Exam #3 (CH 54 - Mgmnt of Pts W/ Kidney Disorders)

C

11. A patient undergoing a CT scan with contrast has a baseline creatinine level of 3 mg/dL, identifying this patient as at a high risk for developing kidney failure. What is the most effective intervention to reduce the risk of developing radiocontrast-induced nephropathy (CIN)? a. Performing the test without contrast b. Administering Garamycin (gentamicin) prophylactically c. Hydrating with saline intravenously before the test d. Administering sodium bicarbonate after the procedure

C

15. A patient is placed on hemodialysis for the first time. The patient complains of a headache with nausea and begins to vomit, and the nurse observes a decreased level of consciousness. What does the nurse determine has happened? a. The dialysis was performed too rapidly. b. The patient is having an allergic reaction to the dialysate. c. The patient is experiencing a cerebral fluid shift. d. Too much fluid was pulled off during dialysis.

B

5. The nurse is educating a patient who is required to restrict potassium intake. What foods would the nurse suggest the patient eliminate that are rich in potassium? a. Butter b. Citrus fruits c. Cooked white rice d. Salad oils

A

8. A patient with chronic kidney failure experiences decreased levels of erythropoietin. What serious complication related to those levels should the nurse assess for when caring for this patient? a. Anemia b. Acidosis c. Hyperkalemia d. Pericarditis

D

1. The nurse notes that a patient who is retaining fluid had a 1-kg weight gain. The nurse knows that this is equivalent to about how many mL? a. 250 mL b. 500 mL c. 750 mL d. 1,000 mL

A

13. The nurse is administering calcium acetate (PhosLo) to a patient with ESKD. When is the best time for the nurse to administer this medication? a. With food b. 2 hours before meals c. 2 hours after meals d. At bedtime with 8 ounces of fluid

D

14. A patient with ESKD is scheduled to have a arteriovenous fistula created. The nurse explains that the patient will have a temporary dialysis catheter because the fistula has to "mature." The nurse will explain that the patient will have to wait how long before using the fistula? a. 1 to 2 weeks b. 2 to 3 weeks c. 1 month d. 2 to 3 months

A

6. A patient has AKI with a negative nitrogen balance. How much weight does the nurse expect the patient to lose? a. 0.5 kg/day b. 1.0 kg/day c. 1.5 kg/day d. 2.0 kg/day

B

7. A patient has stage 3 chronic kidney failure. What would the nurse expect the patient's glomerular filtration rate (GFR) to be? a. A GFR of 90 mL/min/1.73 m2 b. A GFR of 30-59 mL/min/1.73 m2 c. A GFR of 120 mL/min/1.73 m2 d. A GFR of 85 mL/min/1.73 m2

B

9. At the end of five peritoneal exchanges, a patient's fluid loss was 500 mL. How much is this loss equal to? a. 0.5 lb b. 1.0 lb c. 1.5 lb d. 2 lb

B

10. The nurse is caring for a patient after kidney surgery. What major danger should the nurse closely monitor for? a. Abdominal distention owing to reflex cessation of intestinal peristalsis b. Hypovolemic shock caused by hemorrhage c. Paralytic ileus caused by manipulation of the colon during surgery d. Pneumonia caused by shallow breathing because of severe incisional pain

D

12. The nurse is reviewing the potassium level of a patient with kidney disease. The results of the test are 6.5 mEq/L, and the nurse observes peaked T waves on the ECG. What priority intervention does the nurse anticipate the physician will order to reduce the potassium level? a. Administration of an insulin drip b. Administration of a loop diuretic c. Administration of sodium bicarbonate d. Administration of sodium polystyrene sulfonate [Kayexalate])

A

2. A patient admitted with electrolyte imbalance has carpopedal spasm, ECG changes, and a positive Chvostek's sign. What deficit does the nurse suspect the patient has? a. Calcium b. Magnesium c. Phosphorus d. Sodium

A, C, D

3. The nurse is reviewing a patient's laboratory results. What findings does the nurse assess that are consistent with acute glomerulonephritis? (Select all that apply.) a. Red blood cells in the urine b. Polyuria. c. Proteinuria d. White cell casts in the urine e. Hemoglobin of 12.8 g/dL

C

4. The nurse is caring for a patient in the oliguric phase of AKI. What does the nurse know would be the daily urine output? a. 1.5 L b. 1.0 L c. Less than 400 mL d. Less than 50 mL