Page 1 of 56
NURS 240: CARE OF PATIENTS WITH
KIDNEY DISORDERS
Which assessment finding would the nurse expect for a patient
with chronic glomerulonephritis? Select all that apply. One, some,
or all responses may be correct. - answer-*** A: Edema of the
foot and ankle
*** B: Flapping tremor of the fingers
*** C: Itching and dryness of the skin
*** D: Presence of an S3 heart sound
*** E: Engorgement of the neck veins
Rationale: Flapping tremor of the fingers is a uremic symptom
seen in chronic glomerulonephritis. Itching and dryness of the
skin may also be due to uremia. Engorgement of the neck veins
and presence of an S3 heart sound on auscultation are due to
systemic circulatory overload related to chronic
glomerulonephritis. Circulatory overload may also cause edema
of the foot and ankle.
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Which information would the nurse provide to a patient after a
renal echography that indicates hydronephrosis? - answer-A: The
ureter dilates above the obstruction.
*** B: It is caused by an obstruction in the renal pelvis.
C: The bladder dilates after urethral obstruction.
D: It is caused by an obstruction in the lower part of the ureter.
Rationale: In hydronephrosis, the kidney enlarges as urine
collects in the renal pelvis and kidney tissue. This occurs after an
obstruction in the pelvis or at the point where the ureter joins the
renal pelvis. Hydroureter or enlargement of the ureter is caused
by an obstruction in the lower part of the ureter. The ureter dilates
above this obstruction. The bladder dilates after urethral
obstruction. In patients with a urethral stricture, the obstruction is
very low in the urinary tract, causing bladder distention before
hydroureter and hydronephrosis.
When taking the health history of a patient with acute
glomerulonephritis (GN), the nurse would question the patient
about which related cause of the problem? - answer-A:
Hypertension
B: Neoplastic disease
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C: Unexplained weight loss
*** D: Recent respiratory infection
Rationale: An infection often occurs before the kidney
manifestations of acute GN. The onset of symptoms is about 10
days from the time of infection. Hypertension is a result of GN, not
a cause. Weight gain, not weight loss, is symptomatic of fluid
retention in GN. Neoplastic disease is not part of the cause of
GN.
Which complication of polycystic kidney disease (PKD) may result
in high blood pressure? - answer-A: Kidney calculi
B: Kidney abscess
*** C: Kidney ischemia
D: Necrosis of the kidney
Rationale: Enlargement of cysts in the kidneys compress the
blood vessels, resulting in kidney ischemia. Kidney ischemia
activates the rennin-angiotensin system, resulting in high blood
pressure in patients with PKD. Kidney calculi are the formation of
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stones in the kidneys obstructing urinary excretion. A kidney
abscess is the collection of the pus formed by tissue debris during
an infection. Necrosis of the kidney refers to the death of renal
tissue.
Which condition is the nurse concerned about for a patient whose
ultrasound shows an obstruction in the upper part of the ureter? -
answer-A: Pyelonephritis
*** B: Hydronephrosis
C: Glomerulonephritis
D: Polycystic kidney disease
Rationale: Hydronephrosis is an obstructive disorder of the kidney
characterized by a blockage in the upper part of the ureter.
Pyelonephritis is a bacterial infection in the kidney and pelvis; it is
not associated with an obstruction in the ureter.
Glomerulonephritis is a group of kidney diseases characterized by
inflammation of the filtering units of the kidney, called glomeruli; it
is not associated with an obstruction in the ureter. Polycystic
kidney disease is an inherited kidney disorder causing fluid-filled
cysts to form in the kidneys; it is not associated with an
obstruction in the ureter.
NURS 240: CARE OF PATIENTS WITH
KIDNEY DISORDERS
Which assessment finding would the nurse expect for a patient
with chronic glomerulonephritis? Select all that apply. One, some,
or all responses may be correct. - answer-*** A: Edema of the
foot and ankle
*** B: Flapping tremor of the fingers
*** C: Itching and dryness of the skin
*** D: Presence of an S3 heart sound
*** E: Engorgement of the neck veins
Rationale: Flapping tremor of the fingers is a uremic symptom
seen in chronic glomerulonephritis. Itching and dryness of the
skin may also be due to uremia. Engorgement of the neck veins
and presence of an S3 heart sound on auscultation are due to
systemic circulatory overload related to chronic
glomerulonephritis. Circulatory overload may also cause edema
of the foot and ankle.
, Page 2 of 56
Which information would the nurse provide to a patient after a
renal echography that indicates hydronephrosis? - answer-A: The
ureter dilates above the obstruction.
*** B: It is caused by an obstruction in the renal pelvis.
C: The bladder dilates after urethral obstruction.
D: It is caused by an obstruction in the lower part of the ureter.
Rationale: In hydronephrosis, the kidney enlarges as urine
collects in the renal pelvis and kidney tissue. This occurs after an
obstruction in the pelvis or at the point where the ureter joins the
renal pelvis. Hydroureter or enlargement of the ureter is caused
by an obstruction in the lower part of the ureter. The ureter dilates
above this obstruction. The bladder dilates after urethral
obstruction. In patients with a urethral stricture, the obstruction is
very low in the urinary tract, causing bladder distention before
hydroureter and hydronephrosis.
When taking the health history of a patient with acute
glomerulonephritis (GN), the nurse would question the patient
about which related cause of the problem? - answer-A:
Hypertension
B: Neoplastic disease
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C: Unexplained weight loss
*** D: Recent respiratory infection
Rationale: An infection often occurs before the kidney
manifestations of acute GN. The onset of symptoms is about 10
days from the time of infection. Hypertension is a result of GN, not
a cause. Weight gain, not weight loss, is symptomatic of fluid
retention in GN. Neoplastic disease is not part of the cause of
GN.
Which complication of polycystic kidney disease (PKD) may result
in high blood pressure? - answer-A: Kidney calculi
B: Kidney abscess
*** C: Kidney ischemia
D: Necrosis of the kidney
Rationale: Enlargement of cysts in the kidneys compress the
blood vessels, resulting in kidney ischemia. Kidney ischemia
activates the rennin-angiotensin system, resulting in high blood
pressure in patients with PKD. Kidney calculi are the formation of
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stones in the kidneys obstructing urinary excretion. A kidney
abscess is the collection of the pus formed by tissue debris during
an infection. Necrosis of the kidney refers to the death of renal
tissue.
Which condition is the nurse concerned about for a patient whose
ultrasound shows an obstruction in the upper part of the ureter? -
answer-A: Pyelonephritis
*** B: Hydronephrosis
C: Glomerulonephritis
D: Polycystic kidney disease
Rationale: Hydronephrosis is an obstructive disorder of the kidney
characterized by a blockage in the upper part of the ureter.
Pyelonephritis is a bacterial infection in the kidney and pelvis; it is
not associated with an obstruction in the ureter.
Glomerulonephritis is a group of kidney diseases characterized by
inflammation of the filtering units of the kidney, called glomeruli; it
is not associated with an obstruction in the ureter. Polycystic
kidney disease is an inherited kidney disorder causing fluid-filled
cysts to form in the kidneys; it is not associated with an
obstruction in the ureter.
