ATI LPN
Test Bank for Medical Surgical Nursing: Concepts for Interprofessional Collaborative Care 10th Edition
Chapter 67 : Care of Patients with Kidney Disorders Questions
Question 1 of 5
A nurse cares for a client with autosomal dominant polycystic kidney disease (ADPKD). The client asks, 'Will my children develop this disease?' How should the nurse respond?
Correct Answer: D
Rationale: ADPKD is an autosomal dominant disorder, meaning there is a 50% chance of passing the gene to each child, regardless of gender. It is not sex-linked, and only one parent needs to have the gene for the child to be at risk.
Question 2 of 5
After teaching a client with early polycystic kidney disease (PKD) about nutritional therapy, the nurse assesses the client's understanding. Which statement made by the client indicates a correct understanding of the teaching?
Correct Answer: B
Rationale: Clients with PKD often experience constipation, which can be managed by increasing dietary fiber and fluid intake. Laxatives should be used cautiously, salt intake should be restricted, and white bread is low in fiber, making it inappropriate for a high-fiber diet.
Question 3 of 5
A nurse cares for a middle-aged female client with diabetes mellitus who is being treated for the third episode of acute pyelonephritis in the past year. The client asks, 'What can I do to help prevent these infections?' How should the nurse respond?
Correct Answer: C
Rationale: Increasing fluid intake (especially water) and frequent voiding help flush bacteria from the urinary tract, reducing the risk of pyelonephritis. Chronically elevated blood glucose in diabetes can promote bacterial growth, but frequent voiding is the most direct preventive measure. Testing urine for ketones/proteins, using tampons, or controlling hemoglobin A1C are not as directly related to preventing urinary tract infections.
Question 4 of 5
The nurse should first fully assess the client for signs of volume depletion and shock, and then notify the provider. The radical nature of the surgery and the proximity of the surgery to the adrenal gland put the client at risk for hemorrhage and adrenal insufficiency. Hypertension is a clinical manifestation associated with both hemorrhage and adrenal insufficiency. Hypertension is particularly dangerous for the remaining kidney, which must receive adequate perfusion to function effectively. Which action should the nurse take first?
Correct Answer: D
Rationale: Assessing the rate and quality of the client's pulse is critical to evaluate for signs of volume depletion or shock, which are potential complications post-nephrectomy due to hemorrhage or adrenal insufficiency. This assessment provides essential data before notifying the provider. Repositioning, measuring urine specific gravity, or administering pain medication do not address the immediate risk of these complications.
Question 5 of 5
A nurse cares for a client with a nephrostomy tube and notes that the drainage has decreased. Which action should the nurse take first?
Correct Answer: D
Rationale: Decreased drainage from a nephrostomy tube may indicate obstruction, necessitating immediate assessment of the client's abdomen for pain or distention and vital signs to detect complications like infection or obstruction. This information should be reported to the provider. Documenting, evaluating in hand-off, or clamping the tube are not appropriate initial actions.