Ati Adult 2

Front 1

RN caring for PT with nephrotic syndrome and has been taking prednisone for 3 days. What adverse effects should you look for?

1. Sore throat

2. Frequent stools

3 drowsiness

4. Tremors

Back 1

1. Sore throat- glucocorticoids depress immune system= risk for infection

2. Frequent stools-adverse effect would be back, tarry stools

3 drowsiness- insomnia would be adverse effect

4. Tremors- should look for psychological alterations.

Front 2

Rn working in Women's Health PT reports urinary urgency and dysuria. Which of the following should the RN identify as UTI indication?

1. Vag discharge

2. Pyuria

3. Glucosuria

4.elevated CR kinase-MB

Back 2

1. Vag discharge- indicates vulvovaginitis

2. Pyuria- WBC in urine is a common manifestation of UTI

3. Glucosuria- indicates hyperglycemia

4.elevated CR kinase-MB- indicates cardiac involment

Front 3

RN caring for PT following ESWL (extracorpeal shock wave lithotripsy) for treatment of calcium phosphate kidney stones. Which are appropriate actions?

1. monitor urine for ketones

2. provide PT with increased animal protein diet

3. Limit fluid to 1.5 per day

4 strain all the urine

Back 3

1. monitor urine for ketones- only do this to check for diabetic ketoacidosis

2. provide PT with increased animal protein diet-should DECREASE

3. Limit fluid to 1.5 per day- should encourage 3L to promote urine= decrease risk of stones

4 strain all the urine- check for stones

Front 4

RN caring for a hospitalized PT who received hemodialysis 1 hr ago. Once back from dialysis what should you assess for first?

1. Serum K level

2. Body Weight

3. Serum CR level

4. VS

Back 4

1. Serum K level-should check but not priority

2. Body Weight- should compare but not priority

3. Serum CR level- not priority

4. VS- ABC's

Front 5

RN obtaining a voided urine culture and sensitivity for a PT who has manifestations of a UTI what should you do first?

1. collect the urine in a clean specimen container

2. instruct PT to initiate the flow of urine before collecting the specimen.

3. Obtain the PT's first morning voiding on the following day

4. Place urine in container with preservative.

Back 5

1. collect the urine in a clean specimen container-should be sterile

2. instruct PT to initiate the flow of urine before collecting the specimen.- sterile, accurate results

3. Obtain the PT's first morning voiding on the following day- can be done anytime

4. Place urine in container with preservative.- not needed

Front 6

RN discussing hemodialysis with a newly licensed nurse. The RN should identify that hemodialysis is contraindicated in which PT?

1. PT who cannot have anticoagulants

2. PT unable to ambulate

3. PT who is immunocompromised

4. PT allergic to iodine

Back 6

1. PT who cannot have anticoagulants- these meds are required for hemodialysis

2. PT unable to ambulate- does not matter

3. PT who is immunocompromised- can still receive

4. PT allergic to iodine- does not matter

Front 7

RN providing discharge teaching to a PT with chronic kidney disease CKD. what shows teaching was understood?

1. I will consume foods high in protein

2. I will decrease my intake of foods high in phosphorus

3. I will limit my intake of foods high in calcium

4. i will add salt to the foods i consume.

Back 7

1. I will consume foods high in protein- low proteins

2. I will decrease my intake of foods high in phosphorus- CKD PT's should limit phos b/c kidneys ability to excrete

3. I will limit my intake of foods high in calcium-most of the time need supplements

4. i will add salt to the foods i consume.- CKD PT's retain sodium and fluid therefore should limit salt intake.

Front 8

RN planning care for PT who has acute glomerulonephritis. What interventions should you plan to provide.

1. Weigh the client daily

2. Encourage to drink 2-3L a day

3. Instruct the client to ambulate Q2

4. Obtain serum Blood glucose

Back 8

1. Weigh the client daily- monitor fluid retention

2. Encourage to drink 2-3L a day-have calculated fluid allowances by adding 500-600 to past 24hr urine output

3. Instruct the client to ambulate Q2- should conserve energy

4. Obtain serum Blood glucose- this is for diabetes mellitus

Front 9

RN caring for client who has received hemodialysis which of the following places the PT at risk for seizures?

1. Hypokalemia

2.Rapid increase of catecholamines

3.Rapid decrease in fluid

4.Hypercalcemia

Back 9

1. Hypokalemia- at risk for hyporeflexia

2.Rapid increase of catecholamines- at risk for tachycardia

3.Rapid decrease in fluid- risk for cerebral edema= increasing ICP =Seizures

4.Hypercalcemia-at risk for muscle weakness

Front 10

PT just had arteriovenous shunt placed in left arm. Which action would need intervention?

1. auscultating for bruits in the shunt Q4 while PT is awake

2. Elevating the shunted arm on pillows postoperativly

3. Measuring blood pressure in the shunted arm Q4

4. Palpating distal pulses of the shunted arm.

Back 10

1. auscultating for bruits in the shunt Q4 while PT is awake- should do this

2. Elevating the shunted arm on pillows postoperativly-should do this to reduce swelling and increase circulation

3. Measuring blood pressure in the shunted arm Q4- should not do this

4. Palpating distal pulses of the shunted arm.- should do this

Front 11

RN providing education regarding cyclosporine for a PT who had a kidney transplant 2 days ago. Which is appropriate?

1. You may experience hair loss due to medication

2. You will need to continue taking this medication to protect your new kidneys

3. Use an OTC anti inflammatory med for aches and pains

4. You will be at an increased risk for infection if you stop the med.

Back 11

1. You may experience hair loss due to medication- side effect is hirsutism

2. You will need to continue taking this medication to protect your new kidneys- will need to take everyday following transplant

3. Use an OTC anti inflammatory med for aches and pains- renal damage can be intensified by using NSAIDs

4. You will be at an increased risk for infection if you stop the med.-Increases the risk of infection stopping puts you at risk for rejection

Front 12

RN caring for a PT before a intravenous urography what is the nurses priority intervention?

1. Inform PT about dietary limitations

2. Place informed consent document in PTs record

3. Administer a bowel preparation to the PT

4. Determine if the Pt has an allergy to iodine or shellfish.

Back 12

1. Inform PT about dietary limitations- not first

2. Place informed consent document in PTs record-not first

3. Administer a bowel preparation to the PT- should do but not first

4. Determine if the Pt has an allergy to iodine or shellfish. - should be assessed as this will place PT high risk for contrast reaction

Front 13

Rn performing an admission on a PT who has CKD severe chronic kidney disease which findings would be expected?

1.tachypnea

2.hypotension

3.exopthalmos

4. insomnia

Back 13

1.tachypnea- expected due to metabolic acidosis

2.hypotension- would be hypertension

3.exopthalmos-hyperthyroidism disease

4. insomnia- would have lethargy and drowsiness

Front 14

PT comes in with n/v and costovertebral angel tenderness what lab results do you need to report?

1. WBC 15,000

2. BUN 15mg/dl

3. Urine specific gravity 1.020

4. Urine PH 5.5

Back 14

1. WBC 15,000- HIGH indicative infection

2. BUN 15mg/dl- within range

3. Urine specific gravity 1.020-within range

4. Urine PH 5.5-within range

Front 15

PT has urinary incontinence RN should include what instructions?

1. Sit on toilet with water running Q4

2. Set an interval for tilting based on previous voiding pattern.

3. Respond immediately to the urge to void.

4. self catheterize daily following a regular voiding.

Back 15

1. Sit on toilet with water running Q4- does not reduce incontinence

2. Set an interval for tilting based on previous voiding pattern.- tolieting schedule

3. Respond immediately to the urge to void.-they are not holding it

4. self catheterize daily following a regular voiding.-should be used for functional urinary incontinence not urge incontinence

Front 16

you are giving dietary instruction to a PT who has chronic kidney disease regarding potassium which is appropriate?

1. 1 cup cubed cantaloupe

2. 1 cup boiled spinach

3. one baked potato

4. One large apple

Back 16

1. 1 cup cubed cantaloupe- High in K

2. 1 cup boiled spinach- High in K

3. one baked potato- high in K

4. One large apple- of the choices this is the lowest in K

Front 17

post op care following a nephrectomy what is priority for the RN to evaluate.

1. Bowel sounds

2.WBC count

3. Pain level

4. BP

Back 17

1. Bowel sounds- not first

2.WBC count- not first

3. Pain level- not first

4. BP- greatest risk is acute adrenal insufficiency as it can be removed or damaged during a nephrectomy leading to hypotension, low UOP, LOC change

Front 18

PT has continent internal ileal reservoir following surgery to treat bladder cancer which statement should the RN include in teaching plan?

1. This should not affect your ability to have sexual intercourse

2. you should empty your new bladder when it feels full

3. you will need to avoid foods that produce intestinal gas

4. you must insert a catheter through your stoma to drain the urine.

Back 18

1. This should not affect your ability to have sexual intercourse- it will cause impotence

2. you should empty your new bladder when it feels full- will not have a sensation

3. you will need to avoid foods that produce intestinal gas- not needed

4. you must insert a catheter through your stoma to drain the urine. - will need to cath to drain

Front 19

PT has acute kidney injury which is expected SELECT ALL?

1. BUN 30mg

2.UOP of 40 for the last 3 hr

3. K 3.6

4.CA 9.8

5.Hct- 30%

Back 19

1. BUN 30mg- elevated BUN is expected

2.UOP of 40 for the last 3 hr-oliguria is expected

3. K 3.6-normal should be elevated with AKI

4.CA 9.8-normal should be decreased with AKI

5.Hct- 30%- decreased to be expected with AKI

Front 20

PT has AKI acute kidney injury which labs should be reported?

1.K 5.0

2. Ca 9.0

3. CR 4.0

4. Amylase 84 IU

Back 20

1.K 5.0- normal

2. Ca 9.0-normal

3. CR 4.0- elevated

4. Amylase 84 IU-normal

Front 21

PT had continous bladder irrigation following a transurethral resection of the prostate. Upon detection and output obstruction, what action should happen next?

1. Irrigate the catheter with NS

2. Notify provider

3. Check irrigation tubing for kinks

4. Provide PRN pain meds

Back 21

1. Irrigate the catheter with NS

2. Notify provider

3. Check irrigation tubing for kinks- first action

4. Provide PRN pain meds-

Front 22

you are providing teaching to a PT with CKD chronic kidney disease which statement demonstrates understanding?

1. I will monitor my BP on the same day each week

2. I will take milk of magnesia if I'm constipated

3. I will weigh myself each morning

4 I will use a salt substitute in my diet.

Back 22

1. I will monitor my BP on the same day each week-should be daily

2. I will take milk of magnesia if I'm constipated-should not use milk of magnesia b/c of ts magnesium and Na content

3. I will weigh myself each morning- accurate fluid assessment

4 I will use a salt substitute in my diet.- should avoid b/c salt substitutes are high in K

Front 23

Pt is scheduled to undergo extracorporeal shock wave lithotripsy ESWL for urolithiasis. What action should the RN take?

1. Place PT in semi fowlers

2. Assist PT with intubation

3. Begin a 24 hr urine collection after the procedure

4. apply electrodes for cardiac monitoring.

Back 23

1. Place PT in semi fowlers- should be supine

2. Assist PT with intubation- only need moderate sedation

3. Begin a 24 hr urine collection after the procedure- should plan to strain urine

4. apply electrodes for cardiac monitoring.- will be needed to apply shock waves so they are in sync with the R wave.

Front 24

PT just received new kidney. RN knows that what can show a delay in function of the transplanted kidney?

1. BP 110/58

2. incisional tenderness

3. Pink and bloody urine

4. UOP 30ml in 2 hr

Back 24

1. BP 110/58

2. incisional tenderness

3. Pink and bloody urine

4. UOP 30ml in 2 hr

Front 25

which of the following PTs should theRN plan to monitor for signs of nephrotoxicity?

1. PT receiving gentamicin for treatment of wound infection

2. PT receiving digoxin

3. PT on methyprednisolone for asthma

4. PT on propranolol for hypertension

Back 25

1. PT receiving gentamicin for treatment of wound infection-can cause acute tubular necrosis

2. PT receiving digoxin-does not cause toxicity

3. PT on methyprednisolone for asthma-not toxic

4. PT on propranolol for hypertension-not toxic

Front 26

Which of the following conditions is a risk factor for chronic pyelonephritis?

1. Parkinson's disease

2. Diabetes Mellitus

3. Peptic ulcer disease

4. Gallbladder disease

Back 26

1. Parkinson's disease-not related

2. Diabetes Mellitus- higher risk due to decreased bladder tone

3. Peptic ulcer disease-not related

4. Gallbladder disease- not related

Front 27

Teaching a PT with acute pyelonephritis. what instruction should the RN include?

1. Drink 1500ml/day

2. Avoid use of NSAIDS for pain

3. Monitor peripheral blood glucose twice per day

4. Increase dietary protein intake.

Back 27

1. Drink 1500ml/day-should promote 2000mL

2. Avoid use of NSAIDS for pain-can further damage kidneys

3. Monitor peripheral blood glucose twice per day-not needed

4. Increase dietary protein intake.- should decrease protein

Front 28

chronic kidney pailure Pt labs read BUN 196, Na 152, K 7.3, which intervention should the RN implement?

1. Initiate an IV of 0.9 nacl

2. Give oral spironolactone

3.infuse regular insulin dextrose 10% in water

4. Administer furosemide

Back 28

1. Initiate an IV of 0.9 nacl should not receive NaCl

2. Give oral spironolactone- should not get K sparing

3.infuse regular insulin dextrose 10% in water-this will move K out of the extracellular fluid and into intracellular fluid

4. Administer furosemide- diuretics are ineffective

Front 29

Pt just finished 3rd perennial dialysis what findings should the RN report?

1. greater outflow of dialysate than inflow

2. weight loss

3. cloudy dialysate effluent

4. report of pain during inflow

Back 29

1. greater outflow of dialysate than inflow-is expected

2. weight loss-

3. cloudy dialysate effluent- cloudy/opaque drainage is sign of peritonitis

4. report of pain during inflow- will resolve within 1-2 wks of PD

Front 30

You are performing an admisson assessment of a PT with acute glomerulonephritis. RN should expect?

1. low BP

2. Polyuria

3.Dark colored urine

4. Weight loss

Back 30

1. low BP- should be elevated

2. Polyuria- should be decreased urine

3.Dark colored urine- expected finding

4. Weight loss- should gain due to retention

Front 31

You are providing teaching to PT with chronic kidney disease and is to start hemodialysis. Which of the following information should you include?

1. Hemodialysis restores renal function

2. Hemodialysis replaces hormonal function of the renal system

3. Hemodialysis allows an unrestricted diet.

4. Hemodialysis returns a balance to serum electrolytes.

Back 31

1. Hemodialysis restores renal function-legthens life of PT

2. Hemodialysis replaces hormonal function of the renal system- does not b/c of tissue damage causing dysfunction of renin-angiotensin-aldosterone system

3. Hemodialysis allows an unrestricted diet.-need a diet high in folate, protein an low Na, K, Phos.

4. Hemodialysis returns a balance to serum electrolytes.- It provides an acid base balance and removes waste products

Front 32

RN preparing to initiate hemodialysis for a PT which of the following are correct? SELECT ALL

1. Review the PT current medications

2. Assess PTs fistula for a bruit

3. Calculate PTs total urine output

4. Obtain PTs weight

5. check PTs serum electrolytes

6. check PTs access site area for venipuncture

Back 32

1. Review the PT current medications-may need to hold meds

2. Assess PTs fistula for a bruit- determines patency

3. Calculate PTs total urine output

4. Obtain PTs weight- needed to compare

5. check PTs serum electrolytes-detrmines need for dialysis

6. check PTs access site area for venipuncture- should never be used

Front 33

Your planning post procedure care for a PT who received HD(hemodialysis) what should you include in the plan of care? SELECT ALL

1. Check BUN and serum CR

2. Administer meds held prior to dialysis

3. Observe signs of hypovolemia

4. Assess the access site for bleeding

5. Evaluate BP on the side of AV access.

Back 33

1. Check BUN and serum CR-shows remain waste products

2. Administer meds held prior to dialysis- needs

3. Observe signs of hypovolemia- side effect

4. Assess the access site for bleeding- b/c of heparin given to prevent clots.

5. Evaluate BP on the side of AV access.- should not do

Front 34

PT develops disequilibrium syndrome what action is appropriate?
1. give opioid

2. check for hypertension

3. Assess LOC

4. Increase the dialysis exchange rate

Back 34

1. give opioid- should give a anti seizure med

2. check for hypertension- should check for hypotension

3. Assess LOC- change in urea levels can cause ICP = LOC changes

4. Increase the dialysis exchange rate- should decrease the rate

Front 35

PT is to have peritoneal dialysis which are correct nursing actions?

1. check serum glucose levels

2. report cloudy dialysate return

3. warm the diaslysate in microwave

4. Assess for SOB

5. check site dressing for wetness

6. maintain medical sepsis when accessing the catheter insertion site.

Back 35

1. check serum glucose levels-soulition contains glucose

2. report cloudy dialysate return-sign of infection

3. warm the diaslysate in microwave- NEVER

4. Assess for SOB- ABC's

5. check site dressing for wetness- can increase infection risk

6. maintain medical sepsis when accessing the catheter insertion site.- Should maintain surgical asepsis

Front 36

You are assessing a PT with end stage kidney disease what do you expect to find?

1.Anuria

2.Marked Azotemia

3.Crackles in the lungs

4.Increased Ca level

5.Proteinuria

Back 36

1.Anuria- indicates need for transplant

2.Marked Azotemia =elevated BUN & CR indicating need

3.Crackles in the lungs- indicates pulmonary edema

4.Increased Ca level-usually are decreased due to increased phos. level

5.Proteinuria- indicates the need for transplant

Front 37

You are planning post op care for a client who just had a kidney transplant. Which of the following should you include in care? SELECT ALL

1. daily weights

2.assess dressing for bloody drainage

3.replace hourly UOP with fluids

4.position in semi fowlers

5. check electrolytes

Back 37

1. daily weights-checks fluid status

2.assess dressing for bloody drainage-can indicate hemorrhage

3.replace hourly UOP with fluids-check for decreased UOP

4.position in semi fowlers

5. check electrolytes-decrease may occur

Front 38

You are teaching diet recommendations to a PT following a kidney transplant and taking cyclosporine. what should you include in teaching?

1. Decrease protein rich foods

2. Drink grapefruit juice

3. Take a magnesium supplement

4. Restrict intake of bananas and raisins

Back 38

1. Decrease protein rich foods- not needed after transplant

2. Drink grapefruit juice-should not drink b/c it can raise levels of the drug

3. Take a magnesium supplement- Mag. is lost when on this med so need to replace

4. Restrict intake of bananas and raisins- K can be consumed in normal amounts following transplant

Front 39

You're providing info to a PT with chronic rejection of a transplanted kidney. What should you include? SELECT ALL

1. Immediate removal of the donor kidney is planned

2. Check electrolytes frequently determines kidney status.

3. Scheduled biopsies to determine status

4. restarting dialysis depends on marked azotemia

5. plan to have immunosuppressive meds increased.

Back 39

1. Immediate removal of the donor kidney is planned- need to be hyper acute rejection

2. Check electrolytes frequently determines kidney status.- determines progression(DP)

3. Scheduled biopsies to determine status- DP

4. restarting dialysis depends on marked azotemia-DP

5. plan to have immunosuppressive meds increased.-may suppress enough for dialysis

Front 40

PT is scheduled for Kidney transplant being assessed by RN for risk factors. Which of the following would increase the PT's risk of surgery? Select All

1.70 yrs old

2. BMI of 41

3. Administers NPH every morning

4. Past history of lymphoma

5. BP averages 120/70

Back 40

1.70 yrs old-greater risk

2. BMI of 41- greater risk

3. Administers NPH every morning- greater risk (co morbidity)

4. Past history of lymphoma- past cancer greater risk

5. BP averages 120/70- within normal limits

Front 41

You are giving teaching to a PT who is to receive an KUB (kidneys/Ureters/Bladder) what should you include in teaching?

1. Contrast dye is given during the procedure

2. An enema is needed before surgery

3. You will need to lie in a prone position

4. The procedure will determine if kidney stone is present.

Back 41

1. Contrast dye is given during the procedure- NO

2. An enema is needed before surgery-NO

3. You will need to lie in a prone position-supine

4. The procedure will determine if kidney stone is present.- can identify stones, strictures, calcium deposits, obstructions

Front 42

You are monitoring a post op PT who had a kidney biopsy which complication poses the most immediate risk?

1. Infection

2. Hemorrhage

3. Hematuria

4. Kidney Failure

Back 42

1. Infection- not immediate

2. Hemorrhage-ABCs

3. Hematuria- common complication

4. Kidney Failure- not immediate

Front 43

You are reviewing a PTs laboratory findings from a UA. It is + leukoesterase and nitrites. Which of the following is correct RN action?

1. Repeat the test early next AM

2. Start a 24 hr urine collection

3. obtain a clean catch for a UA & sensitivity

4. Insert a urinary catch to collect specimen

Back 43

1. Repeat the test early next AM- NO PT may have a UTI need to clarify immediately

2. Start a 24 hr urine collection- you do this for CR clearance not UTI

3. obtain a clean catch for a UA & sensitivity-this determines what antibiotic will be needed to treat

4. Insert a urinary catch to collect specimen- NO

Front 44

type 2 diabetes PT is to undergo excretory urography what nursing actions are appropriate prior to procedure? Select ALL

1. Identify PT allergy to seafood

2. Hold metformin for 24hr

3. Administer Enema

4. Obtain PTs serum coagulation profile

5. Assess PT for history of asthma

Back 44

1. Identify PT allergy to seafood- higher risk to contrast

2. Hold metformin for 24hr- puts them at risk for lactic acidosis

3. Administer Enema- better visualization

4. Obtain PTs serum coagulation profile- should be obtained before a biopsy not this

5. Assess PT for history of asthma- higher risk for allergic response to contrast

Front 45

You administered Captopril to a PT during a Renography which action is correct to take?

1. assess the PT for hypertension

2. Limit fluid intake

3. Monitor for Orthostatic HTN

4. encourage early ambulation

Back 45

1. assess the PT for hypertension- would be Hypotensive

2. Limit fluid intake- Increase fluids to aid from hypotensive effects

3. Monitor for Orthostatic HTN-anti-HTN drug

4. encourage early ambulation- Fall risk

Front 46

PT has a diagnosis of chronic glomerulonephritis which statement is appropriate?

1. High sodium diet is recommended

2. Destruction of the glomeruli occurs rapidly

3. The cause of the disease is not known

4. To compensate the number of functioning nephrons is increased.

Back 46

1. High sodium diet is recommended- should be low Na

2. Destruction of the glomeruli occurs rapidly- progressive over long time frame

3. The cause of the disease is not known- hard to determine why

4. To compensate the number of functioning nephrons is increased.- nephrons are decreased over time leading to end stage kidney failure.

Front 47

RN is assessing lab values for a PT who MAY have acute glomerulonephritis. Which of the findings would the RN report?

1. urine specific gravity of 1.022

2. BUN of 16

3. CR clearance of 48

4. K level of 4.2

Back 47

1. urine specific gravity of 1.022- WNL

2. BUN of 16-WNL

3. CR clearance of 48- the 24hr CR clearance is not within normal limits

4. K level of 4.2-WNL

Front 48

What is a CR clearance and what should the normals be for males and females?

Back 48

It is a 24 hr urine collection

decreased if 50ml/min

Males- 90-139 mL/min/m2

Females- 80-125mL/min/m2

Front 49

PT has a dx of acute glomerulonephritis. Which is expected? Select All

1. Fever

2. Peripheral edema

3. Polyuria

4. Dyspnea

5. Proteinuria

Back 49

1. Fever- may have low grade fever b/c of possible strep

2. Peripheral edema- fluid retention

3. Polyuria- not a finding fluid retention may cause dilution

4. Dyspnea- will present b/c fluid retention causing pulm. edema or CHF

5. Proteinuria- will have protein loss b/c glomeruli involvement.

Front 50

Rn is watching a PT receiving plasmaphersis. Which of the following would indicate PT is experiencing side effects from the procedure? Select All?

1. HR 140

2. Vertigo

3. Muscle cramps

4. BP 90/56

5. Tinnitus

Back 50

1. HR 140- sign of hypovolemia

2. Vertigo- sign of hypovolemia

3. Muscle cramps- sign of tetany caused by removal of Ca with the blood plasma

4. BP 90/56- low sign of hypovolemia

5. Tinnitus- Not a sign of hypovolemia which plasmapheresis will cause

Front 51

You are teaching about the manifestations of complications to a PT with acute glomerulonephritis. which complication should the PT report?

1. dry cough

2. pitting edema

3. weight gain of 2 lbs in 1 wk

4. Temp of 98.4

Back 51

1. dry cough- would be concerned with a wet cough= fluid overload

2. pitting edema- indicates fluid overload which is the common complication of Acute Glomerulonephritis

3. weight gain of 2 lbs in 1 wk- would need to be 5lbs in a wk to be fluid overload

4. Temp of 98.4- not a complication although low grade fever may signal infection.

Front 52

PT has prerenal acute kidney injury following abdominal aortic aneurysm repair. The PTs UOP is 80ml in the past 4 hr, BP is 92/58 which of the following should the RN include in care?

1. Prep PT for a CAT Scan with contrast dye

2. Anticipate urine specific gravity to be 1.010

3. Plan to administer a fluid challenge

4. Place PT in trendelenberg position.

Back 52

1. Prep PT for a CAT Scan with contrast dye- Contraindicated no contrast in kidney injury

2. Anticipate urine specific gravity to be 1.010- Should expect 1.030 with kidney injury

3. Plan to administer a fluid challenge- used to treat hypovolemia which PT is suffering from

4. Place PT in trendelenberg position.- should be reverse trendeleberg head down feet up to treat hypotension.

Front 53

PT has postern acute kidney injury due to metastatic cancer and has a CR of 5 which actions are appropriate by the RN? Select All

1. give high protein diet

2. assess the urine for blood

3. monitor for intermittent anuria

4. administer diuretic medication

5. provide NSAIDs for pain

Back 53

1. give high protein diet- want to replace the breakdown of protein that happens with kidney injury

2. assess the urine for blood- assess for blood,stones, obstructions

3. monitor for intermittent anuria- possible bilateral obstruction of urinary structures

4. administer diuretic medication-can increase destruction

5. provide NSAIDs for pain- toxic to nephrons

Front 54

You are planning care for PT with stage 4 chronic kidney disease what should the RN add in plan of care? Select all

1. assess jugular vein distention

2. provide frequent mouth washes

3. auscultate for a pleural friction rub

4. assess using the GCS

5. Monitor for dysrhythmias

Back 54

1. assess jugular vein distention- indicate fluid overload

2. provide frequent mouth washes- will need b/c uremic halitosis caused by urea waste in blood

3. auscultate for a pleural friction rub- sign of pulmonary edema=fluid overload

4. assess using the GCS-head injury

5. Monitor for dysrhythmias- increased K not being excreted can cause dysrhythmias

Front 55

PT has stage 4 chronic kidney disease which of the following is an expected laboratory finding?

1. BUN 54

2. GFR 20

3. CR 1.2

4. K 5.0

Back 55

1. BUN 54- would be 180-200 in stage 4

2. GFR 20- severely decreased indicative of stage 4 chronic kidney disease

3. CR 1.2- would be 15-30 in stage 4

4. K 5.0- would be greater than 5 in stage 4

Front 56

You are assessing a PT with prerenal acute kidney injury(AKI) what should you include in the assessment? Select all

1. BP

2. Cardiac enzymes

3. UOP

4. Serum CR

5. Serum electrolytes

Back 56

1. BP- may become hypotensive due to hypovolemia

2. Cardiac enzymes- not needed

3. UOP- should assist in determinig oliguria

4. Serum CR- will determine the extent of AKI

5. Serum electrolytes- will determine the extent of AKI

Front 57

PT has a UTI. PT reports pain and a burning sensation when urinating and urine is cloudy with an odor. What is priority?

1. offer warm sitz bath

2. Recommend cranberry juice

3. Encourage fluids

4. Administer antibiotic

Back 57

1. offer warm sitz bath- temporary relief

2. Recommend cranberry juice- may help in prevention but only in the future

3. Encourage fluids- will relieve symptoms but not priority

4. Administer antibiotic- Greatest risk is damage from UTI

Front 58

You are giving education to female PT with frequent UTIs what info should you include? Select all

1. avoid sitting in a wet bathing suit

2. Wipe the perineal area back to front

3. empty the bladder when there is an urge to void

4. wear synthetic fabric underwear

5. take a tub bath daily.

Back 58

1. avoid sitting in a wet bathing suit- increase risk for UTI=moist and wet

2. Wipe the perineal area back to front- front to back

3. empty the bladder when there is an urge to void- urine retention = increased risk UTI

4. wear synthetic fabric underwear- should wear cotton underwear

5. take a tub bath daily.- promotes good body hygiene and decreased colonization of bacteria

Front 59

You are reviewing lab findings of an UA of a client who reports urgency and nocturia. Which of the following findings should the RN report?

1. + casts

2. + leukocyte esterase

3. + epithelial cells

4. + crystals

Back 59

1. + casts-may have some WNL

2. + leukocyte esterase- + indicates 68-88% possible UTI and should be reported

3. + epithelial cells- may have some indicating contamination

4. + crystals- may have some WNL

Front 60

Which PT is at risk for developing pyelonephritis? Select All

1. Pt 32 wks gestation

2. Pt who has kidney calculi

3. Pt with urine PH of 4.2

4. Pt with a neurogenic bladder

5. Pt with diabetes mellitus

Back 60

1. Pt 32 wks gestation-risk b/c increased pressure on urinary system causing retention and reflux

2. Pt who has kidney calculi- risk =stones harbor bacteria

3. Pt with urine PH of 4.2- to acidic to grow bacteria

4. Pt with a neurogenic bladder- may retain urine promoting growth

5. Pt with diabetes mellitus - glucose in urine promoting growth

Front 61

What is an expected finding of a PT with a renal calculi?

1. Bradycradia

2. Diaphoresis

3. Nocturia

4. Bradypnea

Back 61

1. Bradycradia- would be tachycardia with stone

2. Diaphoresis- associated with stones

3. Nocturia- would be oliguria with kidney stone

4. Bradypnea- would be tachypnea with stone

Front 62

PT is scheduled for extracorpeal shock wave therapy what statement shows an understanding of the procedure?

1. I will be fully awake during

2. will reduce my chance of having stone in the future

3. I will report any bruising

4. I will have to strain my urine following the procedure.

Back 62

1. I will be fully awake during- moderate sedation

2. will reduce my chance of having stone in the future- breaks the stone up not prevention

3. I will report any bruising - expected

4. I will have to strain my urine following the procedure. -verify the stone has passed

Front 63

Informing a Pt who just passed a Calcium oxalate stone. What food should the PT avoid? Select All

1. Red meat

2. Black Tea

3. Cheese

4. Whole grains

5. Spinach

Back 63

1. Red meat-contains mag,amonia,phos(struvite)

2. Black Tea- contains calcium

3. Cheese-contains mag,amonia,phos(struvite)

4. Whole grains-contains mag,amonia,phos(struvite)

5. Spinach- contains calcium