Question 1

The nurse is caring for a client in the oliguric phase of acute renal failure who has a

Accepted Answer

A) 400 
B)  800 
C) 1 000 
D)  1 400

Question 2

The nurse is interviewing a client with chronic kidney disease (CKD) who brings all home medications to the clinic to be reviewed by the nurse. Which of the following medications being used by the client indicates that client teaching is required?

Accepted Answer

A) Multivitamin with iron 
B) Milk of magnesia 30 mL 
C) Calcium acetate 
D) Acetaminophen 650 mg

Question 3

The nurse is caring for a client who is receiving hemodialysis and has symptoms of nausea, vomiting, and a headache. Which of the following actions is priority?

Accepted Answer

A) Infuse a hypotonic solution 
B) Increase the rate of the dialysis 
C) Administer an antiemetic medication 
D) Stop the dialysis solution

Question 4

The nurse is taking a history for a client who is a possible candidate for a kidney transplant. Which of the following information indicates that the client is not an appropriate candidate for transplantation?

Accepted Answer

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

Question 5

The nurse is caring for a client with chronic kidney disease (CKD) who is prescribed calcium carbonate. Which of the following parameters should the nurse assess in order to determine the effectiveness of the treatment?

Accepted Answer

A) Blood pressure 
B) Phosphate level 
C) Neurological status 
D) Creatinine clearance

Question 6

The nurse is assessing a client who is receiving peritoneal dialysis with 2 L inflows. Which of the following information should be reported immediately to the health care provider?

Accepted Answer

A) The client has an outflow volume of 1 800 mL. 
B) The client's peritoneal effluent appears cloudy. 
C) The client has abdominal pain during the inflow phase. 
D) The client complains of feeling bloated after the inflow.

Question 7

The nurse is caring for a client with a history of benign prostatic hyperplasia (BPH) with acute urinary retention and an elevated blood urea nitrogen (BUN) and creatinine. Which of the following prescribed therapies should the nurse implement first?

Accepted Answer

A) Obtain renal ultrasound. 
B) Insert retention catheter. 
C) Infuse normal saline at 50 mL/hour. 
D) Draw blood for complete blood count.

Question 8

The nurse is teaching a client who is receiving hemodialysis about appropriate dietary choices. Which of the following menu choices by the client indicates that the teaching has been effective?

Accepted Answer

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

Question 9

The nurse is caring for a client with hypertension and stage 2 chronic kidney disease (CKD) who is prescribed ramapril. Which of the following laboratory tests should the nurse assess before administration of the medication?

Accepted Answer

A) Glucose 
B) Potassium 
C) Creatinine 
D) Phosphate

Question 10

The nurse is caring for a client who has had progressive chronic kidney disease (CKD) for several years and is starting hemodialysis. Which of the following information about diet should the nurse include in client teaching?

Accepted Answer

A) Increased calories are needed because glucose is lost during hemodialysis. 
B) Unlimited fluids are allowed since retained fluid is removed during dialysis. 
C) More protein will be allowed because of the removal of urea and creatinine by dialysis. 
D) Dietary sodium and potassium are unrestricted because these levels are normalized by dialysis.

Question 11

The nurse is caring for a client with a left arm arteriovenous fistula. Which of the following actions should the nurse include in the plan of care to maintain the patency of the fistula?

Accepted Answer

A) Check the fistula site for a bruit and thrill. 
B) Assess the rate and quality of the left radial pulse. 
C) Compare blood pressures in the left and right arms. 
D) Irrigate the fistula site with saline every 8-12 hours.

Question 12

The nurse is caring for a client with stage 2 chronic kidney disease (CKD) who is scheduled for an intravenous pyelogram (IVP). Which of the following prescriptions for the client should the nurse question?

Accepted Answer

A) NPO for 6 hours before IVP procedure 
B) Normal saline 500 mL IV before procedure 
C) Ibuprofen 400 mg PO PRN for pain 
D) Dulcolax suppository 4 hours before IVP procedure

Question 13

The RN observes a nursing student carrying out all of these actions while caring for a client with stage 2 chronic kidney disease. Which of the following actions require the RN to intervene?

Accepted Answer

A) The student administers erythropoietin subcutaneously. 
B) The student assists the client to ambulate in the hallway. 
C) The student gives the iron supplement and phosphate binder with lunch. 
D) The student carries a tray containing low-protein foods into the client's room.

Question 14

Which of the following actions by a client who is using peritoneal dialysis (PD) indicates that the nurse should provide more teaching about PD?

Accepted Answer

A) The client slows the inflow rate when experiencing pain. 
B) The client leaves the catheter exit site without a dressing. 
C) The client plans 30-60 minutes for a dialysate exchange. 
D) The client cleans the catheter while taking a bath every day.

Question 15

Which of the following information is most useful to the nurse in evaluating improvement in kidney function for a client who is hospitalized with acute kidney injury (AKI)?

Accepted Answer

A) Blood urea nitrogen (BUN) level 
B) Urine output 
C) Creatinine level 
D) Calculated glomerular filtration rate (GFR)

Question 16

The nurse is caring for a client with diabetes who has been admitted with pneumonia and is prescribed gentamicin 60 mg IV. Which of the following parameters should the nurse monitor to evaluate the client for adverse effects of the medication?

Accepted Answer

A) Urine osmolality 
B) Serum potassium 
C) Blood glucose level 
D) Blood urea nitrogen (BUN) and creatinine

Exam 49: Nursing Management Acute Kidney Injury and Chronic Kidney Disease