FA Davis Renal Disorders- Chp. 22

A patient has polycystic kidney disease. The nurse correctly determines which of the following is the cause? 1. Bacterial infection 2. Autoimmune disorder 3. Genetic disorder 4. Too much calcium in the diet

3: PKD is a genetic disorder

A patient's chart shows blood urea nitrogen (BUN) is 22 mg/dL and creatinine is 2.0 mg/dL. The nurse is asked to report the BUN-to-creatinine level. What number does the nurse report? Enter numerals only.

11: The BUN to creatinine ration is calculated by dividing BUN levels by creatinine levels.

The urinalysis results of a patient in the end stage of chronic renal failure is likely to show which of the following? 1. Presence of WBC, RBC, and protein 2. Elevated Leukocyte esterase 3. Elevated ketones 4. Elevated nitrates

1: As glomerular damage increases, substances not normally passing the filter of the glomerulus will be able to pass through and appear in the urine.

For which of the following would antibiotics be appropriate as the primary treatment? Select all that apply. 1. Group A beta-hemolytic streptococci (GABHS) glomerulonephritis 2. Nephrotic syndrome 3. Pyelonephritis 4. Goodpasture's syndrome 5. Polycystic kidney disease

1: GABHS glomerulonephritis is a disorder caused by streptococcal bacteria 3: Pyelonephritis is an infection of the renal pelvis.

A patient wants to know how he can prevent future kidney stones. Which of the following is an appropriate recommendation? 1. Drink at least 3L per day 2. Take calcium supplements 3. Maintain current dietary choices 4. Take a daily prophylactic antibiotic

1: Increasing hydration can help to prevent stone formation.

A nurse is speaking to a patient with nephrotic syndrome. Which recommendations will be helpful for the patient? 1. Ingest a high protein diet (3-4 g/kg/day) 2. Ingest a low-sodium diet (less than 1500 g/day) 3. Encourage overhydration 4. Ingest a low-calorie/restrictive diet

2: A low-sodium diet is recommended for patients with nephrotic syndrome.

Which of the following would alert the clinician that the patient may have acute glomerulonephritis? Select all that apply. 1. Pain with urination 2. Protein in urine 3. Oliguria 4. Blood in urine 5. Fluid accumulation in renal pelvis

2: Glomerular damage can lead to protein in the urine 3: As GFR decreases, oliguria, which is a lack of sufficient urine production, develops. 4: As glomeruli are damaged, blood may appear in the urine.

For a confirmative diagnosis of Goodpasture's disease, the nurse anticipates which of the following? 1. Glomerular filtration rate (GFR) measurement decreases. 2. Positive immunoglobulin results 3. Intravenous pyelogram (IVP) shows obstruction 4. Urinalysis

2: Goodpasture's diseases is an autoimmune disease diagnosed by the presence of antibodies

A patient is diagnosed with nephrotic syndrome. Which of the following does the nurse expect to observe? 1. Decreased BUN 2. Fatty casts in urine 3. Absence of edema 4. Patient in severe pain due to stone formation

2: In nephrotic syndrome, casts may appear in the urine due to nephron damage.

A patient with chronic renal failure reports that he is feeling like his skin is "itching." What is an appropriate response by the nurse? 1. Suggest that the patient switch to a different cream or lotion. 2. Suggest that the patient switch laundry detergents. 3. Evaluate lab values to assess toxin levels in the blood. 4. Suggest the patient may be developing a sensitivity to the bed linen.

3: Buildup of toxins in the blood, which can occur with renal failure, may lead to a sensation of skin itching.

A nursing student suspects that a patient has a lower urinary tract infection (UTI). The nursing educator, however, believes that the patient may have pyelonephritis. Which of the following signs or symptoms did the nursing educator notice that may indicate pyelonephritis? 1. Presence of leukocyte esterase in the urinalysis results 2. Level of pain the patient is self-reporting 3. Presence of fever 4. Patient's past medical history

3: Fever may be present in pyelonephritis but is often not present in UTIs.

Which of the following findings may encourage a clinician to begin considering discussing the possibility of a need for a kidney transplant? 1. Damage to 50% of the nephrons 2. Presence of periorbital edema 3. GFR less than 12mL/min 4. Protein in urine

3: GFR should be above 90 mL/min for normal renal function. This value shows highly compromised renal function.

A nurse is treating a patient with kidney dysfunction. She notices that serum albumin levels are 2.8 g/dl. Which of the following is the appropriate interpretation by the nurse? 1. Albumin levels are normal 2. Albumin levels are increased. GFR may be reduced 3. Albumin levels are decreased, due to loss in urine. 4. Albumin levels are unaffected by renal function; thus, this value is not helpful.

3: Normal serum albumin levels are around 3.5-5.4 mg/gL. Albumin can be lost in the urine with kidney damage.

A patient arrives in the emergency department complaining of a kidney stone. Which of the following is the appropriate nursing intervention? 1. Restrict all fluids 2. Withhold pain medications until the stone is passed 3. Strain urine 4. Offer sedative

3: Straining the urine is important so that the stone can be captured.

Plasmapheresis would be a treatment option for a patient with which of the following conditions? 1. AKI 2. ESRD 3. Pyelonephritis 4. Goodpasture's syndrome

4: Plasmapheresis would remove the antibodies that cause damage in Goodpasture's syndrome