Question 1

A client is having a peritoneal dialysis treatment.The nurse notes an opaque color to the effluent.What is the priority action by the nurse?

Accepted Answer

A)  Warm the dialysate solution in a microwave before instillation. 
B)  Take a sample of the effluent and send to the laboratory. 
C)  Flush the tubing with normal saline to maintain patency of the catheter. 
D)  Check the peritoneal catheter for kinking and curling.

Question 2

A client is assessed by the nurse after a hemodialysis session.The nurse notes bleeding from the client's nose and around the intravenous catheter.What action by the nurse is the priority?

Accepted Answer

A)  Hold pressure over the client's nose for 10 minutes. 
B)  Take the client's pulse, blood pressure, and temperature. 
C)  Assess for a bruit or thrill over the arteriovenous fistula. 
D)  Prepare protamine sulfate for administration.

Question 3

A client in the intensive care unit with acute kidney injury (AKI)must maintain a mean arterial pressure (MAP)of 65 mm Hg to promote kidney perfusion.What is the client's MAP if the blood pressure is 98/50 mm Hg? (Record your answer using a whole number.)_____ mm Hg

Accepted Answer

The answer of A client in the intensive care unit...

Question 4

A client is placed on fluid restrictions because of chronic kidney disease (CKD).Which assessment finding would alert the nurse that the client's fluid balance is stable at this time?

Accepted Answer

A)  Decreased calcium levels 
B)  Increased phosphorus levels 
C)  No adventitious sounds in the lungs 
D)  Increased edema in the legs

Question 5

A nurse is caring for a postoperative 70-kg client who had major blood loss during surgery.Which findings by the nurse should prompt immediate action to prevent acute kidney injury? (Select all that apply.)

Accepted Answer

A)  Urine output of 100 mL in 4 hours 
B)  Urine output of 500 mL in 12 hours 
C)  Large amount of sediment in the urine 
D)  Amber, odorless urine 
E)  Blood pressure of 90/60 mm Hg

Question 6

The charge nurse is orienting a float nurse to an assigned client with an arteriovenous (AV)fistula for hemodialysis in her left arm.Which action by the float nurse would be considered unsafe?

Accepted Answer

A)  Palpating the access site for a bruit or thrill 
B)  Using the right arm for a blood pressure reading 
C)  Administering intravenous fluids through the AV fistula 
D)  Checking distal pulses in the left arm

Question 7

The nurse is teaching a client how to increase the flow of dialysate into the peritoneal cavity during dialysis.Which statement by the client demonstrates a correct understanding of the teaching?

Accepted Answer

A)  "I should leave the drainage bag above the level of my abdomen." 
B)  "I could flush the tubing with normal saline if the flow stops." 
C)  "I should take a stool softener every morning to avoid constipation." 
D)  "My diet should have low fiber in it to prevent any irritation."

Question 8

A client has a serum potassium level of 6.5 mmol/L,a serum creatinine level of 2 mg/dL,and a urine output of 350 mL/day.What is the best action by the nurse?

Accepted Answer

A)  Place the client on a cardiac monitor immediately. 
B)  Teach the client to limit high-potassium foods. 
C)  Continue to monitor the client's intake and output. 
D)  Ask to have the laboratory redraw the blood specimen.

Question 9

A nurse is giving discharge instructions to a client recently diagnosed with chronic kidney disease (CKD).Which statements made by the client indicate a correct understanding of the teaching? (Select all that apply.)

Accepted Answer

A)  "I can continue to take antacids to relieve heartburn." 
B)  "I need to ask for an antibiotic when scheduling a dental appointment." 
C)  "I'll need to check my blood sugar often to prevent hypoglycemia." 
D)  "The dose of my pain medication may have to be adjusted." 
E)  "I should watch for bleeding when taking my anticoagulants."

Question 10

The nurse is teaching a client with chronic kidney disease (CKD)about the sodium restriction needed in the diet to prevent edema and hypertension.Which statement by the client indicates more teaching is needed?

Accepted Answer

A)  "I am thrilled that I can continue to eat fast food." 
B)  "I will cut out bacon with my eggs every morning." 
C)  "My cooking style will change by not adding salt." 
D)  "I will probably lose weight by cutting out potato chips."

Question 11

A client is recovering from a kidney transplant.The client's urine output was 1500 mL over the last 12-hour period since transplantation.What is the priority assessment by the nurse?

Accepted Answer

A)  Checking skin turgor 
B)  Taking blood pressure 
C)  Assessing lung sounds 
D)  Weighing the client

Question 12

A client in the intensive care unit is started on continuous venovenous hemofiltration (CVVH).Which finding is the cause of immediate action by the nurse?

Accepted Answer

A)  Blood pressure of 76/58 mm Hg 
B)  Sodium level of 138 mEq/L 
C)  Potassium level of 5.5 mEq/L 
D)  Pulse rate of 90 beats/min

Question 13

A client with chronic kidney disease (CKD)is experiencing nausea,vomiting,visual changes,and anorexia.Which action by the nurse is best?

Accepted Answer

A)  Check the client's digoxin (Lanoxin) level. 
B)  Administer an anti-nausea medication. 
C)  Ask if the client is able to eat crackers. 
D)  Get a referral to a gastrointestinal provider.

Question 14

A client is undergoing hemodialysis.The client's blood pressure at the beginning of the procedure was 136/88 mm Hg,and now it is 110/54 mm Hg.What actions should the nurse perform to maintain blood pressure? (Select all that apply.)

Accepted Answer

A)  Adjust the rate of extracorporeal blood flow. 
B)  Place the client in the Trendelenburg position. 
C)  Stop the hemodialysis treatment. 
D)  Administer a 250-mL bolus of normal saline. 
E)  Contact the health care provider for orders.

Question 15

A client is admitted with acute kidney injury (AKI)and a urine output of 2000 mL/day.What is the major concern of the nurse regarding this client's care?

Accepted Answer

A)  Edema and pain 
B)  Electrolyte and fluid imbalance 
C)  Cardiac and respiratory status 
D)  Mental health status

Question 16

A male client with chronic kidney disease (CKD)is refusing to take his medication and has missed two hemodialysis appointments.What is the best initial action for the nurse?

Accepted Answer

A)  Discuss what the treatment regimen means to him. 
B)  Refer the client to a mental health nurse practitioner. 
C)  Reschedule the appointments to another date and time. 
D)  Discuss the option of peritoneal dialysis.

Exam 68: Care of Patients with Acute Kidney Injury and Chronic Kidney Disease

A client is having a peritoneal dialysis treatment.The nurse notes an opaque color to the effluent.What is the priority action by the nurse?

A client is assessed by the nurse after a hemodialysis session.The nurse notes bleeding from the client's nose and around the intravenous catheter.What action by the nurse is the priority?

A client in the intensive care unit with acute kidney injury (AKI)must maintain a mean arterial pressure (MAP)of 65 mm Hg to promote kidney perfusion.What is the client's MAP if the blood pressure is 98/50 mm Hg? (Record your answer using a whole number.)_____ mm Hg

A client is placed on fluid restrictions because of chronic kidney disease (CKD) .Which assessment finding would alert the nurse that the client's fluid balance is stable at this time?

A nurse is caring for a postoperative 70-kg client who had major blood loss during surgery.Which findings by the nurse should prompt immediate action to prevent acute kidney injury? (Select all that apply.)

The charge nurse is orienting a float nurse to an assigned client with an arteriovenous (AV) fistula for hemodialysis in her left arm.Which action by the float nurse would be considered unsafe?

The nurse is teaching a client how to increase the flow of dialysate into the peritoneal cavity during dialysis.Which statement by the client demonstrates a correct understanding of the teaching?

A client has a serum potassium level of 6.5 mmol/L,a serum creatinine level of 2 mg/dL,and a urine output of 350 mL/day.What is the best action by the nurse?

A nurse is giving discharge instructions to a client recently diagnosed with chronic kidney disease (CKD) .Which statements made by the client indicate a correct understanding of the teaching? (Select all that apply.)

The nurse is teaching a client with chronic kidney disease (CKD) about the sodium restriction needed in the diet to prevent edema and hypertension.Which statement by the client indicates more teaching is needed?

A client is recovering from a kidney transplant.The client's urine output was 1500 mL over the last 12-hour period since transplantation.What is the priority assessment by the nurse?

A client in the intensive care unit is started on continuous venovenous hemofiltration (CVVH) .Which finding is the cause of immediate action by the nurse?

A client with chronic kidney disease (CKD) is experiencing nausea,vomiting,visual changes,and anorexia.Which action by the nurse is best?

A client is undergoing hemodialysis.The client's blood pressure at the beginning of the procedure was 136/88 mm Hg,and now it is 110/54 mm Hg.What actions should the nurse perform to maintain blood pressure? (Select all that apply.)

A client is admitted with acute kidney injury (AKI) and a urine output of 2000 mL/day.What is the major concern of the nurse regarding this client's care?

A male client with chronic kidney disease (CKD) is refusing to take his medication and has missed two hemodialysis appointments.What is the best initial action for the nurse?