put pressure on the large intestine. B. Patient becomes dehydrated because the kidneys are dysfunctional. C. Constipation is a side effect from the medication given to treat PKD. D. Patient with PKD have special dietary restriction's that cause constipation.
A. Polycystic kidneys enlarge and put pressure on the large intestine.
The nurse is reviewing the laboratory results for a patient with chronic glomerulonephritis. The serum albumin level is low. What else else does the nurse expect to see? A. Proteinuria B. Elevated hematocrit C. High specific gravity D. Low white blood cell count
A. Proteinuria
The nurse is reviewing the medical history of a patient who was admitted for acute glomerulonephritis. Which systemic conditions may have caused acute glomerulonephritis and should be included in the overall plan of care? A. Systemic lupus erythematosus and diabetic glomerulopathy B. Myocardial infarction and atrial fibrillation C. Ischemic stroke and hemiparesis D. Blunt trauma to the kidney with hematuria
A. Systemic lupus erythematosus and diabetic glomerulopathy
A patient is brought to the emergency department because he was in a fight and was repeatedly kicked and punched in the back. What does the nurse include in the initial physical assessment? SATA A. Take complete vital signs B. Check apical and peripheral pulses C. Inspect flanks for bruising, asymmetry or penetrating injuries D. Inspect abdomen, chest, and lower back for bruising or penetrating wounds E. Deeply palpate the abdomen for signs of rigidity F. Inspect the urethra for gross bleeding
A. Take complete vital signs B. Check apical and peripheral pulses C. Inspect flanks for bruising, asymmetry or penetrating injuries D. Inspect abdomen, chest, and lower back for bruising or penetrating wounds F. Inspect the urethra for gross bleeding
A patient has had one kidney removed as a treatment for kidney cancer. The patient's spouse ask, "Does the good kidney take over immediately? I know a person can live with just one kidney." What is the nurses best response? A. The other kidney will provide adequate function, but it but this may take days or weeks. B. The other kidney isn't able to provide adequate function, so other therapies are needed. C. That's a good question. Remember to ask your doctor next time he or she comes in. D. It varies a lot, but with an a few days we expect everything to normalize.
A. The other kidney will provide adequate function, but this may take days or weeks.
A patient with diabetic nephropathy reports having frequent hypoglycemic episodes "so my doctor reduce my insulin, which means my diabetes is improving." What is the nurses best response? A. "Congratulations! That's great news. You must be carefully following the diet and lifestyle recommendations." B. "When kidney function is reduced, the insulin is available for a longer time and less of it is needed." C. "You should talk to your doctor again. You have been diagnosed with nephropathy and that changes the situation." D. "Let me get you a brochure about the relationship of diabetes and kidney disease it can be hard to understand."
B. "When kidney function is reduced, the insulin is available for a longer time and thus less of it is needed."
Which manifestation is primarily associated with acute pyelonephritis? A. Obstruction caused by hydroureter B. Active bacterial infection C. Increased urinary retention D. Peripheral and facial edema
B. Active bacterial infection
The nurse is assessing a patient who reports chills, high fever, and flank pain with urinary urgency and frequency. On physical examination, the patient has costovertebral angle tenderness, pulse is 110 bpm, and respirations are 28 per minute. How does the nurse interpret these findings? A. Complicated cystitus B. Acute pyelonephritis C. Chronic pyelonephritis D. Acute glomerulonephritis
B. Acute pyelonephritis
The nurse is caring for a patient with nephrotic syndrome. What interventions are included in the plan of care for this patient? SATA A. Fluids should be restricted B. Administer mild diuretics C. Assess for edema D. Administer antihypertensive medications E. Assess for dysuria F. Assess hydration status.
B. Administer mild diuretics C. Assess for edema D. Administer antihypertensive medications F. Assess hydration status.
The nurse is caring for a patient with a nephrostomy. The nurse notifies the healthcare provider about which assessment findings? A. Urine drainage is red tinged four hours after surgery. B. Amount of drainage decreases and the patient has back pain. C. There's a small steady drainage for the first four hours post surgery. D. The nephrostomy side looks dry and intact.
B. Amount of drainage decreases and the patient has back pain.
A patient has chronic glomerulonephritis. In order to assess for uremic symptoms, what does the nurse do? A. Evaluate the blood urea nitrogen B. Ask the patient to extend the arms and hyperextend the wrists C. Gently palpate the flank for asymmetry and tenderness D. Auscultate for the presence of an S3 heart sound
B. Ask the patient to extend the arms and hyperextend the wrists
The nurse is assessing a patient with possible acute glomerulonephritis. During the inspection of the hands, face, and eyelids, what is the nurse primarily observing for? A. Redness B. Edema C. Rashes D. Dryness
B. Edema
The nurse is caring for a patient with kidney so carcinoma who manifest paraneoplastic syndromes. What findings does the nurse expect to see in this patient? Select all that apply. A. Urinary tract infection B. Erythrocytosis C. Hypercalcemia D. Liver dysfunction E. Decreased sedimentation rate F. Hypertension
B. Erythrocytosis C. Hypercalcemia D. Liver dysfunction F. Hypertension
An older adult male patient reports an acute problem with urine retention. The nurse advises the patient to seek medical attention because permanent kidney damage can occur in what timeframe? A. In less than six hours B. In less than 48 hours C. Within several weeks D. Within several years
B. In less than 48 hours
A patient with polycystic kidney disease would exhibit which signs/symptoms? Select all that apply. A. Frequent urination B. Increased abdominal girth C. Hypertension D. Kidney stones E. Diarrhea F. Bloody or cloudy urine
B. Increased abdominal girth C. Hypertension D. Kidney stones F. Bloody or cloudy urine
The nurse is caring for a postoperative nephrectomy patient. The nurse notes during the first several hours of the shift, a marked and steady downward trend in blood pressure. How does the nurse interpret this finding? A. Hypertension has been corrected. B. Internal hemorrhage is possible. C. The other kidney is failing. D. Fluids are shifting into the interstitial space.
B. Internal hemorrhage is possible.
Under what circumstances would it be appropriate for the nurse to seek an order for catheter replacement if the healthcare provider fails to order it? A. Family request a long-term care catheter to prevent urinary incontinence for a confused relative B. Patient has had current catheter for two weeks and new antibiotics were just ordered C. Patient has an existing catheter but exterior of closed system becomes soiled D. Nurse notices a large amount of dark amber urine in the drainage bag.
B. Patient has had current catheter for two weeks and new antibiotics were just ordered
The nurse is reviewing the patient's history, assessment findings and laboratory results for a patient with suspected kidney problems. Which manifestation is the main feature of nephrotic syndrome? A. Abrupt onset flank asymmetric B. Proteinuria greater than 3.5 g in 24 hours C. Serum sodium greater than 148MMOL/L serum cholesterol (total) 190 mg/dL
B. Proteinuria greater than 3.5 g in 24 hours
A patient with polycystic kidney disease reports sharp flank pain followed by blood in the urine. How does the nurse interpret these signs/symptoms? A. Infection of cyst B. Ruptured cyst C. Ruptured berry aneurysm D. Increased kidney size
B. Ruptured cyst
After a nephrectomy, one adrenal gland remains. Based on this knowledge, which type of medication replacement therapy does the nurse expect if the remaining adrenal gland function is insufficient? A. Potassium B. Steroid C. Calcium D. Estrogen
B. Steroid
Which patient history factor is considered causative for acute glomerulonephritis? A. Urinary incontinence for six months B. Strep throat three weeks ago C. Kidney stones two years ago D. Mild hypertension diagnosed one year ago
B. Strep throat three weeks ago
A patient is diagnosed with kidney cancer and the healthcare provider recommends the best therapy. Which treatment does the nurse anticipate teaching the patient about? A. Chemotherapy B. Surgical removal C. Hormonal therapy D. Radiation therapy
B. Surgical removal
The nurse is reviewing the laboratory results for a patient being evaluated for difficulties with passing urine. The urinalysis shows tubular epithelial cells on microscopic examination. How does the nurse interpret this finding? A. Blood chemistries should be evaluated. B. The obstruction is prolonged. C. The patient has a urinary tract infection. D. Glomerular filtration rate is reduced.
B. The obstruction is prolonged.
After the nurse instructed patient with polycystic kidney disease on home care, the patient knows to contact the healthcare provider immediately when what signs/symptoms occurs? A. Urine is a clear, pale yellow color B. Weight has increased by 5 pounds in two days C. Two days have passed since the last bowel movement D. Morning systolic blood pressure has decreased by 5 mmHg
B. Weight has increased by 5 pounds in two days
Which ethnic or cultural groups are most likely to develop end stage kidney disease related to hypertension? SATA A. Caucasian American B. Jewish Americans C. American Indians D. African-Americans E. Hispanic Americans F. Bisexual American
C. American Indians D. African-Americans
The nurse is assessing a patient with glomerulonephritis and notes crackles in the lung fields and neck vein distention. The patient reports mild shortness of breath. Based on these findings, what does the nurse do next? A. Check for costovertebral angle tenderness or flank pain. B. Obtain a urine sample to check for proteinuria. C. Assess for additional signs of fluid overload. D. Alert the health care provider about the respiratory symptoms.
C. Assess for additional signs of fluid overload.
A patient with a history of polycystic kidney disease reports dull, aching flank pain and the urinalysis is negative for infection. The healthcare provider tells the nurse that the pain is chronic and related to enlarging kidneys compressing abdominal contents. What nursing intervention is best for this patient? A. Administer an angiotensin converting enzyme (ACE) inhibitor such as lisinopril B. Apply cold compresses to the abdomen or flank C. Teach methods of relaxation such as deep breathing D. Administer around the clock nonsteroidal anti-inflammatory drugs
C. Teach methods of relaxation such as deep breathing
The nurse is interviewing and assessing a patient who has the signs/symptoms of acute glomerulonephritis. Which disorder is most likely to mimic similar signs/symptoms? A. Acute flare up of rheumatoid arthritis B. Metastasis of renal carcinoma to distal sites C. Urinary obstruction due to hydroureter D. Acute exacerbation of heart failure
D. Acute exacerbation of heart failure
A patient with acute glomerulonephritis has edema of the face. The blood pressure is moderately elevated and the patient has gained 2 pounds within the past 24 hours. The patient reports fatigue and refuses to eat. What is the priority for nursing care? A. Cluster care to allow rest periods for the patient B. Obtain a dietary consult to plan an adequate nutritional diet C. Monitor urine output with accurate intake and output amounts D. Assess for signs and symptoms of fluid volume overload.
D. Assess for signs and symptoms of fluid volume overload.
For a patient with acute glomerulonephritis, a 24 hour urine test was initiated and the glomerular filtration rate results are pending. What is the correct clinical implications of GFR results? A. GFR is normal; the therapy can be discontinued. B. GFR is low; the patient is at risk for retention. C. GFR is high; the patient is at risk for infection. D. GFR is low; the patient is at risk for fluid overload.
D. GFR is low; the patient is at risk for fluid overload.
The nurse is caring for a patient who had a nephrectomy yesterday. To manage the patients pain, what is the best plan for analgesia therapy? A. Limit narcotics because of respiratory depression. B. Give an oral analgesic when the patient can eat. C. Alternate parenteral and oral medications. D. Give parenteral medications on a schedule.
D. Give parenteral medications on a schedule.