Lewis - Chapter 49: Nursing Management: Acute Kidney Injury and Chronic
Kidney Exam Questions and Answers With Verified Solutions 2025
The nurse is caring for a client who has had an insertion of an arteriovenous graft (AVG)
in the right forearm and has symptoms of pain and coldness of the right fingers. Which of
the following actions should the nurse take?
a. Elevate the client's arm above the level of the heart
b. Report the client's symptoms to the health care provider
c. Remind the client about the need to take a daily low-dose Aspirin tablet
d. Educate the client about the normal vascular response after AVG insertion - ✔✔ANS: B
The client's complaints suggest the development of distal ischemia (steal syndrome) and
may require revision of the AVG. Elevation of the arm above the heart will decrease
perfusion. Pain and coolness are not normal after AVG insertion. Aspirin therapy is not
used to maintain grafts.
The nurse is caring for a client with acute kidney injury (AKI) who has an arterial blood
pH of 7.30. Which of the following assessment findings should the nurse anticipate?
a. Vasodilation
b. Poor skin turgor
c. Bounding pulses
d. Rapid respirations - ✔✔ANS: D
Clients with metabolic acidosis caused by AKI may have Kussmaul's respirations as the
lungs try to regulate carbon dioxide. Bounding pulses and vasodilation are not associated
with metabolic acidosis. Because the client is likely to have fluid retention, poor skin
turgor would not be a finding in AKI.
, The nurse is caring for a client with severe heart failure who develops elevated blood urea nitrogen
(BUN) and creatinine levels. The nurse will plan care to meet which of the
following goals of treatment?
a. Replace fluid volume
b. Prevent hypertension
c. Maintain cardiac output
d. Dilute nephrotoxic substances - ✔✔ANS: C
The primary goal of treatment for acute kidney injury (AKI) is to eliminate the cause and
provide supportive care while the kidneys recover. Because this client's heart failure is
causing AKI, the care will be directed toward treatment of the heart failure. For renal
failure caused by hypertension, hypovolemia, or nephrotoxins, the other responses would
be correct.
The nurse is caring for a client with acute glomerulonephritis, acute kidney injury (AKI),
and hyperkalemia who is prescribed calcium gluconate IV. Which of the following
parameters should the nurse assess to evaluate the effectiveness of the medication?
a. Urine output
b. Calcium level
c. Cardiac rhythm
d. Neurologic status - ✔✔ANS: C
The calcium gluconate helps prevent dysrhythmias that might be caused by the
hyperkalemia. The nurse will monitor the other data as well, but these will not be helpful
in determining the effectiveness of the calcium gluconate.
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?
Kidney Exam Questions and Answers With Verified Solutions 2025
The nurse is caring for a client who has had an insertion of an arteriovenous graft (AVG)
in the right forearm and has symptoms of pain and coldness of the right fingers. Which of
the following actions should the nurse take?
a. Elevate the client's arm above the level of the heart
b. Report the client's symptoms to the health care provider
c. Remind the client about the need to take a daily low-dose Aspirin tablet
d. Educate the client about the normal vascular response after AVG insertion - ✔✔ANS: B
The client's complaints suggest the development of distal ischemia (steal syndrome) and
may require revision of the AVG. Elevation of the arm above the heart will decrease
perfusion. Pain and coolness are not normal after AVG insertion. Aspirin therapy is not
used to maintain grafts.
The nurse is caring for a client with acute kidney injury (AKI) who has an arterial blood
pH of 7.30. Which of the following assessment findings should the nurse anticipate?
a. Vasodilation
b. Poor skin turgor
c. Bounding pulses
d. Rapid respirations - ✔✔ANS: D
Clients with metabolic acidosis caused by AKI may have Kussmaul's respirations as the
lungs try to regulate carbon dioxide. Bounding pulses and vasodilation are not associated
with metabolic acidosis. Because the client is likely to have fluid retention, poor skin
turgor would not be a finding in AKI.
, The nurse is caring for a client with severe heart failure who develops elevated blood urea nitrogen
(BUN) and creatinine levels. The nurse will plan care to meet which of the
following goals of treatment?
a. Replace fluid volume
b. Prevent hypertension
c. Maintain cardiac output
d. Dilute nephrotoxic substances - ✔✔ANS: C
The primary goal of treatment for acute kidney injury (AKI) is to eliminate the cause and
provide supportive care while the kidneys recover. Because this client's heart failure is
causing AKI, the care will be directed toward treatment of the heart failure. For renal
failure caused by hypertension, hypovolemia, or nephrotoxins, the other responses would
be correct.
The nurse is caring for a client with acute glomerulonephritis, acute kidney injury (AKI),
and hyperkalemia who is prescribed calcium gluconate IV. Which of the following
parameters should the nurse assess to evaluate the effectiveness of the medication?
a. Urine output
b. Calcium level
c. Cardiac rhythm
d. Neurologic status - ✔✔ANS: C
The calcium gluconate helps prevent dysrhythmias that might be caused by the
hyperkalemia. The nurse will monitor the other data as well, but these will not be helpful
in determining the effectiveness of the calcium gluconate.
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?
