Question 1

To assess whether or not an arteriovenous fistula is functioning,what must the nurse do and why?

Accepted Answer

A)  Palpate the quality of the pulse distal to the site to determine whether a thrill is present; auscultate with a stethoscope to appreciate a bruit to assess the quality of the blood flow. 
B)  Palpate the quality of the pulse proximal to the site to determine whether a thrill is present; auscultate with a stethoscope to appreciate a bruit to assess the quality of the blood flow. 
C)  Palpate gently over the site of the fistula to determine whether a thrill is present; listen with a stethoscope over this site to appreciate a bruit to assess the quality of the blood flow. 
D)  Palpate over the site of the fistula to determine whether a thrill is present; check whether the extremity is pink and warm. 
A)  Palpate the quality of the pulse distal to the site to determine whether a thrill is present; auscultate with a stethoscope to appreciate a bruit to assess the quality of the blood flow. 
B)  Palpate the quality of the pulse proximal to the site to determine whether a thrill is present; auscultate with a stethoscope to appreciate a bruit to assess the quality of the blood flow. 
C)  Palpate gently over the site of the fistula to determine whether a thrill is present; listen with a stethoscope over this site to appreciate a bruit to assess the quality of the blood flow. 
D)  Palpate over the site of the fistula to determine whether a thrill is present; check whether the extremity is pink and warm.

Question 2

A patient has developed acute kidney injury (AKI)secondary to hemorrhage shock.Which intravenous solution would the nurse expect to be ordered for this patient?

Accepted Answer

A)  Dextrose in water 
B)  Normal saline 
C)  Albumin 
D)  Lactated Ringer solution 
A)  Dextrose in water 
B)  Normal saline 
C)  Albumin 
D)  Lactated Ringer solution

Question 3

Which medication is classified as a loop diuretic?

Accepted Answer

A)  Acetazolamide 
B)  Furosemide 
C)  Mannitol 
D)  Metolazone 
A)  Acetazolamide 
B)  Furosemide 
C)  Mannitol 
D)  Metolazone

Question 4

What is the recommended nutritional intake of protein to control azotemia in the patient with acute kidney injury?

Accepted Answer

A)  0.5 to 1.0 g/kg/day 
B)  1.2 to 1.5 g/kg/day 
C)  1.7 to 2.5 g/kg/day 
D)  2.5 to 3.5 g/kg/day 
A)  0.5 to 1.0 g/kg/day 
B)  1.2 to 1.5 g/kg/day 
C)  1.7 to 2.5 g/kg/day 
D)  2.5 to 3.5 g/kg/day

Question 5

Laboratory results come back on a newly admitted patient: Serum blood urea nitrogen,64 mg/dL; serum creatinine,2.4 mg/dL; urine osmolality,210 mOsm/kg; specific gravity,1.002; and urine sodium,96 mEq/L.The patient's urine output has been 120 mL since admission 2 hours ago.These values are most consistent with which diagnosis?

Accepted Answer

A)  Prerenal acute kidney injury 
B)  Postrenal acute kidney injury 
C)  Oliguric acute kidney injury 
D)  Intrarenal acute kidney injury 
A)  Prerenal acute kidney injury 
B)  Postrenal acute kidney injury 
C)  Oliguric acute kidney injury 
D)  Intrarenal acute kidney injury

Question 6

A patient with acute kidney injury (AKI)has been started on continuous venovenous hemodialysis (CVVHD).The nurse understands that this type of continuous renal replacement therapy (CRRT)is indicated for the patient who needs what type of treatment?

Accepted Answer

A)  Fluid removal only 
B)  Fluid removal and moderate solute removal 
C)  Fluid removal and maximum solute removal 
D)  Maximum fluid and solute removal 
A)  Fluid removal only 
B)  Fluid removal and moderate solute removal 
C)  Fluid removal and maximum solute removal 
D)  Maximum fluid and solute removal

Question 7

What is the most common site for short-term vascular access for immediate hemodialysis?

Accepted Answer

A)  Subclavian artery 
B)  Subclavian vein 
C)  Femoral artery 
D)  Radial vein 
A)  Subclavian artery 
B)  Subclavian vein 
C)  Femoral artery 
D)  Radial vein

Question 8

An alert and oriented patient presents with a pulmonary artery occlusion pressure (PAOP)of 4 mm Hg,blood pressure of 88/50 mm Hg,cardiac index of 1.8,and urine output of 15 mL/h.The patient's blood urea nitrogen (BUN)is 44 mg/dL and creatinine is 3.2 mg/dL.Lungs are clear to auscultation with no peripheral edema noted.Which treatment would the nurse expect the practitioner to order?

Accepted Answer

A)  Lasix 40 mg intravenous push 
B)  0.9% normal saline at 125 mL/h 
C)  Dopamine 15 mcg/kg/min 
D)  Transfuse 1 U of packed red blood cells 
A)  Lasix 40 mg intravenous push 
B)  0.9% normal saline at 125 mL/h 
C)  Dopamine 15 mcg/kg/min 
D)  Transfuse 1 U of packed red blood cells

Question 9

One therapeutic measure for treating hyperkalemia is the administration of dextrose and regular insulin.Which statement regarding how this treatment works is accurate?

Accepted Answer

A)  Glucose and insulin force potassium out of the cells, lowering it on a cellular level. 
B)  Glucose and insulin promote higher excretion of potassium in the urine. 
C)  Glucose and insulin bind with potassium, lowering available amounts. 
D)  Glucose and insulin force potassium into the cells, lowering it on a serum level. 
A)  Glucose and insulin force potassium out of the cells, lowering it on a cellular level. 
B)  Glucose and insulin promote higher excretion of potassium in the urine. 
C)  Glucose and insulin bind with potassium, lowering available amounts. 
D)  Glucose and insulin force potassium into the cells, lowering it on a serum level.

Question 10

The nursing management plan for the patient with a urinary drainage catheter would include which interventions to prevent catheter-associated urinary tract infection (CAUTI)?

Accepted Answer

A)  Insert urinary catheters using aseptic techniques. 
B)  Change the urinary catheter daily. 
C)  Review the need for the urinary catheter daily and remove promptly. 
D)  Flush the urinary catheter q8 hours to maintain patency. 
E)  Avoid unnecessary use of indwelling urinary catheters. 
A)  Insert urinary catheters using aseptic techniques. 
B)  Change the urinary catheter daily. 
C)  Review the need for the urinary catheter daily and remove promptly. 
D)  Flush the urinary catheter q8 hours to maintain patency. 
E)  Avoid unnecessary use of indwelling urinary catheters.

Exam 26: Kidney Disorders and Therapeutic Management

To assess whether or not an arteriovenous fistula is functioning,what must the nurse do and why?

A patient has developed acute kidney injury (AKI)secondary to hemorrhage shock.Which intravenous solution would the nurse expect to be ordered for this patient?

Which medication is classified as a loop diuretic?

What is the recommended nutritional intake of protein to control azotemia in the patient with acute kidney injury?

A patient with acute kidney injury (AKI)has been started on continuous venovenous hemodialysis (CVVHD).The nurse understands that this type of continuous renal replacement therapy (CRRT)is indicated for the patient who needs what type of treatment?

What is the most common site for short-term vascular access for immediate hemodialysis?

One therapeutic measure for treating hyperkalemia is the administration of dextrose and regular insulin.Which statement regarding how this treatment works is accurate?

The nursing management plan for the patient with a urinary drainage catheter would include which interventions to prevent catheter-associated urinary tract infection (CAUTI)?

Critical Care Nursing Practice

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Nutrition Alterations and Management

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Cardiovascular Anatomy and Physiology

Cardiovascular Clinical Assessment

Cardiovascular Diagnostic Procedures

Cardiovascular Disorders

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Pulmonary Anatomy and Physiology

Pulmonary Clinical Assessment

Pulmonary Diagnostic Procedures

Pulmonary Disorders

Pulmonary Therapeutic Management

Neurologic Anatomy and Physiology

Neurologic Clinical Assessment and Diagnostic Procedures

Neurologic Disorders and Therapeutic Management

Kidney Anatomy and Physiology

Kidney Clinical Assessment and Diagnostic Procedures

Gastrointestinal Anatomy and Physiology

Gastrointestinal Clinical Assessment and Diagnostic Procedures

Gastrointestinal Disorders and Therapeutic Management

Endocrine Anatomy and Physiology

Endocrine Clinical Assessment and Diagnostic Procedures

Endocrine Disorders and Therapeutic Management

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Shock,sepsis,and Multiple-Organ Dysfunction Syndrome

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