Chapter 71: Care of Patients with Acute Kidney Injury and Chronic Kidney Disease

Chapter 71: Care of Patients with Acute Kidney Injury and Chronic Kidney Disease

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Which client is most at risk for developing postrenal kidney failure?

a.	Client diagnosed with renal calculi
b.	Client with congestive heart failure
c.	Client taking NSAIDs for arthritis pain
d.	Client recovering from glomerulonephritis

 

 

ANS:  A

Causes of postrenal kidney failure include disorders that obstruct the flow of urine, such as renal calculi. Heart failure can lead to prerenal failure, which is due to decreased blood flow to the kidneys. Both NSAIDs and glomerulonephritis can damage the kidney, leading to intrarenal failure.

 

DIF:    Cognitive Level: Comprehension/Understanding               REF:   p. 1538

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

MSC:  Integrated Process: Nursing Process (Assessment)

 

2. A client is admitted to the hospital with a serum creatinine level of 2 mg/dL. When taking the client’s history, which question does the nurse ask first?

a.	“Do you take any nonprescription medications?”
b.	“Does anyone in your family have kidney disease?”
c.	“Do you have yearly blood work done?”
d.	“Is your diet low in protein?”

 

 

ANS:  A

Acute renal failure can be caused by certain medications considered to have a nephrotoxic effect, such as NSAIDs and acetaminophen. Asking the client whether he or she takes any nonprescription drugs can help determine which medication(s) might have contributed to the problem. A family history is important but is not as vital as assessing for nephrotoxic agents that the client may have ingested. Yearly blood work might reveal a trend in kidney function, but again would not be as important. A diet low in protein would not be an important factor to assess.

 

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

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

MSC:  Integrated Process: Nursing Process (Assessment)

 

3. A client with a decreased glomerular filtration rate asks how to prevent further damage to the kidneys. Which is the nurse’s best response?

a.	“The diuretics you are taking will prevent further damage.”
b.	“Kidney damage is inevitable as you age.”
c.	“Avoid taking NSAIDs.”
d.	“You will need to follow a high-protein diet.”

 

 

ANS:  C

Kidney failure causes many problems, including decreased glomerular filtration rate. Nephrotoxins can worsen renal failure, especially in someone who already has some loss of kidney function.

 

DIF:    Cognitive Level: Comprehension/Understanding               REF:   p. 1539

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

MSC:  Integrated Process: Nursing Process (Implementation)

 

4. A client who has chronic kidney disease is being discharged from the hospital after receiving treatment for a hip fracture. Which information is most important for the nurse to provide to the client before discharge?

a.	“Increase your intake of foods with protein.”
b.	“Monitor your daily intake and output.”
c.	“Maintain bedrest until the fracture is healed.”
d.	“Take your aluminum hydroxide (Nephrox) with meals.”

 

 

ANS:  D

Aluminum hydroxide lowers serum phosphate levels by binding phosphorus present in food. High blood phosphate levels cause hypocalcemia and osteodystrophy; this makes a client prone to fracture. Increasing protein may not be feasible for a client with chronic kidney disease and would not help prevent fracture. Intake and output will not be helpful for orthopedic problems. Bedrest will promote complications.

 

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

TOP:   Client Needs Category: Physiological Integrity (Pharmacological and Parenteral Therapies—Expected Actions/Outcomes)    MSC:  Integrated Process: Teaching/Learning