Question 1

A patient with acute kidney injury is demonstrating signs of gastrointestinal bleeding.The nurse would explain this bleeding to be secondary to which event?&#10;A)Low creatinine level&#10;B)Elevated potassium level&#10;C)Increased ammonia level&#10;D)Low calcium level&#10;

Accepted Answer

Increased ammonia level is associated with gastrointestinal bleeding in patients with acute kidney injury. Ammonia toxicity can lead to damage to the gastric mucosa and increase the risk of bleeding. Low creatinine level, elevated potassium level, and low calcium level are not typically associated with gastrointestinal bleeding in patients with acute kidney injury.

Question 2

A patient with chronic renal failure and a blood pressure of 158/98 mm Hg refuses to take medication for the blood pressure.What information should the nurse provide for this patient?&#10;A)&#34;One of the problems associated with high blood pressure in people with renal failure is the development of heart failure.&#34;&#10;B)&#34;Some people with chronic renal failure and high blood pressure end up with an infection around their heart.&#34;&#10;C)&#34;You must realize that untreated hypertension may cause you to develop pneumonia.&#34;&#10;D)&#34;There is a significant increase in risk for anemia if hypertension is not treated.&#34;&#10;

Accepted Answer

Chronic renal failure puts individuals at high risk for developing heart failure, and hypertension further increases this risk. It's important for the patient to understand this potential complication and the importance of managing their blood pressure to prevent it. The other answer choices are not accurate and may cause confusion or anxiety for the patient.

Question 3

The nurse is transferring to a high-acuity unit where many patients receive intermittent hemodialysis.Which patient characteristic would the nurse expect?&#10;A)Patients whose hemodynamic status requires slow removal of waste products&#10;B)Patients whose kidney injury will resolve since intermittent dialysis is only done temporarily&#10;C)Patients whose blood pressure and heart rate can be stabilized&#10;D)Patients who have few imbalances in electrolyte levels&#10;

Accepted Answer

Patients in a high-acuity unit receiving intermittent hemodialysis often have unstable conditions, including blood pressure and heart rate, which need to be stabilized during treatment.

Question 4

A patient's potassium level is 6.5 mEq/L.The nurse would prepare for which intervention?&#10;A)Administration of intravenous fluids supplemented with 40 mEq of potassium in each liter of fluid&#10;B)Administration of oral potassium 2 or 3 times daily until levels are normal&#10;C)Administration of Kayexalate&#10;D)Administration of a D50W bolus&#10;

Accepted Answer

A potassium level of 6.5 mEq/L indicates severe hyperkalemia, which can lead to cardiac dysrhythmias and cardiac arrest. Kayexalate is a medication that helps remove excess potassium from the body and is the most appropriate intervention in this situation. Intravenous fluids with potassium should not be given, as it would only exacerbate the hyperkalemia. Oral potassium is also contraindicated in this case. A D50W bolus would not be helpful in treating hyperkalemia.

Question 5

A patient in the intensive care unit is receiving continuous venovenous hemofiltration for acute kidney injury.In order for the nurse to successfully provide the treatment for the patient,what needs to occur?

A)Infusion of a dialysate through the hemofilter
B)Creation of a fistula
C)Connection to a small pump
D)Successful placement of the catheter in an artery and a vein

Accepted Answer

Continuous venovenous hemofiltration (CVVH) requires connection to a small pump to facilitate the movement of blood through the hemofilter, as it is a continuous renal replacement therapy that does not rely on arterial pressure.

Question 6

A patient who has acute kidney injury and who weighs 90 kg had a urine output of 25 mL over the last 12 hours.The nurse would place this patient in which RIFLE category?&#10;A)Injury&#10;B)Risk&#10;C)Failure&#10;D)Loss&#10;

Accepted Answer

According to the RIFLE criteria, a patient with acute kidney injury who has a urine output of less than 0.5 mL/kg/hour for more than 12 hours or less than 0.3 mL/kg/hour for more than 24 hours is placed in the Failure category. In this case, the patient's urine output over the last 12 hours was only 25 mL, which is significantly below the target of 810 mL (0.5 mL/kg/hour x 90 kg x 12 hours). Therefore, the patient would be placed in the Failure category.

Question 7

The nurse is assessing the integumentary system of a patient with chronic renal failure.Which findings would the nurse associate with this disease history? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Flushed,ruddy color
B)Yellow-brown hue
C)Areas of excoriation
D)Moist,clammy skin
E)Rubbery consistency

Accepted Answer

Chronic renal failure can lead to skin discoloration, such as a yellow-brown hue due to the accumulation of waste products in the blood. Areas of excoriation may also be present due to itching and scratching from uremia, which can result from the buildup of toxins in the body. Flushed, ruddy color would not be associated with chronic renal failure, and moist, clammy skin and rubbery consistency are not specific to this disease history.

Question 8

An older adult is scheduled for a CT scan with contrast.The nurse would anticipate preprocedure administration of which medication to help prevent renal damage?&#10;A)N-acetylcysteine&#10;B)Vitamin B12&#10;C)Intravenous infusion of 5% dextrose&#10;D)Vitamin D&#10;

Accepted Answer

N-acetylcysteine is an antioxidant commonly given prior to contrast media administration to help prevent renal damage, particularly in older adults with compromised renal function. Vitamin B12, intravenous infusion of 5% dextrose, and vitamin D are not indicated for preventing renal damage from contrast media.

Question 9

A patient diagnosed with kidney injury is on fluid restriction.Which nursing interventions should the nurse add to the patient's plan of care? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Provide all fluid in the form of ice chips.
B)Provide frequent oral care.
C)Allow the patient to decide when the fluid will be ingested.
D)Provide fluids only when the patient complains of thirst.
E)Consider the amount of fluids that can be provided over a shift.

Accepted Answer

- Providing frequent oral care can help alleviate the discomfort of dry mouth without adding to fluid intake, which is crucial for a patient on fluid restriction. Considering the amount of fluids that can be provided over a shift helps in planning and evenly distributing the restricted fluid intake throughout the day, ensuring the patient does not exceed their fluid limit.

Question 10

The nurse is assessing the neurological status of a patient with chronic renal failure.Which finding would the nurse attribute to chronic renal failure (CRF)?&#10;A)Numbness and pain of the lower extremities&#10;B)Expressive aphasia&#10;C)Flaccid paralysis on the left side&#10;D)Weak hand grasps&#10;

Accepted Answer

Chronic renal failure can lead to peripheral neuropathy, which often presents as numbness and pain in the lower extremities due to the accumulation of toxins that affect nerve function.

Question 11

A patient with an acute kidney injury is identified as being at risk for infection.Which nursing interventions are indicated? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Turn and reposition when necessary.
B)Avoid manipulation of venous access devices.
C)Post signs to remind visitors and staff to wash their hands.
D)Limit the use of antibiotic therapy.
E)Remove invasive devices as soon as medically possible.

Accepted Answer

The answer of A patient with an acute kidney injury...

Question 12

A patient's serum creatinine level is increasing,but the urine creatinine clearance is decreasing.How would the nurse evaluate these two findings?&#10;A)The patient may be experiencing the onset of heart failure.&#10;B)The patient will probably have associated hypokalemia.&#10;C)The patient is malnourished.&#10;D)There is a decrease in glomerular function.&#10;

Accepted Answer

The answer of A patient's serum creatinine level is increasing,but...

Question 13

A patient with an acute kidney injury is identified as being at risk for infection.Which nursing interventions are indicated? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Turn and reposition when necessary.
B)Avoid manipulation of venous access devices.
C)Post signs to remind visitors and staff to wash their hands.
D)Limit the use of antibiotic therapy.
E)Remove invasive devices as soon as medically possible.

Accepted Answer

The answer of A patient with an acute kidney injury...

Question 14

A patient's acute kidney injury is suspected of being of postrenal etiology.Which medical history would support this diagnosis? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)The patient has been taking nonsteroidal anti-inflammatory drugs (NSAIDs)for arthritis pain.
B)The patient was diagnosed with heart failure last week.
C)The patient reports having the "flu" with vomiting and diarrhea for the last 6 days.
D)The patient has large renal calculi in the kidney and ureter.
E)The patient was just diagnosed with prostate cancer.

Accepted Answer

The answer of A patient's acute kidney injury is suspected...

Question 15

A patient with acute kidney injury has a hemoglobin level of 9 mg/dL.How would the nurse explain this change to the patient?&#10;A)&#34;Your kidneys may not be making enough of a hormone that is required to build red blood cells.&#34;&#10;B)&#34;Since you are retaining so much fluid,your blood is more dilute.&#34;&#10;C)&#34;I am afraid you may have some bleeding we have not found as of yet.&#34;&#10;D)&#34;Your lungs are not exchanging oxygen as well as they should,so your body is not producing hemoglobin.&#34;&#10;

Accepted Answer

The answer of A patient with acute kidney injury has...

Question 16

A patient with reduced glomerular filtration has a blood pressure of 168/100 mm Hg.The nurse suspects which pathophysiological effect is occurring?&#10;A)Rebound hypertension due to fluid volume deficit&#10;B)Sluggish response by the renin-angiotensin system&#10;C)Kidneys hyper-excreting hydrogen ions&#10;D)Increased renin production causing the retention of water and electrolytes&#10;

Accepted Answer

The answer of A patient with reduced glomerular filtration has...

Question 17

A patient with acute kidney injury is receiving renal replacement therapy (CRRT).Which assessment finding would the nurse evaluate as best indicating this therapy is having its desired effects?&#10;A)The patient had a soft formed stool this morning.&#10;B)The patient's lung sounds have improved.&#10;C)The patient slept for 2 hours without awakening.&#10;D)The patient's serum protein level is normal.&#10;

Accepted Answer

The answer of A patient with acute kidney injury is...

Question 18

A patient with chronic renal failure is diagnosed with anemia.The nurse anticipates providing which therapy for this patient?&#10;A)Vitamin B12 injections&#10;B)Routine whole blood transfusions&#10;C)Recombinant erythropoietin supplementation&#10;D)Protein restriction&#10;

Accepted Answer

The answer of A patient with chronic renal failure is...

Question 19

A patient is receiving slow continuous ultrafiltration to treat an acute kidney injury.Which nursing assessment will this treatment specifically require?&#10;A)Electrolyte levels&#10;B)White blood cell count&#10;C)Appetite&#10;D)Urine output&#10;

Accepted Answer

The answer of A patient is receiving slow continuous ultrafiltration...

Question 20

A patient is scheduled for arteriovenous access continuous renal replacement therapy (CRRT).Which nursing intervention should the nurse add to the patient's plan of care? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Monitor the access site for leaking or hemorrhage.
B)Check settings on the external pump every 2 hours.
C)Monitor pulses in distal extremities.
D)Monitor for hemodynamic instability from rapid removal of water and wastes from the blood.
E)Monitor the tube for clotting.

Accepted Answer

The answer of A patient is scheduled for arteriovenous access...

Deck 27: Alterations in Kidney Function