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 client in chronic kidney disease becomes confused and complains of abdominal cramping, racing heart rate, and numbness of the extremities. The nurse relates these symptoms to which lab value?
Correct Answer: B
Rationale: Hyperkalemia is the life-threatening effect of renal failure. The client can become apathetic, confused, and have abdominal cramping, dysrhythmias, nausea, muscle weakness, and numbness of the extremities. Symptoms of hypocalcemia are muscle twitching, irritability, and tetany. Elevation in urea levels can result in azotemia, which can be exhibited in fluid and electrolyte and/or acid-base imbalance. Elevation of WBCs is not indicated.
Question 2 of 5
A client with newly diagnosed renal cancer is questioning why detection was delayed. Which is an appropriate response by the nurse?
Correct Answer: C
Rationale: Renal cancers rarely cause symptoms in the early stage. Tumors can become quite large before causing symptoms. Painless, gross hematuria is often the first symptom in renal cancer and does not present until later stages of the disease. Adenocarcinomas are the most common renal cancer (about 80%) whereas squamous cell renal cancers are rare. It is not therapeutic to place doubt or blame for delayed diagnosis.
Question 3 of 5
A client has undergone a renal transplant and returns to the health care agency for a follow-up evaluation. Which finding would lead the nurse to support that the client is experiencing rejection?
Correct Answer: D
Rationale: Signs and symptoms of transplant rejection include abdominal pain, hypertension, weight gain, oliguria, edema, fever, increased serum creatinine levels, and swelling or tenderness over the transplanted kidney site.
Question 4 of 5
A client is experiencing acute glomerulonephritis. Which assessment finding by the nurse is most important in determining the severity of the client's condition?
Correct Answer: C
Rationale: Visual disturbances can be indicative of rising blood pressure in a client with acute glomerulonephritis. Severe hypertension needs prompt treatment to prevent convulsions. Presence of albumin (protein) and RBCs in the urine, along with periorbital and peripheral edema, are common symptoms associated with glomerulonephritis.
Question 5 of 5
The nurse is providing education to a client with acute glomerulonephritis. What should the nurse include in the teaching? Select all that apply.
Correct Answer: B,C,D
Rationale: The nurse should explain the purpose of diuretic therapy or other prescribed medications, the dosing regimen, and side effects, recommend regular blood pressure monitoring, and caution the client to avoid contact with persons who have infections. The nurse should identify the specific amount of sodium that the client is allowed and identify sources of sodium to avoid. The nurse should also advise the client to contact the primary provider if urinary volumes diminish, or if headaches, nosebleeds, or unexpected weight gain occur.