./
,Set 1………………………………………………………..1- 81
set 2………………………………………………………...1- 431
set 3…………………………………………………………….1- 412
set 4 ………………………………………………………………1- 85
SET 1
1. A client presents to the outpatient clinic with urinary discomfort that began
yesterday. The client reports burning during urination and describes pain in the
lower abdomen just above the pubic bone. The nurse suspects a lower urinary tract
infection (UTI) and reviews the client's symptoms. Which three symptoms are most
consistent with a lower UTI?
Correct answer: Burning on urination, dysuria, and suprapubic pain.
Burning on urination is a common symptom of inflammation or irritation of the lower
urinary tract. Dysuria refers to painful or uncomfortable urination and is a
characteristic finding in lower UTIs. Suprapubic pain occurs because the bladder and
surrounding tissues become irritated, producing discomfort in the lower abdomen.
Together, these findings are more consistent with a lower UTI than with an infection
involving the upper urinary tract.
2. A client arrives at the emergency department with urinary symptoms and
reports feeling increasingly ill. The client has a temperature of 39°C (102.2°F), pain
in the right flank, and tenderness over the costovertebral angle. The client also
reports nausea, vomiting, and generalized weakness. Which six findings should the
nurse recognize as symptoms of an upper urinary tract infection?
,Correct answer: Pyelonephritis, fever, flank pain, costovertebral angle
tenderness, nausea and vomiting, and malaise.
Pyelonephritis is an infection of the kidney and is the primary upper UTI represented
by these findings. Fever, flank pain, and costovertebral angle tenderness are
characteristic findings that suggest the infection has extended beyond the bladder.
Nausea and vomiting may occur because kidney infection can produce a more
significant systemic response. Malaise reflects the generalized feeling of illness that
commonly accompanies an upper UTI.
3. A client develops acute renal failure after a period of severe illness and reduced
kidney function. The nurse explains that acute renal failure differs from chronic
kidney disease because the kidneys may recover when the underlying cause is
treated. The healthcare provider asks whether the client's kidney function can
return to normal. Is acute renal failure reversible?
Correct answer: Yes.
Acute renal failure, also called acute kidney injury, can be reversible when the
underlying cause is identified and treated promptly. Recovery depends on the
severity of the injury, the cause, and the condition of the kidneys before the episode.
Some clients recover completely, while others may have incomplete recovery or
progress to chronic kidney disease. Therefore, reversibility is possible, but it is not
guaranteed in every client.
4. A client is admitted with acute renal failure and has a significant decrease in
urine output. The healthcare provider administers a diuretic to determine whether
, the kidneys can respond. After administration, the client produces urine. How does
the nurse determine the prognosis of acute renal failure from this response?
Correct answer: If a diuretic produces urine output, this suggests that the
kidneys are still functioning.
Urine production after a diuretic suggests that the kidneys retain some functional
capacity to respond. This finding may indicate that the kidneys are not completely
nonfunctional and that recovery is possible. However, urine output alone does not
establish the extent of kidney recovery or guarantee a favorable prognosis. The nurse
must also evaluate laboratory results, fluid balance, and the underlying cause of the
renal failure.
5. A client with diabetes mellitus develops severe dehydration after several days of
excessive urination and inadequate fluid intake. Another client with heart failure
develops acute renal failure because the heart is unable to pump enough blood to
adequately perfuse the kidneys. The nurse recognizes that both conditions can
reduce blood flow to the kidneys. Which two examples represent causes of
prerenal failure?
Correct answer: Dehydration and inability to adequately perfuse the kidneys
because of heart failure.
Prerenal failure occurs when the kidneys receive insufficient blood flow or perfusion.
Dehydration reduces circulating blood volume, which decreases the amount of blood
reaching the kidneys. Heart failure can reduce cardiac output, limiting renal perfusion
even when the kidneys themselves are initially structurally intact. Both conditions
can cause acute kidney injury by reducing the delivery of blood to functioning renal
tissue.
,Set 1………………………………………………………..1- 81
set 2………………………………………………………...1- 431
set 3…………………………………………………………….1- 412
set 4 ………………………………………………………………1- 85
SET 1
1. A client presents to the outpatient clinic with urinary discomfort that began
yesterday. The client reports burning during urination and describes pain in the
lower abdomen just above the pubic bone. The nurse suspects a lower urinary tract
infection (UTI) and reviews the client's symptoms. Which three symptoms are most
consistent with a lower UTI?
Correct answer: Burning on urination, dysuria, and suprapubic pain.
Burning on urination is a common symptom of inflammation or irritation of the lower
urinary tract. Dysuria refers to painful or uncomfortable urination and is a
characteristic finding in lower UTIs. Suprapubic pain occurs because the bladder and
surrounding tissues become irritated, producing discomfort in the lower abdomen.
Together, these findings are more consistent with a lower UTI than with an infection
involving the upper urinary tract.
2. A client arrives at the emergency department with urinary symptoms and
reports feeling increasingly ill. The client has a temperature of 39°C (102.2°F), pain
in the right flank, and tenderness over the costovertebral angle. The client also
reports nausea, vomiting, and generalized weakness. Which six findings should the
nurse recognize as symptoms of an upper urinary tract infection?
,Correct answer: Pyelonephritis, fever, flank pain, costovertebral angle
tenderness, nausea and vomiting, and malaise.
Pyelonephritis is an infection of the kidney and is the primary upper UTI represented
by these findings. Fever, flank pain, and costovertebral angle tenderness are
characteristic findings that suggest the infection has extended beyond the bladder.
Nausea and vomiting may occur because kidney infection can produce a more
significant systemic response. Malaise reflects the generalized feeling of illness that
commonly accompanies an upper UTI.
3. A client develops acute renal failure after a period of severe illness and reduced
kidney function. The nurse explains that acute renal failure differs from chronic
kidney disease because the kidneys may recover when the underlying cause is
treated. The healthcare provider asks whether the client's kidney function can
return to normal. Is acute renal failure reversible?
Correct answer: Yes.
Acute renal failure, also called acute kidney injury, can be reversible when the
underlying cause is identified and treated promptly. Recovery depends on the
severity of the injury, the cause, and the condition of the kidneys before the episode.
Some clients recover completely, while others may have incomplete recovery or
progress to chronic kidney disease. Therefore, reversibility is possible, but it is not
guaranteed in every client.
4. A client is admitted with acute renal failure and has a significant decrease in
urine output. The healthcare provider administers a diuretic to determine whether
, the kidneys can respond. After administration, the client produces urine. How does
the nurse determine the prognosis of acute renal failure from this response?
Correct answer: If a diuretic produces urine output, this suggests that the
kidneys are still functioning.
Urine production after a diuretic suggests that the kidneys retain some functional
capacity to respond. This finding may indicate that the kidneys are not completely
nonfunctional and that recovery is possible. However, urine output alone does not
establish the extent of kidney recovery or guarantee a favorable prognosis. The nurse
must also evaluate laboratory results, fluid balance, and the underlying cause of the
renal failure.
5. A client with diabetes mellitus develops severe dehydration after several days of
excessive urination and inadequate fluid intake. Another client with heart failure
develops acute renal failure because the heart is unable to pump enough blood to
adequately perfuse the kidneys. The nurse recognizes that both conditions can
reduce blood flow to the kidneys. Which two examples represent causes of
prerenal failure?
Correct answer: Dehydration and inability to adequately perfuse the kidneys
because of heart failure.
Prerenal failure occurs when the kidneys receive insufficient blood flow or perfusion.
Dehydration reduces circulating blood volume, which decreases the amount of blood
reaching the kidneys. Heart failure can reduce cardiac output, limiting renal perfusion
even when the kidneys themselves are initially structurally intact. Both conditions
can cause acute kidney injury by reducing the delivery of blood to functioning renal
tissue.
