patho exam 3

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An older male comes to the clinic with the chief report of having difficulty voiding. The physician diagnoses him with a lower urinary tract obstruction and stasis. What should the nurse suspect to be the most frequent cause of this client's problem? Gonorrhea Kidney infection Enlargement of prostate gland Bladder tumor

Enlargement of prostate gland

Most common uncomplicated urinary tract infections are caused by ____ that enter through the urethra.

Escherichia coli

Which of the following is the most common cause of lower uncomplicated urinary tract infections? H. pylori Helicobacter Proteus amoeba Escherichia coli

Escherichia coli

A nurse advises a client with recurring UTIs to drink large amounts of water. What normal protective action is the nurse telling the client to utilize? Decrease acidity of urine Increase immune availability Thin mucus to prevent bacterial adherence Increase washout of urine

Increase washout of urine

A client in renal failure has marked decrease in renal blood flow caused by hypovolemia, the result of gastrointestinal bleeding. The nurse is aware that this form of renal failure can be reversed if the bleeding is under control. Which form of acute renal injury does this client have? Postrenal failure Prerenal failure Chronic renal failure Intrarenal failure

Prerenal failure

A 35-year-old client is diagnosed with acute kidney injury (AKI) and is started on hemodialysis. The client is concerned with the diagnosis and wants to know what to expect in the progression of this disorder. Which statement best addresses the client's concern? "You will need to have a renal transplant to live a productive, healthy life." "Once your condition improves you can be placed on peritoneal dialysis for the rest of your life." "The occurrence of acute kidney injury will always eventually result in chronic renal failure." "Acute kidney injury is abrupt in onset and often reversible if recognized early and treated appropriately."

"Acute kidney injury is abrupt in onset and often reversible if recognized early and treated appropriately."

A neighbor is complaining to a friend (who happens to be a nurse) about several changes in her body. Which of the following complaints raises a "red flag" because it could be a sign of epithelial cell bladder cancer? "Sometimes I get a sharp pain in my side while exercising." "Every now and then, I have urine leak when I cough." "I noticed my urine is pinkish red, but I'm not having any pain when I pee." "Seems like I'm holding onto more water these days."

"I noticed my urine is pinkish red, but I'm not having any pain when I pee."

A client has undergone a kidney transplant and voices concerns about organ rejection to the nurse. The most appropriate response by the nurse would be: "Kidney transplantation is 100% successful, and there is no need for you to worry." "Your new kidney will continue to work fine as long as you do not drink any alcohol." "You will be given medication to decrease the likelihood of your immune system attacking your new kidney." "There is no need to worry about rejection because the occurrence of rejection is low with kidney transplant."

"You will be given medication to decrease the likelihood of your immune system attacking your new kidney."

A 34-year-old woman presents with an abrupt onset of shaking chills, moderate to high fever, and a constant ache in her lower back. She is also experiencing dysuria, urinary frequency, and a feeling of urgency. Her partner states that she has been very tired the last few days and that she looked like she may have the flu. What is the most likely diagnosis? Renal cell carcinoma Acute renal failure Acute pyelonephritis Renal calculi

Acute pyelonephritis

The nurse is caring for a client who has had acute blood loss from ruptured esophageal varices. What does the nurse recognize is an early sign of prerenal failure? Baseline heart rate of 100 bpm that has increased to 120 bpm Foul smelling, cloudy urine Baseline urine output of 50 mL/hr that is now 10 mL/hr Baseline blood pressure of 150/90 mm Hg that is now 130/80 mm Hg

Baseline urine output of 50 mL/hr that is now 10 mL/hr

A nurse is caring for a client with systemic lupus erythematosis (SLE). The client asks why a urinalysis is necessary. The best answer is that a urinalysis would determine whether which factor was present in the urine?

Blood or protein

A client with a history of chronic kidney disease (CKD) is experiencing increasing fatigue, lethargy, and activity intolerance. The care team has established that the client's glomerular filtration rate (GFR) remains at a low, but stable, level. Which laboratory assessments will most likely be prescirbed to help determine the cause of these new symptoms? Cystoscopy and ureteroscopy Assessment of pancreatic exocrine and endocrine function Blood work for white cells and differential Blood work for hemoglobin, red blood cells, and hematocrit

Blood work for hemoglobin, red blood cells, and hematocrit

The nurse caring for four male clients recognizes which client is at highest risk for developing postrenal kidney failure? Client with prostatic hyperplasia Client with severe hypovolemia Client with intratubular obstruction Client with acute pyelonephritis

Client with prostatic hyperplasia

A nurse is caring for a client who has a recent history of passing calcium urinary stones. Which of the following is a priority nursing consideration for this client?

Hydration

A nurse is assessing a client for early manifestations of chronic kidney disease (CKD). Which would the nurse expect the client to display? Asterixis Terry nails Hypertension Impotence

Hypertension

Unilateral obstruction of the urinary tract may result in renin secretion, thereby leading to which manifestation? Increased blood pressure Decreased sodium retention Decreased heart rate Increased urinary output

Increased blood pressure

A female client asks the nurse if there is any noninvasive treatment to help with the involuntary loss of urine that occurs when she coughs or sneezes. Which is the best response by the nurse? Kegel exercises Self-catheterization Periurethral injection of a bulking agent Implanted artificial sphincter

Kegel exercises

Vitamin D metabolism is deranged in clients with chronic kidney disease (CKD). The nurse recognizes that which statement regarding vitamin D is correct? Calcitriol blocks gastrointestinal absorption of calcium. Suppression of parathyroid hormone release is characteristic of CKD. Kidneys convert inactive vitamin D to its active form, calcitriol. Calcitriol stimulates release of parathyroid hormone (PTH).

Kidneys convert inactive vitamin D to its active form, calcitriol.

While assessing a peritoneal dialysis client in the home, the nurse notes that the fluid draining from the abdomen is cloudy, is white in color, and contains a strong odor. The nurse suspects this client has developed a serious complication known as: Bowel perforation Bladder erosion Peritonitis Too much sugar in the dialysis solution

Peritonitis

The nurse reviews the lab results for a client who has advanced autosomal dominant polycystic kidney disease (ADPKD). The client 's hemoglobin is 8.8 g/dL (88 g/L). The nurse suspects this lab value is related to which cause? Low calcium levels Reduced production of erythropoietin Poor dietary intake of iron Hemorrhage

Reduced production of erythropoietin

A female teenager has experienced three uncomplicated urinary tract infections in the past 3 months. Which action should the nurse include in education for this teenager? Taking antimicrobials to treat Escherichia coli while forcing fluids Washing hands prior to inserting a tampon to minimize the risk of group B Streptococcus Wearing gloves when wiping perineum after defecation to prevent Staphylococcus aureus infection Proper handwashing to decrease amount of Pseudomonas growing on the hands

Taking antimicrobials to treat Escherichia coli while forcing fluids

Which client should have a feeling of bladder fullness? The client with 200 mL of urine in the bladder The client with 25 mL of urine in the bladder The client who is incontinent The client who has neuropathy

The client with 200 mL of urine in the bladder

A nurse observes that a client's urine is cola colored and considers which factor as a possible reason? The client's urine contains material from the degradation of red blood cells. The client has an elevation of urine potassium. The client has ingested a dark-colored drink. The client's urine has a decrease in the specific gravity.

The client's urine contains material from the degradation of red blood cells.

A client with chronic kidney disease (CKD) will be managed with peritoneal dialysis. Which description of this type of dialysis is most accurate? The dialyzer is usually a hollow cylinder composed of bundles of capillary tubes. Treatment involves the introduction into the peritoneum of a sterile dialyzing solution, which is drained after a specified time. Vascular access is achieved through an internal arteriovenous fistula or an external arteriovenous shunt. Treatments typically occur three times each week for 3 to 4 hours.

Treatment involves the introduction into the peritoneum of a sterile dialyzing solution, which is drained after a specified time.

Bruising of the skin is a manifestation of bleeding disorders in patients with CKD. False True

True

An obese client with a history of gout and a sedentary lifestyle has been advised by the primary health care provider to avoid organ meats, certain fish, and other foods that are high in purines. The care provider is demonstrating an awareness of the client's susceptibility to which type of kidney stones? Cystine stones Uric acid stones Calcium stones Magnesium ammonium phosphate stones

Uric acid stones

A client is admitted with lower urinary tract obstruction and stasis. Which action is the primary intervention? Administration of intravenous fluids Urinary catheterization Laxative administration Increased oral fluids

Urinary catheterization

One of the most damaging effects of urinary obstruction on kidney structures is which effect? Concentrated urine Urinary stasis Renal hypertension Kidney hyperplasia

Urinary stasis

The primary care provider for a newly admitted hospital client has added the glomerular filtration rate (GFR) to the blood work scheduled for this morning. The client's GFR results return as 50 mL/minute/1.73 m2. The nurse explains to the client that this result represents: a need to increase water intake. that the kidneys are functioning normally. concentrated urine. a loss of over half the client's normal kidney function.

a loss of over half the client's normal kidney function.


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