Elimination

a child with a history of nephrotic syndrome has a pale, muddy appearance, has poor appetite, and reports unusual fatigue after school. which situation would the nurse suspect? 1. impending renal failure 2. excessive activity at school 3. development of a viral infection 4. non adherence to the medication protocol

1

which intervention would be included in the plan of care for a child with nephrotic syndrome? 1. providing meticulous skin care 2. restricting fluids to 4 oz (120 mL) each shift 3. offering a diet low in carbohydrates and protein 4. sending blood to the laboratory for typing and crossmatching

1

which is correct regarding the length of time a child with acute glomerulonephritis (AGN) will need bed rest? 1. no longer a necessary part of the treatment plan 2. limited to 72 hours after the start of antihypertensive therapy 3. required for 3 weeks and does not depend on the response to therapy 4. needed until the blood pressure decreases and the hematuria has lessened

1

which mechanism of action explains how aluminum hydroxide decreases serum phosphate? 1. binding with phosphorus in the intestine 2. promoting excretion of phosphorus 3. promoting excretion of excessive urinary phosphates 4. dissolving stones as they pass through the urinary tract

1

which rationale explains why insulin is prescribed for clients in acute renal failure? 1. it promotes transfer of potassium into cells to lower serum potassium levels 2. insulin is required because the alpha cells of the pancreas cease to function with renal failure 3. it is necessary to manage the elevated blood glucose levels that accompany renal failure 4. insulin reduces the accumulated toxins by lowering the metabolic rate

1

a child who nephrotic syndrome has been receiving prednisone for 1 week. which information in the child's record indicates to the nurse that the medication has been effective? select all that apply 1. weight loss 2. lower blood pH 3. decreased lethargy 4. increased urine output 5. decreased blood pressure

1, 3, 4

a client who has renal failure asks the true why anemia keeps recurring. with reason would the nurse explain to the client? 1. increase in blood pressure 2. decrease in erythropoietin 3. increase in serum phosphate levels 4. decrease in sodium concentration

2

a client with renal failure receives prescriptions for vitamin D and calcium supplements. the client asks the nurse, "why do I need to take these?" the nurse explains that, with renal failure, which condition exists? 1. a decrease in the inactive forms for vitamin D in the body 2. a decrease in the active metabolite of vitamin D in the body 3. an increase in the conversion of skin cholesterol into vitamin D 4. an increase in the vitamin D-associated intestinal absorption of calcium

2

what microorganism would the nurse suspect as the cause of acute glomerulonephritis? 1. haemophilus 2. streptococcus 3. pseudomonas 4. staphylococcus

2

when caring for a preschool child with nephrotic syndrome, which clinical manifestation would the nurse be able to detect when monitoring the blood pressure and pulse rate and quality? 1. heart failure 2. hypovolemia 3. pulmonary embolus 4. increased serum potassium

2

which abnormal finding would the nurse monitor for during the oliguric phase of acute kidney injury? 1. hypothermia 2. hyperkalemia 3. hypocalcemia 4. hypernatremia

2

which laboratory test provides evidence consistent with a client having renal impairment? select all that apply 1. serum albumin: 4.7 2. serum creatinine: 2.0 3. serum potassiumL 5.9 4. serum cholesterol: 120 5. blood urea nitrogen (BUN): 32

2, 3, 5

which nutrients would the nurse list as restricted for the child with the diagnosis of acute glomerulonephritis? select all that apply 1. fats 2. sodium 3. glucose 4. potassium 5. lipids

2, 4

which play activities are appropriate for a 6 yo child who is in the acute phase of nephrotic syndrome? select all that apply 1. hula hoop 2. video game s 3. large puzzles 4. stuffed animal 5. children's books

2, 5

when planning nursing care for a child with acute poststreptococcal glomerulonephritis, which would the nurse emphasize that the child and family must maintain? 1. a bland diet high in protein 2. bed rest lasting at least 4 weeks 3. isolation from children with infections 4. a daily intramuscular dose of penicillin

3

which assessment finding would the nurse recognize as indicating improvement in a 4 yo child being treated for nephrotic syndrome? 1. the child gains weight 2. urine output decreases 3. urine specific gravity decreases 4. the child's hemoglobin and hematocrit increase

3

which medication may be useful in managing hypertension in a child with acute glomerulonephritis? 1. digoxin 2. diazepam 3. captopril 4. phenytoin

3

which test result would the nurse anticipate in the laboratory reports of a client with a diagnosis of end-stage renal disease? 1. arterial pH of 7.5 2. hematocrit of 54%v 3. potassium of 6.3 4. creatinine of 1.2

3

a child is admitted to the pediatric unit with nephrotic syndrome. which measures would the nurse expect to include in the plan of care for this child? select all that apply 1. maintaining bed rest 2. administering antibiotics 3. providing symptomatic care 4. eliminating high-sodium foods 5. monitoring response to steroids

3, 4, 5

for which potential compilation would the nurse monitor a client receiving continuous ambulatory peritoneal dialysis for end-stage kidney disease? select all that apply 1. pruritus 2. oliguria 3. tachycardia 4. cloudy outflow 5. abdominal pain

3, 4, 5

which clinical manifestation indicates the need for immediate hemodialysis in a client with chronic kidney disease? 1. ascites 2. acidosis 3. hypertension 4. hyperkalemia

4

which statement by a client who has chronic kidney failure treated with continuous ambulatory peritoneal dialysis (CAPD) indicates understanding of the therapy? 1. "it provides continuous contact of dialyzer and blood to clear toxins by ultrafiltration" 2. "it exchanges and cleanses blood by correction of electrolytes and excretion of creatinine" 3. "it decreases the need for immobility because it clears toxins in short and intermittent periods" 4. "it uses the peritoneum as a semipermeable membrane to clear toxins by osmosis and diffusion"

4

a client with end-stage renal disease receiving hemodialysis has a prescribed diet restricting proteins, sodium, and potassium. which client statement incites understanding of provided dietary instructions? 1. "I should avoid using salt substitutes" 2. "I should exclude meat from my diet" 3. "I may not add seasoning to my food" 4. "I may eat low-sodium canned vegetables"

1

a postoperative client has 180 mL of urine in the urinary drainage bag from the past 8 hours. for which condition would the nurse monitor? 1. renal failure 2. liver cirrhosis 3. diabetes mellitus 4. rheumatoid arthritis

1

a school-aged child with acute glomerulonephritis has fluid intake restricted to the pervious day's output plus 40 mL. the child's output over the past 24 hours was 140 mL> from 3:00 PM to 11:00PM the child is to receive one-third of the total daily fluid permitted. how much fluid would the nurse provide for the evening intake? 1. 60 mL 2. 70 mL 3. 80 mL 4. 90 mL

1

an arterail blood gas report indicates the client's pH is 7.25, PCO2 is 35, and HCO3 is 20. which disturbance would the nurse identify based on these results? 1. metabolic acidosis 2. metabolic alkalosis 3. respiratory acidosis 4. respiratory alkalosis

1

which considerations would the nurse integrate into the postoperative plan of care of a client scheduled for an internal artiovenous fistula in one arm and placement of an external arteriovenous shunt in the other arm for hemodialysis? 1. the graft has a higher risk of hemorrhage, clotting, and infection than the fistula does 2. staff will obtain blood pressure readings from the arm with the fistula, but not the one with the shunt 3. administer intravenous (IV) fluids in the arm with the shunt, but not the one with the fistula 4. cover the fistula with a light dressing, and cover the shunt thoroughly with a heavy dressing

1

which food would the nurse encourage the client requiring hemodialysis to include in his or her dietary intake? 1. rice 2. potatoes 3. canned salmon 4. barbecued beef

1

which history statement would be expected when admitting a child with acute glomerulonephritis to the inpatient unit? 1. the child had a sore throat a few weeks ago 2. the child has just recovered form the measles 3. the child's father has a family history of urinary tract infections 4. the child's immunizations were administered at the start of school

1

which would the nurse plan to offer the parent of a child who was treated for acute glomerulonephritis in preparation for the discharge? 1. samples of no-salt-added diets for the child to continue at home 2. suggestions about activities to keep the child mobile for longer periods 3. instructions about when the child should return for a workup for a kidney transplant 4. phone numbers to reach the nurse on the unit so the parents may call if there are any questions

1

when receiving hemodialysis, the client may develop hyponatremia. which clinical findings related to the potential development of hyponatremia would the nurse monitor? select all that apply 1. diarrhea 2. seizure 3. Chvostek sign 4. cardiac dysrhythmias 5. increased temperature

1, 2

which statement would the nurse include in the preoperative teaching plan of a client who, after receiving hemodialysis for several years, has a kidney transplant scheduled? select all that apply 1. "the kidney may not function immediately" 2. "precautions are needed to prevent infection" 3. "a urinary catheter will be present postoperatively" 4. "immunosuppressive medications will be given preoperatively" 5. "the arteriovenous fistula will be used fro drawing blood specimens preoperatively"

1, 2, 3

which action would the nurse take before the client's scheduled hemodialysis treatment? 1. obtain the client's urine specimen to evaluate kidney function 2. weigh the client to establish a baseline for later comparison 3. administer medications that are scheduled to be given within the next hour 4. explain that the peritoneum serves as a semipermeable membrane to remove wastes

2

which clinical finding would the nurse anticipate when assessing a school-aged child with acute glomerulonephritis? 1. ketonuria 2. periorbital edema 3. increased appetite 4. decreased blood pressure

2

which dietary instruction would the nurse provide a client receiving continuous ambulatory peritoneal dialysis (CAPD) for chronic glomerulonephritis? 1. low-calorie foods 2. high-quality protein 3. increased fluid intake 4. foods rich in potassium

2

which nursing intervention would the nurse direct toward a child admitted for acute glomerulonephritis? 1. enforcing bed rest 2. promoting diuresis 3. encouraging fluids 4. removing dietary salt

2

which possible complication would the nurse be most concerned about when a client receiving hemodialysis has an external shunt for circulatory access? 1. infection 2. hemorrhage 3. skin breakdown 4. impaired circulation

2

which statement by the wife of a client receiving hemodialysis who undergoes surgery to create an arteriovenous fistula indicates that further teaching is required? 1. "I must touch the shunt several times a day to feel for the bruit" 2 "I have to take his blood pressure every day in the arm with the fistula" 3. "he will have to be vary careful at night not to lie on the arm with the fistula" 4. "we really should check the fistula every day for signs of redness and swelling"

2

which explanation for the client's behavior would be useful to consider in planning care for a client who has been on hemodialysis for 2 years, communicates in an angry, critical manner, and does not adhere to the prescribed medications and diet? 1. an attempt to punish the nursing staff 2. a constructive method of accepting reality 3. a defense against underlying depression and fear 4. an effort to maintain life and to live it as fully as possible

3

which nursing intervention would be important for the nurse to implement when caring for an adolescent child with acute glomerulonephritis (AGN)? 1. assess for dysuria 2. inspect for jaundice 3. monitor for hypertension 4. test vomitus for occult blood

3

which option would the nurse offer a client with acute glomerulonephritis who reports thirst? 1. ginger ale 2. milkshake 3. hard candy 4. cup of broth

3

which prescribed hemodialysis protocol would the nurse implement when a client with end-stage renal failure, beginning hemodialysis for the first time, reports nausea and a headache, and then appear to become confused? 1. administer an analgesic for the headache 2. administer an antiemetic for the nausea 3. decrease the rate of the hemodialysis exchange 4. discontinue the procedure immediately

3

which roommate would the nurse manager assign to a 4 yo boy who has been admitted to the pediatric unit with nephrotic syndrome? 1. 3 yo boy with impetigo 2. 2 yo boy with pneumonia 3. 5 yo boy with thalassemia 4. 4 yo girl with conjunctivitis

3

which finding is associated with nephrotic syndrome (NS) rather than acute glomerulonephritis (AGN)? select all that apply 1. lethargy 2. gross hematuria 3. generalized edema 4. massive proteinuria 5. unchanged blood pressure

3, 4, 5

a child in renal failure who has undergone creation of an arteriovenous fistula access begins hemodialysis three times a week. the nurse teaches the parent the specific care the child needs. which statement indicates that further teaching is necessary? 1. "I'll offer more drinks in warm weather" 2. "I should call the clinic if he vomits or has diarrhea" 3. "I'll check his pulse at the wrist on each arm every day" 4. "it OK to take his blood pressure on the arm with the fistula"

4

a child with a diagnosis of acute renal failure has additional blood drawn for laboratory testing. which serum level requires immediate intervention? 1. sodium 126 2. bilirubin 0.3 3. creatinine 1.3 4. potassium 6.1

4

a school-aged child is admitted with hypertensive acute glomerulonephritis. which medication would the nurse anticipate being prescribed initially in addition to hydralazine? 1. digoxin 2. alprazolam 3. phenytoin 4. furosemide

4

which change in laboratory values and/or intake and output would the nurse expect after corticosteroid therapy fora 4 yo child with nephrotic syndrome? 1. oliguria 2. increase in hematuria 3. decrease in glycosuria 4. decrease in proteinuria

4

which finding provides evidence that he intervention is effective after the nurse administers sodium polystyrene sulfonate to a client with chronic renal failure? 1. pruritus decreases 2. mental status improves 3. sodium decreases to 137 4. potassium decreases to 4.2

4

which information would the nurse include when answering a client's question about peritoneal dialysis? 1. the clinic performs hemodialysis and peritoneal dialysis at the same time 2. the ambulatory care clinic performs the peritoneal dialysis on a weekly basis 3. the peritoneal cavity retains about 1/4 L of dialysate between exchanges to filter the urea and creatinine 4. the dialysate maintains constant contact with the peritoneal membrane during the dwell time

4