NSG 252 - Fluid and Electrolytes Practice Questions

The client with polycystic kidney disease asks the nurse, "Will my kidneys ever function normally again?" The best response by the nurse is: A) "As the disease progresses, you will most likely require renal replacement therapy." B) "Dietary changes can reverse the damage that has occurred in your kidneys." C) "Draining of the cysts and antibiotic therapy will cure your disease." D) "Genetic testing will determine the best treatment for your condition."

A) "As the disease progresses, you will most likely require renal replacement therapy."

The health care provider has ordered a urinalysis for a normally healthy client admitted to the hospital with dehydration. The client has been vomiting for the past 3 days and has had minimal oral intake. Upon analysis of the results, the urine specific gravity reflects: A) 1.040 B) 1.001 C) 1.010 D) 1.025

A) 1.040

Which of the following is a term used to describe excessive nitrogenous waste in the blood, as seen in acute glomerulonephritis? A) Azotemia B) Proteinuria C) Hematuria D) Bacteremia

A) Azotemia

The nurse is completing a routine urinalysis using a dipstick. The test reveals an increased specific gravity. The nurse should suspect which condition? A) Decreased fluid intake B) Increased fluid intake C) Glomerulonephritis D) Diabetes insipidus

A) Decreased fluid intake

When the nurse notes that, after cardiac surgery, the client demonstrates low urine output (less than 25 mL/h) with high specific gravity (greater than 1.025), the nurse suspects which condition? A) Inadequate fluid volume B) Normal glomerular filtration C) Overhydration D) Anuria

A) Inadequate fluid volume

A nurse is reviewing the mechanisms of action of diuretics. Which diuretic is the most effective? A) Loop diuretics B) Thiazide diuretics C) Aldosterone agonists D) Osmotic diuretics

A) Loop diuretics

A 40-year-old client is admitted to the hospital after experiencing 3 days of extreme vomiting. The doctor reviews the lab results and notes that the hemoglobin and hematocrit are elevated. What is the likely cause of these abnormal lab findings? A) Manifestation of dehydration B) Increased production of red cells by the body C) Extreme blood loss D) Normal consequence of aging

A) Manifestation of dehydration

The nurse has identified a collaborative problem of Risk for Complications of Electrolyte Imbalance for a client with diarrhea. The client begins to exhibit a decrease in level of consciousness. What is the nurse's most appropriate action? A) Notify the health care provider for additional orders. B) Document the client's level of consciousness. C) Consult with another nurse to validate the assessment. D) Decrease stimulation and allow the client to rest.

A) Notify the health care provider for additional orders.

Phosphate excretion is impaired in chronic kidney disease (CKD), resulting in high serum phosphate levels and the development of phosphate crystals. Which manifestation of hyperphosphatemia should the nurse assess for? A) Pruritus B) Asterixis C) Azotemia D) Uremia

A) Pruritus

The nurse knows that which clinical manifestations may be present with the diagnosis of acute nephritic syndrome? Select all that apply. A) Sudden onset of hematuria B) Proteinuria C) Flank pain D) Excess urine output E) Edema

A) Sudden onset of hematuria B) Proteinuria E) Edema

A 44-year-old client is being treated for dehydration in an acute care hospital. The nurse determines that the rehydration treatment is working by assessing which values? A) Urine output of 1500 mL in 24 hours B) An elevated hematocrit level C) An elevated urine specific gravity D) Oral intake of 1500 mL in 24 hours

A) Urine output of 1500 mL in 24 hours

Which measure would the nurse expect to be included in the plan of care for an infant of a mother with diabetes who has a serum calcium level of 6.2 mg/dl (1.55 mmol/l)? A) administration of calcium gluconate B) initiation of phototherapy C) infusions of intravenous glucose D) initiation of oral feedings

A) administration of calcium gluconate

A client is admitted for treatment of chronic renal failure (CRF). The nurse knows that this disorder increases the client's risk of: A) water and sodium retention secondary to a severe decrease in the glomerular filtration rate. B) a decreased serum phosphate level secondary to kidney failure. C) an increased serum calcium level secondary to kidney failure. D) metabolic alkalosis secondary to retention of hydrogen ions.

A) water and sodium retention secondary to a severe decrease in the glomerular filtration rate.

The most accurate indicator of fluid loss or gain in an acutely ill client is: A) blood pressure. B) weight. C) pulse rate. D) edema.

B) weight.

An investment banker with chronic renal failure informs the nurse of the choice for continuous cyclic peritoneal dialysis. Which is the best response by the nurse? A) "The risk of peritonitis is greater with this type of dialysis." B) "This type of dialysis will provide more independence." C) "Peritoneal dialysis will require more work for you." D) "Peritoneal dialysis does not work well for every client."

B) "This type of dialysis will provide more independence."

A 91-year-old client, who is being prepared for discharge, has been prescribed the diuretic spironolactone. While teaching the client about the drug, what major adverse effect should the nurse be sure to mention? A) Hypokalemia B) Hyperkalemia C) Angina D) Hypertension

B) Hyperkalemia

A client with chronic kidney disease becomes confused and reports abdominal cramping, racing heart rate, and numbness of the extremities. The nurse relates these symptoms to which lab value? A) Elevated urea levels B) Hyperkalemia C) Hypocalcemia D) Elevated white blood cells

B) Hyperkalemia

What is a characteristic of the intrarenal category of acute kidney injury (AKI)? A) Decreased creatinine B) Increased BUN C) High specific gravity D) Decreased urine sodium

B) Increased BUN

A client is prescribed digitalis medication. Which condition should the nurse closely monitor when caring for the client? A) Vasculitis B) Nausea and vomiting C) Flexion contractures D) Enlargement of joints

B) Nausea and vomiting

The nurse cares for a client with acute kidney injury (AKI). The client is experiencing an increase in the serum concentration of urea and creatinine. The nurse determines the client is experiencing which phase of AKI? A) Initiation B) Oliguria C) Diuresis D) Recovery

B) Oliguria

A patient with a history of poorly controlled type 1 diabetes has begun displaying the characteristic signs and symptoms of diabetic nephropathy. The patient's nurse recognizes that the patient is at risk of disruptions to fluid balance. What role do the kidneys play in the maintenance of normal fluid balance? A) Secreting or withholding antidiuretic hormone in response to extracellular fluid volume B) Selectively retaining needed substances and excreting waste products C) Synthesizing and releasing angiotensin in cases of fluid volume deficit D) Maintaining the correct concentration of H+ ions in the blood

B) Selectively retaining needed substances and excreting waste products

When trying to explain to a client on dialysis the movement of substances through the capillary pores, the nurse will explain that in the kidneys, the glomerular capillaries have: A) no capillary openings since this would lead to extensive hemorrhage. B) Small openings that allow large amounts of smaller molecular substances to filter through the glomeruli. C) Large pores so that substances can pass easily through the capillary wall. D) Endothelial cells that are joined by tight junctions that form a barrier to medication filtration.

B) Small openings that allow large amounts of smaller molecular substances to filter through the glomeruli.

The nurse is caring for a client who has produced an average of 20 mL/hour for the previous day. The nurse recognizes this compares in which way to the normal urine output? A) This represents normal urinary output for 24 hours. B) The kidneys should produce about 1.5 L of urine each day. C) The kidneys should produce a minimum of 10 mL/hr over one day. D) The normal kidney produces an average 3000 mL of urine daily.

B) The kidneys should produce about 1.5 L of urine each day.

A client receiving peritoneal dialysis in the home is suspected of having peritonitis. Which finding should the nurse expect to assess in this client? Select all that apply. A) weight loss B) hypotension C) extreme thirst D) abdominal pain E) rebound tenderness

B) hypotension D) abdominal pain E) rebound tenderness

For which client would epoetin alfa NOT be indicated? A) A client with a hemoglobin of 8, who is asymptomatic. B) A client with a hemoglobin of 11, with shortness of breath. C) A client with a hemoglobin of 12, with shortness of breath. D) A client with a hemoglobin of 10, who is asymptomatic.

C) A client with a hemoglobin of 12, with shortness of breath.

A client with a diagnosis of chronic renal failure secondary to diabetes has seen a gradual increase in her blood pressure over the past several months, culminating in a diagnosis of secondary hypertension. Which factor has most likely resulted in the client's increased blood pressure? A) Coarctation of the aorta B) Increased levels of adrenocortical hormones C) Activation of the renin-angiotensin-aldosterone mechanism D) Increased sympathetic stimulation by the autonomic nervous system

C) Activation of the renin-angiotensin-aldosterone mechanism

When teaching a class of nursing students, the pathophysiology instructor asks, "What is the majority of energy used for by the kidney?" Which response is most accurate? A) Filtration of drugs out of the body. B) Secretion of erythropoietin for production of red blood cells. C) Active sodium transport mechanisms. D) Removal of excess glucose from the blood.

C) Active sodium transport mechanisms.

A client with chronic renal failure (CRF) is admitted to the urology unit. Which diagnostic test results are consistent with CRF? A) Increased pH with decreased hydrogen ions B) Increased serum levels of potassium, magnesium, and calcium C) Blood urea nitrogen (BUN) 100 mg/dL and serum creatinine 6.5 mg/dL D) Uric acid analysis 3.5 mg/dL and phenolsulfonphthalein (PSP) excretion 75%

C) Blood urea nitrogen (BUN) 100 mg/dL and serum creatinine 6.5 mg/dL

When describing the functions of the kidney to a client, which of the following would the nurse include? A) Regulation of white blood cell production B) Synthesis of vitamin K C) Control of water balance D) Secretion of enzymes

C) Control of water balance

An older adult client with high blood pressure is prescribed a thiazide diuretic. What should the nurse expect to happen to this client's potassium and calcium levels? A) Potassium and calcium levels will not change. B) Potassium and calcium levels will both go down. C) Potassium level will drop, but calcium level may rise. D) Potassium level will rise, but calcium level may drop.

C) Potassium level will drop, but calcium level may rise.

Client and family education regarding peritoneal dialysis should include assessing the client for: A) bleeding around the arteriovenous fistula or an external arteriovenous shunt. B) signs and symptoms of hypoglycemia such as weakness, irritability, and shakiness. C) dehydration that may appear as dry mucous membranes or poor skin turgor. D) muscle cramps associated with hypoparathyroidism.

C) dehydration that may appear as dry mucous membranes or poor skin turgor.

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]

D) Administration of sodium polystyrene sulfonate [Kayexalate]

The client with chronic renal failure complains of intense itching. Which assessment finding would indicate the need for further nursing education? A) Pats skin dry after bathing B) Uses moisturizing creams C) Keeps nails trimmed short D) Brief, hot daily showers

D) Brief, hot daily showers

A nurse working on a cardiac unit knows that monitoring magnesium levels is important for which reason? A) Magnesium is essential for replication and transcription of DNA. B) Magnesium is essential for membrane stabilization and nerve conduction. C) Magnesium acts as a cofactor in many intracellular enzyme reactions. D) Hypomagnesemia causes intracellular potassium depletion, creating risk for cardiac dysrhythmias.

D) Hypomagnesemia causes intracellular potassium depletion, creating risk for cardiac dysrhythmias.

A client with acute kidney failure is placed on fluid restriction of 1000 mL of fluid over a 24-hour period. What is the priority nursing action? A) Eliminate the liquids between meal times. B) Divide the fluids equally among the three 8-hour nursing shifts. C) Notify the dietary department of a clear fluids order. D) Offer the client proportioned fluids in the day and less during the night.

D) Offer the client proportioned fluids in the day and less during the night.

A client admitted with a gunshot wound to the abdomen is transferred to the intensive care unit after an exploratory laparotomy. IV fluid is being infused at 150 mL/hour. Which assessment finding suggests that the client is experiencing acute renal failure (ARF)? A) Blood urea nitrogen (BUN) level of 22 mg/dl B) Serum creatinine level of 1.2 mg/dl C) Temperature of 100.2° F (37.8° C) D) Urine output of 250 ml/24 hours

D) Urine output of 250 ml/24 hours