AKI/CKD/ESRD questions Flashcards

1
Q

which is a prerenal cause of AKI?
A. Acute glomerulonephritis and neoplasms
B. Septic shock and nephrotoxic injury from medications
C. Pyelonephritis and calculi formation
D. Hypovolemia and myocardial infarction

A

D. Hypovolemia and myocardial infarction

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2
Q

When the patient is in the diuretic phase of AKI, the nurse must monitor which serum electrolyte imbalance ?

A. Hypokalemia and hyponatremia
B. Hypokalemia and Hypernatremia
C. Hyperkalemia and Hyponatremia
D. Hyperkalemia and Hypernatremia

A

B. Hypokalemia and Hypernatremia

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3
Q

The risk factor or factors most often associated with CKD include which of the following ? SATA

A. HTN
B. Diabetes mellitus
C. Malnutrition
D. Peripheral vascular disease
E. Smoking

A

A. HTN
B. Diabetes mellitus

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4
Q

the nurse understands that cod is characterized by which of the following ?

A. A rapid decrease in urine output with CKD - elevated BUN
B. Progressive , Irreversible destruction to the kidneys
C. Abrupt increasing creatinine clearance with a decrease in urinary output.
D. confusion an somnolence leading to coma and death

A

B. Progressive , Irreversible destruction to the kidneys

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5
Q

the nurse understands that CRRT is indicated for which of the following patients ?
A. a hospitalized but hemodynamically stable client
B. a hospitalized , hemodynamically unstable patient
C. a hospitalized ESRD patient being discharged home soon
D. A hospitalized ESRD patient who is stable but in an ICU setting

A

B. a hospitalized , hemodynamically unstable patient

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6
Q

a nurse is planning care for a client who has prerenal acute kidney injury following abdominal aortic aneurysm repair. Urinary output is 60ml is the past 2 hrs and blood pressure is 92/58. the nurse should expect which of the following interventions?

A. prepare the client for CT scan without contrast dye
B. plan to administer nitroprusside
C. prepare to administer fluid exchange
D. plan to position the client in trendelenburg

A

C. prepare to administer fluid exchange

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7
Q

a nurse is planning care for a client who has post renal AKI due to metastatic cancer. the client has a blood creatinine of 5mg/dl. which of the following interventions should the nurse plan to include in the plan? SATA

A. provide a high protein diet
D. assess the urine for blood
C. monitor for intermittent anuria
D. weight the client once per week
E. provide NSAIDS for pain

A

A. provide a high protein diet
D. assess the urine for blood
C. monitor for intermittent anuria

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8
Q

A nurse is planning care for a client who has Stage 4 CKD. which of the following actions should the nurse include in the plan of care?
SATA

A. assess for jugular vein distention
B. provide frequent mouth rinses
C. auscultate for pleural friction rub
D. provide a high sodium diet
E. monitor for dysrhythmias

A

A. assess for jugular vein distention
B. provide frequent mouth rinses
C. auscultate for pleural friction rub
E. monitor for dysrhythmias

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9
Q

a nurse is reviewing client laboratory data. which of the following findings is expected for a client who has stage 4 CKD

A. BUN 15
B. GFR 20
C. Blood Creatinine 1.1
D. Potassium 5.0

A

B. GFR 20

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10
Q

a nurse is assessing a client who has prerenal AKI. Which of the following findings should the nurse expect
SATA

A. Reduced BUN
B. Elevated Cardiac enzymes
C. reduced urine output
D. Elevated blood creatinine
E. Elevated blood calcium

A

C. reduced urine output
D. Elevated blood creatinine

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11
Q

a client with AKI has a serum potassium level of 7.0. the nurse should plan which actions as a Priority ? SATA

A. place the client on a cardiac monitor
B. notify the HCP
C. put the client on NPO except for ice chips
D. review the clients medications to determine if any contain or retain potassium
E. allow an extra 500 ml of IV fluid intake to dilute the electrolyte concentration

Nclex q706

A

A. place the client on a cardiac monitor
B. notify the HCP
D. review the clients medications to determine if any contain or retain potassium

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12
Q

a client being hemodialyzed becomes Short of breath and complains of chest pain. the client is tachycardic, pale and anxious and the nurse suspect air embolism. what are the priority nursing actions ? SATA

A. administer oxygen to the client
B. continue dialysis at a slower rate after checking the lines for air
C. notify the HCP Nad rapid response team
D. stop dialysis and turn the client on the left side with head lower than the feet
E. bolus the client with 500 ml of NS to break up air embolism

Nclex q.707

A

A. administer oxygen to the client
C. notify the HCP and rapid response team
D. stop dialysis and turn the client on the left side with head lower than the feet

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13
Q

the nurse is assessing the potency of a client’s left arm arteriovenous fistula prior to initiating hemodialysis. which finding indicates that the fistula is patent

A. palpation of thrill over the fistula
B. presence of radial pulse in the left wrist
C. visualization of enlarged blood vessels at the fistula site
D. capillary refill less than 3 seconds in the nail beds of the fingers on the left hand

Nclex q.711

A

A. palpation of thrill over the fistula

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14
Q

the nurse monitoring a client receiving PD notes that the clients outflow is less than the inflow. which actions should the nurse take?
SATA

A. check the level of the drainage bag
B. reposition the client to his or her side
C. contact the HCP
D. place the client in a good body alignment
E. check the PD system for kinks
F. increase the flow rate of the PD solution

Nclex q 716

A

A. check the level of the drainage bag
B. reposition the client to his or her side
D. place the client in a good body alignment
E. check the PD system for kinks

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15
Q

a hemodialysis client with a left arm fistula is at risk for arterial steal syndrome. the nurse should assess for which manifestations of this complication?

A. warmth , redness, and pain in the left hand
B. ecchymosis and audible bruit over the fistula
C. edema and reddish discoloration of the left arm
D. pallor, diminished pulse and pain in the left hand

Nclex q 717

A

D. pallor, diminished pulse and pain in the left hand

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16
Q

the nurse is reviewing a clients record and notes that the health care provider has documented that the client has chronic renal disease. on review of the laboratory results , the nurse most likely would expect to note which finding ?

A. elevated creatinine level
B. decreased HGB level
C. decreased red blood cell count
D. increased number of white blood cells in the urine

Nclex q.718

A

A. elevated creatinine level

17
Q

a client with chronic kidney disease returns to the nursing unit following a hemodialysis treatment on assessment the nurse notes that the clients temp is 101.2 . which nursing action is most appropriate ?

A. encourage fluid intake
B. notify the HCP
C. continue to monitor vitals
D. monitor the site of the shunt for infection

Nclex q 719

A

B. Notify the HCP

18
Q

the nurse is performing an assessment on a client who has returned form the dialysis unit following HD. the client is complaining of headache and nausea and is extremely restless. which is the priority nursing action?

A. monitor the client
B. elevate the head of the bed
C. assess the fistula site and dressing
D. notify the HCP

Ncle q 720

A

D. notify the HCP

19
Q

the nurse is instructing a client with diabetes mellitus about peritoneal dialysis. the nurse tells the client that it is important to maintain the prescribed dwell time for the PD because if the risk of which complications ?

A. peritonitis
B. hyperglycemia
C. hyperphosphatmia
D. Disequilibrium syndrome

NCLEX q. 722

A

B. hyperglycemia

20
Q

A week after kidney transplantation a client develops a temperature of 101. The BP is elevated and there is tenderness over the transplanted kidney. the serum creatinine is rising and urine output is decreased. the X-ray indicates that the kidney is enlarged. based on these assessment findings , the nurse anticipates which treatment ?

A. antibiotic therapy
B. peritoneal dialysis
C. removal of the transplanted kidney
D. increased immunosuppressive therapy

Nclex q.723

A

D. increased immunosuppressive therapy

21
Q

the client is newly diagnosed with chronic kidney disease recently begun hemodialysis. knowing that the client is at risk for Disequilibrium syndrome , the nurse should assess the client during dialysis for which associated manifestation?

A. Hypertension , tachycardia , and fever
B. Hypotension, bradycardia and hyponatremia
C. restlessness, irritability and generalized weakness
D. headache, deteriorating level of consciousness and twitching

Nclex q 725

A

D. headache, deteriorating level of consciousness and twitching

22
Q
A