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 is diagnosed with polycystic kidney disease. Which symptom would the nurse most likely assess?
Correct Answer: A
Rationale: Hypertension is often present in clients with polycystic kidney disease at the time of diagnosis. Pain from retroperitoneal bleeding, lumbar discomfort, and abdominal pain also may be noted based on the size and effects of the cysts. Fever would suggest an infection. Periorbital edema is noted with acute glomerulonephritis.
Question 2 of 5
An instructor is teaching a group of students about how to perform peritoneal dialysis. Which statement would indicate to the instructor that the students need additional teaching?
Correct Answer: B
Rationale: The dialysate should be warmed in a commercial warmer and never in a microwave oven. Strict aseptic technique is essential. The infusion clamp is opened during the infusion and clamped after the infusion. When the dwell time is done, the drain clamp is opened and the fluid is allowed to drain by gravity into the drainage bag.
Question 3 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 4 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 5 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.