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N120 Quiz2 Dong > Chapter 44 > Flashcards

Chapter 44 Flashcards

1
Q
  1. You are caring for a patient with acute renal failure. What is the most common clinical manifestation of acute renal failure?
A

A. Decrease in BUN
B. Anuria
C. Oliguria
D. Decrease in serum creatinine

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2
Q
  1. The nurse is working on the renal transplant unit. To reduce the risk of infection in a patient with a transplanted kidney, it is imperative for the nurse to do what?
A

A. Wash hands carefully and frequently.
B. Ensure immediate function of the donated kidney.
C. Instruct the patient to wear a face mask.
D. Restrict visitors.

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3
Q
  1. The nurse is caring for a patient receiving hemodialysis treatments. The patient has had surgery to form an arteriovenous fistula. What is most important for the nurse to be aware of when providing care for this patient?
A

A. Using a stethoscope for auscultating the fistula is contraindicated.
B. The patient feels best immediately after the dialysis treatment.
C. Taking a blood pressure reading on the affected arm can cause clotting of the fistula.
D. The patient shouldn’t feel pain during initiation of dialysis.

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4
Q
  1. A patient has a glomerular filtration rate (GFR) of 43 mL/min/1.73 m2. Based upon this GFR, the nurse interprets that the patient’s chronic kidney disease is at what stage?
A

A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4

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5
Q
  1. A patient admitted with nephrotic syndrome is being cared for on your unit. When writing this patient’s care plan, based upon the major clinical manifestation of nephrotic syndrome, what nursing diagnosis would you include?
A

A. Constipation related to immobility
B. Risk for injury related to altered thought processes
C. Hyperthermia related to the inflammatory process
D. Excess fluid volume related to generalized edema

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6
Q
  1. The nurse coming on shift is taking a report on four patients. What patient does the nurse know is at the greatest risk of developing end-stage renal disease (ESRD)?
A

A. History of polycystic kidney disease
B. Diabetes mellitus with poorly controlled hypertension
C. History of vascular disorders
D. History of respiratory infections

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7
Q
  1. A patient waiting for a kidney transplant asks the nurse what signs and symptoms most likely indicate rejection. What would be the nurse’s best response?
A

A. “Oliguria is a sign of rejection.”
B. “Shortness of breath is a sign of rejection.”
C. “Decreasing blood pressure is a sign of rejection”
D. “Weight loss is a sign of rejection.”

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8
Q
  1. The nurse is caring for a patient in acute renal failure. The nurse should expect hypertonic glucose, insulin infusions, and sodium bicarbonate to be used to treat:
A

A. Hypernatremia.
B. Hypokalemia.
C. Hyperkalemia.
D. Hypercalcemia.

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9
Q
  1. Renal failure can have prerenal, renal, or postrenal causes. A patient presents with acute renal failure and is being assessed to determine where, physiologically, the cause is. If the cause is found to be prerenal, which condition most likely caused it?
A

A. Heart failure
B. Glomerulonephritis
C. Ureterolithiasis
D. dAminoglycoside toxicity

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10
Q
  1. A 45-year-old man with diabetic nephropathy has end-stage renal failure and is starting dialysis. He asks for information about hemodialysis. What would the nurse include in the teaching for this patient?
A

A. Hemodialysis is a treatment option that is required three times a week.
B. Hemodialysis is a treatment option that is required daily.
C. You will have surgery and a catheter will need to be inserted into the abdomen.
D. Hemodialysis is a treatment that is used for a few months until your kidney heals and starts to produce urine again.

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11
Q
  1. A patient is receiving patient education prior to beginning continuous ambulatory peritoneal dialysis. What would the nurse teach the patient that the most common complication associated with this procedure is?
A

A. Peritonitis
B. Blood loss
C. Constipation
D. Dehydration

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12
Q
  1. The nurse is planning patient teaching for a patient with end-stage renal disease who is scheduled for the creation of a fistula. The nurse would include which of the following in teaching the patient about the fistula?
A

A. A vein and an artery in your arm will be attached surgically.
B. The arm should be immobilized for 4 to 6 weeks.
C. One needle will be inserted into the fistula for each dialysis treatment.
D. The fistula can be used immediately after the surgery for dialysis treatment.

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13
Q
  1. A patient with ESRD is scheduled for his first hemodialysis treatment. The patient asks the nurse what common complications may occur from the treatment. What would be the nurse’s best reply?
A

A. “High blood sugar levels and low protein levels may occur.”
B. “Excessive bleeding and double vision may occur.”
C. “Confusion and diarrhea may occur.”
D. “Hypotension and cramping may occur.”

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14
Q
  1. A living organ donor is 1 hour postoperative after donating a kidney. The critical care nurse caring for the patient notes that the patient is clammy and pale. The nurse knows the patient is exhibiting symptoms of what?
A

A. Urinary retention
B. Shock
C. Increased blood pressure
D. Normal symptoms of anesthetic administration

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15
Q
  1. A patient is scheduled for a CT scan of the abdomen with contrast. The patient has a baseline creatinine of 2.3 mg/dL. In preparing this patient for the procedure, the nurse anticipates what orders?
A

A. Monitor the patient’s electrolyte values every hour before the procedure
B. Preprocedure hydration and administration of acetylcysteine
C. Hemodialysis immediately prior to the CT scan
D. Obtain a creatinine clearance by collecting a 24-hour urine specimen

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16
Q
  1. The nurse caring for a patient with acute glomerulonephritis would expect the patient’s urine to what?
A

A. Have a cola-color
B. Have fibrinous threads
C. Contain renal calculi
D. Be copious in amount

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17
Q
  1. A specific disease process is a major cause of CKD and ESRD. It is a disease that develops usually after prolonged hypertension and diabetes. What disease process is this?
A

A. Azotemia
B. Nephrosclerosis
C. Glomerulonephritis
D. Nephritic syndrome

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18
Q
  1. A 16-year-old is admitted to the renal unit with a diagnosis of postinfectious glomerular disease. What is a cause of postinfectious glomerular disease?
A

A. Viral tonsillitis that precedes the onset of glomerulonephritis by 4 to 6 weeks
B. Staphylococcal infection of the sinuses that precedes the onset of glomerulonephritis by 3 to 4 weeks
C. Group A beta-hemolytic streptococcal infection of the throat that precedes the onset of glomerulonephritis by 5 to 6 weeks
D. Group A beta-hemolytic streptococcal infection of the throat that precedes the onset of glomerulonephritis by 2 to 3 weeks

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19
Q
  1. A patient presents at the walk-in clinic complaining of edema around the eyes and flank tenderness bilaterally. Acute glomerular inflammation is suspected. What tests would the nurse expect to be ordered to confirm the diagnosis?
A

A. CBC
B. Urinalysis
C. BUN
D. Creatinine

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20
Q
  1. The nurse is caring for a patient with chronic glomerulonephritis. What can cause chronic glomerulonephritis?
A

A. Epstein-Barr virus
B. Atherosclerosis
C. Repeated episodes of acute nephritic syndrome
D. Hypertensive encephalopathy

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21
Q
  1. What disease of the kidney is genetic in nature and leads to kidney failure?
A

A. Nephritic syndrome
B. Acute glomerulonephritis
C. Nephrotic syndrome
D. Polycystic kidney disease

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22
Q
  1. A patient is brought to the renal unit from the PACU status post resection of a renal tumor. What would be a priority nursing action in the care of this patient?
A

A. Increase oral intake
B. Management of postoperative pain
C. Decrease urine output
D. Increase mobility

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23
Q
  1. A nurse is caring for a renal patient in the dieresis period of ARF. What must the patient be observed closely for during this phase?
A

A. Hyperkalemia
B. Hypocalcimia
C. Dehydration
D. Hypervolemia

24
Q
  1. A 71-year-old patient has ESRD and has been told by the physician that it is time to consider hemodialysis until a transplant can be found. The patient tells the nurse she is not sure she wants to undergo a kidney transplant. What would be an appropriate response for the nurse to make?
A

A. “The decision is certainly yours to make, just don’t make the wrong one.”
B. “Kidney transplants in patients your age are as successful as they are in younger patients.”
C. “I understand your hesitancy to commit to a transplant surgery. It is not as successful as it is in younger people.”
D. Have you talked this over with your family?”

25
Q
  1. Peritonitis is a common and dangerous complication of peritoneal dialysis. What is a nursing action that helps these patients fight peritonitis?
A

A. Green’s stain is used to identify the invading organism.
B. Drainage fluid is cultured to eradicate the organism.
C. Aminoglycosides are added to the dialysate for subsequent exchanges.
D. Cephalosporins are given intravenously.

26
Q
  1. The critical care nurse is monitoring her patient’s urine output and drainage from tubes inserted intraoperatively. What would the nurse promptly report to the physician?
A

A. Increased pain on movement
B. Absent drainage
C. Increased urine output
D. Blood-tinged serosanguineous drainage

27
Q
  1. You are writing a teaching plan for a patient you are caring for status post resection of a renal tumor. What would you include in that teaching plan?
A

A. Postsurgical hygiene
B. Signs and symptoms of rejection
C. To inspect and care for the incision
D. Post surgical urine retention

28
Q
  1. A patient, status post resection of renal tumor, is being discharged home. You are planning discharge for this patient. What would you include in a teaching plan for this patient?
A

A. Emotional support
B. Need for dialysis
C. Recurrence of cancer
D. Continuing care

29
Q
  1. A critical care nurse is caring for a trauma patient who has gone into acute renal failure. The critical care nurse knows that he can set up, initiate, maintain, and terminate what system of dialysis for this patient?
A

A. Continuous ambulatory peritoneal dialysis
B. Continuous venovenous hemofiltration
C. Continuous venovenous hemodialysis
D. Peritoneal dialysis (PD)

30
Q
  1. The most accurate indicator of fluid loss or gain in an acutely ill patient is:
A

a. blood pressure.
b. capillary refill.
c. serum sodium levels.
d. weight.

31
Q
  1. The nurse notes that a patient who is retaining fluid had a 1-kg weight gain. The nurse knows that this is
    equivalent to about:
A

a. 250 mL.
b. 500 mL.
c. 750 mL.
d. 1,000 mL.

32
Q
  1. A patient is admitted with electrolyte imbalance. He has carpopedal spasm, ECG changes, and a positive
    Chvostek’s sign. The nurse suspects a deficit of:
A

a. calcium.
b. magnesium.
c. phosphorus.
d. sodium.

33
Q
  1. Acute glomerulonephritis refers to a group of kidney diseases in which there is:
A

a. an inflammatory reaction.
b. an antigen–antibody reaction to streptococci
that results in circulating molecular complexes.
c. cellular complexes that lodge in the glomeruli
and injure the kidney.
d. a combination of all of the above.

34
Q
  1. In most cases, the major stimulus to acute glomerulonephritis is:
A

a. Escherichia coli.
b. group A streptococcal infection of the throat.
c. Staphylococcus aureus.
d. Neisseria gonorrhoeae.

35
Q
  1. Laboratory findings consistent with acute glomerulonephritis include all of the following except:
A

a. hematuria.
b. polyuria.
c. proteinuria.
d. white cell casts.

36
Q
  1. Chronic glomerulonephritis is manifested by:
A

a. anemia secondary to erythropoiesis.
b. hypercalcemia and decreased serum
phosphorus.
c. hypokalemia and elevated bicarbonate.
d. metabolic alkalosis.

37
Q
  1. The major manifestation of nephrotic syndrome is:
A

a. hematuria.
b. hyperalbuminemia.
c. edema.
d. anemia.

38
Q
  1. A clinical diagnosis of nephrotic syndrome is consistent with an exceedingly high level of:
A

a. albumin.
b. low-density lipoproteins.
c. protein in the urine.
d. serum cholesterol.

39
Q
  1. Acute renal failure (ARF) caused by parenchymal damage to the glomeruli or kidney tubules results in all
    of the following except:
A

a. decreased GFR.
b. increased urine’s specific gravity.
c. impaired electrolyte balance.
d. progressive azotemia.

40
Q
  1. Oliguria is a clinical sign of ARF that refers to a daily urine output of:
A

a. 1.5 L.
b. 1.0 L.
c. less than 400 mL.
d. less than 50 mL.

41
Q
  1. A fall in CO2-combining power and blood pH indicates what state accompanying renal function?
A

a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis

42
Q
  1. Hyperkalemia is a serious electrolyte imbalance that occurs in ARF and results from:
A

a. protein catabolism.
b. electrolyte shifts in response to metabolic
acidosis.
c. tissue breakdown.
d. all of the above.

43
Q
  1. Potassium intake can be restricted by eliminating high-potassium foods such as:
A

a. butter.
b. citrus fruits.
c. cooked white rice.
d. salad oils.

44
Q
  1. A patient with ARF and negative nitrogen balance is expected to lose about:
A

a. 0.5 kg/day.
b. 1.0 kg/day.
c. 1.5 kg/day.
d. 2.0 kg/day.

45
Q
  1. The leading cause of end-stage renal disease is:
A

a. diabetes mellitus.
b. hypertension.
c. glomerulonephritis.
d. toxic agents.

46
Q
  1. A patient with stage 3, chronic renal failure would be expected to have:
A

a. a GFR of 90 mL/min/1.73 m2.
b. a GFR 30 to 59 mL/min/1.73 m2.
c. severe decreases in GFR.
d. kidney failure.

47
Q
  1. In chronic renal failure (end-stage renal disease), decreased glomerular filtration leads to:
A

a. increased pH.
b. decreased creatinine clearance.
c. increased blood urea nitrogen (BUN).
d. all of the above.

48
Q
  1. Decreased levels of erythropoietin, a substance normally secreted by the kidneys, leads to which serious
    complication of chronic renal failure?
A

a. Anemia
b. Acidosis
c. Hyperkalemia
d. Pericarditis

49
Q
  1. Recent research about the long-term toxicity of aluminum products has led physicians to recommend
    antacids that lower serum phosphorus, such as:
A

a. calcium carbonate.
b. sodium bicarbonate.
c. magaldrate.
d. milk of magnesia.

50
Q
  1. Dietary intervention for renal deterioration includes limiting the intake of:
A

a. fluid.
b. protein.
c. sodium and potassium.
d. all of the above.

51
Q
  1. The process that underlies and supports the procedure of hemodialysis is:
A

a. diffusion.
b. osmosis.
c. ultrafiltration.
d. all of the above processes.

52
Q
  1. An incomplete protein not recommended for the diet of a patient managed by long-term hemodialysis is
    that found in:
A

a. eggs.
b. fish.
c. milk.
d. nuts.

53
Q
  1. With peritoneal dialysis, urea and creatinine pass through the peritoneum by:
A

a. active transport.
b. diffusion and osmosis.
c. filtration.
d. ultrafiltration.

54
Q
  1. At the end of five peritoneal exchanges, the patient’s fluid loss was 500 mL. This loss is equal to approximately:
A

a. 0.5 lb.
b. 1.0 lb.
c. 1.5 lb.
d. 2 lb.

55
Q
  1. The major danger after renal surgery is:
A

a. abdominal distention owing to reflex cessation
of intestinal peristalsis.
b. hypovolemic shock caused by hemorrhage.
c. paralytic ileus caused by manipulation of the
colon during surgery.
d. pneumonia caused by shallow breathing
because of severe incisional pain.

56
Q
  1. Preoperative management for a patient who is to undergo kidney transportation includes:
A

a. bringing the metabolic state to as normal a
level as possible.
b. making certain that the patient is free of
infection.
c. suppressing immunologic defense mechanisms.
d. all of the above.

57
Q
  1. Postoperative management for a recipient of a transplanted kidney includes:
A

a. aseptic technique to avoid infection.
b. hourly urinary output measurements to
estimate the degree of kidney function.
c. protective isolation while immunosuppressive
drug therapy is at its maximum dosage.
d. all of the above.

N120 Quiz2 Dong (3 decks)

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