Fluid & Electrolyte Practice Questions

The nurse is caring for a patient with acute kidney injury (AKI). For which urine amount should the nurse report promptly to the healthcare provider? Less than 30 mL/hr Less than 35 mL/hr Less than 45 mL/hr Less than 40 mL/hr

Less than 30 mL/hr

A nurse is reviewing laboratory reports for a client who has C. diff infection and receiving vancomycin. Which of the following results should the nurse report to the provider before administering the next dose? A. Hematocrit 46% B. Serum glucose 110mg/dL C. Serum creatinine 2.5mg/dL D. Serum potassium 4.8 mEq/dL

C

A patient with acute kidney injury (AKI) is on fluid restriction. Which statement by the nurse indicates an appropriate intervention? "I should encourage the patient to lose weight." "I should provide frequent mouth care." "I should monitor weekly intake and output." "I should order extra solids with their meals."

"I should provide frequent mouth care."

A patient with chronic kidney disease (CKD) is concerned about having anemia. How should the nurse explain the development of this health problem? "Your kidneys are not producing a hormone that tells your body to make more blood cells." "Your bone marrow is depressed because of low calcium levels." "Your kidneys are excreting more blood cells." "You are retaining more fluid, so your blood is diluted."

"Your kidneys are not producing a hormone that tells your body to make more blood cells."

The nurse is providing care to a patient with chronic kidney disease (CKD). Which prescription should the nurse question for this patient? Daily weight Fluid restriction of 1-2 L per day 4-g sodium diet Dairy restrictions

4-g sodium diet

A nurse is caring for a child who has electrical burns on the lower arms and hands. Which of the following findings indicate the child is experiencing a complication of the injury? A. Dark urine B. 2+ radial pulses C. Respiratory rate of 20/min D. Minimal pain

A

A nurse is caring for a client who has acute renal failure. Which of the following assessments provides the most accurate measure of the client's fluid status? A. Daily weight B. Blood pressure C. Specific gravity D. Intake and output

A

A nurse is reviewing the laboratory results of a client who has end-stage renal disease and reports fatigue. The client's hemoglobin level is 8g/dL. The nurse should expect a prescription for which of the following medications? A. Erythropoietin B. Erythromycin C. Filgrastim D. Calcitriol

A

A nurse is planning care for a client who has postrenal AKI due to metastatic cancer. The client has a blood creatinine of 5mg/dL. Which of the following interventions should the nurse include in the plan? SATA A. Provide a high-protein diet B. Assess the urine for blood C. Monitor for intermittent anuria D. Weigh the client once per week E. Provider NSAIDs for pain

A B C

A nurse is planning care for a client who has Stage 4 CKD. Which of the following actions should the nurse include in the plan of care? SATA A. Assess for jugular vein distention B. Provider frequent mouth rinses C. Auscultate for a pleural friction rub D. Provide a high-sodium diet E. Monitor for dysrhythmias

A B C E

The nurse is reviewing a list of patients scheduled for clinic appointments. Which patient should the nurse identify as having an increased risk of developing progressive renal failure? A 72-year-old man with a history of hypertension A 47-year-old man with long-standing coronary artery disease (CAD) A 65-year-old woman who has a history of cystitis A 57-year-old smoker with chronic obstructive pulmonary disease (COPD)

A 72-year-old man with a history of hypertension

The nurse identifies the goal of promoting balanced nutrition for a patient with chronic kidney disease (CKD). Which intervention should the nurse implement for this patient? Provide three meals per day. Administer antiemetic agents 30-60 min before meals. Weigh daily before bed. Discourage from eating between-meal snacks.

Administer antiemetic agents 30-60 min before meals.

A 65-year-old patient with acute kidney injury (AKI) is meeting with the nurse to review their medication regimen at home. Which teaching should the nurse include? Avoiding the use of NSAIDs Taking all prescribed medications in the morning Utilizing only ibuprofen for any pain Taking vitamins daily

Avoiding the use of NSAIDs

Which statement is accurate regarding the development of azotemia as it relates to oliguria? Oliguria is constant in a patient with renal failure. Azotemia is not affected by oliguria. Azotemia is more severe when oliguria is present. Azotemia is less severe when oliguria is present.

Azotemia is more severe when oliguria is present.

A nurse is caring for a client who is in the oliguric-anuric stage of AKI. The client reports diarrhea, a dull headache, palpitations, and muscle tingling and weakness. Which of the following actions should the nurse take first? A. Administer an analgesic to the client B. Check the client's electrolyte values C. Measure the client's weight D. Restrict the client's protein intake

B

A nurse is preparing an in-service program about the stages of acute kidney injury. Which of the following pieces of information should the nurse include about prerenal azotemia? A. Prerenal azotemia begins prior to the onset of symptoms B. Interference with renal perfusion causes prerenal azotemia C. Prerenal azotemia is irreversible, even in the early stages D. Infections and tumors cause prerenal azotemia

B

A nurse is providing dietary teaching to a client who has chronic renal failure. Which of the following food choices by the client indicates an understanding of the teaching? A. Canned soup B. Grilled fish C. Pastrami D. Peanut butter

B

A nurse is reviewing client laboratory data. Which of the following findings is expected for a client who has Stage 4 CKD? A. BUN 15mg/dL B. GFR 20mL/min C. Creatinine 1.1mg/dL D. Potassium 5.0 mEq/L

B

An older adult patient with severe dehydration has the following vital signs: P 106 beats/min, R 24 breaths/min, BP 80/50 mmHg. Which tests should the nurse expect to be prescribed for this patient? Blood urea nitrogen (BUN) and serum creatinine Prothrombin time and partial thromboplastin time Digoxin level Magnetic resonance imaging (MRI) scan

Blood urea nitrogen (BUN) and serum creatinine

A nurse is reviewing the laboratory values for a 6 months old infant who has acute renal failure. Which of the following findings should the nurse expect? A. BUN 5mg/dL B. Creatinine 0.2mg/dL C. Sodium 125mEq/L D. Potassium 4.2 mEq/L

C

A nurse is assessing a client who has prerenal AKI. Which of the following findings should the nurse expect? SATA A. Reduced BUN B. Elevated cardiac enzymes C. Reduced urine output D. Elevated blood creatinine E. Elevated blood calcium

C D

In an initial interview, the nurse asks a patient who is newly diagnosed with acute kidney injury (AKI) if they had any radiologic testing using a contrast medium recently. Which would be the purpose of this question? Contrast medium is associated as a cause of AK. Impaired perfusion affects liver functioning. It will complete the patient's health history. It will prevent recent tests from being repeated.

Contrast medium is associated as a cause of AK.

The nurse identifies that a patient with acute kidney injury (AKI) is experiencing hyperkalemia. The nurse should monitor the patient for which manifestation? Hypotension Electrocardiographic changes Weight gain Constipation

Electrocardiographic changes

Which nursing intervention should be a priority for a patient diagnosed with acute kidney injury (AKI) who has an edematous abdomen while hospitalized? Cleanse the patient's skin with an antimicrobial soap. Restrict the patient's movement to decrease the potential fluid shift. Encourage frequent position changes. Use a hoyer lift to move the patient.

Encourage frequent position changes.

The nurse is reviewing chronic kidney disease (CKD) in older adults with a colleague. The nurse should explain that which stressor might precipitate the development of renal failure in an older adult? Smoking Death of a spouse Exposure to nephrotoxic drugs Social drinking of alcohol

Exposure to nephrotoxic drugs

The nurse is caring for a patient with acute kidney injury (AKI) resulting from a urethral obstruction due to cancer. Which type of AKI is the patient experiencing? Intrarenal Prerenal Intrinsic Postrenal

Postrenal

The nurse is caring for a patient with acute kidney injury (AKI) resulting from a urethral obstruction due to cancer. Which type of AKI is the patient experiencing? Prerenal Intrinsic Postrenal Intrarenal

Postrenal

The nurse is preparing to assess a patient with chronic kidney disease (CKD). Which assessment should the nurse make a priority? Presence and location of a peritoneal catheter Vital signs, especially blood pressure Presence of skin rashes History of autoimmune diseases

Presence and location of a peritoneal catheter

The nurse is providing teaching to a patient diagnosed with acute kidney injury (AKI). Which intervention would be important to review with the patient as a means to assess fluid balance? Showing them how to weigh themselves accurately on a monthly basis Teaching them how to monitor their blood pressure Showing them how to calculate calories at each meal Demonstrating how to measure their waistline

Teaching them how to monitor their blood pressure

The nurse is caring for a patient with a 20-year history of poorly controlled hypertension and type 2 diabetes mellitus. The laboratory studies show a blood urea nitrogen (BUN) level of 18 mg/dL and a creatinine level of 0.9 mg/dL. The patient had a urine output of 400 mL over the past 8 hours. Which assumption should the nurse make about this patient's renal status? The patient has normal renal function. The patient is experiencing renal insufficiency. The patient will need to be monitored for advancing renal disease. The patient is experiencing renal failure.

The patient will need to be monitored for advancing renal disease.

The nurse discusses prenatal care of patients diagnosed with chronic kidney disease (CKD) with a colleague. Which information should the nurse include? Serum albumin levels should be kept low to avoid risk to the fetus. It is most advantageous to maintain a normal blood pressure using several different antihypertensive agents. The use of higher doses of iron and erythropoietin replacement may help in preventing preterm birth. It is best to decrease the frequency of hemodialysis to 2 days per week.

The use of higher doses of iron and erythropoietin replacement may help in preventing preterm birth.

A patient is diagnosed with acute kidney injury (AKI). The patient asks how the function of the kidneys can be assessed. Which statement by the nurse provides an appropriate answer? "Serum osmolality concentrations can provide that information to your healthcare provider." "The healthcare provider assesses serial hematocrit values." "A serum creatinine blood level will be obtained." "We monitor the hemoglobin level in the blood."

"A serum creatinine blood level will be obtained."

The nurse preceptor is discussing the care of a 10-year-old child newly diagnosed with chronic kidney disease (CKD) with a new nurse. Which statement by the new nurse indicates the need for further teaching? "Physical activity is important to help the child maintain health and self-esteem." "Because of the CKD, I will try to keep the child occupied with sedentary, quiet activities." "Encouraging the child to participate in age-appropriate activities will help them cope with a chronic disease." "Physical activity as tolerated will help promote the development of strong bones."

"Because of the CKD, I will try to keep the child occupied with sedentary, quiet activities."

A patient with chronic kidney disease (CKD) asks if there are any non-medication-based actions that can help improve the condition. How should the nurse respond to this patient? "You may take herbal supplements such as gingko and ginseng if necessary." "Foods that may help increase kidney function include green vegetables, whole grains, and yogurt." "Drink orange juice to increase urine acidity." "You might want to drink diet cola with your meals."

"Foods that may help increase kidney function include green vegetables, whole grains, and yogurt."

A 6-year-old child presents with a history of renal insufficiency. Which question should the nurse ask the parents to assist with the diagnosis of acute kidney injury (AKI)? "Has your child had a recent acute gastrointestinal illness?" "Which previous major surgeries has your child had?" "Can you tell me about your child's past infections?" "How much protein does your child consume each day?"

"Has your child had a recent acute gastrointestinal illness?"

The nurse is teaching a patient about the long-term complications of diabetes and hypertension. Which patient statement causes the nurse to determine that additional teaching is required? "I will try to have good control over my blood pressure." "It is important that I get my laboratory work drawn like the healthcare provider orders." "I will check my blood sugar and blood pressure every day." "I don't need to worry about my kidneys because diabetes is about sugar in the blood."

"I don't need to worry about my kidneys because diabetes is about sugar in the blood."

The nurse preceptor is working with a new graduate nurse to provide care for a patient with fluid volume overload due to acute kidney injury (AKI). Which statement indicates that the new graduate nurse needs further teaching about interventions that should be implemented for this patient? "I need to limit fluid intake." "I need to administer potassium replacements." "I need to place the patient in a semi-Fowler position." "I need to weigh the patient daily."

"I need to administer potassium replacements."

The nurse is performing discharge teaching to a patient recovering from an acute kidney injury (AKI). Which patient statement indicates a need for further teaching on how to manage AKI after discharge? "I need to avoid life stressors." "I will monitor my blood pressure." "I will monitor for symptoms of possible relapse." "I need to avoid NSAIDs for 1 month."

"I need to avoid NSAIDs for 1 month."

The nurse is discussing the effect pregnancy can have on the kidneys with a patient. Which patient statement demonstrates effective teaching? "If I feel a lot of pressure in my abdomen, that demonstrates stress on the kidneys." "If I am not moving around daily, that stresses the kidneys." "If I have burning during urination, I should call my healthcare provider." "I should not drink more than 20 ounces of water per day."

"If I have burning during urination, I should call my healthcare provider."

A patient being evaluated for chronic kidney disease (CKD) asks why blood tests are necessary. Which response by the nurse is accurate? "The blood test is to check for the color of your blood, which is affected by kidney disease." "The blood test is to check for how well your blood clots, which is affected by kidney disease." "The blood test is to check for oxygen levels in your blood, which are decreased in kidney disease." "The blood test is to check for blood urea nitrogen (BUN) and serum creatinine, which are elevated in kidney disease."

"The blood test is to check for blood urea nitrogen (BUN) and serum creatinine, which are elevated in kidney disease."

After discussing the pathophysiology of diabetic nephropathy, the nurse preceptor asks the new nurse to describe how this process affects the kidney. Which response indicates that the new nurse understands the teaching? "Cysts in the kidney press on the functional tissue." "Antibody and antigen complexes get stuck in the nephron." "The capillary walls in the nephron become thickened." "Excess pressure in the glomerulus causes the damage in diabetic nephropathy."

"The capillary walls in the nephron become thickened."

A patient receiving peritoneal dialysis asks the nurse how it works. Which response by the nurse is accurate? "The fluid that infuses into your abdomen will pull fluid and toxins from the bloodstream, and then the waste products will drain from your abdomen." "The fluid that infuses into your abdomen diffuses into the blood and dilutes the toxins." "Your blood is filtered through an external filter that will pull excess fluid and toxins out of your blood." "Your body exchanges the fluid in the bloodstream with the clean fluid in the abdomen, and then the fluid with the toxins drains out."

"The fluid that infuses into your abdomen will pull fluid and toxins from the bloodstream, and then the waste products will drain from your abdomen."

The nurse is preparing teaching for colleagues regarding the risks for pregnant patients who are being treated for chronic kidney disease (CKD). Which statement by a colleague indicates the need for further teaching? "The rate of small-for-gestational-age neonates increases in women with CKD." "The rate of preterm delivery sharply increases in women with CKD." "The frequency of dialysis remains the same in pregnancy for women with CKD." "The rate of neonatal death increases in women with CKD."

"The frequency of dialysis remains the same in pregnancy for women with CKD."

The nurse discusses chronic kidney disease (CKD) with a colleague. The nurse asks the colleague why the diagnosis of CKD in older adult patients might sometimes be difficult or delayed. Which response by a colleague indicates understanding? "Older adults are less likely to have hypertension or diabetes." "The manifestations of renal failure are often missed in older adults or attributed to other conditions." "Older adults normally produce more creatinine, so it is difficult to determine what is an abnormal rise." "Serum creatinine levels rise more quickly in older adults than in younger people."

"The manifestations of renal failure are often missed in older adults or attributed to other conditions."

The nurse is teaching a patient who is recovering from a kidney transplant about a newly prescribed glucocorticoid medication. Which patient statement should indicate to the nurse that teaching has been effective? "The medication will boost my immune system." "I am taking the medication to prevent infection after surgery." "I am taking the medication to help control my elevated blood pressure." "The medication will prevent my body from rejecting the new kidney."

"The medication will prevent my body from rejecting the new kidney."

The nurse is teaching a patient about the differences between hemodialysis and peritoneal dialysis. Which statement demonstrates that the patient understands how peritoneal dialysis differs from hemodialysis? "The waste is removed faster." "Waste accumulates during peritoneal dialysis." "The waste is removed more slowly." "Waste is not removed at all."

"The waste is removed more slowly."

A nurse is providing teaching to a patient scheduled for a renal biopsy. Which statement demonstrates that the teaching has been effective? "They are going to operate on my kidneys." "They are going to check the medication level in my system." "They are taking some tissue from my kidneys to see if it is causing my blood pressure to increase." "They are taking a piece of tissue from my kidney to see why I have blood in my urine."

"They are taking a piece of tissue from my kidney to see why I have blood in my urine."

The nurse preceptor is discussing age as a risk factor for acute kidney injury (AKI) in older adults with a graduate nurse. Which statement by the graduate nurse indicates understanding of this risk? "There are higher levels of waste products present in the blood." "Thickening of the renal artery leads to decreased blood flow." "Fluid intake is generally less than the younger population." "Older adults have more gastrointestinal illnesses."

"Thickening of the renal artery leads to decreased blood flow."

A patient beginning hemodialysis asks how long the process takes to complete. How should the nurse respond to this patient? "You can expect to have hemodialysis four times a week for a total of 12-16 hours." "It usually is completed three times a week for a total of 15-18 hours." "You can expect to have hemodialysis three times a week for a total of 9-12 hours." "It usually is completed two times a week for a total of 10-12 hours."

"You can expect to have hemodialysis three times a week for a total of 9-12 hours."

A patient with end-stage renal disease (ESRD) states, "I feel like half a person and do not want to go out into public." Which response by the nurse is appropriate? "Would you like to speak with the hospital chaplain?" "You seem to be upset about the changes that have occurred in your body." "You do not look all that bad. Would you like me to help you wash your hair?" "You should be happy that you are alive."

"You seem to be upset about the changes that have occurred in your body."

The nurse is teaching a patient diagnosed with acute kidney injury (AKI) about diet. Which statement should the nurse include? "Your diet should include an increase in carbohydrates." "You should increase the amount of protein in your diet." "You should decrease the amount of dairy in your diet." "You should decrease the amount of fiber in your diet."

"Your diet should include an increase in carbohydrates."

The nurse identifies the goal of promoting effective tissue perfusion to the nephrons for a patient with chronic kidney disease (CKD). Which intervention should the nurse identify as being appropriate for this patient? Encourage fluids as necessary. Administer antihypertensive medications as ordered. Monitor for metabolic alkalosis. Monitor lung sounds daily.

Administer antihypertensive medications as ordered.

A nurse is planning care for a client who has prerenal acute kidney injury following abdominal aortic aneurysm repair. Urinary output is 60mL in the 2hr, a blood pressure is 92/58mmHg. The nurse should expect which of the following interventions? A. Prepare the client for a CT scan with contrast dye B. Plan to administer nitroprusside C. Prepare to administer a fluid challenge D. Plan to position the client in Trendelenburg

C

A nurse is reviewing laboratory findings of an adolescent who has acute renal failure. Which of the following findings should the nurse expect? A. Hypokalemia B. Hypercalcemia C. Decreased plasma creatinine level D. Metabolic acidosis

D

A nurse is assessing a client who has acute kidney injury. According to the RIFL classification system, which of the following findings indicates that the client has end-stage kidney disease? A. <0.5m;/kg of urine output for 12hr B. No urine output for 12 hr C. No urine output without renal replacement therapy for 4-12 weeks D. No urine output without renal replacement therapy for more than 3 months

D

The nurse is preparing dietary teaching for a patient with chronic kidney disease (CKD). Which diet information should the nurse include? Use salt substitutes in place of salt. Follow a low-protein diet. Follow a low-carb diet. Increase the intake of potassium.

Follow a low-protein diet.

Which action by the nurse would be most appropriate to address the nutritional imbalances of an older adult patient with acute kidney injury? Having the healthcare provider write up meal plans for the patient Having the patient and family consult with a registered dietitian Providing a website to research their new diet Planning weekly meals for the patient

Having the patient and family consult with a registered dietitian

A patient with vague symptoms has the following laboratory values: hemoglobin 8.5, hematocrit 37%, BUN 35 mg/dL, serum creatinine 158 mL/min, ABGs pH 7.25, pCO2, bicarb 33. Which treatment should the nurse expect the healthcare provider will prescribe first? Mechanical ventilation Repeated labs in the morning Hemodialysis Two units of packed red blood cells (PRBCs)

Hemodialysis

An older adult patient recently developed chronic renal failure, which was initially identified by elevated serum blood urea nitrogen (BUN) and creatinine levels. Which item in the patient's health history should the nurse identify as a factor in the development of chronic renal failure? Previous major surgery Hypertension Social drinking for 20 years Obesity

Hypertension

The nurse reviews laboratory data for a patient with acute kidney injury (AKI). For which laboratory value should the nurse expect hemodialysis to be ordered? Increasing serum potassium level Low serum sodium Decreased red blood cells Cell casts in urine

Increasing serum potassium level

A patient admitted for complications from acute kidney injury (AKI) has been prescribed furosemide (Lasix) 80 mg twice daily. Which is most important for the nurse to assess accurately in this patient? Breath sounds Bruising Initial weight Response of pupils to light

Initial weight

A child is admitted to the hospital with nausea, vomiting, lethargy, and oliguria, and the healthcare provider suspects fluid depletion associated with acute kidney injury (AKI). Which prescribed order should the nurse consider appropriate for this patient? Isotonic saline solution Phosphorous supplement Potassium supplement Low doses of a diuretic

Isotonic saline solution

The nurse identifies a goal of preventing infection for a patient receiving peritoneal dialysis for chronic kidney disease (CKD). Which intervention should the nurse identify to help meet this goal? Use protective isolation. Monitor vital signs daily. Allow all visitors access to visit the patient. Monitor the clarity of the dialysate return.

Monitor the clarity of the dialysate return.

The nurse is reviewing the healthcare provider's prescriptions for an older adult patient with chronic kidney disease (CKD). Which medication should the nurse question? Narcotic pain relief A loop diuretic Calcium carbonate An antihypertensive

Narcotic pain relief

A patient is admitted to the medical unit with the diagnosis of postrenal acute kidney injury (AKI). Which should the nurse suspect as a possible cause? Ischemia Surgery Trauma Urinary tract calculi

Urinary tract calculi

An older adult patient being treated for hemorrhagic shock has a serum potassium level of 4.0 mEq/L and a serum creatinine level of 2.2 mg/dL. Which intervention should the nurse add to this patient's plan of care? Report urine output of less than 30 mL/hr. Remove the indwelling urinary catheter. Administer intravenous gentamicin as prescribed. Administer a potassium replacement.

Report urine output of less than 30 mL/hr.

The nurse is caring for a patient diagnosed with prerenal acute kidney injury (AKI). Which condition should the nurse recognize as a cause for this disorder? Hyperkalemia Sepsis Glomerulonephritis Renal calculi

Sepsis

The nurse is preparing a teaching tool about medications used to treat chronic kidney disease (CKD). Which medication should the nurse identify as being used to reduce potassium levels? Aluminum hydroxide Sodium polystyrene sulfonate Calcium carbonate Vitamin D

Sodium polystyrene sulfonate

A patient is diagnosed with postrenal acute kidney injury (AKI) and benign prostatic hyperplasia (BPH). Which condition should the nurse suspect caused the AKI? Urethral obstruction Ureteral obstruction Loss of a kidney Glomerulonephritis

Urethral obstruction