Question

A nurse is caring for a client who has progressing chronic kidney disease (CKD). Which of the following laboratory results would the nurse expect to find in the client's electronic health record?

Answer 1

Correct Answers:

Urine albumin increasing

Rationale :

💎 Indicator of kidney damage: In chronic kidney disease (CKD), the glomerular filtration barrier becomes more permeable, allowing albumin (protein) to leak into urine.

💎 GFR trend: CKD causes a progressive decline in GFR, not an increase, reflecting reduced renal filtration capacity.

💎 Creatinine relationship: Serum creatinine levels rise as kidney function worsens because excretion declines.

💎 Clinical significance: Persistent proteinuria or albuminuria is an early marker of CKD progression and correlates with nephron injury.

💎 Management: Control blood pressure, diabetes, and protein intake to reduce further glomerular damage.

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Answer 2

Correct Answers:

"Filter your urine each day.”

Rationale :

🔷 Purpose: Straining urine allows detection and collection of passed stones for laboratory analysis, identifying composition for targeted prevention.

🔷 Prevention planning: Knowing stone type (e.g., calcium oxalate, uric acid) helps guide dietary and pharmacologic interventions.

🔷 Hydration importance: Encourage 2–3 L/day fluid intake unless contraindicated, to dilute urine and prevent stone formation.

🔷 Diet modification: Avoid sugar-sweetened or caffeine-containing beverages; promote citrus-based fluids for urine alkalinization.

🔷 Patient teaching: Reinforce timely urination and monitor for pain, hematuria, or obstruction signs.

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Answer 3

Correct Answers:

Gastrointestinal upset

Rationale :

💠 Stones irritate the urinary tract and may cause nausea, vomiting, and abdominal discomfort due to shared nerve pathways between GI and renal systems.

💠 Flank pain:

💠 A hallmark symptom; sharp flank or lower back pain occurs from ureteral obstruction and increased renal capsule pressure.

💠 Urinary urgency:

💠 As stones pass into the lower urinary tract, they cause urgency, frequency, and dysuria from mucosal irritation.

💠 Overall: Stone movement causes colicky pain, sometimes radiating to the groin or perineum, depending on location.

💠 Teaching: Encourage hydration and pain management until the stone passes.

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Answer 4

Correct Answers:

Drink plenty of fluids during the day.

Rationale :

🔶 Core prevention: Adequate hydration dilutes urine, reduces crystal formation, and helps flush small stones before they grow.

🔶 Environmental risk: Working outdoors in high heat causes dehydration, concentrating urine and increasing stone risk.

🔶 Medical history: Gout and hyperuricemia predispose to uric acid stones, which are preventable with fluid intake and allopurinol adherence.

🔶 Dietary note: Avoid high-purine or high-oxalate foods; maintain normal calcium intake rather than restriction.

🔶 Goal output: Encourage urine output of at least 2 L/day; water is the best fluid option.

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Answer 5

Correct Answers:

Pelvic organs prolapse
Constipation
Parkinson's disease
Multiple sclerosis

Rationale :

🟢Pelvic organ prolapse: The descent of pelvic organs compresses the urethra or bladder neck, causing urinary retention by mechanical obstruction.

🟢Constipation: A distended rectum can press against the bladder, blocking urine flow and impeding detrusor contraction.

🟢Parkinson’s disease: Neurological degeneration impairs autonomic bladder control, leading to incomplete emptying or retention.

🟢 Multiple sclerosis: Demyelination disrupts neural signaling to bladder muscles, causing neurogenic bladder dysfunction.

🟢 Clinical significance: Address causes with bladder retraining, intermittent catheterization, or treating underlying neurologic disorders.

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Answer 6

Correct Answers:

The glomerular filtration rate decreases because there is injury to the renal tubular cells.

Rationale :

💎 Core concept: Acute tubular necrosis (ATN) is the most common cause of intrarenal acute kidney injury (AKI).

💎 Mechanism: Injury to renal tubular epithelial cells causes cellular debris accumulation, tubular obstruction, and backflow of filtrate, all of which reduce GFR.

💎 Perfusion disruption: Damaged tubules lose the ability to reabsorb sodium and water, worsening renal perfusion and lowering filtration pressure.

💎 Inflammatory role: Necrotic cells trigger inflammation and vasoconstriction, leading to further decline in renal blood flow.

💎 Outcome: If untreated, sustained tubular injury leads to oliguria, azotemia, and possibly irreversible renal failure.

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Answer 7

Correct Answers:

7.5

Rationale :

🟢 Formula: (Desired Dose ÷ Available Strength)×Volume=mL

🟢 Substitute values: (20÷40)×15=0.5×15=7.5 mL

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Answer 8

Correct Answers:

The client reports that they had two urinary tract infections (UTI) in the past 10 months.

Rationale :

🔷 Underlying cause: Pyelonephritis often develops as a complication of recurrent or untreated lower UTIs (cystitis).

🔷 Pathophysiology: Bacteria from the bladder ascend via the ureters to infect the renal pelvis and parenchyma.

🔷 Risk factors: Include frequent UTIs, urinary retention, stones, or reflux, not calcium metabolism or genetics.

🔷 Medication link: Chronic use of nephrotoxic drugs (e.g., NSAIDs) causes interstitial nephritis, not pyelonephritis.

🔷 Clinical signs: Expect flank pain, fever, chills, and dysuria due to upper urinary tract inflammation.

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Answer 9

Correct Answers:

Leakage of urine

Rationale :

💠 Physiology: Urinary retention occurs when the bladder fails to empty completely, leading to overflow leakage.

💠 Presentation: Small, frequent dribbles of urine despite a sensation of fullness or incomplete voiding.

💠 Complications: Can lead to UTIs, bladder distention, and hydronephrosis if unrelieved.

💠 Causes: May result from neurologic disorders, obstruction, or anesthesia effects.

💠 Assessment: Bladder scan shows high post-void residual urine volume.

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Answer 10

Correct Answers:

The client who had general anesthesia for back surgery 4 hr ago.

Rationale :

🔶 Mechanism: General anesthesia and opioid use suppress bladder detrusor muscle tone and reflex voiding.

🔶 Post-operative risk: Retention is common 4–6 hours after surgery until anesthesia fully wears off.

🔶 Contributing factors: Anticholinergics, immobility, pain, and IV fluids can worsen retention risk.

🔶 Nursing management: Encourage early ambulation, assist to void within 6–8 hours, and bladder scan if unable.

🔶 Clinical follow-up: Prolonged retention may need intermittent catheterization to prevent bladder overdistention.

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QLexNursing

1 :
A nurse is caring for a client who has progressing chronic kidney disease (CKD). Which of the following laboratory results would the nurse expect to find in the client's electronic health record?

2 :
A nurse is reinforcing teaching with a client who has kidney stones. Which of the following instructions should the nurse include?

3 :
A nurse is caring for a client admitted for renal calculus. Which of the following assessment findings should the nurse associate with renal calculi? (Select All that Apply.)

5 :
A nurse is caring for a group of clients who have been diagnosed with urinary retention. Which of the following underlying conditions place these clients at risk for urinary retention? (Select All that Apply.)

7 :
A nurse is preparing to administer potassium chloride 20 mEq. The amount available is potassium chloride liquid 40 mEq/15 mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

8 :
A nurse is gathering medical history from a client admitted for pyelonephritis. Which of the following should the nurse expect the client to report when asked about their medical history?

9 :
A nurse is collecting data on a client who has urinary retention. Which of the following findings should the nurse expect?

10 :
A nurse is caring for a group of clients on a medical surgical unit. Which of the following clients is at greatest risk for urinary retention?

QLexNursing

1 : A nurse is caring for a client who has progressing chronic kidney disease (CKD). Which of the following laboratory results would the nurse expect to find in the client's electronic health record?

2 : A nurse is reinforcing teaching with a client who has kidney stones. Which of the following instructions should the nurse include?

3 : A nurse is caring for a client admitted for renal calculus. Which of the following assessment findings should the nurse associate with renal calculi? (Select All that Apply.)

5 : A nurse is caring for a group of clients who have been diagnosed with urinary retention. Which of the following underlying conditions place these clients at risk for urinary retention? (Select All that Apply.)

7 : A nurse is preparing to administer potassium chloride 20 mEq. The amount available is potassium chloride liquid 40 mEq/15 mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

8 : A nurse is gathering medical history from a client admitted for pyelonephritis. Which of the following should the nurse expect the client to report when asked about their medical history?

9 : A nurse is collecting data on a client who has urinary retention. Which of the following findings should the nurse expect?

10 : A nurse is caring for a group of clients on a medical surgical unit. Which of the following clients is at greatest risk for urinary retention?

1 :
A nurse is caring for a client who has progressing chronic kidney disease (CKD). Which of the following laboratory results would the nurse expect to find in the client's electronic health record?

2 :
A nurse is reinforcing teaching with a client who has kidney stones. Which of the following instructions should the nurse include?

3 :
A nurse is caring for a client admitted for renal calculus. Which of the following assessment findings should the nurse associate with renal calculi? (Select All that Apply.)

5 :
A nurse is caring for a group of clients who have been diagnosed with urinary retention. Which of the following underlying conditions place these clients at risk for urinary retention? (Select All that Apply.)

7 :
A nurse is preparing to administer potassium chloride 20 mEq. The amount available is potassium chloride liquid 40 mEq/15 mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

8 :
A nurse is gathering medical history from a client admitted for pyelonephritis. Which of the following should the nurse expect the client to report when asked about their medical history?

9 :
A nurse is collecting data on a client who has urinary retention. Which of the following findings should the nurse expect?

10 :
A nurse is caring for a group of clients on a medical surgical unit. Which of the following clients is at greatest risk for urinary retention?