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.

You are creating a care plan for a premature infant with respiratory distress syndrome. Which aspects of care should the nurse include in the plan? Select all that apply.

	A.	Administration of synthetic surfactant
	B.	Delivery of oxygen under positive pressure
	C.	Monitoring blood glucose
	D.	Frequent stimulation
	E.	Keeping infant in incubator

Which phenomenon is most likely occurring during a child's alveolar stage of lung development?

	A.	Terminal alveolar sacs are developing and surfactant production is beginning.
	B.	A single-capillary network exists and the lungs are capable of respiration.
	C.	The conducting airways are formed, but respiration is not yet possible.
	D.	Primitive alveoli are formed and the bronchi and bronchioles become much larger.

A client has a ureteral calculi in the proximal region. The nurse is planning to educate the client about the treatment of choice for removal of the stone in this location. For which intervention will the nuse eucate the client?

	A.	Nephrostomy tube
	B.	Extracorporeal shock wave lithotripsy
	C.	Ureteral stenting
	D.	Percutaneous nephrolithotomy

An older adult client is admitted with a stroke and has developed pneumonia. While auscultating the right lateral thorax, the nurse hears abnormal breath sounds. Which lobe of the lung is likely effected due to obstruction by thick secretions?

	A.	Right middle lobe
	B.	Right lower lobe
	C.	Right upper lobe
	D.	Left lower lobe

Answer 1

1. EFFECTS OF PREDNISONE IN CHILDREN

Since prednisone is an immunosuppressant agent, and is specifically given after an  organ transplation ,discharge advice is must for the follow up care.Rejection occurs when the body recognizes the transplanted organ as foreign, and attacks the organ as if it were a harmful intruder. Prednisone prevents or treats rejection by suppressing the body’s immune response.

while giving the health education, the nurses should include the effects of;

• Delayed growth
• Bone abnormalities ( Thinning of bone)
• and there is also a chance of rise in blood glucose level, specially in children with history of Diabestes mellitus

2.MEDICATIONS THAT ARE BOUND TO PLASMA PROETINS AND HELP WITH FILTRATION

-Sodium Chloride

-Pottasium chloride

3.PLEURITIS SYMPTOMS

-Usually the patient will have pain in chest cavity

-pain in shoulders or back

4.URINARY INCONTINENCE AFTER STROKE

- Flaccid bladder dysfunction as a result of stroke. (Usually happens due to the muscles that control urine gets weakened after stroke)

5.CONDITION ASSSOCIATED WITH INCREASED PCO2

Increased amount of Co2 in blood caused increased amount of h2co3 and there by increased amount of bicarbonate and H+ ions

6.DIURETIC USED FOR RAPID DIFFUSION

Loop diuretic (it increase the elimination of sodium and chloride and act as a stongest diurectic)

7. PLAN OF CARE FOR A PATIENT WITH ACUTE KIDNEY INJURY

1) Assess fluid balance (chance of excess fluid volume due to compromised regulatory mechanism)

2) Assess electrolyte balance (Due to renal dysfunction ,Compromised regulatory mechanism, Excessive fluid volume, Vomiting there is chance for imbalance)

3)Based on setting priorities ensuring pain control, infection control and prevention of falls also can be apply as interventions.

8.RISK GROUP FOR GETTING UTI

A 30-year-old woman with poorly controlled diabetes mellitus

9.HEALTHY KIDNEY CHARECTERISTICS

• The kidneys are contained within the peritoneal cavity.( RETRO PERITONEAL)
• Blood vessels, nerves and, ureters all connect with the kidney at the hilus

• Each nephron contains several hundred glomeruli that perform filtration

• Each kidney consists of lobes, with each lobe comprised of nephrons ( 2 LOBES, outer cortex, inner medula)

10.RDS

• Administration of synthetic surfactant
• Delivery of oxygen under positive pressure
• Keeping infant in incubator

11. URETHRAL STONES IN PROXIMAL REGION

Treatment given is percutaneous nephrolithotomy