question

As a charge nurse, you would assign the nursing care of which patient to an LPN working under the supervision of an RN?

answer

48 year old with cystitis who is taking oral antibiotics

question

You are supervising a nurse on orientation to the unit who is discharging a patient admitted with kidney stones who underwent lithotripsy. Which statement by the nurse to the patient requires that you intervene?

answer

"Report any signs of bruising to your physician immediately, since this indicates bleeding.

question

As charge nurse, you must rearrange room assignments to admit a new patient. Which two patients would be best suited to be roommates?

answer

24 year old with acute pyelonephritis and severe flank plan. 76 year old with urge incontinence and a UTI.

question

The nursing diagnosis of Constipation related to compression of the intestinal tract has been identified in a patient with polycystic kidney disease. Which nursing care action should you delegate to a newly trained LPN?

answer

Administering docusate sodium (Colace) 100 mg by mouth twice a day.

question

You are the admitting nurse for a patient with nephrotic syndrome. Which assessment finding supports this diagnosis?

answer

Edema formation.

question

You are teaching a patient how best to prevent renal trauma after an injury that required a left nephrectomy. Which points would you include in your teaching plan?

answer

Always wear a seat belt. Avoid all contact sports. Practice safe working habits. Use caution when riding a bicycle.

question

A nurse caring for a client with gomerulonephritis. What should the nurse instruct the client to do to prevent recurrent attacks?

answer

Seek early treatment for respiratory tract infection.

question

What lab values would the nurse interpret for a patient experiencing problems with urinary elimination as a result of acute pyelonephritis?

answer

Observe complete blood count for elevation of differentials. Observe for elevation of BUN and serum creatinine levels. Observe urinalysis for bacteria, leukocyte esterase, nitrate, or red blood cells.

question

What might the nurse notice if the patient is experiencing problems with urinary elimination as a result of acute pyelonephritis?

answer

Patient reports pain and burning on urination. Patient reports back or flank pain. Urine is cloudy and foul-smelling. Urine may be darker or smokey or have obvious blood in it.

question

A patient is brought to the emergency department after being involved in a fight in which the patient was kicked and punched repeatedly in the back. What does the nurse include in the initial physical assessment?

answer

Take complete vital signs. Check apical and peripheral pulses. Inspect both flanks for asymmetry or penetrating injuries of the lower chest or back. Inspect the abdomen for bruising or penetrating wounds. Inspect the urethra for gross bleeding.

question

The ED nurse is preparing for a patient with kidney trauma for emergency surgery. What is the best task to delegate to the UAP?

answer

Go to the blood bank and pick up the units of packed red cells.

question

A patient has sustained a kidney injury. In order to assist the patient to undergo the best diagnostic test to determine the extent of injury, What does the nurse do?

answer

Give an explanation of computed tomography.

question

A patient returning to the unit after a left radical nephrectomy for kidney cell carcinoma reports having some soreness on the right side. What does the nurse tell the patient?

answer

"The soreness is likely to be from being positioned on your right side during surgery."

question

The nurse is caring for a postoperative nephrectomy patient. The nurse notes during the first several hours of the shift a marked and steady downward trend in blood pressure. How does the nurse interpret this finding?

answer

Internal hemorrhage is possible.

question

The nurse is caring for a patient after a nephrectomy. The nurse notes that the urine flow was 50 mL/hr at the beginning of the shift, but several hours later has dropped to 30 mL. What would the nurse do first?

answer

Check the drainage system for kinks or obstructions to flow.

question

The nurse is caring for a patient who had a nephrectomy yesterday. To manage the patient's pain, what is the best plan for analgesia therapy?

answer

Give parenteral medications on a schedule.

question

After a nephrectomy, one adrenal gland remains. Based on this knowledge, which type of medication replacement therapy does the nurse expect if the remaining adrenal gland function is insufficient?

answer

Steroid

question

The nurse is caring for a patient with kidney cell carcinoma who manifests paraneoplastic syndromes. What findings does the nurse expect to see in this patient?

answer

Erythrocytosis. Hypercalcemia. Liver dysfunction. Hypertension.

question

The nurse is caring for a patient with kidney cell carcinoma. What does the nurse expect to find documented about the patient's initial assessment?

answer

Flank pain, gross hematuria, palpable kidney mass, and renal bruit.

question

A patient is diagnosed with kidney cancer and the health care provider recommends the best therapy. Which treatment does the nurse anticipate teaching the patient about?

answer

Surgical removal

question

A patient is newly diagnosed with type 2 DM. Which screening recommendation does the nurse give to the patient regarding the early detection of diabetic kidney disease?

answer

Urine should be tested annually for protein and microalbuminuria.

question

Which data set indicates that the patient with diabetes is achieving the goals of care to prevent the development of microalbuminuria and delay the progression to end stage kidney disease?

answer

A1C less than 7%, BP is 125/75 mmHg, LDL cholesterol is 90 mg/dL

question

A patient diagnosed with renal cell carcinoma that has metastasized to the lungs is considered to be in which stage of cancer?

answer

IV

question

A patient has had one kidney removed as a treatment for kidney cancer. The patient asks, "Does the good kidney take over immediately? I know a person can live with just one kidney." What is the nurse's best response?

answer

"The other kidney will provide adequate function, but this may take days or weeks."

question

Which patient has the greatest risk of developing a kidney abscess?

answer

Patient is diagnosed with acute pyelonephritis.

question

A 53 year old patient is newly diagnosed with renal artery stenosis. What clinical manifestation is the nurse most likely to observe when the patient first seeks health care?

answer

Sudden onset of hypertension

question

A patient has been informed by the health care provider that treatment will be needed for renal artery stenosis. The nurse prepares to teach about a variety of treatment options. What treatments will the nurse include in the teaching plan?

answer

Hypertension control. Balloon angioplasty. Renal artery bypass surgery. Synthetic blood vessel graft.

question

What change in diabetic therapy may be needed for a patient who has diabetic nephropathy?

answer

Decreased insulin dosages.

question

A patient with diabetic nephropathy reports having frequent hypoglycemic episodes "my doctor reduced my insulin, which means my diabetes is improving." What is the nurse's best response?

answer

"when kidney function is reduced, the insulin is available for a longer time and thus less of it is needed."

question

The student is assisting in the postoperative care of a patient who had a recent nephrectomy. The student demonstrates a reluctance to move the patient ot change the linens because "the patient seems so tired." The nurse reminds the student that a priority assessment for this patient is to assess for which factor?

answer

Blood on the linens beneath the patient

question

After a nephrectomy, a patient has a large urine output because of adrenal insufficiency. What does the nurse anticipate the priority intervention for this patient will be?

answer

IV fluid replacement because of subsequent hypotension and oliguria.

question

The nurse is caring for a patient with nephrotic syndrome. What interventions are included in the plan of care for this patient?

answer

Administer mild diuretics. Assess for edema. Administer antihypertensive medications.

question

The nurse is reviewing the patient's history, assessment findings, and laboratory results for a patient with suspected kidney problems. Which manifestation is the main feature of nephrotic syndrome?

answer

Proteinuria greater than 3.5 g of protein in 24 hours.

question

A patient is newly admitted with nephrotic syndrome and has proteinuria, edema, hyperlipidemia, and hypertension. What is the priority for nursing care?

answer

Monitor fluid volume and the patient's hydration status.

question

A patient is diagnosed with interstitial nephritis. Which nursing action is relevant and specific for this patient's medical condition?

answer

Monitor for fever.

question

Which ethnic groups are mostly likely to develop end stage kidney disease related to hypertension?

answer

American Indians African Americans

question

A patient with acute glomerulonephritis has edema of the face. The blood pressure is moderately elevated and the patient has gained 2 pounds within the past 24 hours. The patient reports fatigue and refuses to eat. What is the priority for nursing care?

answer

Assess for signs and symptoms of fluid volume overload.

question

A patient with acute glomerulonephritis is required to provide a 24 hour urine specimen. What does the nurse expect to see when looking at the specimen?

answer

Smoky or cola colored urine.

question

Which nursing intervention is applicable for a patient with acute glomerulonephritis?

answer

Measuring weight daily.

question

Which diagnostic tests and results does the nurse expect to see with acute glomerulonephritis?

answer

Urinalysis revealing hematuria. Microscopic red blood cell casts.

question

A patient has late stage chronic glomerulonephritis. Which educational brochure would be the most appropriate to prepare for the patient?

answer

"Important points to know about dialysis"

question

The nurse is reviewing the lab results of a patient with chronic glomerulonephritis. The phosphorus level is 5.3 mg/dL. What else does the nurse expect to see?

answer

Serum calcium level below normal range.

question

The nurse is reviewing arterial blood gas results of a patient with acute glomerulonephritis. The pH of the sample is 7.35. As acidosis is likely to be present because of hydrogen ion retention and loss of bicarbonate, how does the nurse interpret this data?

answer

Normal pH with respiratory compensation

question

The nurse is taking a history on a patient with chronic glomerulonephritis. What is the patient most likely to report?

answer

Occasional edema and fatigue.

question

Which patient history factor is considered causative for acute glomerulonephritis?

answer

Strep throat 3 weeks ago.

question

A patient is very ill and is admitted to the ICU with rapidly progressing glomerulonephritis. The nurse monitors the patietn for manifestations of which organ system failure?

answer

Renal system

question

Kidney tissue changes in chronic glomerulonephritis are caused by which factors?

answer

Ischemia. Hypertension. Infection.

question

A patient is diagnosed with chronic glomerulonephritis. The patient's spouse reports that the patient is irritable, forgetful, and has trouble concentrating. Which assessment finding does the nurse expect on further examination?

answer

Elevated blood urea nitrogen (BUN).

question

The nurse is reviewing the lab results for a patient with chronic glomerulonephritis. The serum albumin level is low. What else does the nurse expect to see?

answer

Proteinuria

question

A patient has chronic glomerulonephritis. In order to assess for uremic symptoms, what does the nurse do?

answer

Ask the patient to extend the arms and hyper-extend the wrists.

question

A patient is admitted for acute glomerulonephritis. In reviewing the patient's past medical history, which systemic conditions does the nurse suspect may have caused acute glomerulonephritis and will include in the overall plan of care?

answer

Systemic lupus erythermatosus and diabetic nephropathy

question

The nurse is assessing a patient with possible acute glomerulonephritis. During the inspection of the hands, face, and eyelids, what is the nurse primarily observing for?

answer

Edema

question

The nurse is assessing a patient with glomerulonephritis and notes crackles in the lung fields nad neck vein distention. The patient reports mild shortness of breath. Based on these findings, what does the nurse do next?

answer

Assess for additional signs of fluid overload

question

For a patient with acute glomerulonephritis , a 24 hour urine test was initiated and the GFR results are pending. What are the clinical implications of the test results?

answer

GFR is low; the patient is at risk for fluid overload.

question

The health care provider advises the patient that diagnostic testing is needed to identify the possible presence of a renal abscess. Which test does the nurse prepare the patient for?

answer

Radionuclide renal scan

question

A patient with chronic peylonephritis returns to the clinic for follow-up. Which behavior indicates the patient is meeting the expected outcomes to conserve existing kidney function?

answer

Reports taking antibiotics as prescribed.

question

Which patient has the greatest risk for developing chronic pyelonephritis?

answer

36 year old woman with diabetes mellitus who is pregnant

question

A patient is diagnosed with acute pyelonephritis. What is the priority for nursing care for this patient?

answer

Managing pain.

question

A patient has come to the clinic for follow up of acute pyelonephritis. Which action does the nurse reinforce to the patient?

answer

complete all antibiotic regimens.

question

The off going nurse is giving shift report to the oncoming nurse about the care of a patient who had a nephrostomy tube placed 3 days ago and it is to remain in place until the urinary obstruction is resolves. What is the most important point to clearly communicate about the urine drainage?

answer

"Urine is draining only into the collection bag, not the bladder; therefore the minimum expected drainage is 30 mL/hour."

question

What are the key features associated with chronic pyelonephritis?

answer

Hypertension Inability to conserve sodium Decreased urine concentrating ability, resulting in nocturia. Tendency to develop hyperkalemia and acidosis.

question

Which factor/manifestation is primarily associated with acute pyelonephritis?

answer

Active bacterial infection

question

The nurse is assessing a patient who reports chills, high fever, and flank pain with urinary urgency and frequency. On physical examination, the patient has costovertebral angle (CVA) tenderness, pulse is 110 bpm rr 28/min. How does the nurse interpret these findings?

answer

Acute pyelonephritis

question

An older adult male patient reports an acute problem with urine retention. The nurse advises the patient to seek medical attention because permanent kidney damage can occur in what time frame?

answer

In less than 48 hours

question

The nurse is reviewing the lab results for a pt being evaluated for trouble with passing urine. The urinalysis shows tubular epithelial cells on microscopic examination. How does the nurse interpret this finding?

answer

The obstruction is prolonged

question

A patient had a nephrostomy and a nephrostomy tube is in place. What is included in the postoperative care of this patient?

answer

Assess the amount of drainage in the collection bag.

question

The nurse is caring for a patient with a nephrostomy. The nurse notifies the health care provider about which assessment finding?

answer

Amount of drainage decreases and the patient has back pain.

question

What is the common problem of hydronephrosis, hydroureter, and urethral stricture in kidney function?

answer

Obstruction

question

An older adult male patient calls the clinic because he has "not passed any urine all day long." What is the nurse's best response?

answer

"You could have an obstruction, so you should come back in to be checked."

question

A patient reports straining to pass very small amounts of urine today, despite a normal fluid intake, and reports having the urge to urinate. The nurse palpates the bladder and finds that it is distended. Which condition is most likely to be associated with these findings?

answer

urethral stricture

question

A patient is diagnosed with hydronephrosis. What is a complication that could result from this condition?

answer

Damage to the nephrons

question

Which clinical manifestation in a patient with an obstruction in the urinary system is associated specifically with a hydronephrosis?

answer

Flank asymmetry

question

After the nurse instructs a patient with PKD on home care, the patient knows to contact the health care provider immediately when what sign/symptom occurs?

answer

Weight has increased by 3 pounds in 2 days.

question

The health care provider tells the nurse that the patient with PKD has salt wasting. Which intervention is the nurse likely to use related to nutrition therapy?

answer

Advise that a low sodium diet is not currently necessary.

question

The health care team is using a collaborative and interdisciplinary approach to design a treatment plan for a patient with PKD. What is the top priority?

answer

Controlling hypertension

question

A patient with PKD would exhibit which signs/symptoms?

answer

Increased abdominal girth Hypertension Kidney stones

question

In PKD, the effect on the renin-angiotensin system in the kidney has which result?

answer

Increased blood pressure

question

The nurse is reviewing laboratory results for a patient with PKD. Which lab abnormality indicates glomeruli involvement?

answer

Proteinuria

question

A patient is suspected of having PKD. Which diagnostic study has minimal risks and can reveal PKD?

answer

Renal sonography

question

Which pain management strategy does the nurse teach a patient who has pain from infected kidney cysts of PKD?

answer

Apply dry heat to the abdomen or flank.

question

A patient with PKD usually experiences constipation. What does the nurse recommend?

answer

Increased dietary fiber and increased fluids.

question

A patient with PKD has nocturia. What does the nurse encourage the patient to do?

answer

Drink at least 2 liters of fluid daily.

question

For the patient with PKD, which antihypertensive medication may be used because it helps control the cell growth aspects of PKD and reduce microalbuminuria?

answer

Angiotensin-converting enzyme inhibitors

question

Why may a patient with PKD experience constipation?

answer

Polycystic kidneys enlarge and put pressure on the large intestine.

question

The nurse is developing a teaching plan for a patient with PKD. Which topics does the nurse include?

answer

Teach how to measure the record blood pressure. Assist to develop a schedule for self-administering drugs. Explain the potential side effects of the drugs.

question

A patient with PKD reports sharp flank pain followed by blood in teh urine. How does the nurse interpret these signs/symptoms?

answer

Ruptured cyst.

question

A patient with PKD reporrts a severe headache and is at risk for a berry aneurysm. What is the nurse's priority action?

answer

Assess for neurologic changes and check vital signs.

question

A patient with PKD reports nocturia. What is the nocturia caused by?

answer

Decreased urine-concentrating ability.

question

A 22 year old patient comes to the clinic for a wellness check up. History reveals taht the patient's parent has the autosomal dominant form of polycystic kidney disease (PKD). Which vital sign suggests that the patient should be evaluated for PKD?

answer

Blood pressure of 136/88 mmHg

question

Which description of the recessive form of PKD is correct?

answer

Most people with this form of PKD die in early childhood.

question

Which description of the autosomal-dominant form of PKD is correct?

answer

50% of people with this form of PKD develop kidney disease by age 50.

question

The nurse is interviewing a patient with suspected PKD. What questions does the nurse ask the patient?

answer

"Is there any family history of PKD or kidney disease?" "Have you had any constipation or abdominal discomfort?" "Have you noticed a change in urine color or frequency?" "Have you had any problems with headaches?"

question

A patient has a family history of the autosomal dominant form of PKD and has therefore been advised to monitor for and reports symptoms. What is an early symptom of PKD?

answer

Nocturia.

question

A patient with a history of PKD reports dull, aching flank pain and the urinalysis is negative for infection. The health care provider tells the nurse that the pain is chronic and related to enlarging kidneys compressing abdominal contents. What nursing intervention is best for this patient?

answer

Teach methods of relaxation such as deep breathing.

Nursing 309 – Renal Quiz (ch. 67) – Flashcards

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