Exam 4 Renal Practice Questions

A client in kidney failure is to have labs to determine stage of CKD. What lab will not be a diagnostic test measure? a) BUN b) Creatinine clearance c) Albumin d) specific gravity

c) Albumin

Which client is least likely to develop CAD? a) A client with a blood cholesterol level of 289 mg/dl b) A client who is obese, is inactive and has a stressful lifestyle c) A client who has been smoking 2 packs of cigarettes daily for past 20 years. d) A client with HTN whose BP has been maintained at 118/78

d) A client with HTN whose BP has been maintained at 118/78

A client comes into the emergency room and states he had a kidney transplant a month ago. What symptoms would cause the nurse the most concern? a) Fever, increased blood pressure, and increased fatigue b) nausea, vomiting, and diarrhea for the past 6 hours c) inflamed joints and pitting edema in lower extremities d) urine dark with specific gravity of 1.025

a) Fever, increased blood pressure, and increased fatigue

What drugs will be used to treat the client with CKD for mineral and bone disorder (select all that apply) a) cinacalcet (Sensipar) b) IV glucose & insulin c) calcium acetete (eliphos) d) IV 10% calcium gluconate) e) Sevelamer carbonate (renvela)

a) cinacalcet (Sensipar) c) calcium acetete (eliphos) e) Sevelamer carbonate (renvela)

What nursing measure would be included in the plan of care for a client with acute kidney injury? a) observe for signs of a secondary infection b) Provide a high protein, low carbohydrate diet c) in and out catheterization for residual urine d) encourage fluids to 2000 ml in 24 hours

a) observe for signs of a secondary infection

A post-op client is at risk for development of intra-renal failure. Which nursing action should be avoided when caring for this client? a) strict intake and output b) administration of I.V. 3% NSS c) vital signs every 30 minutes d) sequential comprehension device (SCD's)d

b) administration of I.V. 3% NSS

A client with acute kidney injury, determine if cause is pre-renal, intra-renal, or post-renal. the nurse understands that which one of the following most likely caused it? a) glomerulonephritis b) heart failure c) ureterolithiasis d) amino glycoside toxicity

b) heart failure

A 36 year old male patient is diagnosed with acute kidney injury. The patient is voiding 4 L/day of urine. What complication can arise based on the stage of AKI this patient is in? Select all that apply: a) water intoxication b) hypotension c) low urine specific gravity d) hypokalemia e) normal GFR

b) hypotension c) low urine specific gravity d) hypokalemia

The nurse is planning care for a client who is in the diuretic phase of acute kidney injury. The nurse includes all of the nursing diagnosis listed below in the clients care plan. Which does the nurse prioritize as the number 1 diagnosis? a) fluid volume deficit b) risk for electrolyte imbalance c) risk for hypotension d) risk for decrease osmolality

b) risk for electrolyte imbalance

A client on peritoneal dialysis notices that the collecting bag of dialysate is cloudy, what is this an indication of? a) medication was added to the dialysate b) the patient is infected and experiencing peritonitis c) the patient needs a kidney transplant d) the client needs to change their dialysate

b) the patient is infected and experiencing peritonitis

What does dialysate for PD routinely contain? a) calcium in lower concentration than blood b) sodium in higher concentration than the blood c) Dextrose in higher concentration than the blood d) electrolytes in an equal concentration to that of blood

c) Dextrose in higher concentration than the blood

Following report from the night shift, which client should the nurse plan to assess/collect data from first? a) client scheduled for a cardiac cauterization at 10 am b) client scheduled to have an electrocardiogram at 11 am c) client with pulmonary edema who was treated with furosemide at 5 am d) client newly diagnosed with diabetes mellitus who is scheduled for discharge home

c) client with pulmonary edema who was treated with furosemide at 5 am

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. Tipically, dialysis equilibrium syndrome causes: a) hypotension, tachycardia, and tachypnea b) acute bone pain and confusion c) confusion, headache, and seizures d) weakness, tingling, and cardiac dysrhythmias

c) confusion, headache, and seizures

____________is a treatment for renal failure in which blood is 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) hemodialysis b) continuous ambulatory peritoneal dialysis c) continuous renal replacement dialysis d) continuous cyclic peritoneal dialysis

c) continuous renal replacement dialysis

A client with a lacerated spleen has been on strict bed rest for several days. The nurse notes decreased breath sounds in the lower lobes of both lungs. What is the nurse's best explanation of this finding? The client has developed: a) Pulmonary edema related to immobility b) a cold because of decreased resistance c) decreased breath sounds due to atelectasis d) respiratory depression from pain medications

c) decreased breath sounds due to atelectasis

The nurse is caring for a hospitalized client with a diagnosis of heart failure who suddenly report shortness of breath and dyspnea. The nurse should take what immediate action? a) administer O2 to patient b) calls the health care provider c) elevates the head of the clients bed d) prepares to administer furosemide

c) elevates the head of the clients bed

Which patient should the nurse see first? a) surgery 2 hours ago; T 37.5, P 88, R 18, BP 138/84 b) cholecystectomy 4 hr ago; reporting pain level of 8 on a scale of 0-10. c) long leg cast applied 4 hours ago; reporting numbness of toes d) Reported nausea all day; not drinking or eating

c) long leg cast applied 4 hours ago; reporting numbness of toes

A client with AKI has a urinary output of 350 ml/day. In addition, morning labs showed increased BUN and creatinine levels along with a potassium level of 6 mEq/L. What type of diet ordered by the physician is most appropriate for this patient. a) low-sodium, high-protein, and low-potassium b) high-protein, low-potassium, and low-sodium c) low-protein, low-potassium, and low-sodium d) high-protein and high-potassium

c) low-protein, low-potassium, and low-sodium

A 55 year old male patient is admitted with a massive GI bleed. The patient is at risk for what type of acute kidney injury? a) post-renal b) intra-renal c) pre-renal d) intrinsic renal

c) pre-renal

The nurse is caring for patients in the ED. Which patient does the nurse see first? a) pt with abdominal pain b) pt with first degree burn c) pt with severe respiratory distress d) pt with chest pain due to ischemia

c) pt with severe respiratory distress

A 50 year old female is admitted to the ED with a diagnosis of acute MI. She tells the nurse, "I'm scared, I think I'm going to die." Which of the following responses by the nurse would be most appropriate? a) Everything is going to be fine. We'll take good care of you." b) "I know what you mean. I thought I was having a heart attack once." c) "Ill call your doctor, so you can discuss it." d) "Its normal to feel frightened. We're doing everything we can for you."

d) "Its normal to feel frightened. We're doing everything we can for you."