Question 1

The patient is admitted to the unit with the diagnosis of rhabdomyolysis.The patient is started on intravenous (IV)fluids and IV mannitol.Because mannitol is an osmotic diuretic,the nurse should:

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 prior to giving radiological contrast agents.

Question 2

The patient is admitted with complaints of general malaise and fatigue,along with a decreased urinary output.The patient's urinalysis shows coarse,muddy brown granular casts and hematuria.The nurse determines that the patient has:

Accepted Answer

A)  acute kidney injury from a prerenal condition. 
B)  acute kidney injury from postrenal obstruction. 
C)  intrarenal disease, probably acute tubular necrosis. 
D)  a urinary tract infection.

Question 3

The patient's potassium level is 7.0 mEq/L.Besides dialysis,which of the following actually reduces plasma potassium levels and total body potassium content safely in a patient with renal dysfunction?

Accepted Answer

A)  Kayexalate 
B)  Kayexalate with sorbitol 
C)  Regular insulin 
D)  Calcium gluconate

Question 4

Acute kidney injury from post renal etiology is caused by:

Accepted Answer

A)  obstruction of the flow of urine. 
B)  conditions that interfere with renal perfusion. 
C)  hypovolemia or decreased cardiac output. 
D)  conditions that act directly on functioning kidney tissue.

Question 5

Slow continuous ultrafiltration is also known as isolated ultrafiltration and is used to:

Accepted Answer

A)  remove plasma water in cases of volume overload. 
B)  remove fluids and solutes through the process of convection. 
C)  remove plasma water and solutes by adding dialysate. 
D)  combine ultrafiltration, convection and dialysis.

Question 6

The patient's serum creatinine level is 0.7 mg/dL.The expected BUN level should be:

Accepted Answer

A)  1-2 mg/dL. 
B)  7-14 mg/dL. 
C)  10-20 mg/dL. 
D)  20-30 mg/dL.

Question 7

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.

Question 8

The patient is a new postoperative patient.She weighs 75 kg.The nurse expects the minimal acceptable urine output to be:

Accepted Answer

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

Question 9

The patient is in the critical care unit and will receive dialysis this morning.The nurse will: (Select all that apply.)

Accepted Answer

A)  evaluate morning laboratory results and report abnormal results. 
B)  administer the patient's antihypertensive medications. 
C)  assess the dialysis access site and report abnormalities. 
D)  weigh the patient to monitor fluid status. 
E)  give all medications except for antihypertensive medications.

Question 10

The removal of plasma water and some low-molecular weight particles by using a pressure or osmotic gradient is known as:

Accepted Answer

A)  dialysis. 
B)  diffusion. 
C)  clearance. 
D)  ultrafiltration.

Question 11

Continuous venovenous hemodialysis is used to:

Accepted Answer

A)  remove fluids and solutes through the process of convection. 
B)  remove plasma water in cases of volume overload. 
C)  remove plasma water and solutes by adding dialysate. 
D)  combine ultrafiltration, convection and dialysis

Question 12

The patient is in 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.

Question 13

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."

Question 14

The patient is admitted with acute kidney injury from a postrenal cause.Acceptable treatments for that diagnosis include: (Select all that apply.)

Accepted Answer

A)  bladder catheterization. 
B)  increasing fluid volume intake. 
C)  ureteral stenting. 
D)  placement of nephrostomy tubes. 
E)  increasing cardiac output.

Question 15

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.

Question 16

The nurse is caring for a patient receiving peritoneal dialysis.The patient suddenly complains of abdominal pain and chills.The patient's temperature is elevated.The nurse should:

Accepted Answer

A)  assess peritoneal dialysate return. 
B)  check the patient's blood sugar. 
C)  evaluate the patient's neurological status. 
D)  inform the provider of probable visceral perforation.

Question 17

The patient has elevated blood urea nitrogen (BUN)and serum creatinine levels with a normal BUN/creatinine ratio.These levels most likely indicate:

Accepted Answer

A)  increased nitrogen intake. 
B)  acute kidney injury, such as acute tubular necrosis (ATN). 
C)  hypovolemia. 
D)  fluid resuscitation.

Question 18

The critical care nurse is responsible for monitoring the patient receiving continuous renal replacement therapy (CRRT).In doing so,the nurse should:

Accepted Answer

A)  assess that the blood tubing is warm to the touch. 
B)  assess the hemofilter every 6 hours for clotting. 
C)  cover the dialysis lines to protect them from light. 
D)  use clean technique during vascular access dressing changes.

Question 19

Renin plays a role in blood pressure regulation by:

Accepted Answer

A)  activating the renin-angiotensin-aldosterone cascade. 
B)  suppressing angiotensin production. 
C)  decreasing sodium reabsorption. 
D)  inhibiting aldosterone release.

Question 20

The patient is getting hemodialysis for the second time when he complains of a headache and nausea and,a little later,of becoming confused.The nurse realizes these are symptoms of:

Accepted Answer

A)  dialyzer membrane incompatibility. 
B)  a shift in potassium levels. 
C)  dialysis disequilibrium syndrome. 
D)  hypothermia.

Exam 15: Acute Kidney Injury

The patient is admitted to the unit with the diagnosis of rhabdomyolysis.The patient is started on intravenous (IV) fluids and IV mannitol.Because mannitol is an osmotic diuretic,the nurse should: