Deck 35: Management of Clients with Renal Disorders

Question 1

Given the diagnosis of acute glomerulonephritis, the appropriate nursing diagnosis would be

A) Deficient Knowledge related to decreasing risk factors
B) Fatigue related to increased metabolic demands and anemia
C) Impaired Urinary Elimination related to dysuria, pyuria, and frequency
D) Risk for Deficient Fluid Volume related to fever, nausea, vomiting, and diarrhea

Answer 1

Fatigue related to increased metabolic demands and anemia

Question 2

A client has nephritis. Which intervention can the nurse institute to best encourage the client to attain adequate emotional rest?

A) Encourage the family to visit often.
B) Have the client schedule specific rest periods.
C) Help the client deal with emotional reactions.
D) Request anti-anxiety medication from the physician.

Answer 2

Help the client deal with emotional reactions.

Question 3

As part of the care plan for a client with pyelonephritis, the nurse should

A) assess for manifestations of fluid overload.
B) encourage increased activity.
C) increase fluid intake to 3 to 4 L/day.
D) watch for early manifestations of anaphylaxis.

Answer 3

increase fluid intake to 3 to 4 L/day.

Question 4

The nurse caring for a client admitted for massive blood loss from ruptured esophageal varices would assess closely for

A) albuminuria related to renal hypertension.
B) decreasing urine output related to hypovolemia.
C) hematuria related to glomerular damage.
D) urine changes related to rhabdomyolysis.

Question 5

A client with hydronephrosis has undergone stent placement to relieve the obstruction. The priority action of the nurse is to

A) assess serum electrolytes and glucose levels.
B) monitor for manifestations of urinary tract infection.
C) monitor vital signs every 30 minutes for the first 4 hours.
D) provide accurate hourly fluid volume replacement.

Question 6

A client with nephrotic syndrome is being taught about self-care at home. The teaching plan should include information on

A) a high-protein diet.
B) diligent skin care.
C) forcing fluids.
D) prophylactic antibiotics.

Question 7

For a client after nephrectomy and based on the location of the incision, the nurse would formulate the nursing diagnosis of

A) Acute Pain related to surgery
B) Anxiety related to long-term outcome
C) Risk for Impaired Skin Integrity related to immobility
D) Risk for Injury: Postoperative Complications related to surgical procedure

Question 8

A client has renal cancer and is scheduled for a nephrectomy. Preoperatively, the nurse finds the client very quiet with a worried facial expression. Which statement by the nurse would be most appropriate?

A) "Chemotherapy has very good results when given after surgery."
B) "Don't worry; only about 35% of clients have advanced disease when diagnosed."
C) "Most people are worried before they go to surgery to remove cancer."
D) "You look concerned. Are you worried about having only one kidney?"

Question 9

A nurse is caring for a client with chronic kidney disease who is admitted for pneumonia. The nurse would expect that an appropriate antibiotic that the physician might consider is a/an

A) aminoglycoside.
B) cephalosporin.
C) penicillin.
D) sulfonamide.

Question 10

In the nursing care plan for a client with acute pyelonephritis, the nurse would include teaching the client to

A) complete the entire course of antibiotics.
B) drink 4000 ml of fluid daily.
C) maintain complete bed rest.
D) withhold antihypertensive medications.

Question 11

A nurse could advise a group of employees at a work-site health fair that one health promotion measure that may help reduce the risk of renal cancer is

A) consuming a low-protein diet.
B) getting plenty of exercise.
C) limiting antibiotic use.
D) not smoking.

Question 12

The nurse who notes documentation of Grey Turner's sign in a client who experienced renal trauma would interpret this to be a manifestation of

A) increased blood urea nitrogen.
B) proteinuria.
C) retroperitoneal hemorrhage.
D) urine specific gravity of 1.20.

Question 13

In the care plan for a client after nephrectomy, the nurse would include an intervention for

A) encouraging ambulation.
B) maintaining adequate hydration.
C) maintaining patency of wound drains.
D) promoting effective breathing patterns.

Question 14

In a client with glomerulonephritis, the nurse would assess for the cardinal manifestation of

A) edema.
B) fever.
C) hypertension.
D) pyuria.

Question 15

When obtaining the history of a client with acute glomerulonephritis, the nurse should be sure to ask about

A) a history of hypertension.
B) a history of long-term analgesic use.
C) recent respiratory tract infections.
D) recent urinary tract infections.

Question 16

Acute renal artery obstruction would be suspected in a client if the nurse assessed sudden

A) flank pain over the affected kidney.
B) hypothermia.
C) increase in urine output.
D) intermittent fever and sweating.

Question 17

For a client with renal trauma exhibiting gross hematuria, the nurse would enforce the activity limitation of

A) ambulation in hall once daily.
B) ambulation in room only.
C) bed rest.
D) bathroom privileges.

Question 18

A nurse assessing a client with a renal abscess would expect to find

A) bacteria in the urine.
B) high fever.
C) hypertension.
D) oliguria.

Question 19

The nurse warns a client with insulin-dependent diabetes mellitus (IDDM) who has developed proteinuria that this finding is significant because

A) insulin requirements should be lowered.
B) it indicates that the client's diabetes is uncontrolled.
C) renal failure will most likely develop in 5 to 10 years.
D) renal failure will result if diabetes is not well controlled.

Question 20

The nurse would anticipate that a client with rhabdomyolysis would exhibit

A) brown-tinged urine.
B) gross hematuria.
C) hypokalemia.
D) hypophosphatemia.

Question 21

An 88-year-old client has glomerulonephritis, is quite edematous, and has an order for large doses of diuretics. Before administering the first dose, the most appropriate action by the nurse would be to

A) call the physician to clarify the order.
B) educate the client as to the drug's effects.
C) have the unlicensed assistive personnel take a set of vital signs.
D) plan to administer the diuretics evenly spaced throughout the day.

Question 22

A female client has recurrent urinary tract infections (UTIs). Important self-care measures the nurse could teach this client to protect her kidneys include (Select all that apply)

A) acidifying the urine by drinking cranberry juice.
B) ensuring adequate fluid intake.
C) seeking medical attention at the first sign of UTI.
D) wiping the perineal area from front to back.

Question 23

Health promotion measures the nurse could suggest to clients to prevent renal artery disease are

A) avoiding UTIs, or seeking prompt treatment if they occur.
B) eating a "Mediterranean" style diet.
C) the same as those for cardiovascular disease.
D) unknown; it appears that it is an inherited condition.

Question 24

In caring for a client who underwent renal angioplasty and stent placement, the nurse would anticipate administering a(n)

A) antiplatelet agent.
B) aminoglycoside antibiotic.
C) beta-adrenergic blocker.
D) diuretic.

Question 25

The nurse explains that polycystic kidney disease ultimately results in

A) acute renal failure.
B) chronic renal failure.
C) glomerulonephritis.
D) pyelonephritis.