1. Whenapatientwithacute ANS:B
kidneyinjury(AKI)hasanar-
terialblood pH of 7.30, the Patients with metabolic acidosis caused by
nursewillexpectanassess- AKImayhaveKussmaulrespirationsasthe
mentfindingof lungstrytoregulatecarbondioxide.Bound- ing
pulses andvasodilation are not associ-
a. persistentskintenting ated with metabolic acidosis. Because the
patient is likely to have fluid retention,
b. rapid,deeprespirations. poorskin turgor would notbea finding in
AKI.
c. boundingperipheralpuls-
es.
d. hot,flushedfaceandneck.
2. The nurseisplanningcare
forapatientwithsevereheart
,f ANS:B
failurewhohasdeveloped
elevatedbloodureanitro- Theprimarygoaloftreatmentforacutekid-
gen(BUN)andcreatininelev- neyinjury(AKI)istoeliminatethecauseand
,f ,f
els.Theprimarycollaborative providesupportivecarewhilethekidneysre-
treatmentgoalintheplanwill
,f cover.Becausethispatient'sheartfailureis
be causingAKI,thecarewillbedirectedtoward
treatmentoftheheart failure.For renal fail-
a. augmentingfluid volume. ure caused by hypertension, hypovolemia,
or nephrotoxins,theotherresponseswould
b. maintainingcardiacout- be correct.
put.
c. dilutingnephrotoxicsub-
stances.
d. preventingsystemichyper-
tension.
3. Apatientwhohasacute
glomerulonephritisis hos- ANS:C
pitalizedwithhyperkalemia.
Whichinformationwill the Thecalciumgluconatehelpspreventdys-
,f
rhythmiasthat might becausedbythe hy-
,f
1 /
134
, nursemonitortoevaluate perkalemia.Thenursewillmonitortheother
,f ,f
theeffectivenessofthepre- dataaswell, butthese willnotbe helpful in
scribedcalciumgluconate determiningtheeffectivenessofthecalcium
IV? gluconate.
a. Urine volume
b. Calciumlevel
c. Cardiacrhythm
d. Neurologicstatus
4. Whichinformationwill the ANS:B
nursemonitorinordertode-
terminetheeffectivenessof Calcium carbonate is prescribed to bind
prescribedcalciumcarbon- phosphorus and prevent mineral and
ate(Caltrate) forapatientwith bone
chronickidneydisease diseaseinpatientswithCKD.Theotherdata
,f
(CKD)? willnotbehelpfulinevaluatingtheeffective-
ness ofcalcium carbonate.
a. Bloodpressure
b. Phosphatelevel
c. Neurologicstatus
d. Creatinineclearance
5. Sodiumpolystyrenesul-
fonate(Kayexalate)isor- ANS:A
deredforapatientwithhyper-Sodiumpolystyrenesulfonate(Kayexalate)
,f
kalemia. should notbe given toa patient with apar-
Beforeadminister- alytic ileus (as indicated by absent bowel
ingthemedication,thenurse sounds)becausebowelnecrosiscanoccur.
shouldassessthe TheBUNandcreatinine,bloodglucose,and
LOCwouldnotaffectthenurse'sdecisionto
,f ,f ,f
a. bowelsounds. give the medication.
b. bloodglucose.
2 /
134
, c. bloodureanitrogen(BUN).
d. levelofconsciousness
(LOC).
6. Beforeadministration of cal- ANS:C
ciumcarbonate(Caltrate) to
a patientwithchronickid- Ifserumphosphateiselevated,thecalcium
neydisease(CKD),thenurse and phosphate cancause softtissuecalci-
shouldchecklaboratoryre- fication.The calcium carbonate should not
sults for begivenuntilthephosphatelevelislowered.
,f
Totalcholesterol,creatinine,andpotassium
a. potassiumlevel. valuesdonotaffectwhethercalciumcarbon-ate
,f ,f
should be administered.
b. totalcholesterol.
c. serumphosphate.
d. serumcreatinine.
7. A 37-year-oldfemalepatient ANS:C
ishospitalizedwithacutekid-
,f
neyinjury(AKI).Whichin- GFR isthe preferred method for
formationwill be mostuse- evaluating kidney function. BUN levels
ful to thenurseinevaluating can fluctuate
improvementinkidneyfunc- basedonfactorssuchasfluidvolumestatus
,f ,f
tion? andproteinintake.Urineoutputcanbenor-
malorhighinpatientswithAKIanddoesnot
a. Urine volume accuratelyreflectkidneyfunction.Creatinine
,f
alone isnotan accurate reflection of
b. Creatininelevel renal function.
c. Glomerularfiltrationrate
(GFR)
d. Bloodureanitrogen(BUN)
level
3 /
134
, 8. Apatientwillneedvascu- ANS:A
laraccessforhemodialysis.
Whichstatementbythenurse
,f Arteriovenous (AV) fistulas are much less
accuratelydescribesanad- likely toclotthan grafts, although it takes
vantageofafistulaovera longerforthemtomaturetothepointwhere they
,f
graft? can be used for dialysis.The choice ofan AV
fistula oragraft does not have animpact on
,f
a. Afistulaismuchlesslikely to needle sizeorpatient mobility.
,f
clot.
b. Afistulaincreasespatient
,f
mobility.
c. Afistulacanaccommodate
,f
largerneedles.
d. Afistulacanbeusedsoon- er
,f
aftersurgery.
9. A64-year-oldmalepatient
,f ANS:C
whohashadprogressive
chronickidneydisease(CKD) Oncethe patientisstarted on dialysis and
for several yearshasjust nitrogenouswastesareremoved,morepro-
begunregularhemodialysis. tein inthe diet is encouraged. Fluids are
,f
Whichinformationaboutdiet stillrestrictedtoavoidexcessiveweightgain
will the nurseincludein pa- andcomplications such asshortness of
tientteaching? breath.Glucoseisnotlostduringhemodialy-
,f ,f
sis.Sodiumandpotassiumintakecontinues to
a. Increasedcaloriesare be restricted to avoid thecomplications
neededbecauseglucoseis associated with high levels of these elec-
lostduringhemodialysis. trolytes.
b. Unlimitedfluidsareal-
lowedbecauseretainedfluid
,f
isremovedduringdialysis.
c. More protein is allowed
be- cause urea and
creatinine are
removedbydialysis.
4 /
134
kidneyinjury(AKI)hasanar-
terialblood pH of 7.30, the Patients with metabolic acidosis caused by
nursewillexpectanassess- AKImayhaveKussmaulrespirationsasthe
mentfindingof lungstrytoregulatecarbondioxide.Bound- ing
pulses andvasodilation are not associ-
a. persistentskintenting ated with metabolic acidosis. Because the
patient is likely to have fluid retention,
b. rapid,deeprespirations. poorskin turgor would notbea finding in
AKI.
c. boundingperipheralpuls-
es.
d. hot,flushedfaceandneck.
2. The nurseisplanningcare
forapatientwithsevereheart
,f ANS:B
failurewhohasdeveloped
elevatedbloodureanitro- Theprimarygoaloftreatmentforacutekid-
gen(BUN)andcreatininelev- neyinjury(AKI)istoeliminatethecauseand
,f ,f
els.Theprimarycollaborative providesupportivecarewhilethekidneysre-
treatmentgoalintheplanwill
,f cover.Becausethispatient'sheartfailureis
be causingAKI,thecarewillbedirectedtoward
treatmentoftheheart failure.For renal fail-
a. augmentingfluid volume. ure caused by hypertension, hypovolemia,
or nephrotoxins,theotherresponseswould
b. maintainingcardiacout- be correct.
put.
c. dilutingnephrotoxicsub-
stances.
d. preventingsystemichyper-
tension.
3. Apatientwhohasacute
glomerulonephritisis hos- ANS:C
pitalizedwithhyperkalemia.
Whichinformationwill the Thecalciumgluconatehelpspreventdys-
,f
rhythmiasthat might becausedbythe hy-
,f
1 /
134
, nursemonitortoevaluate perkalemia.Thenursewillmonitortheother
,f ,f
theeffectivenessofthepre- dataaswell, butthese willnotbe helpful in
scribedcalciumgluconate determiningtheeffectivenessofthecalcium
IV? gluconate.
a. Urine volume
b. Calciumlevel
c. Cardiacrhythm
d. Neurologicstatus
4. Whichinformationwill the ANS:B
nursemonitorinordertode-
terminetheeffectivenessof Calcium carbonate is prescribed to bind
prescribedcalciumcarbon- phosphorus and prevent mineral and
ate(Caltrate) forapatientwith bone
chronickidneydisease diseaseinpatientswithCKD.Theotherdata
,f
(CKD)? willnotbehelpfulinevaluatingtheeffective-
ness ofcalcium carbonate.
a. Bloodpressure
b. Phosphatelevel
c. Neurologicstatus
d. Creatinineclearance
5. Sodiumpolystyrenesul-
fonate(Kayexalate)isor- ANS:A
deredforapatientwithhyper-Sodiumpolystyrenesulfonate(Kayexalate)
,f
kalemia. should notbe given toa patient with apar-
Beforeadminister- alytic ileus (as indicated by absent bowel
ingthemedication,thenurse sounds)becausebowelnecrosiscanoccur.
shouldassessthe TheBUNandcreatinine,bloodglucose,and
LOCwouldnotaffectthenurse'sdecisionto
,f ,f ,f
a. bowelsounds. give the medication.
b. bloodglucose.
2 /
134
, c. bloodureanitrogen(BUN).
d. levelofconsciousness
(LOC).
6. Beforeadministration of cal- ANS:C
ciumcarbonate(Caltrate) to
a patientwithchronickid- Ifserumphosphateiselevated,thecalcium
neydisease(CKD),thenurse and phosphate cancause softtissuecalci-
shouldchecklaboratoryre- fication.The calcium carbonate should not
sults for begivenuntilthephosphatelevelislowered.
,f
Totalcholesterol,creatinine,andpotassium
a. potassiumlevel. valuesdonotaffectwhethercalciumcarbon-ate
,f ,f
should be administered.
b. totalcholesterol.
c. serumphosphate.
d. serumcreatinine.
7. A 37-year-oldfemalepatient ANS:C
ishospitalizedwithacutekid-
,f
neyinjury(AKI).Whichin- GFR isthe preferred method for
formationwill be mostuse- evaluating kidney function. BUN levels
ful to thenurseinevaluating can fluctuate
improvementinkidneyfunc- basedonfactorssuchasfluidvolumestatus
,f ,f
tion? andproteinintake.Urineoutputcanbenor-
malorhighinpatientswithAKIanddoesnot
a. Urine volume accuratelyreflectkidneyfunction.Creatinine
,f
alone isnotan accurate reflection of
b. Creatininelevel renal function.
c. Glomerularfiltrationrate
(GFR)
d. Bloodureanitrogen(BUN)
level
3 /
134
, 8. Apatientwillneedvascu- ANS:A
laraccessforhemodialysis.
Whichstatementbythenurse
,f Arteriovenous (AV) fistulas are much less
accuratelydescribesanad- likely toclotthan grafts, although it takes
vantageofafistulaovera longerforthemtomaturetothepointwhere they
,f
graft? can be used for dialysis.The choice ofan AV
fistula oragraft does not have animpact on
,f
a. Afistulaismuchlesslikely to needle sizeorpatient mobility.
,f
clot.
b. Afistulaincreasespatient
,f
mobility.
c. Afistulacanaccommodate
,f
largerneedles.
d. Afistulacanbeusedsoon- er
,f
aftersurgery.
9. A64-year-oldmalepatient
,f ANS:C
whohashadprogressive
chronickidneydisease(CKD) Oncethe patientisstarted on dialysis and
for several yearshasjust nitrogenouswastesareremoved,morepro-
begunregularhemodialysis. tein inthe diet is encouraged. Fluids are
,f
Whichinformationaboutdiet stillrestrictedtoavoidexcessiveweightgain
will the nurseincludein pa- andcomplications such asshortness of
tientteaching? breath.Glucoseisnotlostduringhemodialy-
,f ,f
sis.Sodiumandpotassiumintakecontinues to
a. Increasedcaloriesare be restricted to avoid thecomplications
neededbecauseglucoseis associated with high levels of these elec-
lostduringhemodialysis. trolytes.
b. Unlimitedfluidsareal-
lowedbecauseretainedfluid
,f
isremovedduringdialysis.
c. More protein is allowed
be- cause urea and
creatinine are
removedbydialysis.
4 /
134
