Nokea
Which sign is indicative of fluid overload in the patient with chronic glomerulonephritis?
- A. Increase in blood pressure
- B. Increase in daily weight
- C. Clear lung sounds
- D. Edema
- E. Labored respirations
Correct Answer: A,B,D,E
Rationale: Signs and symptoms of fluid overload: increased blood pressure, respirations, cardiac sounds, and lung fields. Increase in daily morning weights.
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Which hormone from the posterior pituitary gland influences the amount of water that is eliminated with the urine?
- A. Pitocin
- B. Renin hormone
- C. Antidiuretic hormone (ADH)
- D. ACTH
Correct Answer: C
Rationale: ADH causes the cells of the distal convoluted tubules to increase their rate of water reabsorption.
In the nephrotic syndrome, the glomeruli are damaged by inflammation and allow small ___ to pass through into the urine.
- A. proteins
Correct Answer: proteins
Rationale: In nephrotic syndrome, the glomeruli are damaged by inflammation and allow small proteins such as albumin to enter the urine. This creates a deficit of protein in the circulation volume (hypoalbuminemia), which leads to massive edema.
As the nurse and the dietitian review a female patient's diet plan with her, she shouts that with her diabetes and now the kidney failure, there is just nothing she can eat. She says she might as well eat what she wants, because there is nothing she can do to help herself. Based on the patient's response, which patient problem does the nurse identify?
- A. The patient will not likely follow a prescribed diet due to anger.
- B. The patient does not understand the diet, and will likely have poor nutrition.
- C. The patient is in the grieving process, due to the probability she will die soon.
- D. The patient is feeling unable to cope, and feels helpless over having diabetes and kidney failure.
Correct Answer: D
Rationale: Ineffective coping due to the feeling of powerlessness against the multiorgan failure may result in aggressive or infantile behavior.
It is 2 days after a 42-year-old male patient's urinary diversion surgery. He continues to be critical of the hospital and the nursing care, even though the staff has spent time explaining the care to him. Which explanation is most likely for his behavior?
- A. He is angry about hospital policy.
- B. He is feeling neglected by the nursing staff.
- C. He is in denial of the effects of the surgery.
- D. He is reacting to the loss of self-esteem and altered body image.
Correct Answer: D
Rationale: Persons with altered body image may react to the loss of self-esteem by behaving in a critical or derogatory manner.
When the patient receiving home health services is started on dialysis, the home health nurse refers the patient to a community support group that assists with the adjustments necessary to living with dialysis. Which group offers this service?
- A. National Kidney Foundation
- B. American Association of Kidney Patients
- C. American Red Cross
- D. Veterans Administration
Correct Answer: B
Rationale: The American Association of Kidney Patients offer support to the patient and family as they adapt to living with dialysis.