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Renal Disorders Chapter 62

front 1

The nurse is teaching about the process involved in hemodialysis. Arrange the correct steps of hemodialysis chronologically.The blood moves through an artificial semipermeable membrane.

  • A dialysate solution is pumped on the other side of the membrane.
  • Bicarbonate is added to the dialysate for acidosis corrections.
  • Negative pressure should be maintained to allow fluid removal.
  • The blood is pumped through a dialyzer.
  • The waste products are diffused into the dialysate.

back 1

no data

front 2

A patient reports frequent fevers, chills, vomiting, and a burning sensation with urination. Urine analysis reports are positive for infection, and the histological examination of renal tissue is negative for inflammation of the renal cells. Which treatment method may reduce the risk of pyelonephritis?

1.Antibiotics

2.Corticosteroids

3.Urinary analgesics

4.Antipyretic medications

back 2

1.Antibiotics

front 3

How is a grade 2 renal trauma described?

1.Superficial lacerations

2.Laceration of the renal artery

3.Hematuria and contusions

4.Renal lacerations above 1 cm in depth

back 3

1.Superficial lacerations

front 4

Which assessment finding would be most consistent with the diagnosis of acute kidney injury (AKI)?

1.Anemia

2.Uremia

3.Calcium deficiency

4.Fluid retention

back 4

4.Fluid retention

front 5

Which cause of acute kidney injury (AKI) would be classified as prerenal?

1.Massive hemorrhage

2.Ischemia to the kidney

3.Contrast dye medication

4.Renal tumor

back 5

1.Massive hemorrhage

front 6

The nurse cares for a patient in the emergency department. Which actions should the nurse take? Select all that apply.

1.Observe for respiratory distress.

2.Obtain a clean-catch urine for culture.

3.Prepare to administer an oral antibiotic.

4.Monitor for irregular heartbeat and rhythm.

5.Monitor urine output closely.

6.Report changes in level of consciousness.

back 6

1.Observe for respiratory distress.

2.Obtain a clean-catch urine for culture.

4.Monitor for irregular heartbeat and rhythm.

5.Monitor urine output closely.

6.Report changes in level of consciousness.

front 7

The nurse is caring for a patient with an injury to the renal system. Which is the priority nursing intervention?

1.Promoting urinary drainage

2.Encouraging the patient to rest

3.Administering IV fluids

4.Determining the extent of damage

back 7

3.Administering IV fluids

front 8

A patient is receiving treatment for glomerulonephritis. Which laboratory parameter should be monitored to determine the degree of renal functioning in the patient? Select all that apply.

1.Creatinine

2.Blood urea nitrogen

3.Red blood cell count

4.Protein levels in the urine

5.White blood cell count

back 8

1.Creatinine

2.Blood urea nitrogen

front 9

Which characteristic would be indicative of nephritic syndrome?

1.Presence of hypoalbuminemia and edema

2.Treatment includes use of immunomodulators

3.Massive proteinuria occurs with this disorder

4.Diabetes mellitus is a common cause

back 9

2.Treatment includes use of immunomodulators

front 10

The nurse is providing instructions to a patient regarding diet management. The patient is in the oliguric phase of an acute kidney injury. Which statement indicates effective learning?

1.“I should reduce salt in my diet.”

2.“I should consume more protein.”

3.“I should increase my intake of water.”

4.“I should increase the intake of phosphorus in my diet.”

back 10

1.“I should reduce salt in my diet.”

front 11

When the laboratory report of a patient diagnosed with chronic kidney disease shows a glomerular filtration rate (GFR) of 50 mL/minute, which stage would the nurse document?

1.G1

2.G2

3.G3a

4.G3b

back 11

3.G3a

front 12

Which assessment should be performed to prevent intrarenal damage from postrenal causes in a patient with acute kidney injury?

1.Examination of prostate gland

2.Measurement of blood volume

3.Measurement of cardiac output

4.Identification of nephrotoxins

back 12

1.Examination of prostate gland

front 13

The nurse is caring for a patient diagnosed with acute kidney injury (AKI). The nurse notes the patient only urinated 150 mL during the 12-hour shift. In which phase of AKI would the nurse suspect the patient to be?

1.Initiating

2.Oliguric

3.Diuretic

4.Recovery

back 13

2.Oliguric

front 14

Which electrolyte abnormality noted in a patient diagnosed with acute kidney injury would be most concerning to the nurse?

1.Serum calcium 10.4 mg/dL

2.Serum sodium 146 mEq/L

3.Serum phosphate 2.4 mg/dL

4.Serum potassium 6.3 mEq/L

back 14

4.Serum potassium 6.3 mEq/L

front 15

Which intervention may be beneficial for a patient with extrarenal metastasis of renal cancer to the bones?

1.Chemotherapy

2.Radiation therapy

3.Partial nephrectomy

4.Radical nephrectomyNext

back 15

no data

front 16

The nurse is assessing the laboratory reports of four patients. Which patient’s report indicates renal failure?

1.Mary

2.Joe

3.Kim

4.Sam

back 16

4.Sam

front 17

A patient is diagnosed with glomerulonephritis caused by vasculitis. Which medication is likely to be prescribed?

1.Diuretics

2.Antibiotics

3.Corticosteroids

4.Antihypertensives

back 17

3.Corticosteroids

front 18

Which intervention for the treatment of anemia in patients with chronic kidney disease requires the addition of stool softeners?

1.Blood transfusions

2.Erythropoietin therapy

3.Oral iron supplementation

4.Folic acid supplementation

back 18

3.Oral iron supplementation

front 19

The nurse is caring for a patient with acute kidney injury who has a serum potassium level of 6.2 mmol/L. Which changes are noted in this electrocardiogram (ECG) rhythm as a result?

1.Prolonged PR interval

2.Wide QRS complex

3.Peaked T wave

4.Elevated ST segment

back 19

3.Peaked T wave

front 20

Which nursing intervention would be most appropriate for a patient diagnosed with polycystic kidney disease (PKD)?

1.Encourage dietary protein intake

2.Make sure the patient drinks at least 2 liters of water daily

3.Administer antihypertensive medications as ordered

4.Obtain weekly weights

back 20

3.Administer antihypertensive medications as ordered

front 21

The nurse is teaching a nursing student about assessing older adult patients with urinary tract infections and delirium. Which statement made by the nursing student indicates successful teaching? Select all that apply.

1.“I should consider the presence of neurological deficits.”

2.“I should assume the delirium is caused by a urinary tract infection unless there is evidence to the contrary.”

3.“I should assess the patient’s baseline cognitive function.”

4.“I should assess for symptoms of dysuria and urinary frequency.”

5.“I should administer antibiotics before sampling for laboratory tests.”

back 21

1.“I should consider the presence of neurological deficits.”

3.“I should assess the patient’s baseline cognitive function.”

4.“I should assess for symptoms of dysuria and urinary frequency.”

front 22

The nurse is instructing a patient with polycystic kidney disease regarding safety precautions. Which statement made by the patient indicates successful teaching?

1.“I should increase my fluid intake.”

2.“I should eat a high-protein diet.”

3.“I should immediately report if my temperature is high.”

4.“I should expect changes in my urinary pattern.”

back 22

3.“I should immediately report if my temperature is high.”

front 23

Which phase of acute kidney injury involves an increase in creatinine levels?

1.Oliguric phase

2.Diuretic phase

3.Initiating phase

4.Recovery phase

back 23

1.Oliguric phase

front 24

The laboratory report of a patient with kidney disease indicates an increase in the blood urea nitrogen (BUN) level. Which is the most likely cause of this condition?

1.Decreased erythropoietin production

2.Decreased gastrointestinal absorption

3.Increased protein intake and breakdown

4.Increased production of nonvolatile acids

back 24

3.Increased protein intake and breakdown

front 25

The nurse is assessing the clinical manifestation reports of four patients. Which patient is most likely to have renal trauma?

1.Patient A

2.Patient B

3.Patient C

4.Patient D

back 25

4.Patient D

front 26

Which laboratory abnormality may lead to a disturbed thought process in a patient with end-stage renal disorder?

1.Anemia

2.Uremic toxins

3.Fluid retention

4.Electrolyte imbalances

back 26

2.Uremic toxins

front 27

A pregnant woman reports fever, chills, urinary frequency, and painful urination. Upon assessment, flank pain and costovertebral tenderness are observed. A histological examination of renal tissue reveals inflammation of the renal cells. Which intervention may be contraindicated in the patient?

1.Antipyretics

2.Fluoroquinolones

3.Aminoglycosides

4.Narcotic analgesics

back 27

2.Fluoroquinolones

front 28

The nurse is caring for a patient who just underwent a kidney transplant 48 hours prior and is showing signs of organ rejection. Which type of rejection would the nurse suspect?

1.Acute rejection

2.Hyperacute rejection

3.Chronic rejection

4.Accelerated rejection

back 28

4.Accelerated rejection

front 29

Which statement would the nurse include when teaching the patient about the prevention of urinary tract infections?

1.“You can stop taking antibiotics once your symptoms clear up.”

2.“Be sure to urinate every six hours during the day.”

3.“Empty the bladder completely before and after sexual intercourse.”

4.“Limit your intake of fluid so that you are not urinating as often.”

back 29

3.“Empty the bladder completely before and after sexual intercourse.”

front 30

A patient reports anorexia along with cloudy and foul-smelling urine. Which condition should the nurse suspect?

1.Renal cancer

2.Renal trauma

3.Pyelonephritis

4.Glomerulonephritis

back 30

3.Pyelonephritis

front 31

The nurse is teaching about this type of dialysis in patients with end-stage renal disease. Which statement indicates successful teaching? Select all that apply.

1.“Patients can opt for this kind of dialysis treatment at home.”

2“The metabolic clearance of wastes occurs quickly in this type of dialysis.”

3.“This kind of dialysis requires very strict dietary restrictions by the patient.”

4.“Longer training sessions are required to teach the patient and their family members about this kind of dialysis.”

5.“This type of dialysis is suggested for patients who respond poorly to hemodialysis.”

back 31

1.“Patients can opt for this kind of dialysis treatment at home.”

5.“This type of dialysis is suggested for patients who respond poorly to hemodialysis.”