NUR 202 Module 6 Quiz

Which findings would the nurse anticipate when reviewing the laboratory reports of a client with an acute kidney injury? Select all that apply. 1. Calcium: 7.6 mg/dL (1.9 mmol/L) 2. Calcium: 10.5 mg/dL (2.6 mmol/L) 3. Potassium: 6.0 mEq/L (6.0 mmol/L) 4. Potassium: 3.5 mEq/L (3.5 mmol/L) 5. Creatinine: 3.2 mg/dL (194 mcmol/L) 6. Creatinine: 1.1 mg/dL (90 mcmol/L)

1, 3, 5 A client with acute kidney injury will have a low calcium level, a high potassium level, and an elevated creatinine level.

Which action would the nurse take before a client's scheduled hemodialysis treatment? 1. Obtain the client's urine specimen to evaluate kidney function. 2. Weigh the client to establish a baseline for later comparison. 3. Administer medications that are scheduled to be given within the next hour. 4. Explain that the peritoneum serves as a semipermeable membrane to remove wastes.

2 A baseline weight must be obtained to be able to determine the net fluid loss from dialysis. Obtaining a urine specimen to evaluate kidney function is not necessary; clients with advanced kidney disease may not produce urine. Medications often are delayed until after dialysis to prevent them from being filtered into the dialysate. Explaining that the peritoneum serves as a semipermeable membrane to remove wastes applies to peritoneal dialysis, not hemodialysis.

A client with acute kidney injury states, "Why am I experiencing twitching and tingling of my fingers and toes?" Which process would the nurse consider when formulating a response to this client? 1. Acidosis 2. Calcium depletion 3. Potassium retention 4. Sodium chloride depletion

2 In kidney failure, as the glomerular filtration rate decreases, phosphorus is retained. As hyperphosphatemia occurs, calcium is excreted. Calcium depletion hypocalcemia causes tetany, which causes twitching and tingling of the extremities, among other symptoms. Acidosis, potassium retention, and sodium chloride depletion are not characterized by twitching and tingling of the extremities.

A client with hepatitis B (HBV) develops cirrhosis and is hospitalized. One potential sequela of chronic liver disease is fluid and electrolyte imbalance. The nurse determines that this may be attributed to a decrease in serum albumin level. Which condition results from this imbalance? 1. Hemorrhage with subsequent anemia 2. Diminished resistance to bacterial insult 3. Malnutrition of cells, especially hepatic cells 4. Reduction of colloidal osmotic pressure in the blood

4 Albumin is an essential component of the bloodstream that helps maintain both osmotic pressure and fluid and electrolytes. This is not a cause of hemorrhage. Blood components such as platelets, thrombin, and erythrocytes are involved in the prevention of hemorrhage or anemia. Diminished resistance to bacterial insult is not involved directly with immunity and resistance. Blood components, such as T and B lymphocytes, are involved in this process; the liver synthesizes specific proteins intrinsic to the function of antibodies. The serum albumin level is not related to nutrition of cells.

A client is admitted to the hospital for acute pancreatitis. The nurse obtains the client's vital signs, performs a physical assessment, and reviews the client's health history. Which intervention is the priority? 1. Reduce environmental stimuli 2. Continue to monitor the vital signs 3. Initiate constant observation 4. Assess for alcohol withdrawal symptoms

4 Further assessment is indicated. Alcohol is a central nervous system depressant that will result in rebound agitation with increased temperature, pulse, respiratory rate, and blood pressure in the presence of acute abstinence. Additional signs/symptoms include tremulousness, agitation, lack of appetite, nausea, vomiting, insomnia, impaired cognition, and mild perceptual changes. Psychotic symptoms (i.e., hallucinations) may begin in 8 to 10 hours, and there are risks of unconsciousness, seizures, and delirium. The health care provider should be notified of the client's status. Reducing environmental stimuli is necessary because the client is in a neurologically irritable and hypermetabolic state. Initiating constant observation and monitoring vital signs are required because alcohol withdrawal can develop into a medical emergency.