NUR425 CC Final Questions
Which of the following is a common major concern related to patients with diabetes inspidus? A) Dehydration B) Hyperglycemia C) Heart failure D) Hypoglycemia
A
Which is a post-renal cause of acute kidney injury? A) Severe dehyrdation B) Renal calculi C) Administration of excessive IV fluids D) Administration of amphotericin B
B
Which of the following is a contraindication for using CRRT on a patient? A) If the patient has life threatening manifestations of uremia B) If the patient has a large amount of uremia toxins and hypervolemia C) If the patient is unable to tolerate a rapid removal of fluid D) If the patient has any type of acid base balance.
A
Which of these is considered the "functional unit" of the kidney? A) Nephron B) Glomerulus C) Collecting duct D) Loop of henle
A
What is the purposes of dialysis? SELECT ALL THAT APPLY A) Dialysis can be used to treat drug overdoses B) Dialysis corrects fluid and electrolyte imbalances C) Dialysis cures kidney disease D) Dialysis removes waste products
ABD
Which answers are true about SIADH? SELECT ALL THAT APPLY A) SIADH will cause the kidneys to be unable to dilute urine B) SIADH will cause low levels of sodium in the vascular system. C) SIADH causes polyuria D) SIADH is a condition where the body produces too little ADH E) SIADH is a condition where the body produces too much ADH
ABE SIADH is a condition where the body produces or secretes and excess amount of ADH which causes the body to hold onto an excess amount of water. This causes dilutional hyponatremia in the vascular system.
A patient with chronic kidney disease is advised to undergo peritoneal dialysis (PD). What advantages of PD over hemodialysis should the nurse explain to the patient? Select all that apply. A) The procedure is simple B) A special water system is required C) The equipment setup is simple D) There is no risk for infection E) It can be performed at home
ACE
Which is true about acute kidney injury? A) AKI is always preceded by direct trauma to the renal tissue B) AKI is not reversible C) The most common cause is infection D) The most common cause is acute tubular necrosis
D
Which of the following is a function of the kidneys? A) Synthesize corticosteroids B) Synthesize antidiuretic hormone C) Synthesize immune mediators D) Synthesize calcitriol
D
Which of the following is a true statement? A) SIADH is caused by head injury, DI is not B) DI is treated with diuretics such as furosemide C) SIADH is caused by excessive IV fluid administration D) DI can be caused by either neurological or renal problems
D
Which of the following is true regarding arteriovenous fistulas (AVF)? A) It is made by attaching a synthetic material to form a bridge between the artery and vein B) If a bruit is heard at the arteriovenous fistulas (AVF) site, it is no longer functional. C) The arteriovenous fistulas (AVF) may be used the same day it is placed. D) It is created with in the arm as an anastomosis of an artery and a vein
D
The nurse teaches a patient with chronic kidney disease about prevention of complications. What should the nurse include in the teaching plan? a. Monitor for proteinuria daily with a urine dipstick. b. Perform self-catheterization every 4 hours to measure urine. c. Adjust sodium intake related to amount of daily urine output. d. Check weight daily and report a gain of greater than 4 pounds.
D
SIADH, DI, BOTH? high serum osmolality
DI
SIADH, DI, BOTH? high serum sodium
DI
SIADH, DI, BOTH? low CVP
DI
SIADH, DI, BOTH? low sodium diet
DI
SIADH, DI, BOTH? low urine specific gravity
DI
SIADH, DI, BOTH? polyuria
DI
SIADH, DI, BOTH? sometimes caused by insensitivity to ADH
DI
SIADH, DI, BOTH? this eat need hypotonic IV solutions
DI
SIADH, DI, BOTH? this pt could benefit from diuretics
DI
SIADH, DI, BOTH? watch out for hypotension
DI
SIADH, DI, BOTH? we can admin vasopressin to these pt
DI
Which of following are true about Diabetes Insipidus? SELECT ALL THAT APPLY A) Diabetes Insipidus is caused by an ADH insensitivity B) Diabetes Insipidus is caused by an ADH excess C) Diabetes Insipidus is caused by an ADH deficiency D) Diabetes Insipidus is caused by antidiuresis
A,C Diabetes is caused by too little ADH (by either deficient amounts or a the kidneys being insensitive to it) so the body does not hold onto water and will diuresis (polyuria) excess water putting the patient at risk for dehydration and hypovolemia.
SIADH, DI, BOTH? carefully monitor electrolytes
BOTH
Which is the most common cause of death for patients with acute kidney injury? A) Dehydration B) Cardiovascular disease C) Infection D) Diabetes
C
Which of the following is a disorder caused by low levels of antidiuretic hormone? A) Addisons Disease B) Myxedema C) Diabetes Insipidus D) Cushings
C
SIADH, DI, BOTH? 1000ml fluid restriction
SIADH
SIADH, DI, BOTH? Low urine output
SIADH
SIADH, DI, BOTH? can't dilute their urine
SIADH
SIADH, DI, BOTH? caused by failure of negative feedback loop
SIADH
SIADH, DI, BOTH? dilution hyponatremia
SIADH
SIADH, DI, BOTH? don't give these pt D5W
SIADH
Before beginning hemodialysis, the nurse weighs the patient and then compares this weight to the patient's last postdialysis weight. What is the purpose of this assessment?
To determine the amount of fluid to remove from the patient
Which IV fluids would you recommend for a patient with Diabetes Insipidus?
0.45% NS
A nurse is planning care for a female client who has a T4 spinal cord injury and is at risk for acquiring urinary tract infections. Which of the following actions should the nurse include in the client's plan of care? A) Encourage fluid intake at and between meals. B) Offer the client the bedpan every 2 hr. C) Obtain a prescription for an indwelling urinary catheter. D) Cleanse the perineum from back to front.
A
A patient has a spinal cord injury at C-6. What could she be at risk for? (Select all that apply) 1.Spinal Shock 2.Apnea 3.Neurogenic Shock 4.Paralytic Ileus 5.Tachycardia 6.Hypotension 7.Autonomic Dysreflexia
13467
Which of the following is most consistent with diabetes insipidus? 1.Fluid volume overload with hypernatremia 2.Fluid volume deficit with hypernatremia 3.Fluid volume overload with hyponatremia 4.Fluid volume deficit with hyponatremia
2
Your patient has had 10cc urine output over the past 2 hours, has a low serum osmolality of 155 and her sodium level is 115. Which of the following statements most pertains to this patient? 1.She has diabetes insipidus and needs an IV bolus of 1000cc 0.9%NS 2.She has SIADH and needs an IV bolus of 1000 cc 0.9%NS 3.She has diabetes insipidus and needs 40mg Furosemide IV 4.She has SIADH and needs 40mg Furosemide IV
4
A nurse is caring for a client who has a T-4 spinal cord injury. Which of the following client findings should the nurse identify as an indication the client is at risk for experiencing autonomic dysreflexia? A) The client's bladder becomes distended. B) The client states having nasal congestion. C) The client's blood pressure becomes elevated. D) The client states having a severe headache.
A Emergency care of the client who experiences autonomic dysreflexia is to place the client into a sitting position and assess and treat the underlying cause.
A rehabilitation nurse is caring for a client who has had a spinal cord injury that resulted in paraplegia. After a week on the unit, the nurse notes that the client is withdrawn and increasingly resistant to rehabilitative efforts by the staff. Which of the following actions should the nurse take? A) Establish a plan of care with the client that sets attainable goals. B) Limit visiting hours until the client begins to participate in therapy. C) Allow the client to control the timing and frequency of the therapy. D) Inform the client that privileges are related to participation in therapy.
A The nurse should develop a plan of care for this client with mutually set goals. This action invests the client in the rehabilitation process, which encourages feelings of ownership for it, and sees the goals as more attainable.
A nurse is teaching the family of a client who is receiving treatment for a spinal cord injury with a halo fixation device. Which of the following statements should the nurse make? A) "The purpose of this device is to immobilize the cervical spine." B) "Turn the screws on the device once each day." C) "Apply talcum powder under the vest to limit friction." D) "The purpose of this device is to allow for neck movement during the healing process."
A A client who has an injury to the cervical spine can have a halo fixation device to provide immobilization of the head and neck for a period of 8 to 12 weeks.
A patient has end-stage kidney disease and is receiving hemodialysis. During dialysis the patient complains of nausea and a headache and appears confused. On examination, the nurse finds that the blood pressure is very low. What is the priority action by the nurse? A) Avoid excess coagulation B) Infuse 0.9% saline solution C) Transfuse blood D) Infuse hypertonic glucose solution
B
A patient is just admitted to the hospital following a spinal cord injury at the level of T4. A priority of nursing care for the patient is monitoring for a.Return of reflexes. b.Bradycardia with hypoxemia. c.Effects of sensory deprivation. d.Fluctuations in body temperature.
B
A patient with DI would most likely present with which clinical manifestation? A) jugular venous distention B) dry mucous membranes C) bilateral lower extremity edema D) crackles auscultated in the lungs bilaterally
B
Which of the following is a function of the kidneys? A) Secrete bile B) Regulate blood pressure C) Synthesize clotting factors D) Break down platelets
B
A patient with CKD does at home PD. She ran out of equipment and missed dialysis for 2 weeks. The physician has ordered stat hemodialysis. What is your priority? a.Ensuring the patient has a fistula placed b.Ensuring the patient has a temporary HD catheter placed c.Ensuring the patient's PD catheter is patent d.Ensuring the patient has calcium replacement available
B -right now need dialysis: temp Cath is fast
A home health nurse is caring for a client who is quadriplegic following a spinal cord injury and who is adjusting to the home environment. Which of the following client statements indicate the client is adapting? A) "My wife tries to get me to go to the grocery store, but I don't like to go out much." B) "I am using the modified feeding utensils at every meal. I still spill, but I'm getting better." C) "My greatest pleasure each day is having a few beers every day." D) "I have all the equipment to take a shower, but I prefer a bed bath, because it is easier."
B The client is adapting to the physical condition and displays goal setting.
Which of the following is true about Continuous Renal Replacement (CRRT). SELECT ALL THAT APPLY. A) Hypotension is common B) Anticoagulation is needed to prevent clotting. C) Answer It is indicated for hemodynamically unstable patients D) Answer A trained ICU nurse can run it.
BCD
SIADH, DI, BOTH? could be caused by head injury
BOTH
SIADH, DI, BOTH? monitor LOC
BOTH
SIADH, DI, BOTH? monitor weight
BOTH
SIADH, DI, BOTH? seizure precautions
BOTH SIADH mostly d/t hyponatremia, sometimes DI
A patient with diabetes insipidus will present with which of the following? A) Low serum osmolality B) High urine osmolality C) High urine output D) Low urine output
C
A patient with CKD does at home PD. She ran out of equipment and missed dialysis for 2 weeks. The physician has ordered stat hemodialysis. What would you expect to see in her assessment? a.Hypotension b.Potassium of 2.9 c.Jugular venous distention d.Elevated RBC count
C HTN, HYPERKAL, LOW RBC
A nurse is caring for a client who has had a spinal cord injury at the level of the T2-T3 vertebrae. When planning care, the nurse should anticipate which of the following types of disability? A) Quadriplegia B) Paraplegia C) Paresthesia D) Hemiplegia
C Paraplegia, or paralysis of both legs, is seen after a spinal cord injury below T1
During assessment of a patient with a spinal cord injury at the level of T2 at the rehabilitation center, which finding would concern the nurse the most? a.A heart rate of 92 b.A reddened area over the patient's coccyx c.Marked perspiration on the patient's face and arms d.A light inspiratory wheeze on auscultation of the lungs
C sit up, see what problem is
A nurse is developing a plan of care to prevent skin breakdown for a client with a spinal cord injury and paralysis. Which of the following nursing actions are appropriate? (Select all that apply.) A) Keep the client's skin dry with powder. B) Massage over erythematous bony prominences. C) Minimize skin exposure to moisture. D) Use pillows to keep heels off the bed surface. E) Implement turning schedule every 4 hr.
CD
A nurse in the emergency department is monitoring a client who has a cervical spinal cord injury from a fall. The nurse should monitor the client for which of the following complications? (Select all that apply.) A) polyuria B) hyperthermia C) hypotension D) absence of bowel sounds E) Weakened gag reflex
CDE
SIADH, DI, BOTH? could become tachycardic
DI
A patient with SIADH would most likely present with which clinical manifestation? A) Syncope B) Hypotension C) Low CVP D) Weight gain
D
Patients with SIADH are most likely to be at risk for which of the following? A) Hypotension B) Hypoperfusion C) Kidney Failure D) Pulmonary edema
D
SIADH, DI, BOTH? give these pt 0.45% NaCl
DI
A nurse is caring for a client who has quadriplegia from a spinal cord injury and reports having a severe headache. The nurse obtains a blood pressure reading of 210/108 mm Hg and suspects the client is experiencing autonomic dysreflexia. Which of the following actions should the nurse take first? A) Administer a nitrate antihypertensive. B) Assess the client for bladder distention. C) Obtain the client's heart rate. D) Place the client in a high-Fowler's position.
D The client who is experiencing autonomic dysreflexia is at risk for a cerebrovascular accident resulting from severe hypertension. According to the safety and risk reduction priority setting framework, the nurse's initial action should be to place the client in a high-Fowler's position to assist in providing immediate reduction in blood pressure and intracranial pressure.
SIADH, DI, BOTH? "too little water in the body"
DI
SIADH, DI, BOTH? cause can be centra or nephrogenic
DI
Which of the following could be considered a pre-renal cause of acute kidney injury?
GI bleed
The dialysis nurse is administering hemodialysis to a patient with chronic kidney failure. For what common complication should the nurse carefully monitor in this patient?
Hypotension
SIADH, DI, BOTH? high PAOP/PAWP
SIADH
SIADH, DI, BOTH? high urine osmolality
SIADH
SIADH, DI, BOTH? los of "water in the body"
SIADH
SIADH, DI, BOTH? low BUN
SIADH
SIADH, DI, BOTH? low serum osmolality
SIADH
SIADH, DI, BOTH? these pt may need 3% NaCl
SIADH
SIADH, DI, BOTH? these pt might have crackles in their lungs
SIADH
The nurse is caring for a patient undergoing peritoneal dialysis. What finding should the nurse report to the primary health care provider that would indicate peritonitis?
abdominal pain
The kidneys are responsible for excreting 90% of the body's ________?
potassium
A patient with chronic kidney disease is prescribed regular peritoneal dialysis (PD). What should the nurse inform the patient while teaching about PD?
take potassium supplements