Deck 22: Renal Disorders

Question 1

The nurse is providing care for a young adult client who has been diagnosed with Goodpasture's syndrome. Which does the nurse identify, when reviewing test results, as an indicator of the client being at high risk for developing Goodpasture's syndrome in the kidney and lungs?
1)HLA-DR2
2)HLA-DR3
3)ANCAs
4)Anti-glomerular basement membrane (GBM) antibodies

Answer 1

1

Question 2

Which statements does the nurse identify as correct after contrasting peritoneal dialysis (PD) with hemodialysis and continuous renal replacement therapy (CRRT)? Select all that apply.
1)In CRRT, the dialysis solution pulls wastes and extra fluid from the blood into the abdominal cavity.
2)The dwell time in PD is 4 hours.
3)The entire blood volume circulates through the dialyzer in 30 to 40 minutes.
4)PD is a slower process used for clients who are hemodynamically unstable.
5)The process of draining and filling in PD takes about 30 to 40 minutes.

Answer 2

2, 5

Question 3

The nurse is assessing a client with suspected nephrolithiasis. Which factors does the nurse identify as possible causes for the disease? Select all that apply.
1)The client excretes excess uric acid in the urine.
2)The client drinks over 3 liters of water every day.
3)The client has a family history of renal calculi.
4)The client does not take calcium supplements.
5)The client suffers from hyperparathyroidism.

Answer 3

1, 3, 5

Question 4

Which constitute the net effects of the renin-angiotensin-aldosterone system (RAAS) of the kidneys? Select all that apply.
1)Sodium reabsorption
2)Water reabsorption
3)Potassium reabsorption
4)Potassium excretion
5)Arterial vasodilation

Question 5

Which statement made by a nurse pertains to the theory of protein deficiency as a possible cause of the formation of renal calculi?
1)"A kidney stone is formed when crystalline constituents settle on uropontin."
2)"Calcium phosphate deposition in the renal papilla leads to formation of a kidney stone."
3)"A Randall plaque is formed when a calcium phosphate compound settles in the renal papilla."
4)"There is a deficiency of the protein nephrocalcin, which inhibits stone formation."

Question 6

A nurse is reviewing the treatment of nephrolithiasis with staff nurses. Which statements made by an attending nurse indicate the need for additional review? Select all that apply.
1)"A low-sodium diet is recommended to limit fluid overload."
2)"Pain management is the major part of treatment."
3)"Clients are instructed to drink at least 3 liters of fluid a day."
4)"Most renal stones are treated with lithotripsy."
5)"Drinking cranberry juice is beneficial in certain types of renal calculi."

Question 7

A health-care provider is evaluating the urine and blood test reports of a client with a muscular body structure. Which observations are most likely to indicate that the client is experiencing renal impairment? Select all that apply.
1)High amount of leukocyte esterase
2)A blood urea nitrogen (BUN) of 25 mg/dL
3)Increased creatinine clearance
4)Decreased creatinine clearance
5)High specific gravity of dilute urine

Question 8

Which statement made by a nurse demonstrates understanding of the secretory functions of the kidney?
1)"Clients with renal failure have higher hemoglobin levels because of constant secretion of erythropoietin."
2)"Kidneys create glucose from amino acids in case of excessive consumption of animal proteins."
3)"The juxtaglomerular apparatus secretes renin in response to high sodium levels in the blood."
4)"Clients with impaired renal function have disrupted calcium balance in the bloodstream due to inactive vitamin D."

Question 9

The nurse is assessing the urinalysis report of a client of average build. Which observation definitely indicates a state of illness in the client?
1)A serum creatinine level of 10 mg/dL
2)A blood urea nitrogen (BUN) level of 15 mg/dL
3)Casts in the urine
4)Slightly hazy urine

Question 10

The nurse notices the glomerular filtration rate of a client has decreased. Which are the possible reasons for this change? Select all that apply.
1)A decrease in the client's blood pressure
2)An increase in the client's blood pressure
3)A decrease in the client's renal perfusion
4)An increase in the client's renal perfusion
5)A part of the normal aging process

Question 11

What percentage of the body's cardiac output is received by the kidneys? 1.5% to 10%
2)20% to 25%
3)30% to 35%
4)45% to 50%

Question 12

The nurse is providing care for a client admitted to the intensive care unit (ICU) after surgery for multiple accident-related injuries. The client's spouse asks why the nurse is measuring the client's urine every hour. What is the reason for the assessment?
1)Limited fluid intake can affect how much urine is produced.
2)Notable reduced urine production indicates serious kidney injury.
3)Blood loss from surgery and injuries can cause prerenal dysfunction.
4)Measuring urine output sets a goal for the rate of fluid replacement.

Question 13

The nurse assesses a client for the presence of proteinuria. What observations indicate the client is experiencing this condition? Select all that apply.
1)Protein excretion in urine of 130 mg/day
2)Protein excretion in urine of 200 mg/day
3)Foamy urine
4)Tea-colored urine
5)Presence of crystals in the urine

Question 14

Which is a likely cause of elevated blood urea nitrogen (BUN) in a client?
1)Increase in glomerular filtration rate
2)Dehydration
3)Low-protein diet
4)Very frail body structure

Question 15

Which percentage of clients diagnosed with Goodpasture's syndrome has clinically apparent manifestations of pulmonary and renal disease? 1.60% to 80%
2)20% to 40%
3)Less than 10%
4)More than 90%

Question 16

The nurse is providing care for a client with a history of insulin-dependent type 2 diabetes mellitus. Currently, the client is diagnosed with renal failure. Which effect does the client's condition have on the insulin administered by the nurse?
1)Higher levels of insulin are needed.
2)The degradation of insulin is decreased.
3)Insulin is not effective during renal failure.
4)Glucose levels are totally controlled by diet.

Question 17

Which statement made by a nurse demonstrates understanding of the basic pathology of renal disorders?
1)"Postrenal dysfunction can be accompanied by an increased risk of infection."
2)"Prerenal dysfunction can be caused by excessive consumption of NSAIDs."
3)"Intrarenal dysfunction can lead to hydronephrosis."
4)"Postrenal dysfunction can result from severe hypovolemia."

Question 18

The nurse is reviewing the difference between acute kidney injury and chronic renal failure. Which client does the nurse identify as having chronic renal failure?
1)Condition was initiated by a drop in blood volume
2)Illness resulting in severe vomiting and diarrhea
3)Diagnosis of systemic lupus erythematosus
4)Injury acquired during a contact sport

Question 19

A client presents with a specific type of renal calculi that is not widely prevalent. The nurse knows this client has been undergoing chemotherapy for the treatment of cancer. Which is an associated characteristic of the type of renal calculi that is most likely to be present in this client?
1)Urine supersaturated with cystine
2)High purine levels in the bloodstream
3)Alkaline pH of urine
4)Pseudomonas infection in the urinary tract

Question 20

A client has a history of kidney stones and states, "My whole family has kidney stones." Which is the most likely reason for the client's formation of renal calculi?
1)A genetic predisposition
2)Chronic urinary tract infection
3)Formation of gout crystals
4)Excessive bone reabsorption

Question 21

Arrange in order the changes that occur in the kidneys during polycystic kidney disease. (Enter the number of each step in the proper sequence; do not use commas or spaces.)
1) Blood leaks into the cysts.
2) An outpocketing of the nephron tubule walls takes place.
3) The cysts develop blood vessels.
4) Hyperplasia of renal epithelial cells occurs.
5) The cystic walls stretch, causing excruciating pain.
6) Gross hematuria occurs.

Question 22

Arrange in order the mechanism related to the occurrence of edema in a client experiencing acute glomerulonephritis (AGN). (Enter the number of each step in the proper sequence; do not use commas or spaces.)
1) The low colloid oncotic pressure is overcome by hydrostatic pressure.
2) Loss of albumin and red blood cells (RBCs) in the urine takes place.
3) The antigen-antibody complexes damage the structure of the glomeruli.
4) Hyperpermeability of the capillaries occurs.
5) Diminished colloid oncotic pressure (COP) occurs throughout the body.
6) Antigen enters the body and stimulates antibody synthesis.

Question 23

A client presents with a colicky type of flank pain that radiates into the groin. Assessment reveals edema and distention of the renal pelvis caused by a buildup of urine. Which conditions is the client at risk for developing if the edema and distention continue for a prolonged period? Select all that apply.
1)Compression of the kidney tissue
2)Ischemia
3)Hematuria
4)Crystalluria
5)Pleural effusion

Question 24

Arrange in order the steps that lead to the formation of a kidney stone related to deposition of calcium phosphate. (Enter the number of each step in the proper sequence; do not use commas or spaces.)
1) The calculus erodes through the urothelium of the renal pelvis.
2) Calcium phosphate compound collects layers of collagenous material and cellular debris.
3) Calcium phosphate deposits in the renal papilla.
4) The plaque collects layers of crystalline elements to become a calculus.
5) Randall plaque forms within the subepithelial membrane.