AKI

How much KCL do normal kidneys excrete each day? A. 6-8 g B. 6-8 mg C. 1 g D. 3 mg

A. 6-8 g

How much salt do normal kidneys excrete each day? A. 6-8 g B. 5 g C. 1-2 mg D. 3-4 g

A. 6-8 g

A client in acute renal failure is a candidate for continuous renal placement therapy (CRRT). The most common indication for use of CRRT is A. Fluid overload B. Pericarditis C. Azotemia D. Hyperkalemia

A. Fluid overload

Impaired metabolic processes such as Hyperkalemia, Acidosis, Hyperlipidemia, Hyperuricemia, and malnutrition are some effects of ___________. A. Uremia B. Oliguria C. Nephrotoxins D. Hematuria

Answer A. Uremia

When the kidneys cannot effectively regulate fluid and electrolyte balance and eliminate metabolic waste products, intake of these substances must be regulated. Fluid and Sodium intake are ________. A. Restricted B. Limited C. Encouraged

Answer B. Limited

A history of infection specifically caused by group A beta-hemolytic streptococci is associated with which of the following disorders? a. Acute glomerulonephritis b. Acute renal failure c. Nephrotic syndrome d. Chronic renal failure

Answer A. Acute glomerulonephritis is also associated with varicella zoster virus, hepatitis B, and Epstein-Barr virus. Acute renal failure is associated with hypoperfusion to the kidney, parenchymal damage to the glomeruli or tubules, and obstruction at a point distal to the kidney. Chronic renal failure may be caused by systemic disease, hereditary lesions, medications, toxic agents, infections, and medications. Nephrotic syndrome is caused by disorders such as chronic glomerulonephritis, systemic lupus erythematosus, multiple myeloma, and renal vein thrombosis.

Which of the following are abnormal to be found in the urine? A. Amino acids and Glucose B. Glucose C. Amino acids D. K E. All of the above

Answer A. Amino acids and Glucose

What is the # 1 renal function test? A. Renal Clearance/Creatinine Clearance B. BUN C. Serum Creatinine D. Osmolarity

Answer A. Renal Clearance/Creatinine Clearance

The nurse is reviewing laboratory results on a client with acute renal failure. Which one of the following should be reported immediately? A. Venous blood pH 7.30 B. Serum potassium 6 mEq/L C. Blood urea nitrogen 50 mg/dl D. Hemoglobin of 10.3 mg/dl

Answer B. Serum potassium 6 mEq/L Although all of these findings are abnormal, the elevated potassium is a life threatening finding and must be reported immediately.

ESRD occurs when the GFR is less than ___ per minute. A. 5 ml B. 25 ml C. 10 ml D. 15 ml

Answer D. 15 ml

The client with renal failure should be on which type of diet? A. Limited protein, low carbohydrate, adequate calorie intake B. Adequate calorie intake, high carbohydrate, limited protein C. Low calorie, limited protein, low carbohydrate D. High protein, high carbohydrate, low calorie

B. Adequate calorie intake, high carbohydrate, limited protein

Signs and symptoms of acute kidney rejection that the nurse should teach the patient to observe for include A. Sever hypotension and weight loss B. Recurrent urinary tract infections and oral yeast infections C. Fever and painful transplant site D. Tachycardia and headache

C. Fever and painful transplant site

What tests and results prove the presence of dilute urine? A. Serum Creatinine (1.5 mg/dl) B. GFR (100 ml/min), and/or Specific Gravity (1.030) C. Fixed Specific Gravity (1.010), and/or Fixed osmolality (300 mOsm/l)

C. Fixed Specific Gravity (1.010), and/or Fixed osmolality (300 mOsm/l)

The most serious electrolyte disorder associated with kidney disease is A. Hypermagnesemia B. Hyponatremia C. Hyperkalemia D. Metabolic acidosis

C. Hyperkalemia

Which of these drugs is nephrotoxic? A. Diuretics B. Sodium bicarbonate/ Potassium bicarbonate C. NSAIDs D. ACE inhibitors

C. NSAIDs

Agents that damage the kidney tissue are called: A. Nephrons B. Antibodies C. Nephrotoxins D. Enterotoxins

C. Nephrotoxins

True or false? Creatinine, phosphate, sulfates, and uric acid should not be present in urine because they signify renal failure. A. False B. True

Answer A. False Creatinine, phosphate, sulfates, and uric acid should be found in urine.

54. A nurse is reviewing the laboratory test results of a client with renal disease. Which of the following would the nurse expect to find? a. Decreased blood urea nitrogen (BUN) b. Decreased potassium c. Increased serum albumin d. Increased serum creatinine

Answer: D Rationale: In clients with renal disease, the serum creatinine level would be increased. The BUN also would be increased, serum albumin would be decreased, and potassium would likely be increased.

How much water do normal kidneys excrete each day? A. 5-6 liters B. 7-8 liters C. 3-4 liters D. 1-2 liters

D. 1-2 liters

A client is admitted to the hospital and has a diagnosis of early stage chronic renal failure. Which of the following would the nurse expect to note on assessment of the client? A. Anuria B. Polyuria C. Oliguria D. Polydypsia

Answer B. Polyuria

Chronic kidney disease is defined by Kidney Disease Outcomes Quality Initiative (K/DOQI) as evidence of structural or functional kidney abnormalities (abnormal urinalysis, imaging studies, or histology) that persists for at least ______________ months, with or without a decreased GFR. A. 2 B. 12 C. 3 D. 1 E. 6

Answer C. 3

Clients on continuous ambulatory peritoneal dialysis (CAPD) must empty their peritoneal cavity and replace the dialysate every __________ hours. A. 24 B. 48 C. 4-6 D. 6-8

Answer C. 4-6

A female client with acute renal failure is undergoing dialysis for the first time. The nurse in charge monitors the client closely for dialysis equilibrium syndrome, a complication that is most common during the first few dialysis sessions. Typically, dialysis equilibrium syndrome causes: a. confusion, headache, and seizures. b. acute bone pain and confusion. c. weakness, tingling, and cardiac arrhythmias. d. hypotension, tachycardia, and tachypnea.

Answer A. Dialysis equilibrium syndrome causes confusion, a decreasing level of consciousness, headache, and seizures. These findings, which may last several days, probably result from a relative excess of interstitial or intracellular solutes caused by rapid solute removal from the blood. The resultant organ swelling interferes with normal physiologic functions. To prevent this syndrome, many dialysis centers keep first-time sessions short and use a reduced blood flow rate. Acute bone pain and confusion are associated with aluminum intoxication, another potential complication of dialysis. Weakness, tingling, and cardiac arrhythmias suggest hyperkalemia, which is associated with renal failure. Hypotension, tachycardia, and tachypnea signal hemorrhage, another dialysis complication.

When the kidneys have too few nephrons to excrete metabolic wastes and regulate fluid and electrolyte balance adequately, the client is said to have ____________, the final stage of Chronic Renal Failure. A. End-stage renal disease (ESRD) B. Renal insufficiency C. Acute tubular necrosis D. Dialysis

Answer A. End-stage renal disease (ESRD)

Clients with chronic renal failure should notify the physician of any weight: A. Gain of 5 pounds over a 2 day period B. Gain of 2 pounds over a 2 day period C. Loss of 5 pounds over a 5 day period D. Loss of 2 pounds over a 5 day period

Answer A. Gain of 5 pounds over a 2 day period

A female client is admitted with a diagnosis of acute renal failure. She is awake, alert, oriented, and complaining of severe back pain, nausea and vomiting and abdominal cramps. Her vital signs are blood pressure 100/70 mm Hg, pulse 110, respirations 30, and oral temperature 100.4°F (38°C). Her electrolytes are sodium 120 mEq/L, potassium 5.2 mEq/L; her urinary output for the first 8 hours is 50 ml. The client is displaying signs of which electrolyte imbalance? A. Hyponatremia B. Hyperkalemia C. Hyperphosphatemia D. Hypercalcemia

Answer A. Hyponatremia The normal serum sodium level is 135 145 mEq/L. The clients serum sodium is below normal. Hyponatremia also manifests itself with abdominal cramps and nausea and vomiting

Marina with acute renal failure moves into the diuretic phase after one week of therapy. During this phase the client must be assessed for signs of developing: A. Hypovolemia B. Renal failure C. Metabolic acidosis D. Hyperkalemia

Answer A. In the diuretic phase fluid retained during the oliguric phase is excreted and may reach 3 to 5 liters daily, hypovolemia may occur and fluids should be replaced.

________ failure is caused by Acute damage to renal tissue and nephrons or acute tubular necrosis: abrupt decline in tubular and glomerular function due to either prolonged ischemia and/or exposure to nephrotoxins. (Acute glomerulonephritis, malignant hypertension, ischemia; nephrotoxic drugs or substances; red blood cell destruction; muscle tissur breakdown due to trauma, heatstroke) A. Intrarenal B. Prerenal C. Perirenal D. Postrenal

Answer A. Intrarenal

The charge nurse assigned in the care for a client with acute renal failure and hypernatremia to you, a newly graduated RN. Which actions can you delegate to the nursing assistant? A. Provide oral care every 3-4 hours B. Monitor for indications of dehydration C. Administer 0.45% saline by IV line D. Assess daily weights for trends

Answer A. Provide oral care every 3-4 hours Providing oral care is within the scope of practice for the nursing assistant. Monitoring and assessing clients, as well as administering IV fluids, require the additional education and skill of the RN.

For a male client in the oliguric phase of acute renal failure (ARF), which nursing intervention is most important? A. Encouraging coughing and deep breathing B. Promoting carbohydrate intake C. Limiting fluid intake D. Providing pain-relief measures

Answer C. During the oliguric phase of ARF, urine output decreases markedly, possibly leading to fluid overload. Limiting oral and I.V. fluid intake can prevent fluid overload and its complications, such as heart failure and pulmonary edema. Encouraging coughing and deep breathing is important for clients with various respiratory disorders. Promoting carbohydrate intake may be helpful in ARF but doesn't take precedence over fluid limitation. Controlling pain isn't important because ARF rarely causes pain.

Nurse Tristan is caring for a male client in acute renal failure. The nurse should expect hypertonic glucose, insulin infusions, and sodium bicarbonate to be used to treat: A. Hypernatremia. B. Hypokalemia. C. Hyperkalemia. D. Hypercalcemia.

Answer C. Hyperkalemia.

A client suffering from acute renal failure has an unexpected increase in urinary output to 150ml/hr. The nurse assesses that the client has entered the second phase of acute renal failure. Nursing actions throughout this phase include observation for signs and symptoms of A. Hypervolemia, hypokalemia, and hypernatremia. B. Hypervolemia, hyperkalemia, and hypernatremia. C. Hypovolemia, wide fluctuations in serum sodium and potassium levels. D. Hypovolemia, no fluctuation in serum sodium and potassium levels.

Answer C. Hypovolemia, wide fluctuations in serum sodium and potassium levels. The second phase of ARF is the diuretic phase or high output phase. The diuresis can result in an output of up to 10L/day of dilute urine. Loss of fluids and electrolytes occur.

A client with acute renal failure is aware that the most serious complication of this condition is: A. Constipation B. Anemia C. Infection D. Platelet dysfunction

Answer C. Infection Infection is responsible for one third of the traumatic or surgically induced death of clients with renal failure as well as medical induced acute renal failure (ARF)

__________ failure is caused by obstruction of urine flow. (urethral obstruction by enlarged prostate or tumor; ureteral or kidney pelvis obstruction by calculi) A. Prerenal B. Intrarenal C. Postrenal D. Perirenal

Answer C. Postrenal

____________ is a treatment for renal failure in which blood id continuously circulated (artery to vein or vein to vein) and filtered, allowing excess water and solutes to empty into a collecting device. Fluid may be replaced with a balanced electrolyte solution as needed during treatment. A. Continuous cyclic peritoneal dialysis B. Continuous ambulatory peritoneal dialysis C. Hemodialysis D. Continuous Renal Replacement Therapy

Answer D. Continuous Renal Replacement Therapy

_________ is the most frequent complication during hemodialysis. A. Dialysis dementia B. Infection C. Bleeding D. Hypertension

Answer D. Hypertension

Which phase of Acute Renal Failure results in FVE and edema due to salt and water retention, hypertension, Azotemia, hyperkalemia, muscle weakness, nausea, diarrhea, and high serum creatinine and BUN levels? A. Initiation phase B. Intrarenal phase C. Recovery fase D. Maintenance phase

Answer D. Maintenance phase

The cause of ___________ failure is impaired blood supply to the kidney (Fluid Volume Deficit, hemorrhage, heart failure, shock) A. Perirenal B. Postrenal C. Intrarenal D. Prerenal

Answer D. Prerenal

The nurse is reviewing laboratory results on a client with acute renal failure. Which one of the following should be reported immediately? A. Blood urea nitrogen 50 mg/dl B. Hemoglobin of 10.3 mg/dl C. Venous blood pH 7.30 D. Serum potassium 6 mEq/L

Answer D. Serum potassium 6 mEq/L. Although all of these findings are abnormal, the elevated potassium is a life threatening finding and must be reported immediately.

A client on peritoneal dialysis notices that the collecting bag of dialysate is cloudy, what is this an indication of? A. The client needs to change their dialysate B. The patient needs a kidney transplant C. Medication was added to the dialysate D. The patient is infected and experiencing peritonitis

Answer D. The patient is infected and experiencing peritonitis

The client with ESRD tells the nurse that she hates the thought of being tied to the machine, but is also glad to start dialysis because she will be able to eat and drink what she wants. Based on this information, the nuse identifies the nursing diagnosis of A. Self-esteem disturbance related to dependence on dialysis B. Ineffective management of therapeutic regimen related to lack of knowledge of treatment plan C. Anxiety related to perceived threat to health status and role functioning D. Risk for imbalanced nutrition: more than body requirements, related to increased dietary intake

B. Ineffective management of therapeutic regimen related to lack of knowledge of treatment plan

The nurse is performing an assessment on a client who has returned from the dialysis unit following hemodialysis. The client is complaining of a headache and nausea and is extremely restless. Which of the following is the most appropriate nursing action? A. Medicate the client for nausea B. Notify the physician C. Elevate the head of the bed D. Monitor the client

B. Notify the physician

Whici is a normal value of Blood Urea Nitrogen (BUN)? A. 250-500 mg/dL B. 40-70 mg/dL C. 0.5-1.1 mg/dL D. 5-20 mg/dL

D. 5-20 mg/dL

The nurse is caring for the client who has had a renal biopsy. Which of the following interventions would the nurse avoid in the care of the client after this procedure? A. Testing serial samples iwth dipsticks for occult blood B. Administering narcotics as needed C. Encourage fluids to at least 3L in the first 24 hours D. Ambulating the client in the room and hall for short distances

D. Ambulating the client in the room and hall for short distances

Which diagnostic test would be monitored to evaluate glomerular filtration rate and renal function? A. Kidney biopsy B. Urinalysis C. Serum creatinine and BUN D. Creatinine clearance

D. Creatinine clearance

The leading cause of ESRD is the client with a history of A. Prostate cancer B. Hypotension C. Anemia D. Diabetes Mellitus

D. Diabetes Mellitus