N4 - test - Interventions for Clients with Renal Disorders

Ignatavicius & Workman: Medical-Surgical Nursing: Critical Thinking for Collaborative Care, 4th Edition

Chapter 71: Interventions for Clients with Renal Disorders

1. What is the priority nursing diagnosis or collaborative problem for a client who has polycystic kidney disease?

A. Acute pain
B. Hypertension
C. Risk for infection
D. Fluid volume excess

2. Which clinical manifestation alerts you to the possibility of hydronephrosis?

A. Flank asymmetry
B. Pain and burning on urination
C. Dull sounds present on bladder percussion
D. Decreased blood urea nitrogen (BUN) level

3. What health problem or condition is most frequently associated with development of acute pyelonephritis?

A. Tuberculosis
B. Prolonged hypovolemia
C. Prolonged indwelling catheterization
D. Chronic exposure to aminoglycoside antibiotics

4. Which clinical manifestations indicate that the therapy for the client with acute pyelonephritis is effective?

A. White blood cell count differential demonstrates a “left shift.”
B. Urine output increases; urine specific gravity decreases.
C. Serum albumin level increases; serum sodium increases.
D. Flank pain decreases; urine specific gravity increases.

5. Which assessment area should you explore to distinguish between acute glomerular nephritis and nephrotic syndrome in a client with clinical manifestations of renal impairment?

A. Serum sodium levels
B. Serum albumin levels
C. Family history of renal disorders
D. Presence/absence of pitting edema

6. On the first postoperative day after a left transthoracic nephrectomy, the client tells you he is having a lot of pain on the right side and is worried that now something is wrong with the right kidney. What is your best response?

A. “The right kidney now has to do the work of two kidneys and the increased function is causing the pain.”
B. “I’m sorry you are having so much pain. I’ll get your pain medication right away.”
C. “The pain on the right side is because of how you were positioned during surgery.”
D. “You may have an infection in the right kidney causing this pain.”

7. The client with type 1 diabetes mellitus now has diabetic nephropathy. What specific complication should you remain alert to with this client? Increased risk for:

A. hypoglycemia
B. hyperglycemia
C. ketoacidosis
D. hyperosmolar, hyperglycemic, nonketotic syndrome

8. The client is being discharged after a nephrectomy for renal cell carcinoma. Which instruction or precaution should you include in a teaching plan for this client?

A. Avoiding all contact sports
B. Measuring abdominal girth daily
C. Increasing intake of dietary fiber
D. Avoiding aspirin or aspirin-containing drugs