Posttest. Renal Disorders

Posttest: Renal Disorders Set A 1. Maria, a 28 years old teacher, is admitted to the hospital with a diagnosis of renal calculi. Her blood studies shows a BUN of 20 mg/dl, serum calcium level of 4.5 mEq/L, serum phosphorus of 1.8 mEq/L, serum sodium of 138 Eq/L and urine pH of 5.1. Which nursing intervention would be most effective in altering Maria’s urine pH? a. Increasing activity b. Forcing fluids c. Administering allopurinol as ordered d. Excluding high calcium fluids from her diet 2. Clinical manifestations of renal calculi depend on all of the following except: a. Composition of calculi b. Degree of obstruction c. Site of calculi d. Presence of infection 3. A patient whose renal calculi is found composed primarily by calcium oxalate should be instructed by the nurse to: a. Reduce salt in the diet b. Increase intake of high calcium foods like milk, dilis, cheese, sardines c. Maintain an acid ash diet d. Maintain an alkaline ash diet 4. The doctor ordered renal ultrasound. In preparing the patient the nurse should not: a. Restrict foods and fluids before the test b. Apply conductive gel over the patient’s back and flank immediately before the procedure c. Tell the patient that the test is not invasive and will last for only 30 – 60 minutes without radiation exposure d. Instruct the patient to remain very still during the procedure 5. Which factor is not likely to predispose an individual to renal calculi development? a. A history of urinary tract infection (UTI) b. Hyperkalemia c. Prolonged immobilization d. Hypervitaminosis D 6. Sandy, age 50, is admitted to the unit with diagnosis of Glomerulonephritis. What organism is the most common cause of this disorder? a. E. Coli b. Grp A Beta-Hemolytic Streptococcus c. S. Aureus d. Pseudomonas 7. She mentions that she likes salty foods. The nurse should instruct her to lower her sodium intake in order to a. Promote urea nitrogen excretion b. Improve her glomerular filtration rate c. Increase potassium absorption d. Reduce edema 8. Before Sandy’s discharge, the nurse should teach her about the need for a. A nephrectomy b. Protection from infection c. A high protein diet d. Foot care

9. 2 months after, Sandy is readmitted with renal failure. The main difference between acute renal failure and chronic failure is that acute renal failure is a. Reversible b. Irreversible c. Permanent d. Requires long treatment 10. After efforts to reverse Sandy’s condition are unsuccessful, the physician creates an arteriovenous (AV) fistula in her left arm for hemodialysis. Which nursing measure is necessary to maintain the fistula? a. Instructing the patient not to exercise her arm b. Avoiding BP measurements in the left arm c. Observing her cannula that it should not separate at the connection site d. Applying a dry sterile dressing daily Set B 1. Which observation involving the AV fistula would require the nurse to notify the physician? a. Blood flow detected while palpating the fistula site b. Blood flow observed through the cannula c. Absence of an audible bruit while auscultating the fistula d. Presence of a “thrill” or a vibrating sensation palpable on the site 2. If Sandy progresses to end-stage renal disease, which of the following statements would indicate that she understood which foods to avoid? “I will avoid foods high in 1. calcium 2. sodium 3. phosphorus 4. magnesium 5. potassium 6. cholesterol a. 1,2,3

b. .2,3,5

c. 3,4,5

d. 2,4,5

3. After performing a physical assessment and reviewing laboratory data, the nurse notifies the physician that what three classic features are present in nephrotic syndrome? 1. (+) CHON in urine 2. edema 3. hypoalbuminemia 4. increased BP a. 1,2,3

b. 2,3,4

c. 1,3,4

d. 1,2,4

4. The nurse is caring for a client having peritoneal dialysis. The nurse should monitor the client for what complication that is the priority risk for this client? a. Infection b. Edema c. Hypertension d. Anemia 5. For a client with chronic renal failure, the diet that he/she will be maintaining all throughout life is a. Low protein diet c. high sodium diet b. High potassium diet d. low calorie diet 6. Gina is recently taking in Gentamycin for her UTI. After a week of treatment, she sought for admission because she had difficulty urinating. Later, she found out that the cause of her situation now is the Gentamycin she was taking in, which is a nephrotoxic drug. If Gina has renal failure now, what type would it be?

a. Prerenal b. Intrarenal

C. Postrenal D. Chronic Renal Failure

7. If a client with chronic renal failure has a GFR of <10%, what stage would this be? a. Renal insufficiency C. end stage renal disease b. Renal failure D. renal disease 8. Which of the following is the best indicator for renal function? a. BUN C. ultrasound of the kidneys b. Creatinine D. KUB 9. In a 24 urine collection, which is true? a. Save all urine b. Discard first voided urine and save subsequent urine c. Collect the middle stream of the urine and submit immediately in a sterile container d. Insert a foley catheter and collect urine from the urobag 10. In a client with an ileal conduit, you teach him/her to assess his/her stoma regularly. A healthy stoma is a. Red C. slightly bleeding continuously b. Dry D. painful