Chapter 70: Care of Patients with Renal Disorders

Chapter 70: Care of Patients with Renal Disorders

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. On assessment of a client with polycystic kidney disease (PKD), which finding is of greatest concern to the nurse?

a.	Flank pain
b.	Periorbital edema
c.	Bloody and cloudy urine
d.	Enlarged abdomen

 

 

ANS:  B

Flank pain and a distended or enlarged abdomen occur in PKD because the kidneys enlarge and displace other organs. Urine can be bloody or cloudy owing to cyst rupture or infection. Periorbital edema would not be a finding related to PKD and should be investigated further.

 

DIF:    Cognitive Level: Comprehension/Understanding               REF:   Chart 70-1, p. 1520

TOP:   Client Needs Category: Physiological Integrity (Physiological Adaptation—Pathophysiology)

MSC:  Integrated Process: Nursing Process (Assessment)

 

2. A client with autosomal dominant polycystic kidney disease (ADPKD) asks whether his children could develop this disease. Which is the nurse’s best response?

a.	“No genetic link is known, so your children are not at increased risk.”
b.	“The disease is sex linked, so only your sons could be affected.”
c.	“Both you and your wife must have the disease for your children to develop it.”
d.	“Each of your children has a 50% risk of having ADPKD.”

 

 

ANS:  D

ADPKD is transmitted as an autosomal dominant trait and therefore is not gender specific. Children whose parents have the autosomal dominant form of PKD have a 50% chance of inheriting the gene that causes the disease.

 

DIF:    Cognitive Level: Comprehension/Understanding               REF:   p. 1519

TOP:   Client Needs Category: Physiological Integrity (Physiological Adaptation—Pathophysiology)

MSC:  Integrated Process: Teaching/Learning

 

3. A client with polycystic kidney disease and hypertension is prescribed a diuretic for blood pressure control. Which statement by the client indicates the need for further teaching regarding these orders?

a.	“I will weigh myself every day at the same time.”
b.	“I will drink only 1 liter of fluid each day.”
c.	“I will avoid aspirin and aspirin-containing drugs.”
d.	“I will avoid nonsteroidal anti-inflammatory drugs.”

 

 

ANS:  B

Diuretics for blood pressure control can lead to fluid volume depletion and can decrease blood flow to the kidney, further decreasing renal function. The client should be instructed to drink at least 2500 mL/24 hr. NSAIDs should be used cautiously because they can reduce kidney blood flow. Aspirin products increase the risk for bleeding and should be avoided.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Physiological Adaptation—Illness Management)  MSC:           Integrated Process: Nursing Process (Evaluation)

 

4. A client with polycystic kidney disease (PKD) has received extensive teaching in the clinic. Which statement by the client indicates that an important goal related to nutrition is being met?

a.	“I take a laxative every night before going to bed.”
b.	“I have a soft bowel movement every morning.”
c.	“Food tastes so much better since I can use salt again.”
d.	“The white bread I am eating does not cause gas.”

 

 

ANS:  B

Clients with PKD often have constipation, which can be managed with increased fiber, exercise, and drinking plenty of water. A soft bowel movement on a regular basis indicates that the client is preventing constipation. Laxatives should be used cautiously, and the need for their use indicates that the goal of preventing constipation via nutritional means is not being met. Clients with PKD should be on a restricted salt diet. White bread has a low fiber count and would not be included in a high-fiber diet.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Reduction of Risk Potential—Potential for Complications from Surgical Procedures and Health Alterations)

MSC:  Integrated Process: Nursing Process (Evaluation)