Question 1

The critical care nurse knows that in critically ill patients,renal dysfunction

Accepted Answer

A)  is a very rare problem. 
B)  affects nearly two thirds of patients. 
C)  has a low mortality rate once renal replacement therapy has been initiated. 
D)  has little effect on morbidity, mortality, or quality of life. 
A)  is a very rare problem. 
B)  affects nearly two thirds of patients. 
C)  has a low mortality rate once renal replacement therapy has been initiated. 
D)  has little effect on morbidity, mortality, or quality of life. B

Question 2

In calculating the glomerular filtration rate (GFR)results for women,the creatinine clearance is usually:

Accepted Answer

A)  the same as for men. 
B)  greater than that for men. 
C)  multiplied by 0.85. 
D)  multiplied by 1.15. 
A)  the same as for men. 
B)  greater than that for men. 
C)  multiplied by 0.85. 
D)  multiplied by 1.15. C

Question 3

The nurse is caring for a patient who has a temporary percutaneous dialysis catheter in place.In caring for this patient,the nurse should

Accepted Answer

A)  apply a sterile gauze dressing to maintain sterility. 
B)  replace the transparent dressing every 10 days to prevent manipulation. 
C)  assess the catheter site for redness and/or swelling. 
D)  use the catheter for drawing blood samples to reduce patient discomfort. 
A)  apply a sterile gauze dressing to maintain sterility. 
B)  replace the transparent dressing every 10 days to prevent manipulation. 
C)  assess the catheter site for redness and/or swelling. 
D)  use the catheter for drawing blood samples to reduce patient discomfort. C

Question 4

What is a minimally acceptable urine output for a patient weighing 75 kg?

Accepted Answer

A)  Less than 30 mL/hour 
B)  37 mL/hour 
C)  80 mL/hour 
D)  150 mL/hour 
A)  Less than 30 mL/hour 
B)  37 mL/hour 
C)  80 mL/hour 
D)  150 mL/hour

Question 5

The most common reasons for initiating dialysis in acute kidney injury include which of the following? (Select all that apply.)

Accepted Answer

A)  Acidosis 
B)  Hypokalemia 
C)  Volume overload 
D)  Hyperkalemia 
E)  Uremia 
A)  Acidosis 
B)  Hypokalemia 
C)  Volume overload 
D)  Hyperkalemia 
E)  Uremia

Question 6

Continuous renal replacement therapy (CRRT)differs from conventional intermittent hemodialysis in that

Accepted Answer

A)  a hemofilter is used to facilitate ultrafiltration. 
B)  it provides faster removal of solute and water. 
C)  it does not allow diffusion to occur. 
D)  the process removes solutes and water slowly. 
A)  a hemofilter is used to facilitate ultrafiltration. 
B)  it provides faster removal of solute and water. 
C)  it does not allow diffusion to occur. 
D)  the process removes solutes and water slowly.

Question 7

The nurse is caring for a patient with acute kidney injury who is being treated with hemodialysis.The patient asks if he will need dialysis for the rest of his life.Which of the following would be the best response?

Accepted Answer

A)  "Unfortunately, kidney injury is not reversible; it is permanent." 
B)  "Kidney function usually returns within 2 weeks." 
C)  "You will know for sure if you start urinating a lot all at once." 
D)  "Recovery is possible, but it may take several months." 
A)  "Unfortunately, kidney injury is not reversible; it is permanent." 
B)  "Kidney function usually returns within 2 weeks." 
C)  "You will know for sure if you start urinating a lot all at once." 
D)  "Recovery is possible, but it may take several months."

Question 8

In determining the glomerular filtration rate (GFR)or creatinine clearance,a 24-hour urine is obtained.If a reliable 24-hour urine collection is not possible,

Accepted Answer

A)  it is not possible to determine the GFR. 
B)  the BUN may be used to determine renal function. 
C)  an elevated BUN/creatinine ratio can be used. 
D)  a standardized formula may be used to calculate GFR. 
A)  it is not possible to determine the GFR. 
B)  the BUN may be used to determine renal function. 
C)  an elevated BUN/creatinine ratio can be used. 
D)  a standardized formula may be used to calculate GFR.

Question 9

The term used to describe an increase in blood urea nitrogen (BUN)and serum creatinine is

Accepted Answer

A)  oliguria. 
B)  azotemia. 
C)  acute kidney injury. 
D)  prerenal disease. 
A)  oliguria. 
B)  azotemia. 
C)  acute kidney injury. 
D)  prerenal disease.

Question 10

A normal urine output is considered to be

Accepted Answer

A)  80 to 125 mL/min. 
B)  180 L/day. 
C)  80 mL/min. 
D)  1 to 2 L/day. 
A)  80 to 125 mL/min. 
B)  180 L/day. 
C)  80 mL/min. 
D)  1 to 2 L/day.

Question 11

The patient has just returned from having an arteriovenous fistula placed.The patient asks,"When will they be able to use this and take this other catheter out?" The nurse should reply,

Accepted Answer

A)  "It can be used immediately, so the catheter can come out anytime." 
B)  "It will take 2 to 4 weeks to heal before it can be used." 
C)  "The fistula will be usable in about 4 to 6 weeks." 
D)  "The fistula was made using graft material, so it depends on the manufacturer." 
A)  "It can be used immediately, so the catheter can come out anytime." 
B)  "It will take 2 to 4 weeks to heal before it can be used." 
C)  "The fistula will be usable in about 4 to 6 weeks." 
D)  "The fistula was made using graft material, so it depends on the manufacturer."

Question 12

Peritoneal dialysis is different from hemodialysis in that peritoneal dialysis

Accepted Answer

A)  is more frequently used for acute kidney injury. 
B)  uses the patient's own semipermeable membrane (peritoneal membrane). 
C)  is not useful in cases of drug overdose or electrolyte imbalance. 
D)  is not indicated in cases of water intoxication. 
A)  is more frequently used for acute kidney injury. 
B)  uses the patient's own semipermeable membrane (peritoneal membrane). 
C)  is not useful in cases of drug overdose or electrolyte imbalance. 
D)  is not indicated in cases of water intoxication.

Question 13

The patient is admitted to the unit with the diagnosis of rhabdomyolysis.The patient is started on intravenous (IV)fluids and IV mannitol.What action by the nurse is best?

Accepted Answer

A)  Assess the patient's hearing. 
B)  Assess the patient's lungs. 
C)  Decrease IV fluids once the diuretic has been administered. 
D)  Give extra doses before giving radiological contrast agents. 
A)  Assess the patient's hearing. 
B)  Assess the patient's lungs. 
C)  Decrease IV fluids once the diuretic has been administered. 
D)  Give extra doses before giving radiological contrast agents.

Question 14

A 100-kg patient gets hemodialysis 3 days a week.In planning the care for this patient,the nurse recommends

Accepted Answer

A)  a diet of 2500 to 3500 kcal per day. 
B)  protein intake of less than 50 grams per day. 
C)  potassium intake of 10 mEq per day. 
D)  fluid intake of less than 500 mL per day. 
A)  a diet of 2500 to 3500 kcal per day. 
B)  protein intake of less than 50 grams per day. 
C)  potassium intake of 10 mEq per day. 
D)  fluid intake of less than 500 mL per day.

Question 15

The patient undergoes a cardiac catheterization that requires the use of contrast dyes during the procedure.To detect signs of contrast-induced kidney injury,the nurse should

Accepted Answer

A)  not be concerned unless urine output decreases. 
B)  evaluate the patient's serum creatinine for up to 72 hours after the procedure. 
C)  obtain an order for a renal ultrasound. 
D)  evaluate the patient's postvoid residual volume to detect intrarenal injury. 
A)  not be concerned unless urine output decreases. 
B)  evaluate the patient's serum creatinine for up to 72 hours after the procedure. 
C)  obtain an order for a renal ultrasound. 
D)  evaluate the patient's postvoid residual volume to detect intrarenal injury.

Question 16

The patient has a temporary percutaneous catheter in place for treatment of acute kidney injury.The catheter has been in place for 5 days.The nurse should

Accepted Answer

A)  prepare to assist with a routine dialysis catheter change. 
B)  evaluate the patient for signs and symptoms of infection. 
C)  teach the patient that the catheter is designed for long-term use. 
D)  use one of the three lumens for fluid administration. 
A)  prepare to assist with a routine dialysis catheter change. 
B)  evaluate the patient for signs and symptoms of infection. 
C)  teach the patient that the catheter is designed for long-term use. 
D)  use one of the three lumens for fluid administration.

Question 17

The patient is on intake and output (I&O),as well as daily weights.The nurse notes that output is considerably less than intake over the last shift,and daily weight is 1 kg more than yesterday.The nurse should

Accepted Answer

A)  draw a trough level after the next dose of antibiotic. 
B)  obtain an order to place the patient on fluid restriction. 
C)  assess the patient's lungs. 
D)  insert an indwelling catheter. 
A)  draw a trough level after the next dose of antibiotic. 
B)  obtain an order to place the patient on fluid restriction. 
C)  assess the patient's lungs. 
D)  insert an indwelling catheter.

Question 18

Noninvasive diagnostic procedures used to determine kidney function include which of the following? (Select all that apply.)

Accepted Answer

A)  Kidney, ureter, bladder ( KUB ) x-ray 
B)  Renal ultrasound 
C)  Magnetic resonance imaging ( MR) 
D)  Intravenous pyelography ( IVP ) 
E)  Renal angiography 
A)  Kidney, ureter, bladder ( KUB ) x-ray 
B)  Renal ultrasound 
C)  Magnetic resonance imaging ( MR) 
D)  Intravenous pyelography ( IVP ) 
E)  Renal angiography

Question 19

The patient is in a progressive care unit following arteriovenous fistula implantation in his left upper arm,and is due to have blood drawn with his next set of vital signs and assessment.When the nurse assesses the patient,the nurse should

Accepted Answer

A)  draw blood from the left arm. 
B)  take blood pressures from the left arm. 
C)  start a new intravenous line in the left lower arm. 
D)  auscultate the left arm for a bruit and palpate for a thrill. 
A)  draw blood from the left arm. 
B)  take blood pressures from the left arm. 
C)  start a new intravenous line in the left lower arm. 
D)  auscultate the left arm for a bruit and palpate for a thrill.

Question 20

An advantage of peritoneal dialysis is that

Accepted Answer

A)  peritoneal dialysis is time intensive. 
B)  a decreased risk of peritonitis exists. 
C)  biochemical disturbances are corrected rapidly. 
D)  the danger of hemorrhage is minimal. 
A)  peritoneal dialysis is time intensive. 
B)  a decreased risk of peritonitis exists. 
C)  biochemical disturbances are corrected rapidly. 
D)  the danger of hemorrhage is minimal.

Exam 16: Acute Kidney Injury

The critical care nurse knows that in critically ill patients,renal dysfunction

In calculating the glomerular filtration rate (GFR)results for women,the creatinine clearance is usually:

The nurse is caring for a patient who has a temporary percutaneous dialysis catheter in place.In caring for this patient,the nurse should

What is a minimally acceptable urine output for a patient weighing 75 kg?

The most common reasons for initiating dialysis in acute kidney injury include which of the following? (Select all that apply.)

Continuous renal replacement therapy (CRRT)differs from conventional intermittent hemodialysis in that

The nurse is caring for a patient with acute kidney injury who is being treated with hemodialysis.The patient asks if he will need dialysis for the rest of his life.Which of the following would be the best response?

In determining the glomerular filtration rate (GFR)or creatinine clearance,a 24-hour urine is obtained.If a reliable 24-hour urine collection is not possible,

The term used to describe an increase in blood urea nitrogen (BUN)and serum creatinine is

A normal urine output is considered to be

The patient has just returned from having an arteriovenous fistula placed.The patient asks,"When will they be able to use this and take this other catheter out?" The nurse should reply,

Peritoneal dialysis is different from hemodialysis in that peritoneal dialysis

The patient is admitted to the unit with the diagnosis of rhabdomyolysis.The patient is started on intravenous (IV)fluids and IV mannitol.What action by the nurse is best?

A 100-kg patient gets hemodialysis 3 days a week.In planning the care for this patient,the nurse recommends

The patient undergoes a cardiac catheterization that requires the use of contrast dyes during the procedure.To detect signs of contrast-induced kidney injury,the nurse should

The patient has a temporary percutaneous catheter in place for treatment of acute kidney injury.The catheter has been in place for 5 days.The nurse should

The patient is on intake and output (I&O),as well as daily weights.The nurse notes that output is considerably less than intake over the last shift,and daily weight is 1 kg more than yesterday.The nurse should

Noninvasive diagnostic procedures used to determine kidney function include which of the following? (Select all that apply.)

The patient is in a progressive care unit following arteriovenous fistula implantation in his left upper arm,and is due to have blood drawn with his next set of vital signs and assessment.When the nurse assesses the patient,the nurse should

An advantage of peritoneal dialysis is that

Overview of Critical Care Nursing

Patient and Family Response to the Critical Care Experience

Ethical and Legal Issues in Critical Care Nursing

End-of-Life Care and Palliative Care in Critical Care Settings

Comfort and Sedation

Nutritional Support

Dysrhythmia Interpretation and Management

Hemodynamic Monitoring

Ventilatory Assistance

Rapid Response Teams and Code Management

Organ Donation

Shock,Sepsis,and Multiple Organ Dysfunction Syndrome

Cardiovascular Alterations

Nervous System Alterations

Acute Respiratory Failure

Hematological and Immune Disorders

Gastrointestinal Alterations

Endocrine Alterations

Trauma and Surgical Management

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