ATI LPN
Timby's Introductory Medical-Surgical Nursing Thirteenth, North American Edition
Chapter 58 : Caring for Clients With Disorders of the Kidneys and Ureters Questions
Question 1 of 5
A child is brought into the clinic with symptoms of edema and dark brown rusty urine. Which nursing assessment finding would best assist in determining the cause of this problem?
Correct Answer: A
Rationale: Acute glomerulonephritis usually occurs as a result of bacterial infection such as seen with a beta-hemolytic streptococcal infection or impetigo. Red blood cells and protein found in the urine and elevated blood pressure are symptoms associated with glomerulonephritis.
Question 2 of 5
A client with chronic glomerulonephritis has generalized edema. Which response by the nurse best describes why anasarca occurs with this disorder?
Correct Answer: A
Rationale: Anasarca is caused by the shift of fluid from the intravascular space to interstitial and intracellular locations, not by a shift of fluid from the tissues into the blood vessels. The fluid shift results from depletion of protein from the blood (serum) to the urine. Sodium intake should be limited in clients with renal disease, and too little sodium intake does not result in anasarca. Urinary retention is not indicated with anasarca.
Question 3 of 5
The home health nurse reviews medications taken by the client with polycystic kidney disease. Which medication should be addressed first?
Correct Answer: D
Rationale: Nephrotoxic drugs are not administered to clients with renal disease unless no other therapeutic agent is available. Ibuprofen (Motrin) is a nephrotoxic drug and nephrotoxic medications, such as nonsteroidal anti-inflammatory drugs and cephalosporin antibiotics, should be avoided in treating clients with polycystic kidney disease. Lovastatin (Mevacor) (antihyperlipidemic agent) and methylprednisolone (Depo-Medrol) (steroid) are drugs presently being reviewed for slowing the rate of disease progression in clients with polycystic kidney disease and are not considered nephrotoxic. Furosemide (Lasix) is a diuretic and has no significance in causing renal damage.
Question 4 of 5
The nurse is teaching a client diagnosed with polycystic kidney disease on the management of the disorder. Which statement made by the client indicates a need for further teaching?
Correct Answer: C
Rationale: Polycystic kidney disease is characterized by the formation of multiple cysts on both kidneys. Polycystic kidney disease is inherited as an autosomal dominant trait. The fluid-filled cysts can cause great enlargement of the kidneys and interfere with kidney function, which can eventually lead to renal failure.
Question 5 of 5
A nephrostomy tube is inserted in a client with a large ureteral calculus. Which is the most important consideration in providing nursing care for this client?
Correct Answer: B
Rationale: Clamping or kinking of the tube will create backup of urine into the renal pelvis, resulting in hydronephrosis and can contribute to renal damage. Always make sure the urine is allowed to flow continuously and freely and do not irrigate. The nephrostomy tube is inserted through a stab wound and enters the kidney. A sterile dressing should be used to prevent pathogen entry.