Chapter 62: Concepts of Care for Patients
with Kidney Disorders
Ignatavicius: Medical-Surgical Nursing, 10th Edition
MULTIPLE CHOICE
1. After teaching a client with nephrotic syndrome and a normal glomerular filtration, the
nurse assesses the client’s understanding. Which statement made by the client
indicates a correct understanding of the diet therapy for this condition?
a. “I must decrease my intake of fat.”
b. “I will increase my intake of protein.”
c. “A decreased intake of carbohydrates will be required.”
d. “An increased intake of vitamin C is necessary.”
ANS: B
In nephrotic syndrome, the renal loss of protein is significant, leading to
hypoalbuminemia and edema formation. If glomerular filtration is normal or near
normal, increased protein loss would be matched by increased intake of protein. The
client would not need to adjust fat, carbohydrates, or vitamins based on this disorder.
DIF: Applying TOP: Integrated Process: Nursing Process: Evaluation
KEY: Nephrotic syndrome, Diet therapy MSC: Client Needs
Category: Physiological Integrity: Basic Care and Comfort
2. A nurse assesses a client who is recovering from a radical nephrectomy for renal cell
carcinoma. The nurse notes that the client’s blood pressure has decreased from 134/90
to 100/56 mm Hg and urine output is 20 mL for this past hour. What action would the
nurse take?
, a. Position the client to lay on the surgical incision.
b. Measure the specific gravity of the client’s urine.
c. Administer intravenous pain medications.
d. Assess the rate and quality of the client’s pulse.
ANS: D
The nurse would first fully assess the client for signs of volume depletion and shock,
and then notify the primary health care provider. The extensive nature of the surgery
and the proximity of the surgery to the adrenal gland put the client at risk for
hemorrhage and adrenal insufficiency. Hypotension is a clinical manifestation
associated with both hemorrhage and adrenal insufficiency. Hypotension is
particularly dangerous for the remaining kidney, which must receive adequate
perfusion to function effectively. Repositioning the patient, measuring specific
gravity, and administering pain medication would not provide data necessary to make
an appropriate clinical decision, nor are they appropriate interventions at this time.
DIF: Applying TOP: Integrated Process: Nursing Process: Planning and
Implementation KEY: Renal cancer, Perioperative nursing MSC:
Client Needs Category: Safe and Effective Care Environment: Management of
Care
3. The nurse is admitting a client who has acute glomerulonephritis caused by beta
streptococcus. What drug therapy would the nurse expect to be prescribed for this
client?
a. Antihypertensives
b. Antilipidemics
c. Antidepressants
d. Antibiotics
ANS: D
Beta streptococcus is a bacterium that can cause acute glomerulonephritis, so
antibiotic therapy is indicated.
with Kidney Disorders
Ignatavicius: Medical-Surgical Nursing, 10th Edition
MULTIPLE CHOICE
1. After teaching a client with nephrotic syndrome and a normal glomerular filtration, the
nurse assesses the client’s understanding. Which statement made by the client
indicates a correct understanding of the diet therapy for this condition?
a. “I must decrease my intake of fat.”
b. “I will increase my intake of protein.”
c. “A decreased intake of carbohydrates will be required.”
d. “An increased intake of vitamin C is necessary.”
ANS: B
In nephrotic syndrome, the renal loss of protein is significant, leading to
hypoalbuminemia and edema formation. If glomerular filtration is normal or near
normal, increased protein loss would be matched by increased intake of protein. The
client would not need to adjust fat, carbohydrates, or vitamins based on this disorder.
DIF: Applying TOP: Integrated Process: Nursing Process: Evaluation
KEY: Nephrotic syndrome, Diet therapy MSC: Client Needs
Category: Physiological Integrity: Basic Care and Comfort
2. A nurse assesses a client who is recovering from a radical nephrectomy for renal cell
carcinoma. The nurse notes that the client’s blood pressure has decreased from 134/90
to 100/56 mm Hg and urine output is 20 mL for this past hour. What action would the
nurse take?
, a. Position the client to lay on the surgical incision.
b. Measure the specific gravity of the client’s urine.
c. Administer intravenous pain medications.
d. Assess the rate and quality of the client’s pulse.
ANS: D
The nurse would first fully assess the client for signs of volume depletion and shock,
and then notify the primary health care provider. The extensive nature of the surgery
and the proximity of the surgery to the adrenal gland put the client at risk for
hemorrhage and adrenal insufficiency. Hypotension is a clinical manifestation
associated with both hemorrhage and adrenal insufficiency. Hypotension is
particularly dangerous for the remaining kidney, which must receive adequate
perfusion to function effectively. Repositioning the patient, measuring specific
gravity, and administering pain medication would not provide data necessary to make
an appropriate clinical decision, nor are they appropriate interventions at this time.
DIF: Applying TOP: Integrated Process: Nursing Process: Planning and
Implementation KEY: Renal cancer, Perioperative nursing MSC:
Client Needs Category: Safe and Effective Care Environment: Management of
Care
3. The nurse is admitting a client who has acute glomerulonephritis caused by beta
streptococcus. What drug therapy would the nurse expect to be prescribed for this
client?
a. Antihypertensives
b. Antilipidemics
c. Antidepressants
d. Antibiotics
ANS: D
Beta streptococcus is a bacterium that can cause acute glomerulonephritis, so
antibiotic therapy is indicated.
