Question

A nurse is caring for a client with a new diagnosis of acute kidney injury. The client states, "This is going to mess my life up." Which of the following is the best response by the nurse to assist the client to begin to understand the impact of this disease?

Answer 1

Correct Answers:

"Clients with this disease typically have concerns with finances, treatment and adjusting to a new normal.

Rationale :

⚫This response promotes therapeutic communication by validating the client’s concerns while introducing the emotional and practical aspects of living with acute kidney injury (AKI).

⚫It encourages patient reflection, establishes empathy, and opens the door to further education and planning.

⚫Unlike dismissive or false reassurance, this answer fosters psychological readiness for health behavior changes and self-management.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 2

Correct Answers:

An intrarenal acute kidney injury

Rationale :

✅Gentamicin is an aminoglycoside antibiotic known to cause nephrotoxicity, specifically acute tubular necrosis, which is a form of intrarenal AKI.

✅Elevated BUN (31), creatinine (1.8), and reduced GFR (55 mL/min) point to impaired filtration at the nephron level, not just reduced perfusion (pre-renal) or obstruction (post-renal).

✅This classification is critical for determining the appropriate intervention and monitoring.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 3

Correct Answers:

Dysuria
Urinary urgency
Incontinence
Urinary frequency
Inability to void

Rationale :

✅BPH causes urinary obstruction and bladder irritation, leading to:

Dysuria : pain from incomplete emptying or straining.
Urgency : from bladder hyperactivity due to obstruction.
Incontinence : often overflow incontinence from full bladder.
Frequency : small frequent voids due to reduced bladder capacity.
Inability to void : late-stage retention or acute urinary retention.
Impotence is not a direct result of BPH, though it may coexist due to age or other factors.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 4

Correct Answers:

Heart failure
Diabetes mellitus
Multiple sclerosis

Rationale :

✅Conditions linked to neurological dysfunction or fluid imbalance often contribute to urinary incontinence:

Heart failure: causes nocturia, urgency due to fluid shifts.
Diabetes: leads to diabetic neuropathy, affecting bladder innervation.
Multiple sclerosis: disrupts central control over the bladder.
COPD is not directly associated unless the client is significantly debilitated.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 5

Correct Answers:

Banana

Rationale :

🔹Bananas are rich in potassium (~422 mg per medium banana), which must be limited in clients with chronic glomerulonephritis due to reduced potassium excretion.

🔹Excess serum potassium (hyperkalemia) can cause life-threatening cardiac arrhythmias.

🔹Safer alternatives include fruits with lower potassium content like apples and grapes.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 6

Correct Answers:

Chronic nephropathies that lead to fibrosis and destruction of normal kidney structure and function

Rationale :

✅Chronic kidney disease (CKD) results from long-standing nephron damage due to conditions like hypertension and diabetes mellitus, leading to renal fibrosis, glomerulosclerosis, and tubular atrophy.

✅These structural changes impair kidney function over time, culminating in fluid overload and symptoms such as shortness of breath from pulmonary edema.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 7

Correct Answers:

"l will drink only the amount of fluid in a day that my doctor told me to."
"l will call my doctor if I feel short of breath all of a sudden."

Rationale :

✅Clients on intermittent peritoneal dialysis must manage fluid intake to prevent volume overload.

Fluid intake must be limited based on the nephrologist’s recommendation and dialysis adequacy.
Sudden shortness of breath suggests fluid overload or infection—both requiring immediate provider notification.
Weight every other day and conditional medicinal use reflect poor fluid and medication adherence.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 8

Correct Answers:

A client who is taking gentamicin for infection
A client who has heart failure
A client who is 1 day postoperative following a colon resection

Rationale :

✅AKI risk is elevated in clients with:

Gentamicin: nephrotoxic potential.
Heart failure: low cardiac output → reduced renal perfusion.
Postoperative patients: risk from anesthesia, blood loss, or hypovolemia.
Pneumonia, unless severe or septic, is not a strong independent AKI risk factor.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 9

Correct Answers:

"It is caused by smooth muscle and epithelial cells multiplying at an uncontrolled rate within the transition zone."

Rationale :

🔹BPH results from hormonal changes (especially increased dihydrotestosterone) leading to hyperplasia of smooth muscle and epithelial cells in the transition zone of the prostate.

🔹This growth narrows the urethra, impeding urine flow.

🔹The condition is non-malignant and differs from conditions involving cysts, glomerular inflammation, or renal stones.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 10

Correct Answers:

"l probably have problems with incontinence due to our strict break policy that they monitor very closely. "

Rationale :

✅This reflects functional incontinence, where external or environmental barriers (like limited restroom breaks) prevent timely urination.

✅The cause is not due to bladder dysfunction but from impaired ability to respond to the urge.

✅Recognizing this helps direct workplace modifications or behavior-based strategies.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

QLexNursing

1 : A nurse is caring for a client with a new diagnosis of acute kidney injury. The client states, "This is going to mess my life up." Which of the following is the best response by the nurse to assist the client to begin to understand the impact of this disease?

4 : A nurse is caring for a group of clients, who all are incontinent of urine, on the medical-surgical unit. Which comorbidities should the nurse expect to find in their medical records? (Select all that apply.)

5 : A nurse is caring for a client who has chronic glomerulonephritis. The assistive personnel (AP) brings a snack into the client's room. Which of the following foods should the nurse stop the AP from giving to this client?

6 : A nurse is caring for a client admitted to the urology unit with complaints of shortness of breath and a diagnosis of chronic kidney disease. Which of the following pathophysiological changes in the renal system led to the admitting diagnosis of chronic kidney disease?

7 : A nurse is assisting with the discharge teaching for a client on home intermittent peritoneal dialysis. Which of the following statements by the client indicates an understanding of fluid balance self-management? (Select all that apply.)

8 : A nurse is caring for a group of clients on a medical unit. Which of the following clients is the most at risk for an acute kidney injury? (Select all that apply.)

9 : A nurse is caring for a client with a history of benign prostatic hypertrophy who has been admitted for a urinary tract infection. A student nurse asks what causes benign prostatic hypertrophy in men. The nurse should respond with which of the following statements?