Question

A 5-year-old child who had been receiving dialysis treatments has undergone renal transplant and will now be taking prednisone. The parents are hopeful the child's development and overall health will normalize. The nurse should inform the parents that taking prednisone can result in some similar adverse effects as living with chronic kidney disease (CKD). Which effects should the nurse include? Select all that apply.

	A.	Fluid retention
	B.	Increased risk for infection
	C.	Delayed growth
	D.	Weakened bone structure
	E.	Hypokalemia
	F.	Increased blood glucose

When explaining the role of the proximal tubule in terms of medication administration, the nursing instructor will emphasize that which medications are bound to plasma proteins and require the proximal tubule secretion of exogenous organic compounds to help with filtration? Select all that apply.

	A.	Penicillin
	B.	Aspirin
	C.	Morphine sulfate
	D.	Potassium chloride
	E.	Sodium chloride

You are caring for a client who is being treated for pneumonia. You suspects the client has developed pleuritis. Which assessment findings support the your suspicion of pleuritis? Select all that apply.

	A.	Shoulder pain
	B.	Bilateral chest wall pain
	C.	Pain when deep breathing and coughing
	D.	Purulent sputum
	E.	Unequal chest expansion on inspiration

A client diagnosed with a cerebrovascular accident (CVA) 5 months prior is now experiencing episodes of urinary incontinence. The client asks, "Why is this happening?" Which statement best captures the facts that would underlie the answer to this question?

	A.	Flaccid bladder dysfunction as a result of neurologic disease like a stroke
	B.	Unable to sense bladder filling as a result of the stroke
	C.	Lesions to the basal ganglia or extrapyramidal tract associated with stroke inhibit detrusor contraction
	D.	Pathological reductions in bladder volume brought on by stroke necessitate frequent micturition

You are in the respiratory unit of a hospital is providing care for a client with end-stage lung disease. Consequently, measurement of the client's arterial blood gases indicates increased PCO₂. Which associated consequence would the nurse anticipate?

	A.	A shift to the left of the oxygen-hemoglobin dissociation curve
	B.	Lower than normal production of HCO3
	C.	Higher than normal production of H+
	D.	An absence of carbaminohemoglobin

You are caring for a client in emergent fluid overload requiring rapid diuresis. Which diuretic should the nurse be prepared to administer?

	A.	Loop
	B.	Potassium sparing
	C.	Thiazide
	D.	Osmotic

You are planning the care for a client with acute kidney injury (AKI). What should the nurse prioritize in the client's plan of care? Select all that apply.

	A.	Assessing fluid balance
	B.	Monitoring electrolyte levels
	C.	Promoting infection control
	D.	Optimizing pain control
	E.	Protecting from falls

Which individual is at the highest risk of developing a urinary tract infection (UTI)?

	A.	A 60-year-old man with a history of cardiovascular disease who is recovering in hospital from a coronary artery bypass graft
	B.	A 66-year-old man undergoing dialysis for the treatment of chronic renal failure secondary to hypertension
	C.	A 38-year-old man with high urine output due to antidiuretic hormone insufficiency
	D.	A 30-year-old woman with poorly controlled diabetes mellitus

A dialysis technician is reviewing a textbook on kidney function. The technician would recognize which statements as characteristic of healthy kidneys? Select all that apply.

	A.	The kidneys are contained within the peritoneal cavity.
	B.	Blood vessels, nerves and, ureters all connect with the kidney at the hilus.
	C.	The medulla of the kidney contains the glomeruli.
	D.	Each kidney consists of lobes, with each lobe comprised of nephrons.
	E.	Each nephron contains several hundred glomeruli that perform filtration.

Answer 1

1. Answer: Increased risk for infection and increased blood glucose.

Here the prednisolone works by weakening the immune system. There fore it lowers the ability to fight infections.

Prednisolone cause spike in blood glucose level by making the liver resistant to insulin. The pancreas secretes insulin, it controls the blood glucose by converting glucose into glycogen.

2. Answer: Pencillin, Aspirin and Morphin sulphate

The kidneys plays an important role in handling of drugs, mostly in excretion. The drug efficiency is affected by the degree of binding with plasma proteins. The less bound drug is more efficient.

3.Answer: Pain when deep breathing and coughing

Pleuritis is the infection or inflammation of the tissues that line the lungs and chest cavity. It causes chest pain that worsens during breathing.

4. Answer: Pathological reductions in bladder volume brought on by stroke necessitate frequent micturition

5. Answer: Higher than normal production of H+

A high pCO2 is compatible with respiratory acidosis and low pCO2 with respiratory alkalosis. Increase in CO2 will result in increased HCO3 and H+ formation.

6. Answer: Loop diuretics

These are Medications used to reduce the extra cellular fluid

7. Answer: Monitoring electrolyte levels

Assessing fluid balance

Optimizing pain control

Promoting infection control

Protecting from falls

8. Answer: A 30-year-old woman with poorly controlled diabetes mellitus

Woman have high risk than man against UTI. Especially the patient have poor control over diabetes. So it increases the proximity to infection.

9.Answer: Blood vessels, nerves and, ureters all connect with the kidney at the hilus.

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