Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. The nurse is providing care for an adolescent patient admitted with a diagnosis of nephrolithiasis. The patient’s symptoms include flank pain, hematuria, and vomiting. The nurse notices an hourly...
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. The nurse is providing care for an adolescent patient admitted with a diagnosis of
nephrolithiasis. The patient’s symptoms include flank pain, hematuria, and vomiting. The
nurse notices an hourly output of 20 mL/hour. Patient’s medical history includes UTIs,
type 1 diabetes mellitus, and one kidney at birth. Which medical prescription does the
nurse expect immediately from the physician?
a. Increase IV fluids to 125 mL/hour.
b. Cover blood glucose on a sliding scale.
c. Establish nothing by mouth (NPO) status and prepare patient for surgery.
d. Administer IV morphine 5 mg every 2 hours for pain.
ANS: C
Chapter: Chapter 17 Renal Disorders
Chapter Learning Objective: 4. Safely perform nursing interventions on selected renal
disorders while in the acute hospital setting.
Page: 409
Heading: Safe and Effective Nursing Care: Promoting Safety—Children With Renal
Calculi and One Kidney
Integrated Processes: Nursing Process
Cognitive Levels: Analysis [Analyzing] Concept: Elimination
Difficulty: Difficult
Feedback
A. This is incorrect. The nurse can expect an increase in fluids by IV and orally, if
oral fluids are appropriate.
B. This is incorrect. The physician may or may not prescribe blood glucose
coverage using a sliding scale. There is no specific information given about the
patient’s type 1 diabetes mellitus.
C. This is correct. Children with a single kidney who have symptoms consistent
with calculi (colicky flank pain, hematuria, vomiting, and abdominal pain) and
have signs of acute renal failure (oliguria, azotemia, hypertension, hyperkalemia)
are to be treated as a surgical emergency.
D. This is incorrect. The nurse can expect a prescription for narcotic pain
management; however, the medication is likely to be prescribed to be given as a
pediatric dose (0.1–0.2 mg/kg per dose every 2–4 hours IV). There is not enough
information in the scenario to determine the specific age or weight of the patient.
PTS: 1 CON: Elimination
,2. The nurse is providing care for a 7-year-old child whose admitting diagnosis is
poststreptococcal glomerulonephritis. The nurse expects which care to be prescribed for
the child?
a. Hemodialysis
b. Nifedipine orally
c. Increase fluids
d. Antibiotic therapy
ANS: D
Chapter: Chapter 17 Renal Disorders
Chapter Learning Objective: 1. Review, comprehend, and apply the basic
pathophysiology of selected renal disorders.
Page: 414
Heading: Disorders of the Renal System > Acute Postinfectious Glomerulonephritis >
Nursing Interventions > Acute Hospital Care
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Analysis [Analyzing]
Concept: Infection
Difficulty: Moderate
Feedback
A. This is incorrect. Hemodialysis is emergency care in the presence of renal failure.
There is no information to support this procedure.
B. This is incorrect. Nifedipine is prescribed as part of the emergency care for
hypertension related to the diagnosis. There is no information to support this
action.
C. This is incorrect. When the child is admitted for poststreptococcal
glomerulonephritis, the nurse expects an order for strict I&O monitoring. Fluid
restrictions are most commonly prescribed.
D. This is correct. The nurse will expect that antibiotic therapy will be prescribed to
eradicate the offending organism if present. A common cause of
poststreptococcal glomerulonephritis is either a missed strep diagnosis or
uncompleted antibiotic therapy.
PTS: 1 CON: Infection
3. The nurse in a pediatric clinic is gathering information from the parent of a toddler who
has anorexia, generalized edema, and joint pain following a bout with strep throat. Which
question(s) will most likely give the nurse information for a specific condition?
a. “What behavior did you see to indicate joint pain?”
b. “When and where did you first notice swelling?”
c. “Is the child urinating, and what color is the urine?”
, d. “How were you managing the symptoms at home?”
ANS: C
Chapter: Chapter 17 Renal Disorders
Chapter Learning Objective: 3. Accurately distinguish between selected renal
disorders based on clinical presentation.
Page: 413
Heading: Disorders of the Renal System > Acute Postinfectious Glomerulonephritis >
Assessment > Clinical Presentation
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Analysis
Concept: Elimination
Difficulty: Difficult
Feedback
A. This is incorrect. The question about the parent-recognized joint pain does not
provide information specific to a condition.
B. This is incorrect. Asking specifically about the time line for the existing edema
does not provide information specific to a condition.
C. This is correct. The nurse may suspect a kidney disorder from the presenting
symptoms and recent health history. The question about urination and the
appearance of the urine will give the nurse information to validate a specific
condition, which is acute postinfectious glomerulonephritis. The urine will
appear tea-colored, cola-colored, or bright red.
D. This is incorrect. It is not incorrect to ask how symptoms were being managed at
home; however, this question does not provide information about a specific
condition.
PTS: 1 CON: Elimination
4. The nurse is providing care for a 9-year-old patient diagnosed with postinfectious
glomerulonephritis. The nurse is aware of hypertension and a prescribed dose of
nifedipine 0.5 mg/kg/dose every 4 hours. The patient weighs 63 pounds. Which dose does
the nurse give every 4 hours?
a. 14 mg
b. 18 mg
c. 22 mg
d. 30 mg
ANS: A
Chapter: Chapter 17 Renal Disorders
Chapter Learning Objective: 4. Safely perform nursing interventions on selected renal
disorders while in the acute hospital setting.
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