Ch. 44, 45, 46 Lewis & Nclex Book
During hemodialysis, the patient develops light-headedness and nausea. What should the nurse do first? a. Administer hypertonic saline. b. Administer a blood transfusion. c. Decrease the rate of fluid removal. d. Administer antiemetic medications.
c. Decrease the rate of fluid removal.
The nurse recommends genetic counseling for the children of a patient with a. nephrotic syndrome b. chronic pyelonephritis c. malignant nephrosclerosis d. adult-onset polycystic kidney disease
d. adult-onset polycystic kidney disease
In teaching a patient with pyelonephritis about the disorder, the nurse informs the patient that the organisms that cause pyelonephritis most commonly reach the kidneys through a. the blood stream b. the lymphatic system c. a descending infection d. an ascending infection
d. an ascending infection
The urinalysis of a patient reveals a high microorganism count. What data should the nurse use to determine which part of the urinary tract is infected (select all that apply.)? a. Pain location b. Fever and chills c. Mental confusion d. Urinary hesitancy e. Urethral discharge f. Postvoid dribbling
a. Pain location e. Urethral discharge
The nurse is teaching resident at the retirement village about prevention of UTIs. One person asks how much fluid she should drink each day. The nurse determines that she weighs 140 lb. Calculate how many ounces of fluid this person should drink each day. ________ oz
56 Divide the weight in pounds by 2; then multiply this number by 80% because 20% of a person's fluid is obtained from food. So 140/2 = 70, 70 × 0.80 = 56 oz to be drunk each day, or seven 8-oz gl
The nurse provides nutritional counseling for a 45-yr-old man with nephrotic syndrome. The nurse determines teaching has been successful if the patient selects which breakfast menu? a. Scrambled eggs, milk, yogurt, and sliced ham b. Oatmeal, nondairy creamer, banana, and orange juice c. Cottage cheese, peanut butter, white bread, and coffee d. Waffle, bacon strips, tomato juice, and canned peaches
b. Oatmeal, nondairy creamer, banana, and orange juice
The client with acute kidney injury has a serum potassium level of 7. The nurse should plan which actions as a priority? Select all that apply: a. Place the client on a cardiac monitor b. notify the health care provider (HCP) c. put the patient on NPO status except for ice chips d. review the client's medications to determine if any contain or retain potassium e. allow an extra 500 mL of intravenous fluid intake to dilute the electrolyte concentration
a. Place the client on a cardiac monitor b. notify the health care provider (HCP) d. review the client's medications to determine if any contain or retain potassium
In addition to urine function, the nurse recognizes that the kidneys perform numerous other functions important to the maintenance of homeostasis. Which physiologic processes are performed by the kidneys (select all that apply.)? a. Production of renin b. Activation of vitamin D c. Carbohydrate metabolism d. Erythropoietin production e. Hemolysis of old red blood cells (RBCs)
a. Production of renin b. Activation of vitamin D d. Erythropoietin production
The nurse is caring for a patient after a right kidney biopsy. Which position would be the most appropriate for this patient immediately after the procedure? a. Right lateral side-lying position b. Reverse Trendelenburg position c. Supine with lower extremities elevated d. High Fowler's position with arms supported
a. Right lateral side-lying position
The nurse counsels a 64-yr-old man on dietary restrictions to prevent recurrent uric acid renal calculi. Which foods should the patient avoid? a. Venison, crab, and liver b. Spinach, cabbage, and tea c. Milk, yogurt, and dried fruit d. Asparagus, lentils, and chocolate
a. Venison, crab, and liver
A patient is admitted to the hospital with severe renal colic. The nurse's first priority in management of the patient is to a. administer opioids as prescribed b. obtain supplies for straining all urine c. encourage fluid intake of 3 to 4 L/day d. keep the patient NPO in preparation for surgery
a. administer opioids as prescribed
A client being hemodialyzed suddenly becomes short of breath and complains of chest pain. The client is tachycardic, pale, and anxious and the nurse suspects air embolism. What are the priority nursing actions? Select all that apply: a. administer oxygen to the client b. continues dialysis at a slower rate after checking the lines for air c. notify the health care provider and rapid response team d. stop dialysis, and turn the client on the left side with head lower than feet e. bolus the client with 500 mL of normal saline to break up the air embolus
a. administer oxygen to the client c. notify the health care provider and rapid response team d. stop dialysis, and turn the client on the left side with head lower than feet
During physical assessment of the urinary system, the nurse a. cannot palpate the left kidney b. palpates an empty bladder as a small nodule c. finds a dull percussion sound when 100 mL of urine is present in the bladder d. palpates above the symphis pubis to determine the level of urine in the bladder
a. cannot palpate the left kidney
The nurse monitoring a client receiving peritoneal dialysis notes that the client's outflow is less than the inflow. Which actions should the nurse take? Select all that apply: a. check the level of the drainage bag b. reposition the client to his or her side c. contact the health care provider d. place the client in good body alignment e. check the peritoneal dialysis system for kinks f. increase the flow rate of the peritoneal dialysis solution
a. check the level of the drainage bag b. reposition the client to his or her side d. place the client in good body alignment e. check the peritoneal dialysis system for kinks
The nurse is reviewing a client's record and notes that the health care provider has documented that the client has chronic renal disease. On review of the laboratory results, the nurse most likely would expect to note which finding? a. elevated creatinine level b. decreased hemoglobin level c. decreased red blood cell count d. increased number of white blood cells in the urine
a. elevated creatinine level
The nurse discusses plans for future treatment options with a client with symptomatic polycystic kidney disease. Which treatment should be included in this discussion? Select all that apply: a. hemodialysis b. peritoneal dialysis c. kidney transplant d. bilateral nephrectomy e. intense immunosuppression therapy
a. hemodialysis c. kidney transplant d. bilateral nephrectomy
Normal findings expected by the nurse on physical assessment of the urinary system include (select all that apply): a. nonpalpable left kidney b. auscultation of renal artery bruit c. CVA tenderness elicited by a kidney punch d. no CVA tenderness elicited by a kidney punch e. palpable bladder to the level of the pubic symphysis
a. nonpalpable left kidney d. no CVA tenderness elicited by a kidney punch
A patient with suspected renal insufficiency is scheduled for a creatinine clearance diagnostic test. Which instructions would be appropriate for the nurse to provide to the patient? a. "Empty your bladder and discard the urine; then save all urine for 24 hours." b. "Your blood creatinine level will be tested after you eat a high-protein meal." c. "This test should not be performed if you have allergies to iodine or shellfish." d. "A sterile container must be used to store the urine during the collection period.
a. "Empty your bladder and discard the urine; then save all urine for 24 hours."
A 21-yr-old female patient came to the clinic for instruction to prevent recurrence of urinary tract infections. Which patient statement indicates that teaching was effective? a. "I will urinate before and after having intercourse." b. "I will use vinegar as a vaginal douche every week." c. "I should drink three 8-oz glasses of water daily." d. "I can stop the antibiotics when symptoms disappear."
a. "I will urinate before and after having intercourse."
A patient with a history of recurrent urinary tract infections has been scheduled for a cystoscopy. What teaching point should the nurse emphasize before the procedure? a. "You might have pink-tinged urine and burning after your cystoscopy." b. "You'll need to refrain from eating or drinking after midnight the day before the test." c. "The morning of the test, you will drink some water that contains a contrast solution." d. "You'll require a urinary catheter inserted before the cystoscopy, and it will be in place for a few days."
a. "You might have pink-tinged urine and burning after your cystoscopy."
Which nursing diagnosis is priority when caring for a patient with renal calculi? a. Acute pain b. Risk for constipation c. Deficient fluid volume d. Risk for powerlessness
a. Acute pain
The nurse is preparing a patient for an intravenous pyelogram (IVP). What is a priority action by the nurse? a. Administer a cathartic or enema. b. Assess patient for allergies to penicillin. c. Keep the patient NPO for 4 hours preprocedure. d. Advise the patient that a metallic taste may occur during procedure.
a. Administer a cathartic or enema.
Which findings will the nurse expect when caring for a patient with chronic kidney disease (CKD) (select all that apply.)? a. Anemia b. Dehydration c. Hypertension d. Hypercalcemia e. Increased risk for fractures f. Elevated white blood cells
a. Anemia c. Hypertension e. Increased risk for fractures
A 78-yr-old patient has stage 3 CKD and is being taught about a low-potassium diet. The nurse knows the patient understands the diet when the patient selects which foods to eat? a. Apple, green beans, and a roast beef sandwich b. Granola made with dried fruits, nuts, and seeds c. Watermelon and ice cream with chocolate sauce d. Bran cereal with ½ banana and milk and orange juice
a. Apple, green beans, and a roast beef sandwich
A 22-yr-old patient's blood pressure during a pre-employment physical examination was 110/68 mm Hg. During a health fair 2 months later, the blood pressure is 154/96 mm Hg. What renal problem could contribute to this rise in blood pressure? a. Renal trauma b. Renal artery stenosis c. Renal vein thrombosis d. Benign nephrosclerosis
b. Renal artery stenosis
A 52-yr-old man with stage 2 chronic kidney disease is scheduled for an outpatient diagnostic procedure using contrast media. Which priority action should the nurse perform? a. Assess skin turgor to determine hydration status. b. Insert a urinary catheter for the expected diuresis. c. Evaluate the patient's lower extremities for edema. d. Check the patient's urine for the presence of ketones.
a. Assess skin turgor to determine hydration status.
A patient underwent a surgical procedure has a urinary catheter. Eight hours after catheter removal and drinking fluids, the patient has not been able to void. What is the nurse's first action to assess for urinary retention? a. Bladder scan b. Cystometrogram c. Residual urine test d. Kidneys, ureters, bladder (KUB) x-ray
a. Bladder scan
A patient with type 2 diabetes is reporting a second urinary tract infections(UTI)within the past month. Which medication should the nurse expect to be ordered for the recurrent infection? a. Ciprofloxacin b. Fosfomycin c. Nitrofurantoin d. Trimethoprim-sulfamethoxazole
a. Ciprofloxacin
Which assessment findings would alert the nurse that the patient has entered the diuretic phase of acute kidney injury (AKI) (select all that apply.)? a. Dehydration b. Hypokalemia c. Hypernatremia d. BUN increases e. Urine output increases f. Serum creatinine increases
a. Dehydration b. Hypokalemia e. Urine output increases
A patient was admitted 2 weeks ago after multiple traumatic injuries in a motor vehicle collision. The patient now has a serum creatinine at 3.9 mg/dL and blood urea nitrogen (BUN) of 100 mg/dL. Which medication, if ordered by the health care provider, should the nurse question? a. Gentamicin b. Nitrofurantoin c. Acetaminophen d. Morphine sulfate
a. Gentamicin
What is the nurse's priority when changing the appliance for a patient with an ileal conduit? a. Keep the skin free of urine. b. Inspect the peristomal area. c. Cleanse and dry the area gently. d. Affix the appliance to the faceplate.
a. Keep the skin free of urine.
Eight months after the delivery of her first child, a 31-yr-old woman sought care for occasional incontinence when sneezing or laughing. Which measure should the nurse recommend first? a. Kegel exercises b. Use of adult incontinence pads c. Intermittent self-catheterization d. Dietary changes including fluid restriction
a. Kegel exercises
The patient has rapidly progressing glomerular inflammation. Weight has increased and urine output is steadily declining. What is the priority nursing intervention? a. Monitor the patient's cardiac status. b. Teach the patient about hand washing. c. Obtain a serum specimen for electrolytes. d. Increase direct observation of the patient.
a. Monitor the patient's cardiac status.
A client is admitted to the emergency department following a fall from a horse and the health care provider (HCP) prescribes insertion of a urinary catheter. While preparing for the procedure, the nurse notes blood at the urinary meatus. The nurse should take which action? a. notify the HCP before performing the catheterization b. use a small-sized catheter and an anesthetic gel as a lubricant c. administer parenteral pain medication before inserting the catheter d. clean the meatus with soap and water before opening the catheterization kit
a. notify the HCP before performing the catheterization
The nurse is assessing the patency of a client's left arm arteriovenous fistula prior to initiating hemodialysis. Which finding indicated that the fistular is patent? a. palpation of a thrill over the fistula b. presence of a radial pulse in the left wrist c. visualization of enlarged blood vessels at the fistula site d. capillary refill less than 3 seconds in the nail beds of the fingers on the left hand
a. palpation of a thrill over the fistula
Which descriptions characterize acute kidney injury (select all that apply): a. primary cause of death is infection b. it almost always affects older people c. disease course is potentially reversible d. most common cause is diabetic nephropathy e. cardiovascular disease is most common cause of death
a. primary cause of death is infection c. disease course is potentially reversible
One of the nurse's most important roles in relation to acute poststreptococcal glomerulonephritis is to a. promote early diagnosis and treatment of sore throats and skin lesions b. encourage patients to obtain antibiotic therapy for upper respiratory tract infections c. teach patients with APSGN that long-term prophylactic antibiotic therapy is necessary to prevent recurrence d. monitor patient for respiratory symptoms that indicate the disease is affecting the alveolar basement membrane
a. promote early diagnosis and treatment of sore throats and skin lesions
In planning nursing intervention to increase bladder control in the patient with urinary incontinence, the nurse includes a. teaching the patient to use kegel exercises b. clamping and releasing a catheter to increase bladder tone c. teaching the patient biofeedback mechanisms to suppress the nurse to void d. counseling the patient concerning choice of intercourse containment device
a. teaching the patient to use kegel exercises
Which statement regarding continuous ambulatory peritoneal dialysis (CAPD) would be most important when teaching a patient new to the treatment? a. "Maintain a daily written record of blood pressure and weight." b. "It is essential that you maintain aseptic technique to prevent peritonitis." c. "You will be allowed a more liberal protein diet once you complete CAPD." d. "Continue regular medical and nursing follow-up visits while performing CAPD."
b. "It is essential that you maintain aseptic technique to prevent peritonitis."
The nurse is caring for a 62-yr-old woman taking tolterodine (Detrol) to treat urinary urgency and incontinence. Which instruction should be included in the discharge plan? a. "Stop smoking for 2 to 3 weeks before starting to take this medication." b. "Suck on sugarless candy or chew sugarless gum if you develop a dry mouth." c. "Have your vision checked every 6 months because this drug can cause cataracts." d. "Ask your physician to prescribe an extended-release form if you have loose stools."
b. "Suck on sugarless candy or chew sugarless gum if you develop a dry mouth."
The home care nurse visits a 34-yr-old woman receiving peritoneal dialysis. Which statement indicates a need for immediate follow-up by the nurse? a. "Drain time is faster if I rub my abdomen." b. "The fluid draining from the catheter is cloudy." c. "The drainage is bloody when I have my period." d. "I wash around the catheter with soap and water."
b. "The fluid draining from the catheter is cloudy."
Which patient has the most significant risk factors for CKD? a. A 50-yr-old white woman with hypertension b. A 61-yr-old Native American man with diabetes c. A 40-yr-old Hispanic woman with cardiovascular disease d. A 28-yr-old African American woman with a urinary tract infection
b. A 61-yr-old Native American man with diabetes
A patient with end-stage renal disease (ESRD) secondary to diabetes mellitus has arrived at the outpatient dialysis unit for hemodialysis. Which assessments should the nurse perform as a priority before, during, and after the treatment? a. Level of consciousness b. Blood pressure and fluid balance c. Temperature, heart rate, and blood pressure d. Assessment for signs and symptoms of infection
b. Blood pressure and fluid balance
A patient has sought care because of recent difficulties in establishing and maintaining a urine stream as well as pain that occasionally accompanies urination. How should the nurse document this abnormal assessment finding? a.Anuria b. Dysuria c. Oliguria d. Enuresis
b. Dysuria
During the oliguric phase of AKI, the nurse monitors the patient for: (select all that apply) a. hypotension b. ECG changes c. hypernatremia d. pulmonary edema e. urine with high specific gravity
b. ECG changes d. pulmonary edema
A 24-yr-old woman donated a kidney via a laparoscopic donor nephrectomy to a nonrelated recipient. The patient is experiencing significant pain and refuses to get up to walk. How should the nurse respond? a. Have the transplant psychologist convince her to walk. b. Encourage even a short walk to avoid complications of surgery. c. Tell the patient that no other patients have ever refused to walk. d. Tell the patient she is lucky she did not have an open nephrectomy.
b. Encourage even a short walk to avoid complications of surgery.
A nurse is admitting a patient with advanced renal carcinoma. Which clinical manifestations represent the "classic triad" observed in patients with renal cancer? a. Fever, chills, and flank pain b. Hematuria, flank pain, and palpable mass c. Hematuria, proteinuria, and palpable mass d. Flank pain, palpable abdominal mass, and proteinuria
b. Hematuria, flank pain, and palpable mass
Diffusion, osmosis, and ultrafiltration occur in both hemodialysis and peritoneal dialysis. Which strategy is used to achieve ultrafiltration in peritoneal dialysis? a. Increasing the pressure gradient b. Increasing osmolality of the dialysate c. Decreasing the glucose in the dialysate d. Decreasing the concentration of the dialysate
b. Increasing osmolality of the dialysate
The nurse is caring for a 68-yr-old man who had coronary artery bypass surgery 3 weeks ago. During the oliguric phase of acute kidney disease, which action would be appropriate to include in the plan of care? a. Provide foods high in potassium. b. Restrict fluids based on urine output. c. Monitor output from peritoneal dialysis. d. Offer high-protein snacks between meals.
b. Restrict fluids based on urine output.
Which nursing intervention is most appropriate in providing care for an adult patient with newly diagnosed adult onset polycystic kidney disease (PKD)? a. Help the patient cope with the rapid progression of the disease. b. Suggest genetic counseling resources for the children of the patient. c. Expect the patient to have polyuria and poor concentration ability of the kidneys. d. Implement appropriate measures for the patient's deafness and blindness in addition to the renal problems.
b. Suggest genetic counseling resources for the children of the patient.
The nurse is performing an assessment for a patient and preparing to palpate the kidneys. How should the nurse position the patient for this assessment? a. Prone b. Supine c. Seated at the edge of the bed d. Standing, facing away from the nurse
b. Supine
The nurse is caring for a patient with a nephrostomy tube. The tube has stopped draining. After receiving orders, what should the nurse do? a. Keep the patient on bed rest. b. Use 5 mL of sterile saline to irrigate. c. Use 30 mL of water to gently irrigate. d. Have the patient turn from side to side.
b. Use 5 mL of sterile saline to irrigate.
The immunologic mechanisms involved in acute poststreptococal glomerulonephritis include a. tubular blocking by precipitates of bacteria and antibody reactions b. deposition of immune complexes and complement along the GBM c. thickening of the GBM from autoimmune microangiopathic changes d. destruction of glomeruli by proteolytic enzymes contained in the GBM
b. deposition of immune complexes and complement along the GBM
A patient with ureterolithotomy returns from surgery with a nephrostomy tube in place. Postoperative nursing care of the patient includes a. encouraging the patient to drink fruit juices and milk b. encouraging fluids of at least 2 to 3 L/day after nausea has subsided c. irrigating the nephrostomy tube with 10 mL of normal saline solution as needed d. notifying the physician if nephrostomy tube drainage is more than 30 mL/hr
b. encouraging fluids of at least 2 to 3 L/day after nausea has subsided
A patient with kidney disease has oliguria and a creatinine clearance of 40 mL/min. These findings most directly reflect abnormal function of a. tubular secretion b. glomerular filtration c. capillary permeability d. concentration of filtrate
b. glomerular filtration
The nurse is instructing a client with diabetes melitus about peritoneal dialysis. The nurse tells the client that it is important to maintain the prescribed dwell time for the dialysis because of the risk of which complication? a. peritonitis b. hyperglycemia c. hyperphosphatemia d. disequilibrium syndrome
b. hyperglycemia
A client with chronic kidney disease returns to the nursing unit following a hemodialysis treatment. On assessment, the nurse notes that the client's temperature is 38.5 C. Which nursing action is most appropriate? a. encourage fluid intake b. notify the health care provider c. continue to monitor vital signs d. monitor the site of the shunt for infection
b. notify the health care provider
The nurse identifies a risk factor for kidney and bladder cancer in a patient who relates a history of a. aspirin use b. tobacco use c. chronic alcohol use d. use of artificial sweeteners
b. tobacco use
The nurse teaches the female patient who has frequent UTIs that she should a. take tub baths with bubble bath b. urinate before and after sexual intercourse c. take prophylactic sulfonamides for the rest of her life d. restrict fluid intake to prevent the need for frequent voiding
b. urinate before and after sexual intercourse
The nurse prepares a patient for discharge after a cystoscopy. It is most important for the nurse to provide additional information in response to which patient statement? a. "I should drink plenty of fluids to prevent complications." b. "If my urine is cloudy, I should contact my health care provider." c. "Bright red bleeding is normal for a few days after the procedure." d. "Sitz baths and acetaminophen will help to reduce my discomfort."
c. "Bright red bleeding is normal for a few days after the procedure."
A patient informs the nurse that they are having burning on urination, dysuria, and frequency. What is the best response by the nurse? a. "Drink less fluid so you don't have to void so often." b. "Take some acetaminophen to decrease the discomfort." c. "Come in so we can check a clean-catch urine specimen." d. "Avoid caffeine and spicy food to decrease inflammation."
c. "Come in so we can check a clean-catch urine specimen."
An older male patient visits his primary care provider because of burning on urination and production of foul-smelling urine. What contributing factor should the health care provider consider? a. High-purine diet b. Sedentary lifestyle c. Benign prostatic hyperplasia (BPH) d. Recent use of broad-spectrum antibiotics
c. Benign prostatic hyperplasia (BPH)
A 56-yr-old woman with type 2 diabetes mellitus and chronic kidney disease has a serum potassium level of 6.8 mEq/L. Which finding will the nurse monitor for? a. Fatigue b. Hypoglycemia c. Cardiac dysrhythmias d. Elevated triglycerides
c. Cardiac dysrhythmias
A patient has scleroderma and hypertension. The nurse knows this could be related to which renal diagnoses? a. Obstructive uropathy b. Goodpasture syndrome c. Chronic glomerulonephritis d. Calcium oxalate urinary calculi
c. Chronic glomerulonephritis
The physician has decided to use renal replacement therapy to remove large volumes of fluid from a patient who is hemodynamically unstable in the intensive care unit. The nurse should expect which treatment to be used for this patient? a. Hemodialysis (HD) three times per week b. Automated peritoneal dialysis (APD) c. Continuous venovenous hemofiltration (CVVH) d. Continuous ambulatory peritoneal dialysis (CAPD)
c. Continuous venovenous hemofiltration (CVVH)
Which instruction should the nurse provide when teaching a patient to exercise the pelvic floor? a. Tighten both buttocks together. b. Squeeze thighs together tightly. c. Contract muscles around rectum. d. Lie on back and lift the legs together.
c. Contract muscles around rectum.
The nurse is caring for an older adult patient taking bumetanide. What age-related changes does the nurse inform the patient that may be experienced? a. Benign enlargement of prostatic tissues b. Decreased sensation of bladder capacity c. Decreased function of the loop of Henle d. Less absorption in the Bowman's capsule
c. Decreased function of the loop of Henle
A patient is recovering in the intensive care unit (ICU) 24 hours after receiving a kidney transplant. What is an expected assessment finding during the earliest stage of recovery? a. Hypokalemia b. Hyponatremia c. Large urine output d. Leukocytosis with cloudy urine output
c. Large urine output
When caring for a patient with nephrotic syndrome, which food selection indicates the patient understands dietary teaching? a. Peanut butter and crackers b. One small grilled pork chop c. Salad made of fresh vegetables d. Spaghetti with canned spaghetti sauce
c. Salad made of fresh vegetables
A nurse is caring for a patient with a history of chronic obstructive pulmonary disease (COPD) admitted for pneumonia. What laboratory finding would be consistent with decreased kidney function in this patient? a. Serum uric acid of 5.2 mg/dL b. Urine specific gravity of 1.040 c. Serum creatinine 2.3 of mg/dL d. Blood urea nitrogen (BUN) of 10 mg/dL
c. Serum creatinine 2.3 of mg/dL
Diminished ability to concentrate urine, associated with aging of the urinary system, is attributed to a. decrease in bladder sensory receptors b. a decrease in the number of functioning nephrons c. decreased function of the loop of Henle and tubules d. thickening of the basement membrane of Bowman's capsule
c. decreased function of the loop of Henle and tubules
The nurse is assessing a client with epididymitis. The nurse anticipates which findings on physical examination? a. fever, diarrhea, groin pain and ecchymosis b. nausea, painful scrotal edema, and ecchymosis c. fever, nausea, vomiting and painful scrotal edema d. diarrhea, groin pain, testicular torsion, and scrotal edema
c. fever, nausea, vomiting and painful scrotal edema
A diagnostic study that indicates renal blood flow, glomerular filtration, tubular function, and excretion is a (n) a. IVP b. VCUG c. renal scan d. loopogram
c. renal scan
A client arrives at the emergency department with complaints of low abdominal pain and hematuria. The client is afebrile. The nurse next assesses the client to determine a history of which condition? a. pyelnephritis b. glomerulonephritis c. trauma to the bladder or abdomen d. renal cancer in the client's family
c. trauma to the bladder or abdomen
A frail 72-yr-old woman with stage 3 chronic kidney disease is cared for at home by her family. The patient has a history of taking many over-the-counter medications. Which over-the-counter medications should the nurse teach the patient to avoid? a. Aspirin b. Acetaminophen c. Diphenhydramine d. Aluminum hydroxide
d. Aluminum hydroxide
A patient with a 25-year history of type 1 diabetes mellitus is reporting fatigue, edema, and an irregular heartbeat. On assessment, the nurse notes newly developed hypertension and uncontrolled blood sugars. Which diagnostic study is most indicative of chronic kidney disease (CKD)? a. Serum creatinine b. Serum potassium c. Microalbuminuria d. Calculated glomerular filtration rate (GFR)
d. Calculated glomerular filtration rate (GFR)
The nurse is providing care for a patient admitted to the hospital for treatment of nephrotic syndrome. What are the priority nursing assessments? a. Assessment of pain and level of consciousness b. Assessment of serum calcium and phosphorus levels c. Blood pressure and assessment for orthostatic hypotension d. Daily weights and measurement of the patient's abdominal girth
d. Daily weights and measurement of the patient's abdominal girth
Which patient diagnosis or treatment is most consistent with prerenal acute kidney injury (AKI)? a. IV tobramycin b. Incompatible blood transfusion c. Poststreptococcal glomerulonephritis d. Dissecting abdominal aortic aneurysm
d. Dissecting abdominal aortic aneurysm
A patient in the intensive care unit is receiving gentamicin for treatment of pneumonia from Pseudomonas aeruginosa. What assessment results should the nurse report to the health care provider? a. Decreased weight b. Increased appetite c. Increased urinary output d. Elevated creatinine level
d. Elevated creatinine level
A patient admitted to the emergency department after a motor vehicle accident. Which urinalysis findings would the nurse expect if kidney trauma occurred (select all that apply.)? a. Casts b. Glucose c. Bilirubin d. Myoglobinuria e. Red blood cells f. White blood cells
d. Myoglobinuria e. Red blood cells
The nurse is caring for a 73-yr-old male patient with a history of benign prostatic hyperplasia and symptoms of a urinary tract infection. Which diagnostic finding would support this diagnosis? a. White blood cell count is 7500 cells/μL. b. Antistreptolysin-O (ASO) titer is 106 Todd units/mL. c. Glucose, protein, and ketones are present in the urine. d. Nitrites and leukocyte esterase are present in the urine.
d. Nitrites and leukocyte esterase are present in the urine.
The nurse preparing to administer a dose of calcium acetate to a patient with chronic kidney disease (CKD). Which laboratory result will the nurse monitor to determine if the desired effect was achieved? a. Sodium b. Potassium c. Magnesium d. Phosphorus
d. Phosphorus
When caring for a patient during the oliguric phase of acute kidney injury (AKI), which nursing action is appropriate? a. Weigh patient three times weekly. b. Increase dietary sodium and potassium. c. Provide a low-protein, high-carbohydrate diet. d. Restrict fluids according to previous daily loss.
d. Restrict fluids according to previous daily loss.
When a patient reports acute, severe, renal colic pain in the lower abdomen, the nurse suspects that the patient is most likely to have an obstruction at which area? a. Kidney b. Urethra c. Bladder d. Ureterovesical junction
d. Ureterovesical junction
The nurse obtained a urine specimen from a patient. What result should the nurse recognize as an abnormal finding? a. pH of 6.0 b. Amber yellow color c. Specific gravity of 1.025 d. White blood cells (WBCs) 9/hpf
d. White blood cells (WBCs) 9/hpf
A client is admitted to the hospital with a diagnosis if benign prostatic hyperplasia, and a transurethral resection of the prostate is performed. Four hours after surgery, the nurse takes the client's vital signs and empties the urinary drainage bag. Which assessment finding indicates the need to notify the health care provider? a. red, bloody urine b. pain rated as 2 on a 0-10 scale c. urinary output of 200 mL higher than intake d. blood pressure 100/50 mm hg; pulse 130 beats/min
d. blood pressure 100/50 mm hg; pulse 130 beats/min
A renal stone in the pelvis of the kidney will alter the function of the kidney by interfering with the a. structural support of the kidney b. regulation of the concentration of urine c. entry and exit of blood vessels at the kidney d. collection and drainage of urine from the kidney
d. collection and drainage of urine from the kidney
The edema that occurs in nephrotic syndrome is due to a. increased hydrostatic pressure caused by sodium retention b. decreased aldosterone secretion from adrenal insufficiency c. increased fluid retention caused by decreased glomerular filtration d. decreased colloidal osmotic pressure caused by loss of serum albumin
d. decreased colloidal osmotic pressure caused by loss of serum albumin
The nurse is collecting data from a client. Which symptom described by the client is characteristic of an early symptom of benign prostatic hyperplasia? a. nocturia b. scrotal edema c. occasional constipation d. decreased force in the stream of urine
d. decreased force in the stream of urine
A patient has had a cystectomy and ileal conduit diversion performed. Four days postoperatively, mucous shreds are seen in the drainage bag. The nurse should a. notify the physician b. notify the charge nurse c. irrigate the drainage tube d. document it as a normal observation
d. document it as a normal observation
A male client has a tentative diagnosis of urethritis. The nurse should assess the client for which manifestation of the disorder? a. hematuria and pyuria b. dysuria and proteinuria c. hematuria and urgency d. dysuria and penile discharge
d. dysuria and penile discharge
The client newly diagnosed with chronic kidney disease recently has begun hemodialysis. Knowing that the client is at risk for disequilibrium syndrome, the nurse should assess the client during dialysis for which associated manifestations? a. hypertension, tachycardia, and fever b. hypotension, bradycardia, and hypothermia c. restlessness, irritability, and generalized weakness d. headache, deteriorating level of consciousness, and twitching
d. headache, deteriorating level of consciousness, and twitching
The nurse identifies a risk for urinary calculi in a patient who relates a past health history includes a. hyperaldosteronism b. serotonin deficiency c. adrenal insufficiency d. hyperparathyroidism
d. hyperparathyroidism
A week after kidney transplantation, a client develops a temperature of 101 F, the blood pressure is elevated, and there is tenderness over the transplanted kidney. The serum creatinine is rising and urine output is decreased. The x-ray indicates that the transplanted kidney is enlarged. Based on these assessment findings, the nurse anticipates which treatment? a. antibiotic therapy b. peritoneal dialysis c. removal of the transplanted kidney d. increased immunosuppression therapy
d. increased immunosuppression therapy
A client with sever back pain and hematuria is found to have hydronephrosis due to urolithiasis. The nurse anticipates which treatment will be done to relieve the obstruction? Select all that apply: a. peritoneal dialysis b. analysis of the urinary stone c. IV opioid analgesics d. insertion of a nephrostomy tube e. placement of a ureteral stent with ureteroscopy
d. insertion of a nephrostomy tube e. placement of a ureteral stent with ureteroscopy
The nurse is performing an assessment on a client who has returned from the dialysis unit following hemodialysis. The client is complaining of headache and nausea and is extremely restless. Which is the priority nursing action? a. monitor the client b. elevate the head of the bed c. assess the fistula site and dressing d. notify the health care provider
d. notify the health care provider
A hemodialysis client with a left arm fistula is at risk for arterial steal syndrome. The nurse should assess for which manifestations of this complication? a. warmth, redness, and pain in the left hand b. ecchymosis and audible bruit over the fistula c. edema and reddish discoloration of the left arm d. pallor, diminished pulse, and pain in the left hand
d. pallor, diminished pulse, and pain in the left hand
RIFLE defines three stage of AKI based on changes in: a. blood pressure and urine osmolality b. fractional excretion of urinary sodium c. estimation of GFR with MDRD equation d. serum creatinine or urine output from baseline
d. serum creatinine or urine output from baseline
On reading the urinalysis results of a dehydrated patient, the nurse would expect to find a. a pH of 8.4 b. RBCs of 4/hpf c. color: yellow, cloudy d. specific gravity of 1.035
d. specific gravity of 1.035
A client complains of fever, perineal pain, and urinary frequency, and dysuria. To assess whether the client's problem is related to bacterial prostatitis, the nurse reviews the results of the prostate examination for which characteristic of this disorder? a. soft and swollen prostate gland b. swollen, and boggy prostate gland c. tender and edematous prostate gland d. tender, indurated prostate gland that is warm to the touch
d. tender, indurated prostate gland that is warm to the touch
