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Sherpath: Diabetes Mellitus Chapter 21 Test Case Study 4 (Short
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A patient experiences severe blood loss c. Prerenal acute kidney injury
and hypovolemia following a motor vehicle
crash. The nurse should assess for signs and
symptoms of which condition most likely to
affect the patient?
a. Chronic kidney disease
b. Intrarenal acute kidney injury
c. Prerenal acute kidney injury
d. Postrenal kidney acute injury
Which assessment findings should the nurse b, c, and e
report to the healthcare provider as being
indicative of possible kidney injury? Select
all that apply.
a. Decreased potassium level
b. Dyspnea
c. Fixed specific gravity of 1.010
d. Increasing glomerular filtration rate
e. Urine output less than 400 mL/day
The nurse is caring for a patient diagnosed d. Potassium chloride
with acute kidney injury. Which medication
order should the nurse question?
a. Bumetanide (Bumex)
b. Furosemide (Lasix)
c. Mannitol
d. Potassium chloride
,The nurse is caring for a patient diagnosed c, d, and e
with chronic kidney disease whose
hemoglobin level is 10 g/dL yet remains
asymptomatic. The nurse should anticipate
the administration of which treatments?
Select all that apply.
a. Aminoglycoside therapy
b. Daily blood transfusion
c. Erythropoietin subcutaneously
d. Folic acid supplements
e. Oral iron supplements
You are a nurse in the emergency a, c, and d
department (ED) who is caring for a 30-
year-old female patient who presents with
symptoms associated with urolithiasis.
Which observation from the initial
assessment supports a diagnosis of
urolithiasis? Select all that apply.
a. Abdominal distention
b. Diarrhea
c. Flank pain
d. Nausea and vomiting
e. Polyuria
Which of the following is the diagnostic c. Non-contrast CT scan
modality of choice to determine if the
patient is experiencing urolithiasis?
a. Kidney ureter bladder (KUB) X-ray
b. Magnetic resonance imagery (MRI)
c. Non-contrast CT scan
d. Ultrasound
The patient is diagnosed with a urolithiasis c. Trial passage
smaller than 5 mm in diameter. She is in
minimal pain and urinalysis does not indicate Rationale: Fifty percent of stones that are less than 5 mm in
infection. What is the first line of treatment? size will pass spontaneously. For patients with minimal pain
and no hydronephrosis or infection, the first line of treatment
a. Extracorporeal shock wave lithotripsy is an opportunity to pass the stone without intervention.
b. Percutaneous nephrolithotomy Surgery is the treatment of choice for a patient who presents
c. Trial passage with a stone larger than 10 mm. Surgical choices are varied
d. Ureteroscopy and dependent on stone size, location, and urgency of
treatment. Ureteroscopy, percutaneous nephrolithotomy, and
extracorporeal shock wave lithotripsy are common surgical
procedures for the management of stones.
When planning care for this patient, which a, b, and e
nursing diagnoses should you include?
Select all that apply.
a. Acute pain
b. Altered elimination
c. Decreased cardiac output
d. Fluid volume deficit
e. Risk for infection
, You are providing discharge education for b and e
this patient. Which clinical manifestations
might necessitate the need for surgical Rationale: A patient may need surgery if he or she is
intervention? Select all that apply. experiencing renal colic with pain and burning on urination, as
these symptoms indicate a urinary tract infection. Pain that is
a. A stone that does not pass in 2 to 3 weeks not controlled by narcotics is also an indication for surgical
b. Pain and burning during urination intervention. A stone that does not pass after 4 to 6 weeks and
c. Pain that is controlled by narcotics development of nausea and vomiting, not a decreased
d. The decreased incidence of nausea and incidence of these findings, would indicate the need for
vomiting surgical intervention.
e. The development of renal colic
Which action should you teach the patient d. Straining the urine
to perform in order to determine if the
kidney stone has passed?
a. Documenting daily urine pH
b. Measuring urine output
c. Monitoring the urine for ketones
d. Straining the urine
Which topics should you include during the b and d
patient teaching session to decrease the risk
for developing urolithiasis in the future?
Select all that apply.
a. Decreasing citrate intake
b. Decreasing oxylate intake
c. Increasing fatty acid intake
d. Increasing fluid intake
e. Increasing sodium intake
Which of the following is a common cause c. Kidney stones
of Post Renal AKI?
a. Acute tubular necrosis (ATN)
b. Dehydration
c. Kidney stones
d. Medications
Why is the glomerular filtration rate (GFR) b/c decreased functioning, not able to clear or filter well?
decreased in patients experiencing AKI or
CKD?
What is the first sign a nurse would see in a a. oliguria
patient with AKI?
a. oliguria
b. dysuria
c. polyuria
d. hematuria
Which of the following are considered a, b, and c
causes of CKD? Select all that apply
a. Diabetes
b. Glomerulonephritis
c. Hypertension
d. Urinary Tract Infections (UTIs)