Unit 6 patho

Accumulation of nitrogenous wastes such as urea in the circulatory system is an early sigh of chronic kidney disease (CKD). The nurse knows that normal levels of urea in blood are approximately:

20 mg/dL

The nurse is educating a client about renal disease. Which percentage of cardiac output perfuses the kidneys?

22%-25%

An older adult presents to the primary health care provider's office with a report of bladder leakage. Which assessment correlates with a diagnosis of stress incontinence?

Loss of small amounts of urine when laughing or sneezing

The health care provider has prescribed an aminoglycoside (gentamicin) for a client. The nurse is aware that the client is at risk for:

Nephrotoxic acute tubular necrosis

The nurse in the cardiac clinic is teaching a client about his antihypertensive medications when he mentions he has strained his back and is taking over-the-counter ibuprofen for relief. Which information does the nurse need to relate to this client?

Non steroidal anti-inflammatory drugs cause fluid retention and should be avoided in those with hypertension.

One of the jobs the liver performs is to export triglyceride. When the liver's capacity to export triglyceride is exceeded, excess fatty acids accumulate in the liver. To what disease do these excess fatty acids contribute?

Nonalcoholic fatty liver disease

A nurse documents that the client has "steatorrhea." What did the nurse most likely assess?

fatty stool

Which option identifies the function of the kidneys in maintaining normal composition of internal body fluids?

filtration and reabsorption of physiologically essential substances

A client who is having problems with his bladder and kidneys is scheduled for a cystoscopy. He asks the nurse why he has to have the test. What would be the best response by the nurse?

"A cystoscopy enables direct visualization of the urethra, bladder, and ureteral orifices."

The nursing instructor who is teaching about disorders of the lower urinary tract realizes a need for further instruction when one of the students makes which statement?

"Alterations in bladder function can only occur when there is incontinence."

A client with a diagnosis of end-stage renal disease received a kidney transplant 2 years ago that was deemed a success. During the most recent follow-up appointment, the nurse should prioritize the client for referral based on which statement?

"I'm feeling a bit under the weather these days and I'm a bit feverish."

Following a health promotion class, which statement by a participant demonstrates an accurate understanding of the risk factors for bladder cancer?

"More than ever, I guess it would be worthwhile for me to quit smoking."

A client in the hospital is frustrated at the inconvenience of having to collect his urine for an entire day and night as part of an ordered 24-hour urine-collection test. The client asks the nurse why the test is necessary since the client provided a single urine sample 2 days prior. How could the nurse best respond?

"Often when an abnormal substance shows up in a urine test, a 24-hour urine collection is needed to determine exactly how much is present in your urine."

In anatomy class, the instructor asks, "Explain how urine is expelled from the bladder during voiding." Which student has given the most accurate response?

"The detrusor muscle contracts down on the urine and the ureteral orifices are forced shut. The external sphincter relaxes as urine moves out of the bladder."

A nurse is teaching a client scheduled for a cystoscopy about the procedure. Which statement made by the client verifies that the teaching has been successful?

"The doctor will insert a lighted tube through my urethra into my bladder in order to inspect the inside of the bladder."

With the increased risk of drug toxicity among chronically ill older adults, which statement by the nurse explains why the older adult's kidney is vulnerable to toxic injury?

"The kidney is rich in blood supply and can concentrate toxins in high levels in the medullary portion of the kidney."

A client has a postvoid residual (PVR) volume of 40 mL. Which information would the nurse teach the client?

"This is a normal value."

The nurse is teaching a group of nursing students about the formation of urine in the nephron. Which component does the nurse teach is a component of the nephron? Select all that apply.

- distal convoluted tubule -loop of henle -proximal convoluted tubule -collecting tubule

Several clients in clinic today are reporting urinary signs/symptoms. Which reported manifestation(s) leads the health care provider to suspect acute pyelonephritis? Select all that apply.

- urinary urgency and frequency - abrupt onset of fever and chills - flank pain in the back

A client who is suspected of having acute renal failure would first be assessed by which blood tests? Select all that apply.

-Blood urea nitrogen -Creatinine

The nurse is instructing a client with neurogenic bladder to perform intermittent self-catheterization. What teaching points should the nurse include? Select all that apply.

-Scheduling catheterization for every 4 hours -Signs and symptoms of autonomic dysreflexia

When educating the public about hepatitis A, the nurse will stress which accurate teaching points? Select all that apply.

-The onset of symptoms include high fever, malaise, abdominal pain, and jaundice. -Persons working in various food industries like in a restaurant can pass on hepatitis A if they do not properly wash their hands after toilet. -Be careful if traveling to a foreign country since many countries do not require vaccination of their workers.

A nurse caring for a client with an intestinal obstruction anticipates which assessment findings? Select all that apply.

-abdominal pain -abdominal distension -vomiting

A client with CKD is being treated for hyperphosphatemia and hypocalcemia. Select the most appropriate interventions. Select all that apply.

-activated vitamin D -phosphate-binding antacids -restriction of foods high in phosphate

What percentage of stool is water?

75%

Urine is an amber, light-yellow fluid that is 5% dissolved solid. What percent of it is water?

95%

What is considered the normal amount of serum bilirubin found in the blood?

<1.5 mg/dL

Select the client at greatest risk for developing colorectal cancer.

A 64-year-old female whose mother had colorectal cancer

A geriatric nurse is caring for several clients. Which alterations in health should the nurse attribute to age-related physiologic changes?

A 78-year-old woman's GFR has been steadily declining over several years.

Which client is likely at the greatest risk of developing a urinary tract infection?

A 79-year-old client with an indwelling catheter

Which individual most likely faces the greatest risk of developing Clostridium difficile colitis?

A 79-year-old hospital patient who is being treated with broad-spectrum antibiotics

Which client is most likely to develop hepatocellular cancer?

A client who has been diagnosed with metastatic breast cancer

Which factor is most strongly associated with the pathogenesis of gallstone formation?

Abnormalities or stasis of bile

A client has begun to display manifestations of hepatic encephalopathy. The family is concerned and asks the nurse what caused this condition to develop. Which is the bestresponse by the nurse?

Accumulation of ammonia in the blood

A client with multiple pain-related injuries to the back, knees, and hips is admitted with acute liver failure. Upon procuring a medication list, the nurse notes that the client is taking several over-the-counter medications that contain a preparation known to be the drug that most commonly causes liver failure. Which drug is this?

Acetaminophen

A child is recovering from a bout with group A beta-hemolytic Streptococcus infection. The child returns to the clinic a week later complaining of decrease in urine output with puffiness and edema noted in the face and hands. The health care provider suspects the child has developed:

Acute postinfectious glomerulonephritis

A child has been brought to an urgent care clinic. The parents state that the child is "not making water." When taking a history, the nurse learns the child had a sore throat about 1 week ago but seems to have gotten over it. "We [parents] only had to give antibiotics for 3 days for the throat to be better." The nurse should suspect the child has developed:

Acute postinfectious glomerulonephritis.

A warehouse worker is experiencing trouble with incontinence, especially when lifting heavy objects. What intervention is most appropriate for this client's needs?

Administration of alpha-adrenergic agonist drugs as ordered

Chronic kidney disease impacts many systems in the body. What is the most common hematologic disorder caused by CKD?

Anemia

A client has been diagnosed with chronic kidney disease (CKD). Which drug category is usually administered to treat coexisting conditions that manifest early in CKD?

Antihypertensive medications

A nurse is reviewing the admission assessment data of a client diagnosed with acute gastritis. The nurse determines that the condition most likely occurred as a result of:

Arthritis treated with high levels of nonsteroidal anti-inflammatory (NSAIDs) agents

When providing care for the client with pancreatic cancer, the nurse should observe for which of these complications?

Deep vein thrombosis

The nurse suspects that a newborn infant who presents with bilateral flank masses, impaired lung development, and oliguria may be suffering from which disorder?

Autosomal recessive polycystic kidney disease (ARPKD)

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 prescribed to help determine the cause of these new symptoms?

Blood work for hemoglobin, red blood cells, and hematocrit

A client presents with epigastric pain, a mild fever, nausea, and vomiting. His history shows a previous episode with similar symptoms that reverted in 24 hours. This time the pain is not subsiding. What diagnosis is the most likely?

Calculous cholecystitis

Which statement is true concerning the digestion of carbohydrates?

Carbohydrates are broken down into monosaccharides before being absorbed.

A client is concerned about the possibility of having bladder cancer after his brother was diagnosed with it 2 years ago. Which assessment data obtained by the nurse would indicate that the client should be screened for this disease?

Client reports that he occasionally has blood in his urine but has no pain with it

The nurse is assigned multiple clients with anemia. Which client may be experiencing a failure of the body to produce erythropoietin and thus may require supplemental injections of this hormone?

Client with history of chronic kidney failure

The incidence of stomach cancer has significantly decreased in the United States, yet it remains the leading cause of death worldwide. The nurse understands the reason for the high mortality rate in stomach cancer is because of which reason?

Clients have few early symptoms of the disease.

A client has been diagnosed with a defect in the plyoric sphincter. How will the nurse explain the likely consequence of a dysfunctional pyloric sphincter?

Contents from the small intestine may flow back into the stomach.

A client with a history of chronic pyelonephritis has been admitted several times with recurrent bacterial infection of the urinary tract. The nurse should anticipate educating this client with regard to which common treatment regimen?

Continue taking antibiotics for 10 to 14 days even if symptoms of infection disappear.

A 24-year-old woman undergoing a screening test is found to have elevated levels of AST, ALT, and IgG, but no antibody-specific markers for viral hepatitis. A liver biopsy reveals inflammation and cellular damage. Which treatment is most likely to be effective for her?

Corticosteroids and immunosuppressant drugs

A nurse is evaluating a client's morning laboratory values. Which result requires that the nurse notify the health care provider?

Creatinine: 10.6 mg/dL (937.04 µmol/L)

A nurse reading a sigmoidoscopy report notes that a client was found to have skip lesions. The nurse interprets this as an indication of:

Crohn disease

A nursing instructor who is teaching students about urinary incontinence in older adults suggests that an easy and effective way to remember the transient and treatable causes of urinary incontinence is to use which acronym?

DIAPPERS

A nurse is concerned about a client's continual use of nonsteroidal anti-inflammatory drugs (NSAIDs). Which problematic occurrence is the nurse concerned about?

Damage to the gastric mucosa

As chronic kidney disease progresses, the second stage (renal insufficiency) is identified by:

Decrease in GFR of 60 to 89 mL/minute/1.73 m2

Which occurrence is most likely to cause increased urination?

Decrease in antidiuretic hormone

The nurse is caring for a client with liver disease who has edema throughout the body. When reviewing the medical record, the nurse recognizes that which altered diagnostic test is consistent with development of edema?

Decreased albumin

A new client presents with elevated BUN, systemic edema, a BP of 145/93 mm Hg, recurrent infections, and a GFR of 51 mL/min/1.73 m2. Which treatment should the nurse anticipate?

Dialysis

A client who has been taking acetaminophen 1000 mg every 4 hours presents to the Urgent Care Center with increased abdominal pain, elevated ALT, AST, and bilirubin levels. The nurse suspects the client is experiencing:

Direct hepatotoxic reaction

A client is beginning to recover from acute tubular necrosis. During which phase of acute kidney injury will the nurse assess an increase in urine output?

Diuretic phase

A client with chronic kidney disease (CKD) has developed asterixis. The nurse knows that asterixis is:

Dorsiflexion of hands and feet

The nurse is caring for a client with recurring urinary tract infections (UTIs). The client asks, "Other than taking antibiotics, what else can I do?" Which response by the nurse is mostaccurate?

Drink lots of fluids to help relieve the signs/symptoms of UTIs.

A client is being treated for chronic kidney disease (CKD). One of the nurse's responsibilities is to explain to the client the need to keep her blood pressure under control. Why is blood pressure control so important in CKD clients?

Elevated blood pressure will exacerbate nephron loss and accelerate renal failure.

Which laboratory findings would the nurse anticipate in a client diagnosed with nephritic syndrome?

Elevated urine protein level (>3.5 g/day) and hypoalbuminemia

A client is admitted with chronic gastritis. The nurse expects which invasive test to be performed to establish the presence of Helicobacter pylori (H. pylori)?

Endoscopic biopsy

A teenager has been diagnosed with failure to thrive possibly due to malabsorption syndrome. In addition to having diarrhea and bloating, the client more than likely has what hallmark manifestation of malabsorption?

Fatty, yellow-gray, foul-smelling stools

A teenager who has a history of achalasia will likely complain of which clinical manifestation?

Feeling like there is food stuck in the back of the throat

In clients with acute diarrhea, many require no treatment. However, the nurse knows the priority assessment in all clients with diarrhea is:

Fluid and electrolyte status

A client is experiencing reflux of stomach contents into the esophagus. The nurse determines that the problem may result from:

Gastroesophageal sphincter

The health care provider is reviewing laboratory results of a client. Select the diagnostic test that is considered the best measurement of overall kidney function.

Glomerular filtration rate (GFR)

In older adults, why do serum creatinine levels have important implications?

Glomerular filtration rate (GFR) decreases without an increase in serum creatinine levels as a person ages.

Acute postinfectious glomerulonephritis, as its name implies, follows an acute infection somewhere else in the body. What is the most common cause of acute postinfectious glomerulonephritis?

Group A Β-hemolytic streptococci

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?

Increase washout of urine.

A client is diagnosed with Crohn disease. The nurse instructs the client on which type of dietary needs?

High-calorie, vitamin, and protein diet

The nurse is caring for a client with right upper quadrant pain secondary to acute choledocholithiasis. If the common bile duct becomes obstructed, which manifestation will the nurse expect?

Hyperbilirubinemia

The nurse is caring for the client with pancreatic cancer. The nurse monitors the client for which complication?

Hyperglycemia due to inability to synthesize insulin

The nurse is reviewing laboratory results of a client who has liver failure. Which finding would place the client at increased risk for bleeding?

Increased prothrombin time

A client is to receive a radiocontrast media as part of a diagnostic scan. Which intervention is intended to reduce the nephrotoxic effects of the radiocontrast media?

Increasing the normal saline intravenous infusion rate prior to the exam

A client presents for follow-up with ongoing treatment for peptic ulcer disease. What is the most likely goal of this client's pharmacologic treatment?

Inhibiting gastric acid production

The client reports something "wrong" with his gallbladder. Which manifestation does the nurse recognize that supports the client's concern?

Intolerance to greasy food; burping

Which substance necessary for vitamin B12 absorption is produced by the parietal cells in the stomach?

Intrinsic factor

A 67-year-old retired textile worker has developed bladder cancer. His history shows that he smoked for 25 years and is 30.8 lb (14 kg) overweight. What conclusion can the nurse best draw about the etiology and pathophysiology of his bladder cancer?

It is caused by carcinogens that are excreted in the urine and stored in the bladder.

A client is prescribed erythromycin for an infection. What manifestations will the nurse recognize that indicate the onset of drug-induced cholestasis?

Jaundice and pruritus

Colonic microorganisms play a role in the synthesis of which vitamin?

K

Vitamin D metabolism is deranged in clients with chronic kidney disease (CKD). The nurse recognizes that which statement regarding vitamin D is correct?

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

The acute care unit has had an increase in Gram-negative septicemia over the last 6 months. Which of the following would the infection care nurse know might require clinical focus of the most common cause of these types of infections?

Knowledge of aseptic technique when inserting urethral catheters

Wilms tumor is a tumor of childhood. It is usually an encapsulated mass occurring in any part of the kidney. What are the common presenting signs of a Wilms tumor?

Large asymptomatic abdominal mass and hypertension

When caring for the client with portal hypertension and ascites, which dietary intervention does the nurse suggest to prevent the progression of fluid accumulation?

Limit intake of sodium.

A client has a marked decrease in the glomerular filtration rate (GFR); lab values with high blood urea nitrogen (BUN), potassium, and creatinine levels; urine output less than 10 mL/hr; 3+ pitting edema in the lower extremities; and BP 170/95. Which phase of acute tubular necrosis (ATN) does the nurse identify the client is in based on assessment data?

Maintenance phase

A nurse is assessing an older adult with reports of constipation, for which the client often takes over-the-counter medications. What assessment should the nurse perform to address the etiology of the client's problem?

Medication regimen for drugs like anticolinergic agents or calcium

A nurse is explaining the clinical manifestations of diabetic nephropathy (diabetic glomerulosclerosis) to a client. Which statement would be the most important information for the nurse to provide?

Microalbuminuria is a predictor of future nephropathies.

A nurse is teaching a client about the difference between digestion and absorption. Which action should the nurse describe as absorption?

Moving nutrients from the external environment of the GI tract into the internal environment

When assessing a client with acute cholecystitis, the nurse anticipates the client's report of pain will be consistent with which description?

Pain in the right upper quadrant referred to the same shoulder

Peptic ulcers can affect one or all layers of the stomach or duodenum. Ulcers that penetrate through the muscularis layer are classified as which type of ulcer?

Perforation

Which layer of the digestive tract constitutes the outer wall of the intestine and contains a serous fluid between its two layers?

Peritoneum

A client is admitted with an abrupt onset of referred pain to the epigastric area, with an episode of nausea. On the nurse's initial assessment, the client is lying still and taking shallow breaths, with a rigid abdomen. Which problem is the client experiencing?

Peritonitis

When teaching a group of nursing students about the liver, the nurse relates that Kupffer cells function to remove harmful substances or cells from the portal blood and venous sinusoids through which process?

Phagocytosis

A client diagnosed with Goodpasture syndrome would require which therapy to remove proteins and autoantibodies from the system?

Plasmapheresis

Which substance would not be found in glomerular filtrate?

Protein

Which assessment finding would lead the nurse to suspect the client has developed nephrotic syndrome?

Proteinuria and generalized edema

The nurse recognizes that acute renal injury is characterized by which of the following?

Rapid decline in renal function

A client is suspected of having the onset of alcoholic liver disease. The nurse should be assessing for which manifestation related to the necrosis of liver cells?

Rapid onset of jaundice

The GFR is considered to be the best measure of renal function. What is used to estimate the GFR?

Serum creatinine

The nurse is caring for a client with Addison disease who has an absence of aldosterone. When reviewing the client's diagnostic test results, which consequence of low aldosterone levels does the nurse anticipate?

Serum potassium of 7.3 mEq/L (7.3 mmol/L)

Which meal choice is most likely to exacerbate an individual's celiac disease?

Spaghetti with meatballs and garlic bread

A client with a gastrointestinal disorder is having the number and quality of stool monitored by the nursing staff. The nurse notes an abnormal amount of fatty substances in the stool sample. Which term should the nurse use when documenting this assessment finding in the medical record?

Steatorrhea

Gastrin production, a task that is performed by the stomach, results in which effect?

Stimulation of gastric acid secretion by parietal cells

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

A client has experienced severe hemorrhage and is in prerenal failure. The nurse anticipates the client's blood urea nitrogen (BUN) and serum creatinine laboratory results will be in which range?

The BUN-to-creatinine ratio is 20:1.

An older adult client with an upper respiratory infection for several weeks has presented with urinary retention. The client reports taking nonprescription cold medications over and above the suggested dose. Which medication most likely is contributing to this urinary retention?

The anticholinergic effects of the medication are impairing normal bladder function.

An older adult states that he awakens at least three times each night to void. When assessing the client, what potential causative factor should the nurse prioritize?

The client takes his prescribed beta-blocker and diuretic each evening at bedtime.

A client with a systemic infection has been given strong doses of broad-spectrum antibiotics for a period of 10 days. The infection recedes and he is taken off the antibiotic therapy. Two days later he presents with a Clostridium difficile infection. How should the nurse best interpret this situation?

The client's antibiotics disrupted the microbial balance and allowed overgrowth.

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.

A busy 45-year-old female executive has been diagnosed with diverticulitis. Her primary treatment is an increase in the fiber content of her diet. What effect will the fiber have on the diverticula?

The fiber increases bulk, promotes regular defecation, and increases colonic contents and colon diameter, thereby decreasing intraluminal pressure.

Which function of the kidneys helps to maintain the pH balance in the body?

The kidneys conserve base bicarbonate and eliminate hydrogen ions.

When discussing digestion with a group of nursing students, the instructor asks, "Where does the digestion of our food begin?" The most accurate student response would be:

The mouth, with ptyalin and amylase breaking down starches

Urinary obstruction in the lower urinary tract triggers changes to the urinary system to compensate for the obstruction. What is an early change the system makes in its effort to cope with an obstruction?

The stretch receptors in the bladder wall become hypersensitive

Which statement is true concerning gastric enterocytes?

They secrete enzymes that aid in digestion of proteins.

Which colon section forms the left colic (splenic) flexure?

Transverse

A client with chronic kidney disease (CKD) will be managed with peritoneal dialysis. Which description of this type of dialysis is most accurate?

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

Which signs and symptoms are most suggestive of acute cholecystitis?

Upper right quadrant or epigastric pain

A client tells the nurse that he is experiencing involuntary loss of urine associated with a strong desire to void (urgency). The nurse would recognize this as:

Urge incontinence

The nurse understands that medications, although very beneficial to clients, can have harmful effects. When working with older adult clients the nurse should recognize that which outcome is a common result of potent, fast-acting diuretics?

Urge incontinence

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?

Uric acid stones

A client has a routine urine sample during an annual checkup. Which result is an expected finding in a healthy individual?

Urine specific gravity of 1.020

The nurse administers the drug vasopressin to a client with a pituitary disorder. Based on knowledge of pathophysiology, the nurse anticipates the client will react in which way?

Water will be retained and decreased urine output will result.

Which clinical manifestations would tell a nurse that a client is having progressive decompensation related to obstruction of urinary outflow?

When tested for residual urine volume, 1400 mL of urine is obtained when client is catheterized.

Select the option that best describes the sensory process involved in the inhibition of micturition.

When the bladder is distended to 150 to 250 mL in the adult, the sensation of fullness is transmitted to the spinal cord and then to the cerebral cortex, allowing for conscious inhibition of the micturition reflex.

An instructor is assisting a nursing student with inserting an indwelling catheter for a client with urinary retention and acute overdistention of the bladder. The student inserts the catheter and gets an immediate return of clear yellow urine. When should the student clamp the catheter?

When the client returns 1000 mL of urine from the bladder at once

When assessing the client during the icteric phase of viral hepatitis, which of these findings does the nurse anticipate observing?

Yellow-tinged sclera

A client who suffers from spastic bladder has been catheterized to promote bladder emptying. Which medication should the nurse plan on the physician ordering to also treat this problem?

anticholinergic medication

Which type of pharmacologic therapy does the nurse anticipate administering to a client for treatment of a spastic bladder in order to decrease bladder hyperactivity?

anticholingeric medications

It is known that high levels of uric acid in the blood can cause gout, while high levels in the urine can cause kidney stones. What medication competes with uric acid for secretion into the tubular fluid, thereby reducing uric acid secretion?

aspirin

Which substance released by atrial muscle cells will inhibit sodium and water reabsorption?

atrial natriuretic peptide (ANP)

Which enzymes adhere to the border of the villus structures to allow access to carbohydrate and protein molecules?

brush border

A client is experiencing an increase in urinary output. Which physiologic response by the body is responsible for how the kidney concentrates urine?

decrease in antidiuretic hormone

A client's most recent blood work reveals a blood urea nitrogen (BUN) level of 36 mg/dL (12.85 mmol/L). Which factor may have contributed to this finding?

dehydration

Disruption of which muscle's contraction can lead to the inability to expel urine from the bladder?

detrusor

While studying about the process of urination, the nursing student learns that which muscle is known as the "muscle of micturition"?

detrusor muscle

A client who is diagnosed with Zollinger-Ellison syndrome will exhibit which symptoms?

diarrhea with fat deposits

Urine specific gravity is normally 1.010 to 1.025 with adequate hydration. When there is loss of renal concentrating ability due to impaired renal function, low concentration levels are exhibited. When would the nurse consider the low levels of concentration to be significant?

first void in morning

A nurse is teaching a client diagnosed with Crohn disease about potential complications. The most appropriate information for the nurse to include would be:

fistula formation

In the emergency department, a client arrives following a car accident. His pulse is 122; BP 88/60; respiration is 18 bpm. Urine output is 4 mL over the first hour on arrival. When in shock, this lower urine output is primarily due to:

innervation of the sympathetic nervous system, causing constriction of the afferent arteriole

A client sustained acute tubular injury approximately 2 hours ago. Which cause of acute kidney injury (AKI) would the nurse suspect the client is experiencing?

intrarenal

The dietitian explains to the client that food is digested and absorbed in the:

jejunum

The nurse is providing dietary instruction for a client with chronic kidney disease (CKD) who is on hemodialysis. Which food would the nurse encourage the client to restrict?

lean meats

The nurse recognizes that antidiuretic hormone (ADH) exerts its effects in which location?

loop of henle

If a client is in the early phases of nephrotic syndrome, which area of the body will likely have the initial presence of edema?

lower extremities

A 45-year-old female is being treated for ovarian cancer. Her treatment involves the chemotherapy agent cisplatin. The nurse should monitor the client for signs and symptoms of:

nephrotoxic acute tubular necrosis (ATN).

A client with a history of peptic ulcer disease presents to the emergency department with the following symptoms: early satiety, feeling of epigastric fullness and heaviness after meals, weight loss, and vomiting. The nurse suspects that the peptic ulcer has caused which problem?

obstruction

A client asks the nurse what the most common sign/symptom of bladder cancer is. Which is the best response by the nurse?

painless hematuria

A client is not able to absorb vitamin B12. The nurse determines that the client is deficient in:

parietal (oxyntic) cells, which secrete HCl and intrinsic factor.

The anemia that occurs with end-stage kidney disease is often caused by the kidneys themselves. What loss of function in the kidney results in anemia of end-stage kidney disease?

produce erythropoietin

The nurse is teaching a group of nursing students about the physiologic consequences of hypotension and reduced perfusion to the kidney. Which compensatory mechanism occurs immediately after renin release from the kidney?

production of angiotensin I

When teaching a client about chronic pancreatitis, which of these does the nurse relate is the long term result of this condition?

progressive destruction of the organ

What is the most common cancer of the kidney?

renal cell carcinoma

An 86-year-old female client has been admitted to the hospital for the treatment of dehydration and hyponatremia after she curtailed her fluid intake to minimize urinary incontinence. The client's admitting laboratory results are suggestive of prerenal failure. The nurse should be assessing this client for which early sign of prerenal injury?

sharp decrease in urine output

Inflammatory bowel disease (IBD) is used to designate two related inflammatory intestinal disorders: Crohn disease and ulcerative colitis. The nurse recognizes the difference between the distribution pattern between Crohn disease and ulcerative colitis. Which pattern describes Crohn's disease?

skip lesions

A client is admitted to the hospital for further evaluation of problems experienced with gastrointestinal digestion and absorption. The nurse anticipates the health care provider will further assess the:

small intestine

Villi are anatomic features that contribute to the enlarged surface area of the:

small intestine

A nurse is caring for a client who has just experienced a spinal cord injury. Which bladder dysfunctions will the client likely experience during the early stage of injury?

the bladder becomes atonic

A client with end-stage kidney disease has developed anemia. The nurse teach this client that the reason anemia has developed is:

the damaged kidney is unable to produce erythropoietin.

Where in the GI tract is food digested and absorbed?

the jejunum and the ileum

Which diuretic acts by preventing sodium chloride reabsorption in the distal convoluted tubule?

thiazide diuretics

A client is admitted with lower urinary tract obstruction and stasis. Which action is the primary intervention?

urinary catheterization

One of the most damaging effects of urinary obstruction on kidney structures is which effect?

urinary stasis

The body uses common physiologic responses that are common to gastrointestinal (GI) disorders. A nurse would expect to see which physiologic response known to be protective by removing noxious agents from the body?

vomiting

Prior to undergoing diagnostic testing with contrast, it is recommended that older adult clients have their creatinine level checked. The rationale for this is to ensure the client:

will not undergo an acute kidney injury by decreasing renal blood flow.

What is the most common cause of a lower urinary tract infection?

e coli

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?

enlargement of prostate gland

When caring for the client with Laennec cirrhosis, the nurse recognizes which pathophysiologic finding to be an expected etiology of jaundice?

-Impaired uptake of bilirubin

The nursing instructor informs the students during a lecture that the control of the emptying functions of the bladder involves which portion of the nervous system? Select all that apply.

-Involuntary autonomic nervous system -Voluntary somatic nervous system

The gastrointestinal laboratory nurse is learning about small intestine secretions. Which explanation is most accurate?

"An extensive array of mucus-producing glands, called Brunner glands, is concentrated where contents from the stomach and secretions from the liver and pancreas enter the duodenum."

A student is comparing the two patterns of contractions in the small intestine. Which statement is most accurate?

"Segmentation waves function mainly to mix the chyme with the digestive enzymes from the pancreas."

The client has just been diagnosed with bladder cancer and asks the nurse what causes it. What would be the nurse's best response to the client?

"The cause is unknown."

A student is studying the esophagus. Which statement made by this student to a faculty member is a correct one?

"The smooth muscle layers provide the peristaltic movements needed to move food along the length of the esophagus."

A client has a postvoid residual (PVR) volume of 250 mL. Which information would the nurse tell the client?

"This value indicates you are having difficulty emptying your bladder."

Absorption is a major function of the GI tract. How is absorption accomplished in the GI tract?

Active transport and diffusion

The nurse is caring for a college student with infectious mononucleosis. For which reason does the nurse teach the client to abstain from alcohol during the acute phase of the disease?

Alcohol may worsen a mild hepatitis which occurs in the acute phase.

A client with history of alcohol abuse is brought to the emergency department after a weekend of heavy drinking, experiencing right upper quadrant pain, anorexia, nausea, jaundice and ascites. The nurse identifies these as manifestations of what disorder?

Alcoholic hepatitis

When assessing the client with acute pancreatitis, which of these diagnostic tests—consistent with the disease— does the nurse anticipate will be altered?

Amylase and lipase

An older adult client presents with loose mucousy stools. The nurse suspects the client has Clostridium difficile. What is a priority assessment for the nurse?

Ask the client about his or her antibiotic use

A client has experienced a stroke affecting the reticular formation of the medulla and lower pons. The nurse tells the client's wife that care must be taken with eating to prevent:

Aspiration pneumonia

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

Which clinical manifestations would you expect to see in an infant diagnosed with autosomal recessive polycystic kidney disease (ARPKD)?

Bilateral flank masses and impaired lung development

A health care provider suspects a client has developed diverticular disease. Which diagnostic test is usually prescribed to confirm the diagnosis?

Computed tomography (CT) scan

Which procedure is a nonsurgical method of treatment for renal calculi (kidney stones)?

Extracorporeal shock wave lithotripsy (ESWL)

The nurse is caring for the client with hepatocellular carcinoma. What does the nurse recognize is a cause of this disease?

Illness with hepatitis B or C

A client reports urinary incontinence, specifically not feeling the urge to urinate until the bladder voids uncontrollably. Client history shows type 1 diabetes of 40+ years and compliance with medication and diet. What is the most likely diagnosis?

Incontinence related to neuropathy causing overactive bladder

An ultrasound confirms appendicitis as the cause of a client's sudden abdominal pain. Which etiologic process is implicated in the development of appendicitis?

Obstruction of the intestinal lumen

The nurse teaches the client that which of these contributed to the development of acute cholelithiasis?

Stasis of bile

A rare condition caused by gastrin-secreting tumors most commonly found in the small intestine or pancreas is called:

Zollinger-Ellison syndrome

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

A client asks the nurse what may have caused elevation in urinary protein levels (proteinuria) on a urine test. The best response by the nurse would be:

abnormal glomerular filtration

When explaining acute pancreatitis to a newly diagnosed client, the nurse will emphasize that the pathogenesis begins with an inflammatory process whereby:

activated pancreatic enzymes escape into surrounding tissues, causing autodigestion of pancreatic tissue.

Which client is displaying manifestations of having a kidney stone?

acute onset of colicky flank pain radiating to lower abdomen

Which of these substances should the nurse teach the client with pancreatitis to absolutely avoid?

alcohol

The nurse teaches the client with acute pancreatitis that the pain is caused by prematurely activated pancreatic enzymes that have leaked into surrounding tissues, causing which outcome?

autodigestion

The form of polycystic kidney disease (PKD) that first manifests in the early infant period is most commonly characterized as:

autosomal recessive

The nursing instructor, while teaching about renal function and disorders, informs the students that the most frequent form of urinary tract cancer is:

bladder

When caring for a client with dehydration, the nurse anticipates the client will have an alteration in which substance in the blood?

blood urea nitrogen

The nurse is caring for a client with chronic renal failure who is on hemodialysis three times a week. In order to treat hyperphosphatemia and hypocalcemia, which medication will the nurse administer to decrease absorption of phosphate from the gastrointestinal tract?

calcium carbonate

Hospitalized neonates are at greatest risk of developing septicemia related to which procedure?

catheter-associated bacteriuria

A student is studying gallbladder function. Which gastrointestinal hormone stimulates contraction of the gallbladder?

cholecystokinin

All diseases have risk factors. What is the most significant environmental risk factor for pancreatic cancer?

cigarette smoking

The nurse caring for four male clients recognizes which client is at highest risk for developing postrenal kidney failure?

client with prostatic hyperplasia

The nurse is reviewing the results of a renal client's laboratory results. This client's urine specific gravity allows the nurse to assess the kidneys' ability to:

concentrate urine

The production of chyme occurs in which organ?

stomach

The nurse is caring for a client who has produced an average of 20 mL/hour for the previous day. The nurse recognizes this compares in which way to the normal urine output?

the kidneys should produce about 1.5 L of urine each day

Which medication may be responsible for a client developing increased uric acid levels by decreasing ECF volume?

thiazide diuretics

An older adult client who recently started taking furosemide tells the nurse about now experiencing problems with urine incontinence. Which type of incontinence is this client likely experiencing?

transient

Which substance is broken down by the emulsification process?

triglycerides

A client is being treated with colchicine for pain in the big right toe. The client begins to complain of severe right flank pain and is diagnosed with kidney stones. Which type of kidney stone does the nurse recognize this client is most likely affected by?

uric acid

A client is diagnosed with gout in the right foot and a kidney stone in the left ureter. The nurse recognizes these conditions may have resulted from accumulation of which chemical in the body?

uric acid

The nurse working in the nursery is caring for a 4-day-old infant with autosomal recessive polycystic kidney disease (ARPKD). Which physical assessment findings would the nurse associate with this disease process? Select all that apply.

-Palpable masses located in the flank area bilaterally -Hypoventilation due to impaired lung development -Severe hypertension 120/90

In a client in the uremic state of chronic kidney failure (CKD), the nurse will monitor for which signs and symptoms correlated with uremia? Select all that apply.

-anemia -apathy -encephalopathy -nausea

While assessing a client diagnosed with inflammatory bowel disease, the nurse should assess for which systemic manifestations? Select all that apply.

-autoimmune anemia -Hypercoagulability of blood -Mouth inflammation

A school nurse is teaching a group of fourth-grade girls about personal hygiene. Important teaching points aimed at reducing the incidence of urinary tract infection (UTI) include which of the following? Select all that apply.

-avoiding bubble bath -careful hand washing -wiping from front to back after a bowel movement

A client is diagnosed with early chronic kidney disease (CKD). The nurse will recommend which actions to slow progression of renal damage? Select all that apply.

-blood glucose control -blood pressure control -angiotensin converting enzyme (ACE) inhibitor administration -smoking cessation

A client with chronic kidney disease who has renal osteodystrophy should be assessed for which complications? Select all that apply.

-bone pain -muscle weakness -stress fractures

Which conditions have the potential to cause chronic kidney disease? Select all that apply.

-diabetes -hypertension -glomerulonephritis

The nursing students have learned in class that causes of urinary obstruction and urinary incontinence include which of the following? Select all that apply.

-impairment of neurologic control of bladder function -structural changes in the bladder -structural changes in the urethra

When caring for clients with alcoholism and cirrhosis, which the nurse recognizes which potential complications of the disease? Select all that apply.

-liver failure -kidney failure -bleeding esophageal varices

A client has been admitted to the hospital with an exacerbation of peptic ulcer disease. The nurse is aware the client is at risk for:

-perforation -hemorrhage -obstruction

A young man presents reporting diarrhea, fecal urgency, and weight loss. His stool is light-colored and malodorous, and it tends to float and be difficult to flush. He has also noted tender, red bumps on his shins and reports pain and stiffness in his elbows and knees. Sigmoidoscopy reveals discontinuous, granulomatous lesions; no blood is detected in his stool. Which diagnosis would his care team first suspect?

Crohn disease

Which carbohydrate is matched to its correct enzyme needed for digestion?

sucrose and sucrase

A client with a history of cancer that metastasized to the liver has arrived at the outpatient clinic to have a paracentesis performed. The physician anticipates that the client will have more than 5 L of fluid removed. The physician has prescribed intravenous albumin following the procedure. The client asks why she needs "more fluids in my vein." The nurse responds:

"Albumin is a volume expander. Since a lot of fluid was removed, you have a decrease in your vascular volume, so without this albumin, your kidneys will try to reabsorb and hold onto water."

A young adult client is currently in a rehabilitation facility following a spinal cord injury at level T2. The nurse and client are discussing long-term options for continence management. Which statement demonstrates the client has a clear understanding of the issue?

"An indwelling catheter certainly would work well, but it comes with a number of risks and possible complications."

The nurse is scheduled to teach a client experiencing urinary incontinence about Kegel exercises. Which descriptor should the nurse include in this education?

"Contract and relax the pelvic floor muscles at least 10 times every hour while awake."

The nursing instructor who is teaching about incontinence in older adults recognizes a need for further instruction when a student makes which statement?

"Frequency is not a major problem for the elderly."

The nurse is caring for a female client with cholelithiasis. When teaching the client about the disease, the nurse includes which of these points?

"Gallstones have developed, which are typically composed of cholesterol."

Antibody testing has confirmed that a client is positive for hepatitis A virus (HAV). Which statement suggests the client understands the new diagnosis?

"I don't know why I didn't bother to get vaccinated against this."

A client with bladder cancer asks the nurse, "What did the doctor mean by intravesicular chemotherapy? Am I going to lose all my hair and have to go for treatments over months and months?" The best response would be:

"This is when they put the chemotherapy directly into the bladder to kill any cancer cells."

A client experienced asymptomatic UTIs while pregnant. The client asks the nurse if this places her at any risk for complications. Which would be the best response by the nurse?

"You are at risk for developing acute pyelonephritis."

A mother asks, "Why can't my 1-year-old go to the bathroom by himself?" What is the nurse's best response?

"Your child is too young to begin toilet training."

An older adult client is reporting chronic constipation. When evaluating the client's medication regimen, the nurse will note that which medications may contribute to this constipation? Select all that apply.

-Calcium channel blockers for his hypertension -Antacids for his heartburn -Diuretics for his heart failure

During a lecture discussing nausea and vomiting, the nurse reviews the role of the chemoreceptor trigger zone which may be stimulated (causing vomiting) by which factors? Select all that apply.

-Chemotherapeutic agents -Salmonella food poisoning -Increased intracranial pressure

A nine year-old boy has been diagnosed with the nephritic syndrome. Place the following stages in the development of his health problem in ascending order. Use all the options.

-Decreased colloidal osmotic pressure -Hypoalbuminemia -Proteins escape from plasma to glomerular filtrate. -Increased glomerular membrane permeability. -Accumulation of fluid in interstitial tissue (edema).

A nurse is completing a history and physical assessment on a client admitted with ulcerative colitis. Which symptoms would the nurse anticipate? Select all that apply.

-Diarrhea -Rectal bleeding

The nurse is assessing a client who has been diagnosed with gastroesophageal reflux disease (GERD). The nurse recognizes which sign/symptom may be associated with GERD? Select all that apply.

-Epigastric pain -Retrosternal pain -Wheezing -hoarseness

When assessing a client with acute pyelonephritis, the nurse would expect the client to exhibit which clinical manifestations? Select all that apply.

-High fever -Flank tenderness -Nausea and vomiting -Chills

Clients with chronic autoimmune hepatitis may display which clinical manifestations upon physical exam? Select all that apply.

-enlarged liver -jaundice

The cause of gastric carcinomas has been influenced by which factors? Select all that apply.

-environmental factors -family history -strain of helicobacter pylori (H.pylori)

Atrophic gastritis and decreased secretion of intrinsic factor are more common with aging. The subsequent deficiency of vitamin B12 can cause which condition to occur? Select all that apply.

-peripheral neuropathy -pernicious anemia

A client on peritoneal dialysis awakens one night to find that the end of the catheter has become disconnected and possibly contaminated by microbes from the bed sheets. The nurse should focus assessment on which possible complications of peritoneal dialysis? Select all that apply.

-peritonitis -hernia formation

What are appropriate interventions in the care of a client diagnosed with renal calculi? Select all that apply.

-straining the client's urine -keeping track of intake and output -addressing the client's pain

The nurse caring for clients who have bladder cancer identifies which treatments to be acceptable for this cancer? Select all that apply.

-surgical removal -radiation therapy -chemotherapy

Which would be considered the results of damage to the gastric mucosa from medications such as aspirin and nonsteroidal anti-inflammatory drugs? Select all that apply.

-tissue necrosis -local ischemia -vascular stasis

A client informs the nurse that he feels as if his bladder is getting full. The nurse understands that a client first experiences the sensation of bladder fullness when the bladder contains:

100-200 ml of urine

One of the many tests done during urodynamic studies is the sphincter electromyelogram. What does this test study?

Activity of the voluntary muscles of the perineal area

A 79-year-old woman reports a recent onset of "nearly constant heartburn." During the assessment interview, she states that she has "lots of aches and pains." She states that she is not on any prescription medications but often takes aspirin for pain. The nurse should suspect what diagnosis?

Acute gastritis

A client has been diagnosed with systemic lupus erythematosus. The client now presents with sudden hematuria, variable proteinuria, and a decreased glomerular filtration rate. What is a probable diagnosis?

Acute nephritic syndrome.

An adult has a serum sample taken to evaluate the BUN-creatinine ratio. Select the result that indicates a normal test.

BUN 10 mg/dL (3.57 mmol/L) to creatinine 1 mg/dL (88.40 µmol/L)

Acute pyelonephritis is a result of:

Bacterial infection

The client has right upper quadrant pain caused by acute choledocholithiasis. The health care provider suspects the common bile duct is obstructed, based on which flowing lab value?

Bilirubin 15 mg/dL (256.56 µmol/L) (high)

Crohn disease is recognized by sharply demarcated, granulomatous lesions that are surrounded by normal-appearing mucosal tissue. The nurse recognizes these lesions to be defined by which description?

Cobblestone

A client is admitted to a nursing unit with severe edema. The nursing student caring for this client overhears the physician and a medical student talking about the client's albumin level. When discussing the flow of fluids into and out of cells, albumin plays a significant role in which pressure gradient?

Colloidal osmotic

An older adult client has been placed on a broad-spectrum antibiotic for a recurrent urinary tract infection. Which potential problem would the nurse anticipate in this client?

Colonization of Clostridium difficile

An older adult with urge incontinence and overactive bladder begins medication treatment with oxybutynin. Which side effects would the nurse include in the education?

Dry mouth and constipation are common.

A client newly diagnosed with pancreatic cancer is admitted to begin treatment. Which pain descriptors can be associated with adenocarcinomas of the pancreas?

Dull epigastric pain accompanied by back pain, worse when lying flat and relieved by sitting forward.

The physiologic rationale for hanging normal saline (0.9% NS) or 5% dextrose in water (D5W) to a client who has been experiencing diarrhea includes:

Facilitating the absorption of osmotically active particles

A nurse is teaching a client about diabetic complications of the gastrointestinal tract. What could the client develop if he or she has poor diabetic control?

gastric atony

When caring for the client with proteinuria, the nurse recognizes that dysfunction in which structure of the kidney allows protein to leak into the urine?

glomerulus

The family asks the nurse what the usual treatment of focal segmental glomerulosclerosis entails. What is the nurse's best response?

corticosteriods

A client asks, "Why did my provider order a glomerular filtration rate (GFR) to my usual blood work?" The nurse's best response is based on the fact that GFR can estimate serum levels of which substance?

creatinine

Which diagnostic study would be effective in determining direct visualization of the bladder and ureters?

cystoscope

A 65-year-old female who smokes presents with increased urinary frequency, dysuria, and sporadic, painless hematuria. The client's follow-up will likely include:

cystoscopy

When the urologist wants to directly visualize the bladder, urethra, and ureteral orifices, what diagnostic test would he use?

cystoscopy

The nurse is instructing a client with advanced kidney disease (AKD) about a dietary regimen. Which restriction should the nurse be sure to include in the treatment plan to decrease the progress of renal impairment in people with AKD?

dietary protein

Which aspect of gastrointestinal function is performed by the brush border enzymes of the villus structures?

digestion of carbohydrates

Which dermatologic problem most often accompanies chronic kidney disease (CKD)?

dry skin and pruritus

The common bile duct and the pancreatic duct release their products into which section of the intestines?

duodenum

The common bile duct opens into which part of the gastrointestinal tract?

duodenum

A nurse is caring for a client with end-stage renal failure who has symptoms of anemia. The nurse anticipates administering which intervention to increase red blood cell production?

epoetin alfa

The nurse is caring for a client with a condition of deficiency of antidiuretic hormone (ADH). When assessing the client, which finding does the nurse anticipate?

excessive urine output

Which reserve urinary structure helps to stop micturition when it is occurring and maintains continence under high bladder pressure?

external sphincter

A client is admitted with a diagnosis of flaccid bladder. The nurse caring for this client understands this client will exhibit which disorder of the bladder?

failure to empty urine

The swallowing reflex is an entirely voluntary activity.

false

The nurse is caring for a client with hepatitis and jaundice. The nurse recognizes that without sufficient circulating bile salts the client will have intolerance to which ingested substance?

fats

A client with chronic pancreatitis is experincing an episode of recurring epigastric pain. The dietitian knows that the client's diet should limit which type of meal to avoid further episodes?

fried chicken and french fries

While explaining digestion and absorption of nutrients to a client, the nurse mentions that the brush border enzymes would facilitate absorption of which food?

garlic toast

A client informs the nurse that she is afraid of developing bladder cancer because her mother had it. She asks the nurse what signs and symptoms are present with this cancer. What does the nurse tell the client is the most common sign of bladder cancer?

gross hemturia

Which client clinical manifestation most clearly suggests a need for diagnostic testing to rule out renal cell carcinoma?

hemturia

A health care provider suspects a client may have developed pancreatitis. Which laboratory value will confirm this diagnosis?

high serum amylase and lipase

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

hypertension

A client asks the nurse what part of the brain regulates appetite. Which is the best response by the nurse?

hypothalamus

A 25-year-old man of Asian ancestry arrives in the emergency room in a panic. Except for a bout with bronchitis a week earlier, he has been healthy his entire life; today he has blood in his urine. He is eventually told that his kidney disease has no known treatment and results in protein deposits accumulating in the glomerulus. The client has likely been diagnosed with:

immunoglobulin A nephropathy.

A client diagnosed with CKD has begun to experience periods of epistaxis and has developed bruising of the skin and subcutaneous tissues. The nurse recognizes these manifestations as:

impaired platelet function

Which assessment indicates to the nurse that a client may have a spastic bladder dysfunction?

incontinence

The nurse is planning care for a client with a urinary tract obstruction. The nurse includes assessment for which possible complication?

increased blood pressure

The nurse is reviewing the laboratory work of several medical clients. Which laboratory result is most suggestive of abnormalities in kidney function?

increased creatinine and blood urea nitrogen (BUN) levels

A client has recently undergone successful extracorporeal shock wave lithotripsy (ESWL) for the treatment of renal calculi. Which measures should the client integrate into his or her lifestyle to reduce the risk of recurrence?

increased fluid intake and dietary changes

What is the usual cause of acute pyelonephritis?

infection

A client is admitted to the medical surgical unit with a history of inflammatory bowel disease. The nurse knows that the clinical manifestations of both Crohn disease and ulcerative colitis are the result of activation of which cells?

inflammatory

Crohn disease is treated by several measures. Treatment with sulfasalazine will focus on which aspect of this disease?

inflammatory suppression

Which action initiates defecation?

mass movements

The nurse is caring for a client with asterixis. Which assessment should the nurse make to help a diagnosis of hepatic encephalopathy?

mental status

A client has been diagnosed with alcohol-induced liver disease. He admits to the nurse, "I know what the lungs do, and I know what the heart does, but honestly, I have no idea what the liver does in the body." The nurse should tell the client that the liver:

metabolizes most components of food and also cleans the blood of bacteria and drugs.

Dietary restrictions placed on clients with chronic kidney disease (CKD) include limiting protein in their diet. The recommended sources of protein for clients with CKD include what source of protein?

milk

Digestion of starch begins in which structure?

mouth

A nurse is caring for a client in spinal shock. Which intervention is appropriate in relation to the client's urinary status?

perform intermittent catheterization

A client with stage 5 chronic kidney disease (CKD) is presenting with fever and chest pain, especially when taking a deep breath. The nurse detects a pericardial friction rub on auscultation. Which condition does the nurse suspect is common with this stage of kidney disease?

pericarditis

An older adult client presents with a perforation of a peptic ulcer. The nurse will monitor for signs and symptoms of which problem?

peritonitis

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:

peritonitis

Select the phase of swallowing that prevents food from entering the nasopharynx when a client is eating.

pharyngeal

The initiating event in the development of nephrotic syndrome is a derangement in the glomerular membrane that causes increased permeability to which substance?

plasma proteins

Which condition/disorder would the nurse see as being likely to cause the most serious long-term problems?

polycystic kidney disease

The nurse knows that which sign is one of the earliest manifestations of acute renal failure (ARF)?

polyuria

A client has an obstructive urine outflow related to benign prostatic hyperplasia. Due to the inability to excrete adequate amounts of urine, which type of renal failure should the nurse closely monitor for?

postrenal failure

An 86-year-old client is being treated for dehydration and hyponatremia after curtailing fluid intake to prevent urinary incontinence. Given these findings, the nurse recognizes that this client is likely in what phase of acute kidney injury?

prerenal

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?

prerenal failure

A nursing student studying pharmacology is learning how angiotensin converting enzyme inhibitors (ACE) work. The student is correct when stating that the mechanism of action of ACE inhibitors is to:

prevent conversion of angiotensin I to II

The nurse is conducting a community health education program on urinary retention and urinary incontinence. The nurse determines that the participants are understanding the education when they state that the most common cause of urinary retention is:

prostate enlargement

When teaching a pharmacology class the nurse relates that 65% of all reabsorptive and secretory processes that occur in the tubular system take place in which area?

proximal tubules

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?

reduced production of erythropoietin

The kidney assists in blood pressure regulation by releasing which substance from the juxtaglomerular cells in response to decreased renal blood flow, causing efferent arteriole vasoconstriction?

renin

The nurse assessing a client with a diagnosis of cholelithiasis will look for pain in which area?

right upper quadrant

An older adult man is brought into the clinic by his daughter, who states, "My father hasn't been himself lately. Now I think he looks a little yellow." What test would the nurse expect to have ordered to check this man's creatinine level?

serum creatinine

Which blood test reflects the glomerular filtration rate (GFR) and is used to estimate renal function?

serum creatinine

A nurse explains to her client that food is moved along the gastrointestinal (GI) tract with intermittent contractions that mix the food and move it along. These movements are found in which organ?

small intestine

When the glomerular transport maximum for blood glucose is exceeded and its renal threshold has been reached, what happens to the excess glucose?

spills into the urine

A 68-year-old man who has smoked for at least 50 years reports that lately he feels as though food is "getting stuck" in his throat. At first this was a problem just with dry food, but now his morning oatmeal is getting stuck. On questioning, he reports drinking at least five alcoholic beverages nearly every day. His problem is most likely:

squamous cell carcinoma of the esophagus.

The results of a client's 24-hour stool specimen indicate 20 g or more of fat. The nurse would interpret this as:

steatorrhea

Which clinical manifestation would lead the nurse to suspect the client has malabsorption syndrome with a deficiency in fat absorption?

steatorrhea

During a lecture about the function of the intestine related to food digestion, the faculty mentions that when the students consume foods high in acid, the intestines will:

stimulate the release of secretin, which then inhibits release of gastrin.

Which factor is likely to result in decreased renal blood flow?

stimulation of the sympathetic nervous system

A client has been diagnosed with an incompetent pyloric sphincter. The nurse educating the client mentions that this is due to abnormal communication between which components of the gastrointestinal tract?

stomach and duodenum

A client who has a problem with incontinence loses a small amount of urine every time she coughs or sneezes. This type of incontinence is known as:

stress

The client who has experienced third-degree burns is susceptible to which specific type of gastrointestinal (GI) ulceration?

stress

A 40-year-old mother of three reports incontinence. Her physician suggests Kegel exercises because they strengthen the pelvic floor muscles. Kegel exercises are most likely to help which type of incontinence?

stress incontinence

A nurse administering a client's medication tells the client that a proton pump inhibitor has been added. When the client asks the purpose of the medication, the nurse responds that it is to prevent:

stress ulcers

Following the analysis of colonoscopy with biopsy, a client is diagnosed with colorectal cancer. Which treatment modality will be the mainstay of this client's treatment regimen?

surgery

A client is admitted to the hospital with a suspected diagnosis of strangulated bowel. The nurse anticipates the client will need:

surgery to release the bowel