Question 1

Which information in a patient's history indicates to the nurse that the patient is not an appropriate candidate for kidney transplantation?

Accepted Answer

A)  The patient has type 1 diabetes.
B)  The patient has metastatic lung cancer.
C)  The patient has a history of chronic hepatitis C infection.
D)  The patient is infected with human immunodeficiency virus. B

Question 2

A patient in the oliguric phase after an acute kidney injury has had a 250-mL urine output and an emesis of 100 mL in the past 24 hours. What is the patient's fluid restriction for the next 24 hours?

Accepted Answer

950 mL
The general rule for calculating fluid restrictions is to add all fluid losses for the previous 24 hours,plus 600 mL for insensible losses: (250 + 100 + 600 = 950 mL).

Question 3

Which statement by a patient with stage 5 chronic kidney disease (CKD)indicates that the nurse's teaching about management of CKD has been effective?

Accepted Answer

A)  "I need to get most of my protein from low-fat dairy products."
B)  "I will increase my intake of fruits and vegetables to 5 per day."
C)  "I will measure my urinary output each day to help calculate the amount I can drink."
D)  "I need to take erythropoietin to boost my immune system and help prevent infection." C

Question 4

Which menu choice by the patient who is receiving hemodialysis indicates that the nurse's teaching has been successful?

Accepted Answer

A)  Split-pea soup, English muffin, and nonfat milk
B)  Oatmeal with cream, half a banana, and herbal tea
C)  Poached eggs, whole-wheat toast, and apple juice
D)  Cheese sandwich, tomato soup, and cranberry juice

Question 5

After the insertion of an arteriovenous graft (AVG)in the right forearm,a patient complains of pain and coldness of the right fingers. Which action should the nurse take?

Accepted Answer

A)  Teach the patient about normal AVG function.
B)  Remind the patient to take a daily low-dose aspirin tablet.
C)  Report the patient's symptoms to the health care provider.
D)  Elevate the patient's arm on pillows to above the heart level.

Question 6

A 55-yr-old patient with end-stage kidney disease (ESKD)is scheduled to receive a prescribed dose of epoetin alfa (Procrit). Which information should the nurse report to the health care provider before giving the medication?

Accepted Answer

A)  Creatinine 1.6 mg/dL
B)  Oxygen saturation 89%
C)  Hemoglobin level 13 g/dL
D)  Blood pressure 98/56 mm Hg

Question 7

A patient has arrived for a scheduled hemodialysis session. Which nursing action is most appropriate for the registered nurse (RN)to delegate to a dialysis technician?

Accepted Answer

A)  Teach the patient about fluid restrictions.
B)  Check blood pressure before starting dialysis.
C)  Assess for causes of an increase in predialysis weight.
D)  Determine the ultrafiltration rate for the hemodialysis.

Question 8

Sodium polystyrene sulfonate (Kayexalate)is ordered for a patient with hyperkalemia. Before administering the medication,the nurse should assess the

Accepted Answer

A)  bowel sounds.
B)  blood glucose.
C)  blood urea nitrogen (BUN) .
D)  level of consciousness (LO
C)  .

Question 9

A 62-yr-old female patient has been hospitalized for 4 days with acute kidney injury (AKI)caused by dehydration. Which information will be most important for the nurse to report to the health care provider?

Accepted Answer

A)  The creatinine level is 3.0 mg/dL.
B)  Urine output over an 8-hour period is 2500 mL.
C)  The blood urea nitrogen (BUN)  level is 67 mg/dL.
D)  The glomerular filtration rate is less than 30 mL/min/1.73 m2.

Question 10

During routine hemodialysis,a patient complains of nausea and dizziness. Which action should the nurse take first?

Accepted Answer

A)  Slow down the rate of dialysis.
B)  Check the blood pressure (BP) .
C)  Review the hematocrit (Hct)  level.
D)  Give prescribed PRN antiemetic drugs.

Question 11

A patient will need vascular access for hemodialysis. Which statement by the nurse accurately describes an advantage of a fistula over a graft?

Accepted Answer

A)  A fistula is much less likely to clot.
B)  A fistula increases patient mobility.
C)  A fistula can accommodate larger needles.
D)  A fistula can be used sooner after surgery.

Question 12

Which assessment finding may indicate that a patient is experiencing adverse effects to a corticosteroid prescribed after kidney transplantation?

Accepted Answer

A)  Postural hypotension
B)  Recurrent tachycardia
C)  Knee and hip joint pain
D)  Increased serum creatinine

Question 13

After receiving change-of-shift report,which patient should the nurse assess first?

Accepted Answer

A)  Patient who is scheduled for the drain phase of a peritoneal dialysis exchange
B)  Patient with stage 4 chronic kidney disease who has an elevated phosphate level
C)  Patient with stage 5 chronic kidney disease who has a potassium level of 3.4 mEq/L
D)  Patient who has just returned from having hemodialysis and has a heart rate of 124/min

Question 14

Before administration of calcium carbonate to a patient with chronic kidney disease (CKD),the nurse should check laboratory results for

Accepted Answer

A)  potassium level.
B)  total cholesterol.
C)  serum phosphate.
D)  serum creatinine.

Question 15

A 42-yr-old patient admitted with acute kidney injury due to dehydration has oliguria,anemia,and hyperkalemia. Which prescribed action should the nurse take first?

Accepted Answer

A)  Insert a urinary retention catheter.
B)  Place the patient on a cardiac monitor.
C)  Administer epoetin alfa (Epogen, Procrit) .
D)  Give sodium polystyrene sulfonate (Kayexalate) .

Question 16

A patient with acute kidney injury (AKI)has longer QRS intervals on the electrocardiogram (ECG)than were noted on the previous shift. Which action should the nurse take first?

Accepted Answer

A)  Notify the patient's health care provider.
B)  Document the QRS interval measurement.
C)  Review the chart for the patient's current creatinine level.
D)  Check the medical record for the most recent potassium level.

Question 17

A patient complains of leg cramps during hemodialysis. The nurse should

Accepted Answer

A)  massage the patient's legs.
B)  reposition the patient supine.
C)  give acetaminophen (Tylenol) .
D)  infuse a bolus of normal saline.

Question 18

A patient with diabetes who has bacterial pneumonia is being treated with IV gentamicin 60 mg IV BID. The nurse will monitor for adverse effects of the medication by evaluating the patient's

Accepted Answer

A)  blood glucose.
B)  urine osmolality.
C)  serum creatinine.
D)  serum potassium.

Question 19

A 37-yr-old female patient is hospitalized with acute kidney injury (AKI). Which information will be most useful to the nurse in evaluating improvement in kidney function?

Accepted Answer

A)  Urine volume
B)  Creatinine level
C)  Glomerular filtration rate (GFR) 
D)  Blood urea nitrogen (BUN)  level

Question 20

The nurse in the dialysis clinic is reviewing the home medications of a patient with chronic kidney disease (CKD). Which medication reported by the patient indicates that patient teaching is required?

Accepted Answer

A)  Acetaminophen
B)  Calcium phosphate
C)  Magnesium hydroxide
D)  Multivitamin with iron

Exam 46: Acute Kidney Injury and Chronic Kidney Disease

Which information in a patient's history indicates to the nurse that the patient is not an appropriate candidate for kidney transplantation?

A patient in the oliguric phase after an acute kidney injury has had a 250-mL urine output and an emesis of 100 mL in the past 24 hours. What is the patient's fluid restriction for the next 24 hours?

Which statement by a patient with stage 5 chronic kidney disease (CKD) indicates that the nurse's teaching about management of CKD has been effective?

Which menu choice by the patient who is receiving hemodialysis indicates that the nurse's teaching has been successful?

After the insertion of an arteriovenous graft (AVG) in the right forearm,a patient complains of pain and coldness of the right fingers. Which action should the nurse take?

A 55-yr-old patient with end-stage kidney disease (ESKD) is scheduled to receive a prescribed dose of epoetin alfa (Procrit) . Which information should the nurse report to the health care provider before giving the medication?

A patient has arrived for a scheduled hemodialysis session. Which nursing action is most appropriate for the registered nurse (RN) to delegate to a dialysis technician?

Sodium polystyrene sulfonate (Kayexalate) is ordered for a patient with hyperkalemia. Before administering the medication,the nurse should assess the

A 62-yr-old female patient has been hospitalized for 4 days with acute kidney injury (AKI) caused by dehydration. Which information will be most important for the nurse to report to the health care provider?

During routine hemodialysis,a patient complains of nausea and dizziness. Which action should the nurse take first?

A patient will need vascular access for hemodialysis. Which statement by the nurse accurately describes an advantage of a fistula over a graft?

Which assessment finding may indicate that a patient is experiencing adverse effects to a corticosteroid prescribed after kidney transplantation?

After receiving change-of-shift report,which patient should the nurse assess first?

Before administration of calcium carbonate to a patient with chronic kidney disease (CKD) ,the nurse should check laboratory results for

A 42-yr-old patient admitted with acute kidney injury due to dehydration has oliguria,anemia,and hyperkalemia. Which prescribed action should the nurse take first?

A patient with acute kidney injury (AKI) has longer QRS intervals on the electrocardiogram (ECG) than were noted on the previous shift. Which action should the nurse take first?

A patient complains of leg cramps during hemodialysis. The nurse should

A patient with diabetes who has bacterial pneumonia is being treated with IV gentamicin 60 mg IV BID. The nurse will monitor for adverse effects of the medication by evaluating the patient's

A 37-yr-old female patient is hospitalized with acute kidney injury (AKI) . Which information will be most useful to the nurse in evaluating improvement in kidney function?

The nurse in the dialysis clinic is reviewing the home medications of a patient with chronic kidney disease (CKD) . Which medication reported by the patient indicates that patient teaching is required?