Nokea
A nurse cares for a client with autosomal dominant polycystic kidney disease (ADPKD). The client asks, 'Will my children develop this disease?' How should the nurse respond?
- A. No genetic link is present, so your children are not at increased risk.
- B. Your sons will develop this disease because it has a sex-linked gene.
- C. Only if both you and your spouse are carriers of this disease.
- D. Your children have a 50% chance of inheriting the gene that causes this disease.
Correct Answer: D
Rationale: ADPKD is an autosomal dominant disorder, meaning there is a 50% chance of passing the gene to each child, regardless of gender. It is not sex-linked, and only one parent needs to have the gene for the child to be at risk.
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An emergency department nurse cares for a client who is severely dehydrated and is prescribed 3 L of intravenous fluid over 6 hours. At what rate should the nurse set the intravenous pump to infuse the fluids? (Record your answer using a whole number.)
- A. 100 ml/hr
- B. 250 ml/hr
- C. 500 ml/hr
- D. 750 ml/hr
Correct Answer: C
Rationale: To deliver 3 L (3000 ml) over 6 hours, the infusion rate is calculated as 3000 ml ÷ 6 hours = 500 ml/hr. This rate ensures the prescribed volume is administered within the specified time frame.
A nurse reviews laboratory results for a client with glomerulonephritis. The client's glomerular filtration rate (GFR) is 40 ml/min as measured by a 24-hour creatinine clearance. How should the nurse interpret this finding? (Select all that apply.)
- A. Excessive GFR
- B. Normal GFR
- C. Reduced GFR
- D. Potential for fluid overload
- E. Potential for dehydration
Correct Answer: C,D
Rationale: A GFR of 40 ml/min is significantly reduced compared to the normal range of 100-120 ml/min, indicating impaired kidney function. This reduction increases the risk of fluid overload, leading to hypertension and pulmonary edema, rather than dehydration.
A nurse cares for a client with a nephrostomy tube and notes that the drainage has decreased. Which action should the nurse take first?
- A. Document the finding in the client's record.
- B. Evaluate the tube as working in the hand-off report.
- C. Clamp the tube in preparation for removing it.
- D. Assess the client's abdomen and vital signs.
Correct Answer: D
Rationale: Decreased drainage from a nephrostomy tube may indicate obstruction, necessitating immediate assessment of the client's abdomen for pain or distention and vital signs to detect complications like infection or obstruction. This information should be reported to the provider. Documenting, evaluating in hand-off, or clamping the tube are not appropriate initial actions.
A nurse provides health screening for a community health center with a large population of African American clients. Which priority assessment should the nurse include when working with this population?
- A. Measure height and weight.
- B. Assess blood pressure.
- C. Measure blood pressure and pulse.
- D. Ask about medications.
Correct Answer: B
Rationale: African Americans have a high prevalence of hypertension, which is a leading cause of end-stage renal disease. Assessing blood pressure is a priority to monitor and manage this risk. While other assessments are important, blood pressure screening is critical for this population.
A nurse teaches a client with polycystic kidney disease (PKD). Which statements should the nurse include in this client's discharge teaching? (Select all that apply.)
- A. Take your blood pressure every morning.
- B. Weigh yourself at the same time each day.
- C. Adjust your diet to prevent diarrhea.
- D. Contact your provider if you have visual disturbances.
- E. Assess your urine for renal stones.
Correct Answer: A,B,D
Rationale: Clients with PKD should monitor blood pressure and weight daily to track hypertension and fluid status, and report visual disturbances, which may indicate a berry aneurysm. Adjusting diet to prevent constipation, not diarrhea, is appropriate, and renal stones are not a primary concern in PKD.