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
The client with chronic kidney disease is exhibiting signs of anemia. Which is the best nursing rationale for this symptom?
Correct Answer: B
Rationale: Erythropoietin is a hormone produced in the kidneys, and this production is inadequate in chronic renal failure, which results in anemia. Azotemia, impaired immune response, and electrolyte imbalance are associated with chronic kidney disease but not indicated with anemia.
Question 2 of 5
A client with chronic kidney disease complains of generalized bone pain and tenderness. Which assessment finding would alert the nurse to an increased potential for the development of spontaneous bone fractures?
Correct Answer: C
Rationale: Osteodystrophy is a condition in which the bone becomes demineralized due to hypocalcemia and hyperphosphatemia. In an effort to raise blood calcium levels, the parathyroid glands secrete more parathormone. Elevated creatinine, urea, nitrogen, and potassium levels are expected in chronic renal failure and do not contribute to bone fractures.
Question 3 of 5
An investment banker with chronic kidney disease informs the nurse of the choice for continuous ambulatory peritoneal dialysis. Which is the best response by the nurse?
Correct Answer: B
Rationale: Once a treatment has been selected by the client, the nurse should support the client in that decision. Continuous ambulatory peritoneal dialysis will provide more independence for this client and supports the client's decision for treatment mode. The risk of peritonitis is greater, and symptoms should be discussed as a part of the management of the disorder. Peritoneal dialysis is an effective method of dialysis for many clients.
Question 4 of 5
The client with chronic kidney disease complains of intense itching. Which assessment finding would indicate the need for further nursing education?
Correct Answer: D
Rationale: Hot water removes more oils from the skin and can increase dryness and itching. Tepid water temperature is preferred in the management of pruritus. The use of moisturizing lotions and creams that do not contain perfumes can be helpful. Avoiding scratching and keeping nails trimmed short is indicated in the management of pruritus.
Question 5 of 5
The hemodialysis client is scheduled to receive weekly injections of epoetin. Which is the most important consideration to be taken by the nurse in the administration of this medication?
Correct Answer: A
Rationale: After dialysis, do not administer injections for 2 to 4 hours to allow time for the metabolism and excretion of heparin (which is administered during dialysis). Serum laboratory tests are performed on a routine basis to identify normal and abnormal findings. Aspirin use is not indicated with epoetin use.