Renal System

Pathphysiology

100

What type of renal failure would the nurse expect to see in a client who overdosed accidentally on tobramycin? 1. Prerenal failure 2. Postrenal failure 3.Extrarenal failure 4. Intrarenal failure

4. Intrarenal failure

200

A client is admitted for treatment of chronic renal failure (CRF). The nurse knows that this disorder increases the client's risk of: 1. water and sodium retention secondary to a severe decrease in the glomerular filtration rate. 2. a decreased serum phosphate level secondary to kidney failure. 3. an increased serum calcium level secondary to kidney failure. 4. metabolic alkalosis secondary to retention of hydrogen ions.

1. water and sodium retention secondary to a severe decrease in the glomerular filtration rate.

300

Which disorder is characterized by a sudden drop in blood glucose, followed by rebound hyperglycemia caused by the gradual and excessive administration of insulin? 1. Diabetes insipidus 2. Diabetic ketoacidosis 3. Somogyi phenomenon 4. Hyperosmolar hyperglycemic nonketotic syndrome (HHNS)

3. Somogyi phenomenon

400

A client with decreased urine output refractory to fluid challenges is evaluated for renal failure. Which condition may cause the intrinsic (intrarenal) form of acute renal failure? 1. Poor perfusion to the kidneys 2. Damage to cells in the adrenal cortex 3. Obstruction of the urinary collecting system 4. Nephrotoxic injury secondary to use of contrast media

4. Nephrotoxic injury secondary to use of contrast media

500

The nurse is performing an admission assessment on a client diagnosed with diabetes insipidus. Which findings should the nurse expect to note during the assessment? 1. Extreme polyuria 2. Excessive thirst 3. Elevated systolic blood pressure 4. Low urine specific gravity 5. Bradycardia 6. Elevated serum potassium level

1. Extreme polyuria 2. Excessive thirst 4. Low urine specific gravity

Signs and Symptoms

100

Which of the following would indicate that a client has developed water intoxication secondary to treatment for diabetes insipidus? 1. Confusion and seizures 2. Sunken eyeballs and spasticity 3. Flaccidity and thirst 4. Tetany and increased blood urea nitrogen (BUN) levels.

1. Confusion and seizures

200

A client is admitted with a diagnosis of acute renal failure. The nurse should monitor closely for: 1. enuresis. 2. drug toxicity. 3. lethargy. 4. insomnia.

2. drug toxicity.

300

In conducting client teaching with a client who will undergo peritoneal dialysis at home, the nurse includes discussion of what common and significant complication of peritoneal dialysis? 1. Pulmonary Embolism 2. Hypotension 3. Peritonitis 4. Dyspnea

3. Perionitis

400

The nurse caring for a client undergoing a hemodialysis procedure places high priority on evaluating the client frequently for what common complication during the treatment. 1. Hyperglycemia 2. Infection and fever 3. Dialysis demenia 4. Hypotension

4. Hypotension

500

Identify the clinical signs of renal transplant (graft) rejection. 1. Decreased temperature 2. Pain or tenderness over the grafted kidney 3. Weight loss of 2-3lbs in 24 hours 4. Edema 5. Hypotension 6. Elevated BUN and Creatinine levels

2. Pain or tenderness over the grafted kidney 4. Edema 6. Elevated BUN and Creatinine levels

Treatment

100

A client who has been treated for chronic renal failure (CRF) is ready for discharge. The nurse should reinforce which dietary instruction? 1. "Be sure to eat meat at every meal." 2. "Eat plenty of bananas." 3. "Increase your carbohydrate intake." 4. "Drink plenty of fluids, and use a salt substitute."

3. "Increase your carbohydrate intake."

200

A client is admitted with nausea, vomiting, and diarrhea. His blood pressure on admission is 74/30 mm Hg. The client is oliguric and his blood urea nitrogen (BUN) and creatinine levels are elevated. The physician will most likely write an order for which treatment? 1. Force oral fluids. 2. Administer furosemide (Lasix) 20 mg I.V. 3. Start hemodialysis after a temporary access is obtained. 4. Start I.V. fluids with a normal saline solution bolus followed by a maintenance dose.

4. Start I.V. fluids with a normal saline solution bolus followed by a maintenance dose.

300

The nurse is planning to administer a sodium polystyrene sulfonate (Kayexalate) enema to a client with a potassium level of 6.2 mEq/L. Correct administration and the effects of this enema would include having the client: 1. retain the enema for 30 minutes to allow for sodium exchange; afterward, the client should have diarrhea. 2. retain the enema for 30 minutes to allow for glucose exchange; afterward, the client should have diarrhea. 3. retain the enema for 60 minutes to allow for sodium exchange; diarrhea isn't necessary to reduce the potassium level. 4. retain the enema for 60 minutes to allow for glucose exchange; diarrhea isn't necessary to reduce the potassium level.

1. retain the enema for 30 minutes to allow for sodium exchange; afterward, the client should have diarrhea.

400

A client requires hemodialysis. Which type of drug should be withheld before this procedure? 1. Phosphate binders 2. Insulin 3. Antibiotics 4. Cardiac glycosides

4. Cardiac glycosides

500

Which foods should a patient with calcium oxalate stones avoid in their diet. 1. Tea 2. chocolate 3. dairy products 4. spinach 5. whole grains 6. beans

1. Tea 2. chocolate 4. spinach 6. beans

Nursing Intervention

100

Which intervention is essential when performing dressing changes on a client with a diabetic foot ulcer? 1. Applying a heating pad 2. Debriding the wound three times per day 3. Using sterile technique during the dressing change 4. Cleaning the wound with a povidone-iodine solution

3. Using sterile technique during the dressing change

200

For a client in the oliguric phase of acute renal failure (ARF), which nursing intervention is most important? 1. Encouraging coughing and deep breathing 2. Promoting carbohydrate intake 3. Limiting fluid intake 4. Providing pain-relief measures

3. Limiting fluid intake

300

The client with acute renal failure has a serum potassium level of 6.0 mEq/L. The nurse would plan which of the following as a priority action. 1. Check the sodium level. 2. Place the client on a cardiac monitor. 3. Encourage increased vegetables in the diet. 4. Allow an extra 500 mL of fluid intake to dilute the electrolyte concentration.

2. Place the client on a cardiac monitor.

400

The nurse is caring for a client with acute pyelonephritis. Which nursing intervention is most important? 1. Administering a sitz bath twice per day 2. Increasing fluid intake to 3 L/day 3. Using an indwelling urinary catheter to measure urine output accurately 4. Encouraging the client to drink cranberry juice to acidify the urine

2. Increasing fluid intake to 3 L/day

500

Actions to take if a client receiving hemodialysis develops an air embolism. 1. Turn the patient on the left side, with the head down. 2. Administer Oxygen 3. Document 4. Notify the physician 5. Stop the hemodialysis 6. Assess vital signs and pulse oximetry

5, 1, 4, 2, 6, 3

Labs/Diagnostics

100

The nurse is reviewing the client's record and notes that the physician has documented that the client has a renal disorder. On review of the laboratory results, the nurse most likely would expect to note which of the following. 1. Decreased hemoglobin level 2. Elevated creatinine level 3. Decreased red blood cell count 4. Decreased white blood cell count.

2. Elevated creatinine level

200

The nurse is assessing a client diagnosed with cystitis. To percuss the kidneys, the nurse locates the costovertebral angle, which is formed by the spinal column and rib number:

6

300

Because of difficulties with hemodialysis, peritoneal dialysis is initiated to treat a client's uremia. Which finding signals a significant problem during this procedure? 1. Blood glucose level of 200 mg/dl 2. White blood cell (WBC) count of 20,000/mm3 3. Potassium level of 3.5 mEq/L 4. Hematocrit (HCT) of 35%

2. White blood cell (WBC) count of 20,000/mm3

400

A client develops decreased renal function and requires a change in antibiotic dosage. On which factor would the physician base the dosage change? 1. GI absorption rate 2. Therapeutic index 3. Creatinine clearance 4. Liver function studies

3. Creatinine clearance

500

A client with chronic renal failure (CRF) is admitted to the urology unit. Which diagnostic test results are consistent with CRF? 1. Increased pH 2. Increased serum levels of potassium 3. Blood urea nitrogen (BUN) 100 mg/dl 4. Increased levels of calcium 5. Serum creatinine 6.5 mg/dl 6. Uric acid analysis 3.5 mg/dl

2. Increased serum levels of potassium 3. Blood urea nitrogen (BUN) 100 mg/dl 5. Serum creatinine 6.5 mg/dl