Deck 46: Acute Kidney Injury and Chronic Kidney Disease

Question 1

How should the nurse respond when a patient asks how he could have chronic kidney disease (CKD) when he has not had symptoms of the disease?

A) "Symptoms of CKD are often vague."
B) "CKD comes on suddenly."
C) "Your current urinary tract infection may have caused your CKD."
D) "You must have had symptoms that you did not report."

Answer 1

"Symptoms of CKD are often vague."

Question 2

Which findings would the nurse utilize to identify the level of acute kidney injury in a patient?

A) Blood urea nitrogen levels
B) Ratio of fluid intake to fluid output
C) Blood pressure readings
D) Serum creatinine levels and urinary output

Answer 2

Serum creatinine levels and urinary output

Question 3

When the nurse is assessing the glomerular filtration rate (GFR) of a patient, which method is more accurate when the patient's GFR is normal or mildly decreased?

A) Cockcroft-Gault equation
B) Modification of Diet in Renal Disease
C) Chronic Kidney Disease-Epidemiology Collaboration
D) RIFLE

Answer 3

Chronic Kidney Disease-Epidemiology Collaboration

Question 4

When assessing acute kidney injury in the pediatric population using the pRIFLE criteria, the nurse observes which parameters?

A) Serum creatinine levels
B) Changes in glomerular filtration rate
C) Blood urea nitrogen levels
D) Urinary output

Question 5

When planning care for a patient with heart failure, the nurse keeps in mind that this condition may lead to:

A) prerenal AKI.
B) intrinsic AKI.
C) postrenal AKI.
D) glomerulonephritis.

Question 6

The nurse should expect to assess which laboratory value in the patient with prerenal acute kidney disease?

A) Low urine sodium concentration
B) High fractional excretion of sodium
C) High fractional excretion of urea
D) Low urine osmolality

Question 7

Which intervention should be included in the nursing plan of care for a patient with prerenal acute kidney injury?

A) Provide intravenous fluids.
B) Administer antihypertensive medication.
C) Limit fluid intake.
D) Prepare for dialysis.

Question 8

Which concept should the nurse keep in mind when developing a plan of care for the patient with intrinsic acute kidney injury (AKI)?

A) This condition is potentially and easily reversible.
B) This condition in not reversible.
C) This condition may not result in prompt recovery.
D) This condition is caused by chronic kidney disease.

Question 9

The nurse assessing a patient with acute interstitial nephritis is most likely to note which findings?

A) Lymphocytopenia
B) Leukocytosis
C) Neutropenia
D) Eosinophilia

Question 10

Which finding should the nurse expect when assessing the patient with acute kidney injury?

A) Peripheral neuropathy
B) Enlarged kidney
C) Normal hemoglobin
D) Bone pain

Question 11

While admitting a patient with acute kidney injury, the patient reports to the nurse that he has had no urinary output during the last 24 hours. Which of the following would the nurse record in the medical record?

A) The patient is anuric.
B) The patient is oliguric.
C) The patient is nonoliguric.
D) The patient has a normal GFR.

Question 12

The urinalysis of a patient with acute interstitial nephritis is likely to have which characteristics?

A) Hematuria with red blood cell casts, dysmorphic red blood cells, proteinuria
B) Leukocyturia with leukocyte casts or urinary eosinophils
C) Renal tubular epithelial cells and muddy brown casts
D) Few cells with little or no casts or proteinuria

Question 13

The nurse is performing risk assessments for chronic kidney disease (CKD) at a community health fair. Which concept should guide the assessments?

A) African Americans have a higher incidence of CKD than Caucasians.
B) Caucasians have a higher incidence of CKD than Native Americans.
C) Non-Hispanics have a higher incidence of CKD than Hispanics.
D) African Americans progress more slowly to end-stage renal disease than the general population.

Question 14

Which response by a patient with chronic kidney disease indicates to the nurse that more teaching about the disease is needed?

A) "CKD can cause me to have a high blood count."
B) "CKD can progress quickly to ESRD."
C) "Bone fractures may occur."
D) "I need to modify my risk factors for cardiovascular disease."

Question 15

Which laboratory value alerts the nurse that a patient is in stage 3 of chronic kidney disease (CKD)?

A) GFR > 90 mL/min/1.73m²
B) GFR 60-89 mL/min/1.73m²
C) GFR 30-59 mL/min/1.73m²
D) GFR 15-29 mL/min/1.73m²

Question 16

When assessing a patient for modifiable risk factors for chronic kidney disease, the nurse should ask which question?

A) "What is your age?"
B) "Do you use NSAIDs?"
C) "Were you born prematurely?"
D) "Do you have a family history of kidney disease?"

Question 17

Which finding would alert the nurse that a patient with diabetes may be in the early stages of developing diabetic nephropathy?

A) Albuminuria
B) Increased glomerular filtration rate
C) Hypotension
D) Cardiac disease

Question 18

Which assessment data is the nurse likely to observe in a patient with chronic kidney disease?

A) Serum creatinine of 0.7 mg/dL
B) BUN:creatinine ratio of 10:1
C) Serum phosphorous of 3.1 mg/dL
D) Parathyroid hormone of 62 pg/mL

Question 19

Which physician order should the nurse question on a patient with hyperkalemia secondary to chronic kidney disease?

A) Renal replacement therapy
B) Administration of a potassium-sparing diuretic
C) Discontinuing ACE inhibitors
D) Administering potassium binders

Question 20

The nursing plan of care for a patient with stage 4 chronic kidney disease (CKD) includes:

A) controlling blood pressure and diabetes.
B) treating hyperphosphatemia.
C) cardiovascular risk reduction.
D) preparation for renal replacement therapy.