NURS 309 Quiz 12 Acute Renal 3

The nurse is caring for a patient receiving gentamicin. Which laboratory results does the nurse monitor? SATA A. Blood urea nitrogen B. Creatinine C. Drug peak and trough levels D. Prothrombin time E. Platelets count F. Hemoglobin and hematocrit

A. Blood urea nitrogen B. Creatinine C. Drug peak and trough levels

The nurse is caring for a patient in the intensive care unit who sustained blood loss during a traumatic accident. To detect signs and symptoms that suggest the development of kidney dysfunction, the nurse observes for which data? SATA A. Hypotension B. Bradycardia C. Decreased urine output D. Decreased cardiac output E. Increased central venous pressure F. Jugular vein distension

A. Hypotension C. Decreased urine output D. Decreased cardiac output

Which patients are likely to be excluded from receiving a transplant? SATA A. Patient with breast cancer that has metastasized to lungs B. Patient with advanced and uncorrectable heart disease C. Patient with a chemical dependency D. Patient who is 70 years old and has a living related donor E. Patient with type 2 diabetes mellitus F. Patient who is receiving treatment for peptic ulcer disease

A. Patient with breast cancer that has metastasized to lungs B. Patient with advanced and uncorrectable heart disease C. Patient with a chemical dependency

A patient has been diagnosed with acute kidney injury, but the cause is uncertain. The nurse prepares patient educational material about which diagnostic test? A. Flat plate of abdomen B. Renal ultrasonography C. Computed tomography D. Kidney biopsy

D. Kidney biopsy

The nurse is caring for several patients at a walk-in clinic. None of the patients currently has any acute or chronic kidney problems. Which patient has the greatest risk to develop acute kidney injury? A. 73-year-old male who has hypertension and peripheral vascular disease B. 32-year-old female who is pregnant and has gestational diabetes C. 49-year-old male who is obese and has a history of skin cancer D. 23-year-old female who has been treated for a urinary tract infection

A. 73-year-old male who has hypertension and peripheral vascular disease

In order to assist a patient in the the prevention of osteodystrophy, which intervention does the nurse perform? A. Administer phosphate binders with meals B. Encourage high-quality protein foods C. Administer iron supplements D. Encourage extra milk at mealtimes

A. Administer phosphate binders with meals

The nurse is caring for a patient with acute kidney injury who does not have signs or symptoms of fluid overload. Which intervention would be most effective as a fluid challenge to promote kidney perfusion? A. Administering normal saline 500 to 1000 mL infused over 1 hour B. Administering drugs to suppress aldosterone release C. Instilling 500 to 1000 mL normal saline through a nasogastric tube D. Having the patient drink several large glasses of water

A. Administering normal saline 500 to 1000 mL infused over 1 hour

The nurse is evaluating a patient's treatment response to erythropoietin. Which hemoglobin reading indicates that the goal is being met? A. Around 10 g/dL B. Greater than 20 g/dL C. Upward trend D. At baseline for gender

A. Around 10 g/dL

The nurse is caring for a patient with an arteriovenous fistula. What is included in the nursing care for this patient? SATA A. Assess the patient's distal pulses and circulation in the arm with the access B. Encourage routine range-of-motion exercises C. Avoid venipuncture or IV administration on the arm with the access device D. Instruct the patient to carry heavy objects to build muscular strength E. Assess for manifestations of infection of the fistula F. Instruct the patient to sleep on affected side with arm in the dependent position

A. Assess the patient's distal pulses and circulation in the arm with the access B. Encourage routine range-of-motion exercises C. Avoid venipuncture or IV administration on the arm with the access device E. Assess for manifestations of infection of the fistula

The nurse is providing post-dialysis care for a patient. In comparing vital signs and weight measurements to the predialysis data, what does the nurse expect to find? A. Blood pressure and weight are reduced B. Blood pressure is increased and weight is reduced C. Blood pressure and weight are slightly increased D. Blood pressure is low and weight is the same

A. Blood pressure and weight are reduced

A patient with acute kidney injury has a high rate of catabolism with an increase in blood levels of catecholamines, cortisol, and glucagon. How will this pathophysiology manifest? A. Blood urea nitrogen will reflect buildup of nitrogenous wastes in the blood B. Elevated blood sugar will cause hyperglycemia-induced diuresis C. Falsely low sodium level is associated with fluid overload D. Weight gain occurs in response to increased calorie consumption

A. Blood urea nitrogen will reflect buildup of nitrogenous wastes in the blood

The nurse is caring for a patient with acute kidney injury and notes a trend of increasingly elevated blood urea nitrogen levels. How does the nurse interpret this information? A. Breakdown of muscle for protein which leads to an increase in azotemia B. Signs of urinary retention and decreased urinary output C. Expected trend that can be reversed by discontinuing diuretics D. Ominous sign of irreversible kidney failure

A. Breakdown of muscle for protein which leads to an increase in azotemia

The community health nurse is designing programs to reduce kidney problems and kidney injury among the general public. In order to do so, the nurse targets health promotion and compliance with therapy for people with which conditions? A. Diabetes mellitus and hypertension B. Frequent episodes of sexually transmitted diseases C. Osteoporosis and other bone diseases D. Gastroenteritis and poor eating habits

A. Diabetes mellitus and hypertension

The nurse is reviewing urinalysis results for a patient who is in the early stages of chronic kidney disease. What results might the nurse expect to see? A. Excessive protein, glucose, red blood cells, and white blood cells B. Increased specific gravity with a dark amber discoloration C. Dramatically increased urinary osmolarity D. Pink-tinged urine with obvious small blood clots

A. Excessive protein, glucose, red blood cells, and white blood cells

The nurse is taking a history of a patient at risk for kidney failure. What does the nurse ask the patient about during the interview? SATA A. Exposure to nephrotoxic chemicals B. Unexpected weight loss C. History of diabetes mellitus, hypertension, systemic lupus erythematosus D. Recent surgery, trauma, or transfusions E. Leakage of urine when coughing or laughing F. Recent or prolonged use of non-steroidal anti-inflammatory drugs

A. Exposure to nephrotoxic chemicals C. History of diabetes mellitus, hypertension, systemic lupus erythematosus D. Recent surgery, trauma, or transfusions F. Recent or prolonged use of non-steroidal anti-inflammatory drugs

The nurse is assessing a patient with uremia. Which gastrointestinal changes does the nurse expect to find? SATA A. Halitosis B. Hiccups C. Anorexia D. Nausea E. Vomiting F. Salivation

A. Halitosis B. Hiccups C. Anorexia D. Nausea E. Vomiting

Which disorder could be a complication from acute kidney injury? A. Heart failure B. Diabetes mellitus C. Kidney cancer D. Compartment syndrome

A. Heart failure

What might the nurse notice if the patient is experiencing reduce perfusion and altered urinary elimination related to acute kidney injury? SATA A. Hemodynamic instability, especially persistent hypotension and tachycardia B. Urine output of less than 0.5 mL/kg/hour for 6 or more hours C. Serum creatinine below baseline or admission values D. Urine may be clear or have a pale yellow color E. Abnormal urine sodium values F. Bladder distension and flank pain

A. Hemodynamic instability, especially persistent hypotension and tachycardia B. Urine output of less than 0.5 mL/kg/hour for 6 or more hours E. Abnormal urine sodium values

What criteria are included in the current definition of acute kidney injury? SATA A. Increase in serum creatinine by 0.3 mg/dL or more within 48 hours B. Presence of polyuria, and nocturia with very dilute pale yellow urine C. Signs and symptoms of fluid overload, such as edema, and crackles on auscultation D. Increase in serum creatinine to 1.5 times or more from baseline in the previous 7 days E. Hypotension and tachycardia with progressively decreased amounts of urine F. Urine volume of less than 0.5 mL/kilogram/hour for 6 hours

A. Increase in serum creatinine by 0.3 mg/dL or more within 48 hours D. Increase in serum creatinine to 1.5 times or more from baseline in the previous 7 days F. Urine volume of less than 0.5 mL/kilogram/hour for 6 hours

The home health nurse is reviewing the medication list of a patient with chronic kidney disease. The nurse calls the health care provider as a reminder that the patient might need which nutritional supplements? SATA A. Iron B. Magnesium C. Phosphorus D. Calcium E. Vitamin D F. Water-soluble vitamin

A. Iron D. Calcium E. Vitamin D F. Water-soluble vitamin

The patient with chronic kidney disease reports chronic fatigue, lethargy with weakness, and mild shortness of breath with dizziness when rising to a standing position. In addition, the nurse notes pale mucous membranes. Based on the patient's illness and the presenting symptoms, which laboratory result does the nurse expect to see? A. Low hemoglobin and hematocrit B. Low white blood cell count C. Low blood glucose D. Low oxygen saturation

A. Low hemoglobin and hematocrit

A patient is undergoing a dialysis treatment and exhibits a progression of symptoms which include headache, nausea and vomiting, and fatigue. How does the nurse interpret these symptoms? A. Mild dialysis disequilibrium syndrome B. Expected manifestations in end stage kidney disease C. Transient symptoms in a new dialysis patient D. Adverse reaction to the dialysate

A. Mild dialysis disequilibrium syndrome

What should the nurse do in order to monitor kidney function in the patient with chronic kidney disease? SATA A. Monitor intake and output B. Check urine specific gravity C. Review blood urea nitrogen and serum creatinine levels D. Review x-ray reports E. Monitor serum potassium and sodium levels F. Observe albumin-creatinine ration

A. Monitor intake and output B. Check urine specific gravity C. Review blood urea nitrogen and serum creatinine levels E. Monitor serum potassium and sodium levels F. Observe albumin-creatinine ration

Which patients with chronic kidney disease are candidates for intermittent hemodialysis? SATA A. Patient with fluid overload who does not respond to diuretics B. Patient with stage 1 injury according to the KDIGO classifications C. Patient with symptomatic toxin ingestion D. Patient with uremic manifestations, such as decreased cognition E. Patient with symptomatic hyperkalemia and calciphylaxis F. Patient with increased creatinine and blood urea nitrogen

A. Patient with fluid overload who does not respond to diuretics C. Patient with symptomatic toxin ingestion D. Patient with uremic manifestations, such as decreased cognition E. Patient with symptomatic hyperkalemia and calciphylaxis

The nurse is caring for a postoperative patient and is evaluating the patient's intake and output as a measure to prevent acute kidney injury. The patient weighs 60 kg and has an intake of 120 mL and 180 mL of urine in the past 4 hours. What should the nurse do? A. Perform other assessments related to fluid status and record the output B. Call the health care provider and obtain an order for a fluid bolus C. Encourage the patient to drink more fluid, so that the output is increased D. Compare the patient's weight to baseline to determine fluid retention

A. Perform other assessments related to fluid status and record the output

A patient with chronic kidney disease develops severe chest pain, an increased pulse, low-grade fever, and pericardial friction rub with a cardiac dysrhythmia and muffled heart tones. The nurse immediately alerts the health care provider and prepares for which emergency procedure? A. Pericardiocentesis B. Continuous venovenous hemofiltration C. Kidney dialysis D. Endotracheal intubation

A. Pericardiocentesis

A patient with acute kidney injury is receiving total parenteral nutrition (TPN). What is the therapeutic goal of using TPN? A. Preserve a lean body mass B. Promote tubular reabsorption C. Create a negative nitrogen balance D. Prevent infection

A. Preserve a lean body mass

The patient with chronic kidney disease has consistently weighed 63 kg. at each clinic visit. Patient reports eating "a lot of good, salty food" and drinking "too many beers" during the weekend. Today, the patient weighs 65 kg. How much fluids has the patient retained? A. 1 liter B. 2 liters C. 2 kilograms D. 3 kilograms

B. 2 liters

The nurse is caring for a patient with end-stage kidney disease and dialysis has been initiated. Which drug order does the nurse question? A. Erythropoietin B. Diuretic C. Angiotensin-converting enzyme inhibitor D. Calcium channel blocker

B. Diuretic

The nurse is assessing a patient with kidney injury and notes that the patient is having Kussmaul respirations. What condition is the body attempting to compensate for? A. Hypoxia B. Alkalosis C. Acidosis D. Hypoxemia

C. Acidosis

A patient and family are trying to plan a schedule that coordinates with the patient's hemodialysis regimen. The patient asks, "How often will I have to go and how long does it take?" What is the nurse's best response? A. "If you follow diet and fluid therapies, you spend less time in dialysis, about 12 hours a week" B. "Most patients require about 12 hours per week; this is usually divided into three 4-hour treatments" C. "It varies. You will have to call your health care provider for specific instructions" D. "Many patients prefer to have treatments that occur every night while sleeping"

B. "Most patients require about 12 hours per week; this is usually divided into three 4-hour treatments"

A patient is instructed by the dietitian to restrict protein to 0.6 g/kg of body weight. The patient weighs 121 pounds and reports consuming milk and eggs or meat for every meal. What should the nurse do? A. Instruct the patient to carefully review and follow the dietary plan as instructed by the dietician B. Advise the patient that protein intake is excessive and consult the dietitian for reeducation C. Ask the patient to described what he used to eat prior to being told about the dietary plan D. Give the patient a brochure that explains how to calculate grams of protein in typical foods

B. Advise the patient that protein intake is excessive and consult the dietitian for reeducation

The emergency department nurse is assessing a healthy young marathon runner who was brought to the hospital for transient syncope and dizziness that occurred after the race. The nurse notes that the patient has low urine output, decreased systolic blood pressure, decreased pulse pressure, orthostatic hypotension, and thirst. Before obtaining orders from the ED provider, which additional assessment is the most important? A. Auscultate lungs for crackles B. Assess gag reflex and ability to swallow C. Palpate peripheral pulses D. Ask about family history of kidney disease

B. Assess gag reflex and ability to swallow

The night shift nurse sees a patient with kidney failure sitting up in bed. The patient states, "I feel a little short of breath at night when I get up to walk to the bathroom." What assessment does the nurse do? A. Check for orthostatic hypotension because of potential volume depletion B. Auscultates the lungs for crackles, which indicate fluid overload C. Check the pulse and blood pressure for possible decreased cardiac output D. Assess for normal sleep pattern and need for a PRN sedative

B. Auscultates the lungs for crackles, which indicate fluid overload

The nurse is teaching a patient about performing peritoneal dialysis (PD) at home. In order to identify the earliest manifestations of peritonitis, what does the nurse instruct the patient to do? A. Monitor temperature before starting PD B. Check the effluent for cloudiness C. Be aware of feelings of malaise D. Monitor for abdominal pain

B. Check the effluent for cloudiness

If a patient with end-stage kidney disease experiences isothenuria, what must the nurse be alert for? A. Massive diuresis B. Fluid volume overload C. Oliguria D. Alkalosis

B. Fluid volume overload

The nurse is caring for a patient with acute kidney injury that developed after a severe anaphylactic reaction. What is a primary treatment goal of the initial phase that will help to prevent permanent kidney damage for this patient? A. Correct fluid volume by administering IV normal saline B. Maintain a minimal mean arterial pressure of 65 mm Hg C. Prevent kidney infections by administering antibiotics D. Give antihistamines to prevent allergic response

B. Maintain a minimal mean arterial pressure of 65 mm Hg

When a patient is in the diuretic phase of acute kidney injury, the nurse is mainly concerned about implementing which interventions? A. Assessing for hypertension and fluid overload B. Monitoring for hypovolemia and electrolyte loss C. Adjusting the dosage of diuretic medications D. Balancing diuretic therapy with intake

B. Monitoring for hypovolemia and electrolyte loss

A patient with prerenal azotemia receives a fluid challenge. In evaluating response to the therapy, which outcome indicates that the goal was met? A. Patient reports feeling better and appetite is improved B. Patient produces urine soon after the initial bolus C. The therapy is completed without adverse effects D. The health care provider discharges the patient

B. Patient produces urine soon after the initial bolus

The intensive care nurse is caring for a patient who just received a kidney transplant from related donor. The nurse notices hypotension and excessive diuresis, 1000 mL greater than intake over the past 12 hours. At this point, what is the primary concept that affects graft survival? A. Infection B. Perfusion C. Elimination D. Cellular regulation

B. Perfusion

The nurse is caring for a patient who has kidney transplant surgery 3 days ago. The nurse notes sudden and abrupt decrease in urine. The nurse alerts the health care provider for suspected thrombosis, What is the priority concept that under lies this complication? A. Infection B. Perfusion C. Elimination D. Cellular regulation

B. Perfusion

A patient with chronic kidney disease is restless, anxious, and short of breath. The nurse hears crackles that begin at the base of the lungs. The pulse rate is increased and the patient has frothy, blood-tinged sputum. What does the nurse do first? A. Facilitate transfer to intensive care for aggressive treatment B. Place the patient is a high-Fowler's position C. Continue to monitor vital signs and assess breath sounds D. Administer a loop diuretic such as furosemide

B. Place the patient is a high-Fowler's position

The nurse is talking to an older adult male patient who is reasonably healthy for his age, but has benign prostatic hyperplasia (BPH). Which condition does the BPH potentially place him at risk for? A. Prerenal acute kidney injury B. Postrenal acute kidney injury C. Polycystic kidney disease D. Acute glomerulonephritis

B. Postrenal acute kidney injury

The nurse requests a dietary consult to address the patient's high rate of catabolism. Which nutritional element is directly related to this metabolic process? A. Carbohydrates B. Proteins C. Liquids D. Fats

B. Proteins

The nurse is assessing a patient's extremity with an arteriovenous graft. The nurse notes a thrill and a bruit, and the patient reports numbness and a cool feeling in the fingers. How does the nurse interpret this information with regards to the graft? A. The graft is functional and these symptoms are expected B. The patient has "steal syndrome" and may need surgical intervention C. The graft is patent, but the blood is flowing in the wrong direction D. The patient needs to increase active use of hands and fingers

B. The patient has "steal syndrome" and may need surgical intervention

Patients with diabetes or hypertension should be encouraged to have which tests annually? A. Glomerular filtration rate, urinalysis, and urine osmolarity B. Urine albumin-to creatinine ratio, serum creatinine, and blood urea nitrogen C. Urine specific gravity, albumin-creatinine ration, and electrolytes D. Blood urea nitrogen, serum creatinine, urine sodium, and kidney ultrasound

B. Urine albumin-to creatinine ration, serum creatinine, and blood urea nitrogen

A client with acute kidney failure states, "Why am I twitching and my fingers and toes tingling?" The nurse should respond, "This is caused by: A. acidosis" B. calcium depletion" C. potassium retention" D. sodium chloride depletion"

B. calcium depletion"

Which patient is the most likely candidate for continuous venovenous hemofiltration? A. Patient with fluid volume overload B. Patient who needs long-term management C. Patient who is critically ill D. Patient who is ready for discharge

C. Patient who is critically ill

The nurse is caring for patients who have cancers of the bladder, cervix, colon, and prostate. These patients have a risk for developing which type of acute kidney injury? A. Prerenal injury B. Intrarenal injury C. Postrenal injury D. Intrinsic renal failure

C. Postrenal injury

A patient has recently started peritoneal dialysis therapy and reports some mild pain when the dialysate is flowing in. What does the nurse do next? A. Immediately report the pain to the health care provider B. Warm the dialysate in the microwave oven C. Reassure that pain should subside after the first week or two D. Assess the connection tubing for kinking or twisting

C. Reassure that pain should subside after the first week or two

The nurse is monitoring a patient's peritoneal dialysis treatment. The total outflow is slightly less than the inflow. What does the nurse do next? A. Instruct the patient to ambulate B. Notify the health care provider C. Record the difference as intake D. Put the patient on fluid restriction

C. Record the difference as intake

Which behavior is the strongest indicator that a patient with end stage kidney disease is not coping well with the illness and may need a referral for psychological counseling? A. Displays irritability when the meal tray arrives B. Refused to take a drug because it can cause nausea C. Repeatedly misses dialysis appointments D. Is quiet when the health care provider talks about prognosis

C. Repeatedly misses dialysis appointments

What type of breath odor is most likely to be noted in a patient with chronic kidney disease? A. Fruity smell B. Fecal smell C. Smells like urine D. Smells like blood

C. Smells like urine

A nurse is caring for a client with acute kidney failure who is receiving a protein restricted diet. The client asks why this diet is necessary. What information should the nurse include in a response to the client's questions? A. A high-protein intake ensures an adequate daily supply of amino acids to compensate for losses B. Essential and nonessential amino acids are necessary in the diet to supply materials for tissue protein synthesis C. This supplies only essential amino acids, reducing the amount of metabolic waste products, thus decreasing the stress on the kidney D. Urea nitrogen cannot be used to synthesize amino acids in the body, so the nitrogen for amino acid synthesis must come from the dietary protein

C. This supplies only essential amino acids, reducing the amount of metabolic waste products, thus decreasing the stress on the kidney

The patient had a diagnostic imaging test with contrast media. IV fluids were ordered before and after the procedure to prevent contrast-induced nephropathy. Which outcome statement indicates that the goal of giving IV therapy has been met? A. Lung sounds are clear and there are no signs/symptoms of fluid overload B. Patient does not show signs/symptoms of contrast-induced immune response C. Urine output is 150 mL/hr for the first 6 hours after use of contrast agent D. Urine is 0.5 ml/kg/hour for 6 hours and patient remains euvolemic

C. Urine output is 150 mL/hr for the first 6 hours after use of contrast agent

The nurse is taking a history on a patient with diabetes and hypertension. Because of the patient's high risk for developing kidney problems, which early sign of chronic kidney disease does the nurse assess for? A. Decreased output with subjective thirst B. Urinary frequency of very small amounts C. Pink or blood-tinged urine D. Increased output of very dilute urine

D. Increased output of very dilute urine

A patient with acute kidney injury has a poor appetite. What would the health care team try first? A. Parenteral nutrition (PN or hyperalimentation) B. Familiar comfort foods brought by the family C. Nasogastric tube enteral liquids for kidney patients D. Oral supplements designed for kidney patients

D. Oral supplements designed for kidney patients

Which patient with kidney problems is the best candidate for peritoneal dialysis? A. Patient with peritoneal adhesions B. Patient with a history of extensive abdominal surgery C. Patient with peritoneal membrane fibrosis D. Patient with a history of difficulty with anticoagulants

D. Patient with a history of difficulty with anticoagulants

The nurse is caring for a patient who developed acute prerenal kidney injury secondary to severe and extensive burn injuries. What is the primary concept that underlies the etiology of acute kidney injury? A. Elimination B. Tissue integrity C. Immunity D. Perfusion

D. Perfusion

The nurse is teaching the patient to perform continuous ambulatory peritoneal dialysis. Place the steps in the correct order. 1. Fluid stays in the cavity for a specified time prescribed by the health care provider 2. 1 to 2 L of dialysate is infused by gravity over a 10-20 minute period 3. Fluid flows out of the body by gravity into a drainage bag 4. Warm the dialysate bags before instillation by using a heating pad to wrap the bag

3, 2, 4, 1

The nurse and the dietician are planning dietary intake for a patient with acute kidney injury who is currently not on dialysis therapy. The dietitian informs the nurse that 0.6 g/kg of body weight of protein are needed. The patient weighs 130 lb. How many grams of protein should the patient receive? _______ grams

35 grams

The nurse is talking to a patient with end-stage kidney disease. The patient frequently displays weight gain and increased blood pressure beyond baseline measurements. Which question is the nurse most likely to ask to determine if the patient is doing something that is contributing to these assessment findings? A. "Are you controlling your salt intake?" B. "Are you following the protein restrictions?" C. "Have you been eating a lot of sweets?" D. "Have you been exercising regularly?"

A. "Are you controlling your salt intake?"

The home health nurse is visiting a patient who independently performs peritoneal dialysis (PD). Which question does the nurse ask the patient to assess for the major complication associated with PD? A. "Have you noticed any signs or symptoms of infection?" B. "Are you having any pain during the dialysis treatments?" C. "Is the dialysate fluid slow or sluggish?" D. "Have you noticed any leakage around the catheter?"

A. "Have you noticed any signs or symptoms of infection?"

A patient with chronic kidney disease has a potassium level of 8 mEq/L. The nurse notifies the health care provider after assessing for which sign/symptom? A. Cardiac dysrhythmias B. Respiratory depression C. Tremors or seizures D. Decreased urine output

A. Cardiac dysrhythmias

The nurse is caring for a patient requiring peritoneal dialysis. In order to monitor the patient's weight, what does the nurse do? A. Check the weight after a drain and before the next fill to monitor the patient's "dry weight" B. Calculate the "dry weight" by comparing daily weights to baseline weights C. Determine "dry weight" by comparing the patient's weight to a standard weight chart D. Weigh the patient daily and subtract fluid intake and dialysate volume to determine "dry weight"

A. Check the weight after a drain and before the next fill to monitor the patient's "dry weight"

When shock or other problems cause an acute reduction in the blood flow to the kidneys, how do the kidneys compensate? SATA A. Constrict blood vessels in the kidney B. Activate the renin-angiotensin-aldosterone pathway C. Release beta blockers D. Dilate arteries throughout the body E. Release antidiuretic hormones F. Restrict secretions of glucocorticoids

A. Constrict blood vessels in the kidney B. Activate the renin-angiotensin-aldosterone pathway E. Release antidiuretic hormones

In collaboration with the registered dietitian, the nurse teaches the patient about which dietary recommendations for management of chronic kidney disease? SATA A. Controlling protein intake B. Limiting fluid intake C. Restricting potassium D. Increasing sodium E. Restricting phosphorus F. Reducing calories

A. Controlling protein intake B. Limiting fluid intake C. Restricting potassium E. Restricting phosphorus

A patient sustained extensive burns and depletion of vascular volume. The nurse expects which changes in vital signs and urinary function? A. Decreased urine output, hypotension, tachycardia B. Increased urine output, hypertension, tachycardia C. Bradycardia, hypotension, polyuria D. Dysrhythmias, hypertension, oliguria

A. Decreased urine output, hypotension, tachycardia

The health care provider orders IV fluids at a rate of 1 mL/kg/hour for 12 hours prior to an imaging test. The patient weighs 152 lb. What should the nurse do? A. Set the IV pump to deliver 69 mL/hr B. Set the IV pump to deliver 152 mL/hr C. Set the IV pump to deliver 1 mL for 12 hours D. Call provider to clarify the order in mL/hr

A. Set the IV pump to deliver 69 mL/hr

The home health nurse is evaluating the home setting for a patient who wishes to have in-home hemodialysis. What is important to have in the home setting to support this therapy? A. Specialized water treatment system to provide a safe, purified water supply B. Large dust-free space to accommodate and store the dialysis equipment C. Modified electrical system to provide high voltage to power the equipment D. Specialized cooling system to maintain strict temperature control

A. Specialized water treatment system to provide a safe, purified water supply

According to the KDIGO classification (Kidney Disease: Improving Global Outcomes), how would the nurse interpret the following data? Serum creatinine increased x 1.5 over baseline with urine output of <0.5 mL/kg/hr > 6 hours A. Stage 1 B. Stage 2 C. Stage 3 D. End-stage kidney disease

A. Stage 1

A patient has returned to the medical-surgical unit after having a dialysis treatment. The nurse notes that the patient is also scheduled for an invasive procedure on the same day. What is the primary rationale for delaying the procedure for 4 to 6 hours? A. The patient was heparinized during dialysis B. The patient will have cardiac dysrhythmias after dialysis C. The patient will be incoherent and unable to give consent D. The patient needs routine medications that were delayed

A. The patient was heparinized during dialysis

The nurse is caring for a patient who has hypovolemic shock secondary to trauma. Based on the pathophysiology of hypovolemia and prerenal azotemia, what does the nurse assess at least every hour? A. Urinary output B. Presence of edema C. Urine color D. Presence of pain

A. Urinary output

A patient can develop intrarenal kidney injury from which causes? SATA A. Vasculitis B. Pyelonephritis C. Strenuous exercise D. Exposure to nephrotoxins E. Bladder cancer F. Systemic infection (sepsis)

A. Vasculitis B. Pyelonephritis D. Exposure to nephrotoxins F. Systemic infection (sepsis)

The nurse monitors the daily weights for a patient with chronic kidney disease because of the risk for fluid retention. What instructions does the nurse give to the unlicensed assistive personnel? A. Weigh the patient daily at the same time each day, same scale, with the same amount of clothing B. Weigh the patient daily and add 1 kilogram of weight for the intake of each liter of fluid C. Weigh the patient in the morning before breakfast and weigh the patient at nigh just before bedtime D. Ask the patient about normal weight and weigh the patient before and after each voiding

A. Weigh the patient daily at the same time each day, same scale, with the same amount of clothing

A patient has been receiving erythropoietin. Which statements by the patient indicates that the therapy is producing the desired effect? A."I can do my housework with less fatigue" B. "I have been passing more urine than I was before" C. "I have less pain and discomfort now" D. "I can swallow and eat much better than before"

A."I can do my housework with less fatigue"

A nurse is caring for a client with chronic kidney failure. Which clinical findings should the nurse expect when assessing this client? SATA A. Polyuria B. Lethargy C. Hypotension D. Muscle twitching E. Respiratory acidosis

B. Lethargy D. Muscle twitching

The nurse is reviewing the medication list and appropriate dose adjustments made for a patient with chronic kidney disease. The nurse would question the use and/or dosage adjustments of which type of medications? A. Antibiotics B. Magnesium antacids C. Oral antidiabetics D. Opioids

B. Magnesium antacids

Which abnormal electrolyte imbalance is most likely to develop in the early phase of chronic kidney disease? A. Hyperkalemia B. Hyponatremia C. Hypercalcemia D. Hypokalemia

B. Hyponatremia

The health care provider has ordered sodium restriction to 3 g daily for a patient receiving dialysis therapy. What does the nurse teach the patient? A. Add smaller amounts of salt at the table or during cooking B. Identify foods that are high in sodium (i.e. bacon, potato chips, fast food) C. Avoid foods that have a metallic, salty, or bitter taste D. Eat larger amounts of bland foods with very minimal amounts of spicing

B. Identify foods that are high in sodium (i.e. bacon, potato chips, fast food)

As a result of kidney failure, excessive hydrogen ions cannot be excreted. With acid retention, the nurse is most likely to observe what type of respiratory compensation? A. Cheyne-Stokes respiratory pattern B. Increased depth of breathing C. Decreased respiratory rate and depth D. Increased arterial carbon dioxide levels

B. Increased depth of breathing

During peritoneal dialysis, the nurse notes slowed dialysate outflow. What does the nurse do to troubleshoot the system? SATA A. Ensure that the drainage bag is elevated B. Inspect the tubing for kinking or twisting C. Ensure that clamps are open D. Turn the patient to the other side E. Make sure the patient has good body alignment F. Instruct the patient to stand or cough

B. Inspect the tubing for kinking or twisting C. Ensure that clamps are open D. Turn the patient to the other side E. Make sure the patient has good body alignment

The nurse is talking to a group of healthy young athletes about maintaining good kidney health and preventing acute kidney injury. Which health promotion point is the nurse most likely to emphasize with this group? A. "Have your blood pressure checked regularly" B. "Find out if you have a family history of diabetes" C. "Avoid dehydration by drinking at least 2 to 3 L of water daily" D. "Have annual testing for protein and glucose in urine"

C. "Avoid dehydration by drinking at least 2 to 3 L of water daily"

A patient's laboratory results show an elevated creatinine level. The patient's history reveals no risk factors for kidney disease. Which question does the nurse ask the patient to shed further light on the laboratory result? A. "How many hours of sleep did you get the night before the test?" B. "How much fluid did you drink before the test?" C. "Did you take any type of antibiotics before taking the test?" D. "When and how much did you last urinate before having the test?"

C. "Did you take any type of antibiotics before taking the test?"

The nurse is caring for a patient with chronic kidney disease. The family asks about when renal replacement therapy will begin. What is the nurse's best response? A. "As early as possible to prevent further damage in stage 1" B. "When there is reduced kidney function and metabolic wastes accumulate" C. "When the kidneys are unable to maintain a balance in body functions" D. "It will be started with diuretic therapy to enhance the remaining function"

C. "When the kidneys are unable to maintain a balance in body functions"

The intensive care nurse is caring for the kidney transplant patient who was just transferred from the recovery unit. Which finding is the most serious within the first 12 hours after surgery and warrants immediate notification of the transplant surgeon? A. Diuresis with increased output B. Pink or dark reddish urine C. Abrupt decrease in urine D. Small clots in bladder irrigation fluid

C. Abrupt decrease in urine

Which combination of drugs is the most nephrotoxic? A. Angiotensin-converting enzyme inhibitors and aspirin B. Angiotensin II receptor blockers and antacids C. Amino-glycoside antibiotics and non-steroidal anti-inflammatory drugs D. Calcium channel blockers and antihistamines

C. Amino-glycoside antibiotics and non-steroidal anti-inflammatory drugs

A nurse is caring for a client with end-stage renal disease. Which clinical indicators of end-stage renal disease should the nurse expect? SATA A. Polyuria B. Jaundice C. Azotemia D. Hypertension E. Polycythemia

C. Azotemia D. Hypertension

A patient with chronic kidney disease has hypertension and the health care provider has tried different medications, combinations, and adjustments of dosages. Which outcome statement indicates that the goal of drug therapy is being met? A. Patient reports compliance with regimen as prescribed B. Patient reports feeling well and having good urine output C. Blood pressure readings are consistently below 135/85 D. Blood pressure readings are never higher than 150/90

C. Blood pressure readings are consistently below 135/85

For a patient with acute kidney injury, the nurse would consider questioning the order for which diagnostic test? A. Kidney biopsy B. Ultrasonography C. Computed tomography with contrast dyes D. Kidney, ureter, bladder x-ray

C. Computed tomography with contrast dyes

The nurse notes an abnormal laboratory test finding for a patient with chronic kidney disease and alerts the health care provider. The nurse also consults with the registered dietitian because an excessive dietary protein intake is directly related to which factor? A. Elevated serum creatinine level B. Protein presence in the urine C. Elevated blood urea nitrogen level D. Elevated serum potassium level

C. Elevated blood urea nitrogen level

A patient is diagnosed with renal osteodystrophy. What does the nurse instruct unlicensed assistive personnel to do in relation to this patient's diagnosis? A. Assist the patient with toileting every 2 hours B. Gently wash the patient's skin with a mild soap and rinse well C. Handle the patient gently because of risk for fractures D. Assist the patient with eating because of loss of coordination

C. Handle the patient gently because of risk for fractures

The health care provider has ordered intraperitoneal heparin for a patient with a new peritoneal dialysis catheter to prevent clotting of the catheter by blood and fibrin formation. What advice does the nurse give the patient? A. Watch for bruising or bleeding from the gums B. Make a follow-up appointment for coagulation studies C. Intraperitoneal heparin does not affect clotting times D. Certain foods can interact with heparin to alter clotting

C. Intraperitoneal heparin does not affect clotting times

The nurse is caring for a patient with an arteriovenous fistula. What instructions are given to unlicensed assistive personnel regarding the care of this patient? A. Palpate for thrills and auscultate for bruits every 4 hours B. Check for bleeding at needle insertion site C. Assess patient's distal pulses and circulation D. Avoid taking blood pressure readings in the arm with the fistula

D. Avoid taking blood pressure readings in the arm with the fistula

The nurse is assessing a patient who has just returned from hemodialysis. Which assessment finding is cause for greatest concern? A. Feeling of malaise B. Headache C. Muscle cramps in the legs D. Bleeding at the access site

D. Bleeding at the access site

A patient has acute kidney injury related to nephrotoxins. To improve glomerular filtration rate and improve blood flow to the kidneys, which type of medication does the nurse anticipate the health care provider will prescribe? A. Loop diuretics B. Phosphate binders C. Erythropoietin stimulating agents D. Calcium channel blockers

D. Calcium channel blockers

A client with acute kidney failure becomes confused and irritable. Which does the nurse determine is the most likely cause of this behavior? A. Hyperkalemia B. Hypernatremia C. A limited fluid intake D. An increased blood urea nitrogen level

D. An increased blood urea nitrogen level

The nurse is caring for the kidney transplant patient in the immediate postoperative period. During this initial period, the nurse will assess the urine output at least every hour for how many hours? A. First 8 hours B. First 12 hours C. First 24 hours D. First 48 hours

D. First 48 hours

The nursing student is explaining principles of hemodialysis to the nursing instructor. Which statements by the student indicates a need for additional study and research on the topic? A. "Dialysis works as molecules from an area of higher concentration move to an area of lower concentration" B. "Blood and dialyzing solution flow in opposite directions across an enclosed semipermeable membrane" C. "Excess water, waste products, and excess electrolytes are removed from the blood" D. "Bacteria and other organisms can also pass through the membrane, so the dialysate must be kept sterile"

D. "Bacteria and other organisms can also pass through the membrane, so the dialysate must be kept sterile"

The nurse is assessing the skin of a patient with end-stage kidney disease. Which clinical manifestation is considered a sign of very late, premorbid, advanced uremic syndrome? A. Ecchymoses B. Sallowness C. Pallor D. Uremic frost

D. Uremic frost