Question 1

A 2-year-old male is diagnosed with Wilms tumor. Which of the following clinical conditions is often associated with this disease?

a. Cystic disease of the liver

b. Aniridia

c. Anemia

d. Hypothyroidism

Question 2

A nurse is preparing to teach about the loop of Henle. Which information should be included? The descending segment of the loop of Henle primarily allows for:

a. Sodium secretion

b. Potassium secretion

c. Hydrogen ion reabsorption

d. Water reabsorption

Question 3

A nurse is describing the trigone. Which information should be included? The trigone is defined as:

a. The orifice of the ureter

b. The inner area of the kidney

c. A triangular area between the openings of the two ureters and the urethra

d. The three divisions of the loop of Henle

Question 4

When the nurse discusses the glomerulus and Bowman capsule together, it is referred to as the renal:

a. Corpuscle

b. Capsule

c. Medulla

d. Pyramid

Question 5

A 5-year-old male was diagnosed with glomerulonephritis.History reveals that he had an infection 3 weeks before the onset of this condition. The infection was most likely located in the:

a. bone.

b. gastrointestinal (GI) tract.

c. respiratory tract.

d. ear.

Question 6

A 75-year-old male reports to his primary care provider loss of urine with cough, sneezing, or laughing. Which of the following is the most likely diagnosis the nurse will observe on the chart?

a. Urge incontinence

b. Stress incontinence

c. Overflow incontinence

d. Functional incontinence

Question 7

A nurse observes on the chart that a patient is admitted with Wilms tumors. A nurse knows the tumors are found in the:

a. kidneys.

b. ureters.

c. bladder.

d. urethra.

Question 8

A 35-year-old female was severely burned and is hospitalized. She is now suffering from acute tubular necrosis (ATN). Which of the following is the most likely diagnosis the nurse will observe on the chart?

a. Prerenal

b. Intrarenal

c. Extrarenal

d. Postrenal

Question 9

A 24-year-old female is diagnosed with renal calculus that is causing obstruction. Which of the following symptoms would she most likely experience?

a. Anuria

b. Hematuria

c. Pyuria

d. Flank pain

Question 10

If a nurse wants to obtain the best estimate of renal function, which test should the nurse monitor?

a. Glomerular filtration rate (GFR)

b. Circulating antidiuretic hormone (ADH) levels

c. Volume of urine output

d. Urine-specific gravity

Question 11

While planning care for a patient who has acute pyelonephritis. A nurse recalls the most common condition associated with the development of acute pyelonephritis is:

a. Cystitis

b. Renal cancer

c. Urinary tract obstruction

d. Nephrotic syndrome

Question 12

When a nurse is preparing to teach about urine, which information should the nurse include? Just before entering the ureter, urine passes through the:

a. Collecting duct

b. Renal pelvis

c. Urethra

d. Major calyx

Question 13

When a patient’s renal system secretes rennin, what effect will that cause in the body? It causes the direct activation of:

a. Angiotensin I

b. Angiotensin II

c. Antidiuretic hormone

d. Aldosterone

Question 14

Anemia accompanies chronic renal failure because of:

a. Blood loss via the urine

b. Renal insensitivity to vitamin D

c. Inadequate production of erythropoietin

d. Inadequate retention of serum iron

Question 15

A 4-year-old male is diagnosed with nephrotic syndrome.Which of the following assessment findings accompanies this condition?

a. Proteinuria

b. Decreased blood urea nitrogen (BUN)

c. Hematuria

d. Sodium loss

Question 16

A 19-year-old female was involved in a motor vehicle accident during which she sustained a closed head injury. She is now experiencing detrusor sphincter dyssynergia. Which of the following is the most beneficial medication treatment?

a. Alpha blocker

b. Beta blocker

c. Vasodilator

d. Diuretic

Question 17

A 30-year-old male is demonstrating hematuria with red blood cell casts and proteinuria exceeding 3 to 5 g/day, with albumin being the major protein. The most probable diagnosis the nurse will see documented on the chart is:

a. cystitis.

b. chronic pyelonephritis.

c. acute glomerulonephritis.

d. renal calculi.

Question 18

A 25-year-old female is diagnosed with urinary tract obstruction. While planning care, the nurse realizes that the patient is expected to have hydronephrosis and a decreased glomerular filtration rate caused by:

a. decreased renal blood flow.

b. decreased peritubular capillary pressure.

c. dilation of the renal pelvis and calyces proximal to a blockage.

d. stimulation of antidiuretic hormone.

Question 19

A 15-year-old female presents with flank pain, irritability, malaise, and fever. Tests reveal glomerulonephritis. When the parents ask what could have caused this, how should the nurse respond?

a. poststreptococcal infection

b. nephropathy

c. nephrotic syndrome

d. potter syndrome

Question 20

A 60-year-old male is diagnosed with renal failure. While the nurse is reviewing lab results, which of the following lab values would be most consistent with this diagnosis?

a. Elevated plasma creatinine level

b. Decreased plasma potassium level

c. Metabolic alkalosis

d. Increased urea clearance

Question 21

While planning care for a patient with renal calculi, the nurse remembers the most important factor in renal calculus formation is:

a. urine pH.

b. body temperature.

c. gender.

d. serum mineral concentrations.

Question 22

A 30-year-old male is demonstrating hematuria with red blood cell casts and proteinuria exceeding 3 to 5 g/day, with albumin being the major protein. The most probable diagnosis the nurse will see documented on the chart is:

a. cystitis.

b. chronic pyelonephritis.

c. acute glomerulonephritis.

d. renal calculi.

Question 23

A 55-year-old male presents reporting urinary retention.Tests reveal that he has a lower urinary tract obstruction. Which of the following is of most concern to the nurse?

a. vesicoureteral reflux and pyelonephritis

b. formation of renal calculi

c. glomerulonephritis

d. increased bladder compliance

Question 24

The urologist is teaching about the nephrons that determine the concentration of the urine. The urologist is discussing the _ nephrons.

a. Juxtamedullary

b. Midcortical

c. Cortical

d. Medullary

Question 25

A 42-year-old female is diagnosed with chronic renal failure, and the nurse is discussing dietary treatment. Which information indicates the nurse understands dietary regimen? Treatment includes restricting:

a. Fats

b. Complex carbohydrates

c. Proteins

d. Sugars

Question 26

When a newborn is admitted with urinary tract infections (UTIs), which type of infection will the nurse look for in the newborn?

a. blood-borne infections

b. infections caused by bacteria from the gastrointestinal (GI) tract

c. yeast infections

d. viral infections

Question 27

A nurse is reviewing urinalysis results and notices glucose is present in the urine. A nurse realizes glucose will be excreted in the urine when:

a. The maximum rate of glucose filtration is achieved

b. The carrier molecules have reached their maximum

c. Glucose is consumed

d. The ability of the kidneys to regulate blood glucose is lost

Question 28

A 42-year-old male is involved in a motor vehicle accident during which he loses a lot of blood. The nurse realizes he is in acute renal failure caused by:

a. kidney stones

b. immune complex deposition in the glomerulus

c. inadequate renal blood flow

d. obstruction of the proximal tubule

Question 29

On average the kidneys receive approximately _ of the cardiac output.

a. 10-14%

b. 15-19%

c. 20-25%

d. 26-35%

Question 30

When a nurse is checking the urinalysis, plasma proteins should be absent from the urine because:

a. all filtered proteins are subsequently reab-sorbed.

b. the texture of the covering surrounding plasma proteins interferes with reabsorp-tion.

c. filtered proteins are subsequently degrad-ed before elimination.

d. the negative charge of the glomerular fil-tration membrane repels the plasma pro-teins.

Question 31

A 3-year-old female presents with recurrent urinary tract infections (UTIs), fever, poor growth and development, and feeding problems.Tests reveal a retrograde flow of urine from the urinary bladder into the ureters. When giving report to the oncoming shift, the nurse will call this condition:

a. vesicoureteral reflux (VUR)

b. vesicourethral reflux

c. vesicoureteral influx

d. hydronephrosis

Question 32

A 6-year-old male is experiencing urine reflux from the urinary bladder into a grossly dilated ureter and calyces. He was diagnosed with vesicoureteral reflux. This condition would be graded:

a. I

b. II

c. III

d. IV

Question 33

A 35-year-old hypertensive male begins taking a diuretic.Which of the following common side effects of this medication should the nurse monitor?

a. Hypokalemia

b. Hyponatremia

c. Increased uric acid secretion

d. Hypermagnesemia

Question 34

A 27-year-old male has a severe kidney obstruction leading to removal of the affected kidney. Which of the following would the nurse expect to occur?

a. atrophy of the remaining kidney

b. compensatory hypertrophy of the remaining kidney

c. dysplasia in the remaining kidney

d. renal failure

Question 35

When a child is admitted with acute renal failure, a clinician realizes the most common cause of acute renal failure is:

a. glomerulonephritis.

b. obstruction.

c. nephrotic syndrome.

d. hemolytic uremic syndrome (HUS).

Question 36

A 7-year-old male presents to his primary care provider for incontinence. His mother indicates that he has never been continent. Which of the following is the most likely diagnosis the nurse will observe on the chart?

a. Nocturnal enuresis

b. Diurnal enuresis

c. Primary enuresis

d. Secondary enuresis

Question 37

While turning a patient with chronic renal failure, which principle should the nurse recall? Bone fractures are a risk factor in chronic renal failure because:

a. calcium is lost in the urine

b. osteoblast activity is excessive

c. the kidneys fail to activate vitamin D

d. autoantibodies to calcium molecules develop

Question 38

A 56-year-old male presents with flank pain and polyuria.Tests reveal that he has an enlarged prostate. Which of the following types of renal failure should the nurse monitor for as it is the most likely to occur?

a. prerenal

b. intrarenal

c. extrarenal

d. postrenal

Question 39

A 15-year-old male was diagnosed with pharyngitis. Eight days later he developed acute glomerulonephritis. While reviewing the culture results, which of the following is the most likely cause of this disease?

a. Kelbsiella

b. human immunodeficiency virus (HIV)

c. genital herpes virus

d. group A B-hemolytic streptococcus

Question 40

A 29-year-old female presents with cloudy urine, flank pain, hematuria, and fever. Which of the following does the nurse suspect the patient is most likely experiencing?

a. acute cystitis

b. renal calculi

c. chronic renal failure

d. postrenal renal failure

Discussion: Nursing Research and Evidence-Based Practice

In your practice as a nurse, you may use procedures and methods that did not necessarily originate in evidence, but instead were derived from informal and unwritten conventions, traditions, and observations. While these techniques may have merit, practices are constantly being updated and contradicted by information from scholarly research studies and professional guidelines. This new information serves as “evidence” for revising practices to improve outcomes across health care.

Based on this evidence, you can formulate a question. In this Discussion, you consider the use of evidence-based practice in your own organization and formulate a question that you will need to answer for your portfolio project. This is called a PICOT question. You will also investigate strategies for overcoming barriers to implementing evidence-based practice (EBP).

To prepare:

Consider a recent clinical experience in which you were providing care for a patient.
Determine the extent to which the care that you provided was based on evidence and research findings or supported only by your organization’s standard procedures. How do you know if the tasks were based on research?
What questions have you thought about in a particular area of care such as a procedure or policy?
Review Chapter 2, pages 31–34 on “Asking Well worded Clinical Questions” in Polit & Beck and consult the resource from the Walden Student Center for Success: Clinical Question Anatomy & examples of PICOT questions (found in this week’s Learning Resources). Formulate your background questions and PICOT question.
Reflect on the barriers that might inhibit the implementation of evidence-based practice in your clinical environment.
Review the article “Adopting Evidence-Based Practice in Clinical Decision Making” in this week’s Learning Resources. Select one of the barriers described that is evident in your organization and formulate a plan for overcoming this barrier.

By Day 3

Post an evaluation of the use, or lack thereof, of EBP in a recent clinical experience. Identify which aspects of the care delivered, if any, were based on evidence and provide your rationale. List your background questions and PICOT question about this nursing topic. Critique how the policies, procedures, and culture in your organization may hinder or support the adoption of evidence-based practices. Identify the barrier you selected from the article and explain how this barrier could be overcome within your organization.

Course Project: Part 1—Identifying a Researchable Problem

One of the most challenging aspects of EBP is to actually identify the answerable question.

—Karen Sue Davies

Formulating a question that targets the goal of your research is a challenging but essential task. The question plays a crucial role in all other aspects of the research, including the determination of the research design and theoretical perspective to be applied, which data will be collected, and which tools will be used for analysis. It is therefore essential to take the time to ensure that the research question addresses what you actually want to study. Doing so will increase your likelihood of obtaining meaningful results.

In this first component of the Course Project, you formulate questions to address a particular nursing issue or problem. You use the PICOT model—patient/population, intervention/issue, comparison, and outcome—outlined in the Learning Resources to design your questions.

To prepare:

Review the article, “Formulating the Evidence Based Practice Question: A Review of the Frameworks,” found in the Learning Resources for this week. Focus on the PICOT model for guiding the development of research questions.
Review the section beginning on page 75 of the course text, titled, “Developing and Refining Research Problems” in the course text, which focuses on analyzing the feasibility of a research problem.
Reflect on an issue or problem that you have noticed in your nursing practice. Consider the significance of this issue or problem.
Generate at least five questions that relate to the issue which you have identified. Use the criteria in your course text to select one question that would be most appropriate in terms of significance, feasibility, and interest. Be prepared to explain your rationale.
Formulate a preliminary PICO question—one that is answerable—based on your analysis. What are the PICO variables (patient/population, intervention/issue, comparison, and outcome) for this question?

Note: Not all of these variables may be appropriate to every question. Be sure to analyze which are and are not relevant to your specific question.

Using the PICOT variables that you determined for your question, develop a list of at least 10 keywords that could be used when conducting a literature search to investigate current research pertaining to the question.

To complete:

Write a 3- to 4-page paper that includes the following:

A summary of your area of interest, an identification of the problem that you have selected, and an explanation of the significance of this problem for nursing practice
The 5 questions you have generated and a description of how you analyzed them for feasibility
Your preliminary PICOT question and a description of each PICOT variable relevant to your question
At least 10 possible keywords that could be used when conducting a literature search for your PICOT question and a rationale for your selections

By Day 7

Submit your Project. It will also be a component of your Portfolio Assignment for this course, which is due by Day 7 of Week 10.

Reference:

Davies, K. S. (2011). Formulating the evidence based practice question: A review of the frameworks. Evidence Based Library and Information Practice, 6(2), 75–80. Retrieved from https://ejournals.library.ualberta.ca/index.php/EBLIP/article/viewFile/9741/8144

2nd part

Course Project: Part 2—Literature Review

This is a continuation of the Course Project presented in Week 2. Before you begin, review the Course Project Overview document located in the Week 2 Resources area.

The literature review is a critical piece in the research process because it helps a researcher determine what is currently known about a topic and identify gaps or further questions. Conducting a thorough literature review can be a time-consuming process, but the effort helps establish the foundation for everything that will follow. For this part of your Course Project, you will conduct a brief literature review to find information on the question you developed in Week 2. This will provide you with experience in searching databases and identifying applicable resources.

To prepare:

Review the information in Chapter 5 of the course text, focusing on the steps for conducting a literature review and for compiling your findings.
Using the question you selected in your Week 2 Project (Part 1 of the Course Project), locate 5 or more full-text research articles that are relevant to your PICOT question. Include at least 1 systematic review and 1 integrative review if possible. Use the search tools and techniques mentioned in your readings this week to enhance the comprehensiveness and objectivity of your review. You may gather these articles from any appropriate source, but make sure at least 3 of these articles are available as full-text versions through Walden Library’s databases.
Read through the articles carefully. Eliminate studies that are not appropriate and add others to your list as needed. Although you may include more, you are expected to include a minimum of five articles. Complete a literature review summary table using the Literature Review Summary Table Template located in this week’s Learning Resources.
Prepare to summarize and synthesize the literature using the information on writing a literature review found in Chapter 5 of the course text.

To complete:

Write a 3- to 4-page literature review that includes the following:

A synthesis of what the studies reveal about the current state of knowledge on the question that you developed
Point out inconsistencies and contradictions in the literature and offer possible explanations for inconsistencies.
Preliminary conclusions on whether the evidence provides strong support for a change in practice or whether further research is needed to adequately address your inquiry
Your literature review summary table with all references formatted in correct APA style

Note: Certain aspects of conducting a standard review of literature have not yet been covered in this course. Therefore, while you are invited to critically examine any aspect of the studies (e.g., a study’s design, appropriateness of the theoretic framework, data sampling methods), your conclusion should be considered preliminary. Bear in mind that five studies are typically not enough to reflect the full range of knowledge on a particular question and you are not expected to be familiar enough with research methodology to conduct a comprehensive evaluation of all aspects of the studies.

By Day 7 of Week 5

This part of the Course Project is due. It will also be a component in your Portfolio Assignment in this course, which is due by Day 7 of Week 10.

3rd part

Course Project: Part 3—Translating Evidence Into Practice

In Part 3 of the Course Project, you consider how the evidence you gathered during Part 2 can be translated into nursing practice.

Now that you have located available research on your PICOT question, you will examine what the research indicates about nursing practices. Connecting research evidence and findings to actual decisions and tasks that nurses complete in their daily practice is essentially what evidence-based practice is all about. This final component of the Course Project asks you to translate the evidence and data from your literature review into authentic practices that can be adopted to improve health care outcomes. In addition, you will also consider possible methods and strategies for disseminating evidence-based practices to your colleagues and to the broader health care field.

To prepare:

Consider Parts 1 and 2 of your Course Project. How does the research address your PICOT question?
With your PICOT question in mind, identify at least one nursing practice that is supported by the evidence in two or more of the articles from your literature review. Consider what the evidence indicates about how this practice contributes to better outcomes.
Explore possible consequences of failing to adopt the evidence-based practice that you identified.
Consider how you would disseminate information about this evidence-based practice throughout your organization or practice setting. How would you communicate the importance of the practice?

To complete:

In a 3- to 4-page paper:

Restate your PICOT question and its significance to nursing practice.
Summarize the findings from the articles you selected for your literature review. Describe at least one nursing practice that is supported by the evidence in the articles. Justify your response with specific references to at least 2 of the articles.
Explain how the evidence-based practice that you identified contributes to better outcomes. In addition, identify potential negative outcomes that could result from failing to use the evidence-based practice.
Outline the strategy for disseminating the evidence-based practice that you identified throughout your practice setting. Explain how you would communicate the importance of the practice to your colleagues. Describe how you would move from disseminating the information to implementing the evidence-based practice within your organization. How would you address concerns and opposition to the change in practice?

By Day 7 of Week 10

This part of the Course Project is due. It should be combined with the other two components of the Course Project and turned in as your Portfolio Assignment for this course.

Note: In addition, include a 1-page summary of your project.

For this final iteration, you will need to:

Submit your paper to Grammarly and SafeAssign through the Walden Writing Center. Based on the Grammarly and SafeAssign reports, revise your paper as necessary.
Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The School of Nursing Sample Paper provided at the Walden Writing Center provides an example of those required elements (available from the Walden University website found in this week’s Learning Resources). All papers submitted must use this formatting.

Validity in research refers to the extent researchers can be confident that the cause and effect they identify in their research are in fact causal relationships. If there is low validity in a study, it usually means that the research design is flawed, and the results will be of little or no value. Four different aspects of validity should be considered when reviewing a research design: statistical conclusion validity, internal validity, construct validity, and external validity. In this Discussion, you consider the importance of each of these aspects in judging the validity of quantitative research.

To prepare:

Review the information in Chapter 10 of the course text on rigor and validity.

Read the method section of one of the following quasi-experimental studies (also located in this week’s Learning Resources). Identify at least one potential concern that could be raised about the study’s internal validity.

Metheny, N. A., Davis-Jackson, J., & Stewart, B. J. (2010). Effectiveness of an aspiration risk-reduction protocol. Nursing Research, 59(1), 18–25.

Padula, C. A., Hughes, C., & Baumhover, L. (2009). Impact of a nurse-driven mobility protocol on functional decline in hospitalized older adults. Journal of Nursing Care Quality, 24(4), 325–331.

Yuan, S., Chou, M., Hwu, L., Chang, Y., Hsu, W., & Kuo, H. (2009). An intervention program to promote health-related physical fitness in nurses. Journal of Clinical Nursing, 18(10), 1,404–1,411.

Consider Strategies that could be used to strengthen the study’s internal Validity and How this would impact the Three Other Types of Validity.

Think about the consequences of an advanced practice nurse neglecting to consider the validity of a research study When reviewing the research for potential use in developing an Evidence-Based Practice.

By Day 3

Post the Title of the study that you selected and your Analysis of the potential concerns that could be raised about the study’s internal validity.

Propose Recommendations to strengthen the Internal Validity and Assess the effect your Changes could have with regard to the other Three types of Validity.

Discuss the Dangers of failing to consider the Validity of a Research Study.

In this assignment, students will pull together the change proposal project components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. At the conclusion of this project, the student will be able to apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.

Students will develop a 1,500 word paper that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:

Background

Problem statement

Purpose of the change proposal

PICOT

Literature search strategy employed

Evaluation of the literature

Applicable change or nursing theory utilized

Proposed implementation plan with outcome measures

Identification of potential barriers to plan implementation, and a discussion of how these could be overcome

Appendix section, if tables, graphs, surveys, educational materials, etc. are created

Review the feedback on the Topic 3 assignment, PICOT Statement Paper, and Topic 6 assignment, Literature Review. Use the feedback to make appropriate revisions to the portfolio components before submitting.

Prepare this assignment according to the guidelines found in the APA Style Guide.

NO PLAGIARISM PLEASE, MINIMUM OF SIX REFERENCES.

Note: This is an individual assignment. Applying what you have learned thus far, develop a community teaching proposal designed to address the needs of your community.

Select one of the following as the focus for the teaching plan:

Primary Prevention/Health Promotion HAND WASHING PREVENTING ILLNESS/INFECTION. TEACHING DONE IN A RURAL HEALTH CLINIC CALLED (OMNI FAMILY HEALTH CLINIC).
Secondary Prevention/Screenings for a Vulnerable Population
Bioterrorism/Disaster
Environmental Issues
Complete the “Community Teaching Work Plan Proposal.” This will help you organize your plan and create an outline for the written assignment.

After completing the teaching proposal, review the teaching plan with a community health and public health provider in your local community.
Request feedback (strengths and opportunities for improvement) from the provider.
Complete the “Community Teaching Experience” form.
APA format is required for essays only. Solid academic writing is always expected. For all assignment delivery options, documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are not required to submit this assignment to Turnitin.