3310 QUIZ 3 PRACTICE QUESTIONS
Which teaching point would the nurse include when providing education for a patient with chronic kidney disease (CKD)? "All patients with CKD eventually need renal replacement therapy." "CKD can occur suddenly over hours to days." "Acute kidney injury can occur in patients with CKD." "End-stage kidney disease has no impact on length of life."
"Acute kidney injury can occur in patients with CKD."
Which information would the nurse provide for the patient with diabetes and chronic kidney disease (CKD)? Select all that apply. One, some, or all responses may be correct. "Engage in 30 to 60 minutes of moderate-intensity exercise daily." "Use nonsteroidal antiinflammatory drugs (NSAIDs) for pain control." "Obtain yearly testing for urine albumin-to-creatinine ratio (UACR)." "Maintain tight control of blood glucose levels." "Smoking cessation is recommended."
"Engage in 30 to 60 minutes of moderate-intensity exercise daily." "Obtain yearly testing for urine albumin-to-creatinine ratio (UACR)." "Maintain tight control of blood glucose levels." "Smoking cessation is recommended."
Which teaching point about phosphate binders would the nurse include when providing education for a patient with chronic kidney disease (CKD)? "Take your phosphate binders on an empty stomach." "Take your phosphate binder more than 1 hour apart from your scheduled cardiac medications." "Phosphate binders may cause diarrhea." "Report any signs of muscle weakness or confusion."
"Report any signs of muscle weakness or confusion."
A MOTHER WHO IS BREASTFEEDING HER BABY RECEIVES INSTRUCTIONS FROM THE NURSE. WHICH INSTRUCTIONS ARE MOST EFFECTIVE IN PREVENTING NIPPLE SORENESS? (SELECT ALL THAT APPLY) A. Massage a small amount of medical-grade lanolin into the nipple. B. Increase nursing time gradually over several days. C. Ensure that the baby is positioned correctly for latching on. D. Manually express a small amount of milk before nursing. E. Wear a cotton bra with non binding support.
A. Massage a small amount of medical-grade lanolin into the nipple. C. Ensure that the baby is positioned correctly for latching on.
The healthcare provider is giving discharge instructions to the parents of an infant with a history of prematurity and low birth weight. Which of these instructions should be included to help prevent respiratory syncytial virus (RSV) infection? Select all that apply. A. Practice good hand hygiene B. Continue breastfeeding C. Avoid contact with sick individuals D. Obtain palivizumab immunization E. Use a humidifier in the baby's room
A. Practice good hand hygiene B. Continue breastfeeding C. Avoid contact with sick individuals
A 2-month-old child is admitted to the pediatric unit with a diagnosis of bronchiolitis. The child is lethargic and dehydrated. Which of the following should the healthcare provider monitor to assess hydration status? Select all that apply. A. Urine output B. Fontanels C. Emesis D. Skin turgor E. Digital clubbing F. Heart Rate
A. Urine output B. Fontanels C. Emesis D. Skin turgor F. Heart Rate
Which medication is used to terminate an acute episode of supraventricular tachycardia? Adenosine Dronedarone Digoxin Diltiazem
Adenosine
Which intervention would the nurse implement first for a patient experiencing ventricular fibrillation (VF)? Administer high-quality CPR. Administer normal saline bolus. Administer magnesium sulfate. Administer epinephrine.
Administer high-quality CPR.
Which laboratory test finding would be more commonly seen in chronic kidney disease (CKD) than in acute kidney injury (AKI)? Increased blood urea nitrogen (BUN) Increased creatinine Hyperkalemia Anemia
Anemia
Which cue may be seen as a result of chronic kidney disease (CKD)? Select all that apply. One, some, or all responses may be correct. Anemia Hypercalcemia Reduced immunity Uremic fetor Increased bleeding
Anemia Reduced immunity Uremic fetor Increased bleeding
Which antihypertensive medication is most effective at decreasing the risk of cardiovascular events among patients with chronic kidney disease (CKD) and hypertension? Calcium channel blockers Diuretics Angiotensin-converting enzyme inhibitors (ACEIs) Beta-adrenergic blockers
Angiotensin-converting enzyme inhibitors (ACEIs)
Which ECG findings wound the nurse expect in a patient diagnosed with atrial fibrillation (AF)? Atrial rate 80 bpm/regular ventricular rhythm Atrial rate 400 bpm/consistent ventricular rate Atrial rate 200 bpm/ventricular rate irregular and variable Atrial rate of 580 bpm/variable and irregular ventricular rate
Atrial rate of 580 bpm/variable and irregular ventricular rate
When providing care for a patient with chronic kidney disease (CKD), the nurse would monitor for which cue at least every 4 hours during critical illness? Select all that apply. One, some, or all responses may be correct. Auscultation of crackles Elevated blood pressure Dependent edema Decreased oxygen saturation Rapid, bounding pulse
Auscultation of crackles Elevated blood pressure Dependent edema Decreased oxygen saturation Rapid, bounding pulse
To obtain more information about the client's current status, which questions are a priority for the nurse to ask family? (Select all that apply. One, some, or all options may be correct.) A. "Do you have any other children?" B. "Have you offered fluids other than formula?" C. "What was the client's last weight?" D. "Has the client completed all their immunizations?" E. "How many hours does the client normally sleep each day?"
B. "Have you offered fluids other than formula?" C. "What was the client's last weight?"
The healthcare provider is planning care for a child with a diagnosis of bronchiolitis. Which of the following interventions should be included in the child's plan of care? A. Performing chest physiotherapy B. Drawing blood for blood cultures C. Administering a cough suppressant D. Promoting hydration and nutrition
D. Promoting hydration and nutrition
What intravenous fluids does the nurse anticipate for initial rehydration? A. Dextrose 5% in water at 25 mL/hour B. Dextrose 5% lactated ringers as a 150 mL bolus over 30 minutes C. Dextrose 5% in sodium chloride 0.9% + 20 meq KCL/L at 75 mL/hour D. Sodium chloride 0.9% as 100 mL bolus over 20 minutes
D. Sodium chloride 0.9% as 100 mL bolus over 20 minutes
Which cue has been associated with nonadherence to chronic kidney disease (CKD) treatments? Sleep disturbances Depression Fatigue Low appetite
Depression
Which action would the nurse perform first when the patient's continuous electrocardiogram (ECG) monitoring records asystole? Notify the patient's family. Call for help and begin cardiopulmonary resuscitation (CPR). Call the rapid response team. Determine level of consciousness.
Determine level of consciousness.
During hemodialysis, which type of fluid is used to help remove waste products from the blood? Sodium citrate Ultrafiltrate Dialysate Normal saline
Dialysate
Which commonly used drug therapy can darken the stools of patients with chronic kidney disease (CKD)? Sevelamer Ferrous sulfate Calcitriol Epoetin alfa
Ferrous sulfate
For a patient with acute kidney injury (AKI) that does not require dialysis, which food or fluid component should be restricted? Select all that apply. One, some, or all responses may be correct. Foods that are high in sodium Foods high in potassium High-fat foods High-protein foods Oral liquids
Foods that are high in sodium Foods high in potassium High-protein foods Oral liquids
Which item on a patient's meal tray would meet the dietary recommendations of a low-protein, low-sodium, low-potassium diet for a patient with chronic kidney disease (CKD)? Select all that apply. One, some, or all responses may be correct. Beef steak Salt substitutes Plain baked potato Fresh garden peas Iceberg lettuce salad with oil and vinegar
Fresh garden peas Iceberg lettuce salad with oil and vinegar
Which lab value is accepted as the best overall indicator of kidney function? Glomerular filtration rate (GFR) Blood urea nitrogen (BUN) Insulin-like growth factor binding protein 7 (IGFBP-7) Tissue injury metalloproteinase 2 (TIMP-2)
Glomerular filtration rate (GFR)
Which diagnostic test is performed if an immunologic disease is suspected as the cause of acute kidney injury (AKI)? Ultrasonography Kidney biopsy X-ray Computed tomography (CT) scan
Kidney biopsy
Which advantage does the long-term dialysis catheter have when compared with the temporary dialysis catheter? Easier to insert Lower risk of infection Does not require dressing changes Smaller
Lower risk of infection
Which medication is a class II beta blocker? Metoprolol Quinidine Amiodarone Diltiazem
Metoprolol
Which condition may cause cardiac dysrhythmias? Myocardial infarction electrolyte imbalances hypervolemia drug toxicity hypoxia
Myocardial infarction electrolyte imbalances drug toxicity hypoxia
Which patient history information would a nurse expect for a patient diagnosed with ventricular fibrillation (VF)? Hypokalemia Myocardial ischemia Prolonged QT interval Deep vein thrombus (DVT)
Myocardial ischemia
Which medication or substance is considered nephrotoxic? Select all that apply. One, some, or all responses may be correct. Naproxen Ceftriaxone Vancomycin Metformin Ethylene glycol
Naproxen Vancomycin Metformin Ethylene glycol
For the patient who just received contrast medium during an imaging test, which cue would the nurse associate with an acute kidney injury (AKI)? New-onset peripheral edema Urine output of 150 mL/hr for the first 6 hours after the imaging test Stable daily weight Creatinine increased by 0.1 mg/dL
New-onset peripheral edema
Which electrocardiogram (ECG) change would be expected in a patient with atrial fibrillation? No clear P waves Inverted T waves Widened QRS complex Present U waves
No clear P waves
Which complication of chronic kidney disease (CKD) might a patient have when presenting with CKD and a bone fracture? Osteomalacia Osteosarcoma Hyponatremia Hypercalcemia
Osteomalacia
Which potential side effect of loop diuretics increases with kidney impairment? Ototoxicity Respiratory depression Hypotension Constipation
Ototoxicity
Which factor explains why a patient with a history of myocardial infarction (MI) should be monitored closely when premature ventricular contractions (PVCs) are seen on the ECG strip? PVCs may develop into atrial fibrillation. PVCs may develop into a junctional rhythm. PVCs may develop into ventricular tachycardia. PVCs may develop into a first-degree heart block.
PVCs may develop into ventricular tachycardia.
Which symptom might a patient with tachydysrhythmia present with? Select all that apply. One, some, or all responses may be correct. Palpitations Chest discomfort Restlessness and anxiety Warm flushed skin Syncope
Palpitations Chest discomfort Restlessness and anxiety Syncope
Which complication of chronic kidney disease (CKD) would the nurse suspect for the patient with a pericardial friction rub? Heart failure Pericarditis Renin-angiotensin aldosterone system (RAAS) dysfunction Hypertension
Pericarditis
Which condition is a possible indication for kidney replacement therapy (KRT)? pH of 7.3 Serum potassium level of 5.5 mEq/L Pericarditis Hypovolemia
Pericarditis
Which education would a nurse provide to a patient with an implantable cardioverter-defibrillator (ICD)? -Wear tight clothing or a belt over the generator for support. -Avoid using or proximity to microwave ovens. -Place cell phone on the opposite side of the body from the device. -Notify the health care provider after receiving several shocks.
Place cell phone on the opposite side of the body from the device.
Which action is taken during stage 4 chronic kidney disease (CKD)? Implement renal replacement therapy. Prepare for renal replacement therapy. Screen for risk factors for CKD. Increase fluid intake.
Prepare for renal replacement therapy.
Match each category of acute kidney injury (AKI) with a potential cause. Match each option below to proceed to the next question. 1. Prerenal cause Scleroderma Liver failure Bladder cancer 2. Intrarenal cause Scleroderma Liver failure Bladder cancer 3. Postrenal cause Scleroderma Liver failure Bladder cancer
Prerenal -Liver failure Intrarenal -Scleroderma Postrenal -Bladder cancer
To help manage the patient's diagnosis of chronic kidney disease (CKD) and renal osteodystrophy, the nurse would recommend limiting intake of which nutritional food group? Select all that apply. One, some, or all responses may be correct. Protein Calcium Fats/lipids Phosphorus Carbohydrates
Protein Phosphorus
Which condition is considered a complication of acute kidney injury (AKI)? Hypotension Pulmonary edema Jaundice Hypercalcemia
Pulmonary edema
Which patient is at risk of developing acute kidney injury (AKI) due to an intrarenal cause? Select all that apply. One, some, or all responses may be correct. Receiving treatment with aminoglycosides Admitted for benign prostatic hypertrophy Undergoing magnetic resonance imaging (MRI) of the brain with contrast Admitted with gastrointestinal losses from nausea and diarrhea Admitted for treatment of systemic lupus erythematosus
Receiving treatment with aminoglycosides Undergoing magnetic resonance imaging (MRI) of the brain with contrast Admitted for treatment of systemic lupus erythematosus
Which nursing action would be most appropriate for a patient with a urine output of less than 30 mL/hr for the past 2 hours? Report finding to the health care provider immediately. Continue to monitor urine output for the next 4 hours to assess for oliguria. Encourage the patient to drink more fluids. Administer vancomycin as ordered.
Report finding to the health care provider immediately.
Which complication is associated with cardiopulmonary resuscitation (CPR)? Select all that apply. One, some, or all responses may be correct. Rib fractures Pneumothorax Hemothorax Lung contusions Bowel perforation
Rib fractures Pneumothorax Hemothorax Lung contusions
Which condition can cause prerenal acute kidney injury (AKI)? Contrast dye exposure Septic shock Prostate cancer Lupus
Septic Shock
Which cue might suggest blood volume overload for a patient with chronic kidney disease (CKD)? Select all that apply. One, some, or all responses may be correct. Shortness of breath at night Third heart sound (S3) Fever Hypertension Encephalopathy
Shortness of breath at night Third heart sound (S3) Hypertension
Which kidney replacement therapy (KRT) modality may be used for a patient with a fluid overload and a normal blood urea nitrogen (BUN) level? Sustained low-efficiency dialysis (SLED) Slow continuous ultrafiltration (SCUF) Continuous venovenous hemofiltration (CVVH) Continuous venovenous hemodiafiltration (CVVHDF)
Slow continuous ultrafiltration (SCUF)
Which action by the nurse may result in sinus bradycardia? Suctioning Wound irrigation Applying supplemental oxygen Turning and repositioning
Suctioning
Which symptoms would the nurse assess for in a patient with sustained supraventricular tachycardia (SVT)? Select all that apply. One, some, or all responses may be correct. Hypertension Syncope Shortness of breath Palpitations Chest pain
Syncope Shortness of breath Palpitations Chest pain
Which statement describes the location of the transcutaneous pacing pulse generator and electrodes? -Two large external electrodes attached to an external pulse generator -An external battery-operated pulse generator with pacing electrodes to the right ventricle -Surgical implantation of a pulse generator with leads threaded into the right side of the heart through the cephalic or subclavian vein -Leads are tunneled under the skin and placed into the left of the sternum at a right angle below the xiphoid process and attached to the generator.
-Two large external electrodes attached to an external pulse generator
The nurse would assess for a variation in which component to evaluate fluid responsiveness in a patient with acute kidney injury (AKI) and who receives a 500 mL bolus of normal saline? Select all that apply. One, some, or all responses may be correct. Systolic pressure Core body temperature Pulse pressure Stroke volume Urine output
Systolic pressure Pulse pressure Stroke volume
The parents of an infant with a history of nasal congestion, mild cough, and a temperature of 100.4 F 38 C call the clinic to ask what treatments are recommended for their child. Which of the following should be included in the teaching plan? Select all that apply. A. "Give your child a baby aspirin every 4-6 hours." B. "Make sure your child gets plenty of fluids." C. "You may you some saline nose drops and a bulb syringe to help clear the nose." D. "Our office will call in a prescription antibiotic for you to pick up." E. "Be sure to keep your child away from secondhand smoke."
B. "Make sure your child gets plenty of fluids." C. "You may you some saline nose drops and a bulb syringe to help clear the nose." E. "Be sure to keep your child away from secondhand smoke."
WHICH MEASURE MAY PREVENT MASTITIS IN THE BREASTFEEDING MOTHER? A. Initiating early and frequent feedings B. Nursing the infant for 5 minutes on each breast C. Wearing a tight-fitting bra D. Applying ice packs before feeding
A. Initiating early and frequent feedings
A 9-month-old infant with a history of fever and nasal congestion is admitted with a diagnosis of bronchiolitis. During the admission assessment, which of these assessment findings should the healthcare provider expect? A. A barky, seal-like cough B. A pruritic rash on the chest C. Restlessness or lethargy D. A high fever and chills
C. Restlessness or lethargy
A 4-month-old infant has not been feeling well for 2 days. Which number on the image identifies the area of the infant's head where the nurse can assess for dehydration? A. 1 B. 2 C. 3 D. 4 E. 5
C: 3
Which complication is associated with carotid sinus massage? Ventricular fibrillation (VF) Heart block Atrial fibrillation Sinus tachycardia
Ventricular fibrillation (VF)
Which factor is a common cause of fatigue among patients with chronic kidney disease (CKD)? Select all that apply. One, some, or all responses may be correct. Vitamin deficiency Hyperglycemia Anemia Uremia Hypokalemia
Vitamin deficiency Anemia Uremia
The nurse assesses a woman's episiotomy or perineal laceration using the acronym REEDA What factors does this include? (Select all that apply.) a. Redness b. Edema c. Approximation d. Depth e. Discharge
a. Redness b. Edema c. Approximation e. Discharge
Which patient has the highest risk of developing complications from acute kidney injury (AKI)? a)Sustaining a fracture of the tibia b)Being NPO before surgery c)Receiving antihypertensive medications d)Admitted for treatment of chronic obstructive pulmonary disease (COPD)
b)Being NPO before surgery
Which occurrence of premature complexes would be represented on an electrocardiogram (ECG) as a consistent alternating normal complex and a premature complex? -Bigeminy -Quadrigeminy -Trigeminy -hexageminy
bigeminy
Which cue may indicate fluid overload for the patient with an acute kidney injury (AKI)? Mean arterial pressure below 65 mm Hg Thready peripheral pulses Increased blood osmolality Pulmonary crackles
pulmonary crackles
Which side effect may occur after the administration of adenosine?
short period of asystole
Which drug is prescribed for patients with septic shock but not with hypovolemic shock? • Milrinone • Hydrocortisone • Sodium nitroprusside • Phenylephrine hydrochloride (HCL)
• Hydrocortisone
Which interventions should the nurse prioritize for a patient experiencing acute renal failure? (Select all that apply) •A. Administering ordered diuretics •B. Monitoring electrolytes and kidney function tests •C. Encouraging increased fluid intake •D. Educating the patient about dialysis options
•A. Administering ordered diuretics •B. Monitoring electrolytes and kidney function tests •D. Educating the patient about dialysis options
•Which laboratory value is typically identified among patients with acute kidney injury (AKI)? •Select all that apply. One, some, or all responses may be correct. •Increased serum phosphorus •Increased arterial blood pH •Increased serum creatinine •Decreased serum potassium •Decreased blood osmolality
•Increased serum phosphorus •Increased serum creatinine
Which explanation of systolic heart failure demonstrates an understanding of the condition? Select all that apply. One, some, or all responses may be correct. "The ventricle loses compliance over time, so it requires more pressure to perform work." "Systolic HF happens when the heart cannot squeeze hard enough to pump blood efficiently." "Preload increases with increased muscle contractility." "Cardiac output is increased, overwhelming the peripheral vascular system." "The heart has trouble relaxing, so the ventricle cannot fill properly." "Systolic heart failure may manifest in pulmonary and systemic congestion."
"Systolic HF happens when the heart cannot squeeze hard enough to pump blood efficiently." "Systolic heart failure may manifest in pulmonary and systemic congestion."
For the patient with stage 4 chronic kidney disease (CKD), the nurse would include which teaching point related to taking opioids for acute pain? "The effects of this medication may last longer than if you did not have kidney impairment." "Because the kidneys metabolize opioids, we will need to decrease the dose of opioids." "When taking opioids, high potassium levels can increase risk for respiratory depression." "Nonsteroidal antiinflammatory drugs (NSAIDs) are preferred over opioids for pain control."
"The effects of this medication may last longer than if you did not have kidney impairment."
Which chronic kidney disease (CKD) teaching point would the nurse include when providing education for a patient with diabetes? "The recommended volume to drink is 2 to 3 L of any fluid per day." "Pain or burning with urination is normal with a diagnosis of CKD." "The interval recommended to have your kidney function checked is once per year." "Most nonprescription drugs are safe for patients with CKD to take."
"The interval recommended to have your kidney function checked is once per year."
Which teaching point about the active form of vitamin D would the nurse include for a patient with chronic kidney disease (CKD)? "The kidney is no longer activating vitamin D, which will prevent calcium from being absorbed." "Vitamin D is activated in the gut and is required for calcium absorption by the kidney." "The kidney is no longer activating vitamin D, which will increase calcium levels in the blood." "Active-form vitamin D is required for the kidney to reabsorb calcium. As the kidney fails, it cannot absorb calcium."
"The kidney is no longer activating vitamin D, which will prevent calcium from being absorbed."
Which health teaching by the nurse accurately describes why a patient with atrial fibrillation (AF) is required to take warfarin? "Warfarin will reduce the occurrences of irregular heart rate." "Warfarin will increase blood perfusion to the heart and treating the underlying cause of your atrial fibrillation." "Warfarin is a blood thinner to prevent stroke and blood clots." "Warfarin is required to maintain a stable blood pressure and prevent heart damage."
"Warfarin is a blood thinner to prevent stroke and blood clots."
Which teaching point would the nurse include for a patient with diabetes, worsening chronic kidney disease (CKD), and who takes insulin in addition to metformin? "Monitor your blood glucose levels once a day and at the same time." "The effects of metformin may be decreased as CKD progresses." "Insulin is the only antidiabetic drug that may need a dosage change." "You may need to reduce your insulin and metformin dosage as your CKD progresses."
"You may need to reduce your insulin and metformin dosage as your CKD progresses."
Which teaching point about dietary and fluid restrictions would the nurse include for a patient receiving peritoneal dialysis? "You will need to restrict your potassium intake more than you would if you were receiving hemodialysis." "A low prealbumin level indicates that your protein intake is adequate." "Your daily fluid intake should be 500 to 700 mL/day plus the amount of your urine output." "Your daily intake of protein (meat and eggs) should be 1.2 to 1.5 g/kg/day."
"Your daily intake of protein (meat and eggs) should be 1.2 to 1.5 g/kg/day."
A NURSE IS DISCUSSING THE SIGNS AND SYMPTOMS OF MASTITIS WITH A MOTHER WHO IS BREASTFEEDING. WHAT SIGNS AND SYMPTOMS SHOULD THE NURSE INCLUDE IN HER DISCUSSION? (SELECT ALL THAT APPLY) A. Breast tenderness B. Warmth in the breast C. An area of redness on the breast often resembling the shape of a pie wedge D. A small white blister on the tip of the nipple E. Fever and flu like symptoms
A. Breast tenderness B. Warmth in the breast C. An area of redness on the breast often resembling the shape of a pie wedge E. Fever and flu like symptoms
A BREASTFEEDING POSTPARTUM CLIENT IS DIAGNOSED WITH MASTITIS, AND ANTIBIOTIC THERAPY IS PRESCRIBED. WHICH INSTRUCTION SHOULD THE NURSE PROVIDE TO THIS CLIENT? A. Breastfeed the infant, ensuring that both breasts are completely emptied. B. Feed expressed breast milk to avoid the pain of the infant latching onto the infected breast. C. Breastfeed on the unaffected breast only until the mastitis subsides. D. Dilute expressed breast milk with sterile water to reduce the antibiotic effect on the infant.
A. Breastfeed the infant, ensuring that both breasts are completely emptied.
The nurse is assessing an infant with diarrhea and vomiting who is at risk for dehydration. Which of the following assessments would indicate moderate to severe dehydration? (Select all that apply) A. Capillary refill greater than 2 seconds B. Flat anterior fontanelle C. Tachycardia D. Decreased skin turgor E. Rapid respiratory rate
A. Capillary refill greater than 2 seconds C. Tachycardia D. Decreased skin turgor E. Rapid respiratory rate
Which complications should the nurse monitor for in a pediatric patient with dehydration? (Select all that apply) A. Electrolyte imbalances B. Hypovolemic shock C. Constipation D. Hyperglycemia
A. Electrolyte imbalances B. Hypovolemic shock
The nurse is teaching a client's family about the client's diagnosis of septic shock. Which of the following teachings will the nurse include? Select all that apply. A. "The blood cultures will tell us for sure if your loved one has septic shock." B. "The client's change in behavior and lethargy may be associated with septic shock." C. "Antibiotics, as prescribed, will be started within the hour to treat the sepsis." D. "An insulin drip has been started to keep the client's glucose as low as possible." E. "Septic shock is easily treated with multiple antibiotics."
B. "The client's change in behavior and lethargy may be associated with septic shock." C. "Antibiotics, as prescribed, will be started within the hour to treat the sepsis."
Which clinical symptoms in a postoperative client indicate early sepsis with an excellent recovery rate if treated? A. Reduced urinary output and increased respiratory rate B. Low-grade fever and mild hypotension C. Low oxygen saturation rate and decreased cognition D. Localized erythema and edema
B. Low-grade fever and mild hypotension
The nurse is teaching a class on the management of sepsis. What teaching will the nurse include regarding the Hour-1 sepsis management bundle? (Select all that apply.) A. Measure fibrinogen levels. B. Measure lactate levels. C. Initiate insulin therapy according to blood glucose levels. D. Administer broad spectrum antibiotics. E. Begin rapid administration of crystalloids for hypotension. F. A bundle is a group of two or more interventions that has been shown to be effective when applied in a sequence.
B. Measure lactate levels. D. Administer broad spectrum antibiotics. E. Begin rapid administration of crystalloids for hypotension. F. A bundle is a group of two or more interventions that has been shown to be effective when applied in a sequence.
For which cue would the nurse assess next after discovering a patient with chronic kidney disease (CKD) who has a potassium level of 7.0 mEq/L? Urine output Cardiac rhythm Level of consciousness Chvostek and Trousseau signs
Cardiac rhythm
Which action would the nurse take while performing cardiopulmonary resuscitation on a patient in cardiac arrest? Lean into the chest after each compression. Ensure two breaths are given after 30 compressions. Pause compressions for 15 to 20 seconds. Change out compressors every 2 minutes.
Change out compressors every 2 minutes.
For patients with chronic kidney disease (CKD), which potential complication occurs from hyperkalemia? Edema Bone density loss Metastatic calcifications Changes in cardiac rhythm
Changes in cardiac rhythm
Which comorbidity is often associated with a patient with chronic kidney disease (CKD)? Cushing disease Diabetes insipidus Hemochromatosis Chronic hypertension
Chronic hypertension
Which type of kidney replacement therapy (KRT) is indicated for a critically ill patient with acute kidney injury (AKI) and an unstable blood pressure? Hemodialysis Peritoneal dialysis Continuous kidney replacement therapies (CKRTs) Plasmapheresis
Continuous kidney replacement therapies (CKRTs)
Which laboratory value is used to determine the stage of chronic kidney disease (CKD)? Blood urea nitrogen (BUN) level Glomerular filtration rate (GFR) Creatinine clearance Urinalysis
Creatinine clearance
Which complication of chronic kidney disease (CKD) may need emergent treatment with dialysis? Anemia Osteodystrophy Ecchymosis Encephalopathy
Encephalopathy
Which nursing action would be necessary when caring for a patient who is not following an appropriate diet for chronic kidney disease (CKD)? Encourage the patient to keep appointments with the dietitian. Remind the patient about the educational pamphlets provided for diet suggestions. Explain that the diet is only short term and encourage patient to continue to adhere to the diet. Tell the patient to increase fluid intake if unable to follow the provided dietary guidelines.
Encourage the patient to keep appointments with the dietitian.
Which pathology is a common cause of heart failure? Cancer Hypertension Liver congestion Low ejection fraction (EF)
Hypertension
Which condition results in sinus tachycardia due to increased sympathetic stimulation? Heart failure Dehydration Myocardial infarction (MI) Hyperthyroidism
Hyperthyroidism
Which mechanism does the body use to compensate for heart failure? Select all the that apply. One, some, or all responses may be correct. Hypertrophy of the myocardium Renin-angiotensin system (RAS) activation Inflammation of the myocardium Decreased blood pressure Stimulation of the sympathetic nervous system
Hypertrophy of the myocardium Renin-angiotensin system (RAS) activation Stimulation of the sympathetic nervous system
Which cue would the nurse tell a patient with chronic kidney disease (CKD) to report immediately? Select all that apply. One, some, or all responses may be correct. Increasing lethargy Shortness of breath Increase in appetite Weight change from 145 lbs to 150 lbs Development of headaches or dizziness
Increasing lethargy Shortness of breath Weight change from 145 lbs to 150 lbs Development of headaches or dizziness
Which teaching point would the nurse include when providing education about dysrhythmias? Provide the names of over-the-counter medications. Inform the patient of available resources for blood pressure and pulse checks. Teach the patient to drink caffeinated beverages early in the day. Instruct the patient to record symptoms in a weekly medical log.
Inform the patient of available resources for blood pressure and pulse checks.
Which finding would be consistent with stage 3 acute kidney injury (AKI)? Select all that apply. One, some, or all responses may be correct. Serum creatinine 2 to 2.9 times baseline Initiation of renal replacement therapy Urine output <0.5 mL/kg/hr for 6 to 12 hr Increase in serum creatinine to ≥4.0 mg/dL Patients <18 years old: Decrease in eGFR to <35 mL/min/1.73 m2
Initiation of renal replacement therapy Increase in serum creatinine to ≥4.0 mg/dL Patients <18 years old: Decrease in eGFR to <35 mL/min/1.73 m2
Which hospital location is most common for initial acute kidney injury (AKI) management? Intensive care unit (ICU) Medical-surgical floor Telemetry floor Oncology floor
Intensive care unit (ICU)
Which mechanism occurs in the heart during ventricular tachycardia (VT)? The sinus node discharges rapidly resulting in ventricular depolarization. Irritable ventricular ectopic focus repetitively fires due to increase automaticity or a reentry mechanism. Hypermagnesemia results in ventricular irritability and greater threshold for action in the ventricles. Multiple rapid impulses from many atrial foci depolarize the atria at a rate of 150 to 300 times per minute.
Irritable ventricular ectopic focus repetitively fires due to increase automaticity or a reentry mechanism.
Which laboratory abnormality may cause pruritus among patients with chronic kidney disease (CKD)? Uremia Hyperglycemia Anemia Elevated urine albumin-to-creatinine ratio (UACR)
Uremia
Which nursing action would help decrease the risk of a pathologic fracture for a patient with chronic kidney disease (CKD)? Use a lift sheet to reposition the patient. Schedule giving the patient's phosphate binders on an empty stomach. Encourage the patient to avoid antacids with magnesium. Monitor the patient's daily weights at the same time every day.
Use a lift sheet to reposition the patient.
Which patient education is appropriate for a patient with ischemic heart disease? Treat an angina attack with rest and take nitroglycerin as prescribed. Eat foods high in potassium, such as tomatoes, beans, prunes, and avocados. Avoid bearing down or straining during a bowel movement. Stimulating your gag reflex can contribute to dysrhythmia.
Treat an angina attack with rest and take nitroglycerin as prescribed.
Which imaging test is commonly used first to screen for hydronephrosis? Ultrasonography Computed tomography (CT) scan without contrast X-ray Cystoscopy
Ultrasonography
