MS3 Exam 3 Practice Questions With
Correct Answers
The nurse caring for a client in the diuretic phase of acute renal failure (ARF)
| | | | | | | | | | | | | | |
should assess for manifestations of
| | | |
a. dehydration.
|
b. hypertension.
|
c. hypokalemia.
|
d. metabolic acidosis.
| |
A ~ A gradual or abrupt return to glomerular filtration and leveling of blood urea
| | | | | | | | | | | | | | |
nitrogen (BUN) level signal the diuretic phase. Urine output may be 1000 ml/day,
| | | | | | | | | | | | |
which may lead to dehydration.
| | | |
Which is the most common cause of acute renal failure in children?
| | | | | | | | | | |
a. Pyelonephritis
|
b. Tubular destruction
| |
c. Urinary tract obstruction
| | |
d. Severe dehydration
| |
D ~ The most common cause of acute renal failure in children is dehydration or
| | | | | | | | | | | | | | |
other causes of poor perfusion that may respond to restoration of fluid volume.
| | | | | | | | | | | | |
Pyelonephritis and tubular destruction are not common causes of acute renal
| | | | | | | | | | |
failure. Obstructive uropathy may cause acute renal failure, but it is not the most
| | | | | | | | | | | | | |
common cause. |
List the GFR rates in the different stages of renal failure.
| | | | | | | | | |
Stage 1 = <90 mL/min
| | | |
Stage 2 = <60 mL/min
| | | |
Stage 3 = <45 mL/min
| | | |
,Stage 4 = <30 mL/min| | | |
Stage 5 = <15 mL/min| | | |
A client with ARF is allowed a specific amount of fluid by mouth during 24 hours
| | | | | | | | | | | | | | | |
in order to
| |
a. compensate for insensible and measured fluid losses during the previous 24
| | | | | | | | | | | |
hours.
b. equal the expected urine output for the next 24 hours.
| | | | | | | | | |
c. prevent hyperkalemia, which could lead to serious cardiac dysrhythmia.
| | | | | | | | |
d. prevent the development of complicating hypostatic pneumonia.
| | | | | | |
A ~ Fluid replacement volumes are usually calculated on the basis of some
| | | | | | | | | | | | |
fraction of the previous days urine output plus an amount (e.g., 400 ml) to
| | | | | | | | | | | | | |
account for the usual insensible loss that occurs during a 24-hour period.
| | | | | | | | | | |
What is the normal lab value for serum ALBUMIN?
| | | | | | | |
3.5-5.5 g/dL |
The nurse is conducting an admission assessment on a school-age child with
| | | | | | | | | | | |
acute renal failure. Which are the primary clinical manifestations the nurse
| | | | | | | | | | |
expects to find with this condition?
| | | | |
a. Oliguria and hypertension
| | |
b. Hematuria and pallor
| | |
c. Proteinuria and muscle cramps
| | | |
d. Bacteriuria and facial edema
| | | |
A ~ The principal feature of acute renal failure is oliguria; hypertension is a
| | | | | | | | | | | | | |
nonspecific clinical manifestation. Hematuria and pallor, proteinuria and muscle
| | | | | | | | |
cramps, and bacteriuria and facial edema are not principal features of acute renal
| | | | | | | | | | | |
failure.
|
The nurse explains that a cation exchange resin such as Kayexalate will
| | | | | | | | | | |
a. decrease diastolic blood pressure.
| | | |
b. stimulate diuresis by osmosis.
| | | |
c. increase appetite by decreasing insulin degradation.
| | | | | |
d. increase gastrointestinal potassium excretion.
| | | |
,D ~ Hyperkalemia is probably the most dangerous imbalance because of its
| | | | | | | | | | | |
contribution to cardiac dysrhythmias and arrest. Cation exchange resins such as
| | | | | | | | | | |
sodium polystyrene sulfonate (Kayexalate) may be administered orally or rectally
| | | | | | | | | |
to facilitate excretion of potassium from the gastrointestinal (GI) tract.
| | | | | | | | |
The nurse is caring for a child with acute renal failure. Which clinical
| | | | | | | | | | | | |
manifestation should the nurse recognize as a sign of hyperkalemia? | | | | | | | | |
a. Dyspnea
|
b. Seizure
|
c. Oliguria
|
d. Cardiac arrhythmia
| |
D ~ Hyperkalemia is the most common threat to the life of the child. Signs of
| | | | | | | | | | | | | | | |
hyperkalemia include electrocardiograph anomalies such as prolonged QRS | | | | | | | |
complex, depressed ST segments, peaked T waves, bradycardia, or heart block.
| | | | | | | | | | |
Dyspnea, seizure, and oliguria are not manifestations of hyperkalemia.
| | | | | | | |
What is the normal lab value for serum PHOSPHORUS?
| | | | | | | |
2.4-4.1 mg/dL |
A client with oliguric ARF would exhibit
| | | | | |
a. a BUN/creatinine ratio of 30:1.
| | | | |
b. hematuria.
|
c. proteinuria.
|
d. a urine specific gravity of 1.001.
| | | | | |
A ~ In oliguric ARF, urine production usually falls below 400 ml/day. The
| | | | | | | | | | | |
BUN/creatinine ratio is significantly elevated, reaching levels of 10:1 to 40:1.
| | | | | | | | | | |
What is the Normal Osmolality of Urine?
| | | | | |
300-900 mOsm/kg |
When a child has chronic renal failure, the progressive deterioration produces a
| | | | | | | | | | | |
variety of clinical and biochemical disturbances that eventually are manifested in
| | | | | | | | | | |
the clinical syndrome known as:
| | | |
a. uremia.
|
, b. oliguria.
|
c. proteinuria.
|
d. pyelonephritis.
|
A ~ Uremia is the retention of nitrogenous products, producing toxic symptoms.
| | | | | | | | | | | |
Oliguria is diminished urinary output. Proteinuria is the presence of protein,
| | | | | | | | | | |
usually albumin, in the urine. Pyelonephritis is an inflammation of the kidney and
| | | | | | | | | | | | |
renal pelvis. |
The nurse explains to a client's family that the most common overall
| | | | | | | | | | | |
manifestation of ARF is that | | | |
a. expected urine output is altered.
| | | | |
b. the client's breath develops a fruity odor.
| | | | | | |
c. urine specific gravity is greater than 1.040.
| | | | | | |
d. urine develops a root beer color.
| | | | | |
A ~ The most common overall manifestation of ARF is alteration in the expected
| | | | | | | | | | | | | |
urine output. Usually this is oliguria or anuria, although polyuric ARF accounts for
| | | | | | | | | | | | |
30% of cases. | |
What is the normal lab value for Serum Creatinine?
| | | | | | | |
0.6-1.2 mg/dL |
Which is a major complication in a child with chronic renal failure?
| | | | | | | | | | |
a. Hypokalemia
|
b. Metabolic alkalosis
| |
c. Water and sodium retention
| | | |
d. Excessive excretion of blood urea nitrogen
| | | | | |
C ~ Chronic renal failure leads to water and sodium retention, which contributes
| | | | | | | | | | | | |
to edema and vascular congestion. Hyperkalemia, metabolic acidosis, and
| | | | | | | | |
retention of blood urea nitrogen are complications of chronic renal failure.
| | | | | | | | | |
A client has been on dialysis for 6 weeks. The family is complaining that instead of
| | | | | | | | | | | | | | |
feeling grateful at this second chance at life, the client has become irritable with
| | | | | | | | | | | | | | |
them and seems depressed. The most helpful response by the nurse would be
| | | | | | | | | | | |
Correct Answers
The nurse caring for a client in the diuretic phase of acute renal failure (ARF)
| | | | | | | | | | | | | | |
should assess for manifestations of
| | | |
a. dehydration.
|
b. hypertension.
|
c. hypokalemia.
|
d. metabolic acidosis.
| |
A ~ A gradual or abrupt return to glomerular filtration and leveling of blood urea
| | | | | | | | | | | | | | |
nitrogen (BUN) level signal the diuretic phase. Urine output may be 1000 ml/day,
| | | | | | | | | | | | |
which may lead to dehydration.
| | | |
Which is the most common cause of acute renal failure in children?
| | | | | | | | | | |
a. Pyelonephritis
|
b. Tubular destruction
| |
c. Urinary tract obstruction
| | |
d. Severe dehydration
| |
D ~ The most common cause of acute renal failure in children is dehydration or
| | | | | | | | | | | | | | |
other causes of poor perfusion that may respond to restoration of fluid volume.
| | | | | | | | | | | | |
Pyelonephritis and tubular destruction are not common causes of acute renal
| | | | | | | | | | |
failure. Obstructive uropathy may cause acute renal failure, but it is not the most
| | | | | | | | | | | | | |
common cause. |
List the GFR rates in the different stages of renal failure.
| | | | | | | | | |
Stage 1 = <90 mL/min
| | | |
Stage 2 = <60 mL/min
| | | |
Stage 3 = <45 mL/min
| | | |
,Stage 4 = <30 mL/min| | | |
Stage 5 = <15 mL/min| | | |
A client with ARF is allowed a specific amount of fluid by mouth during 24 hours
| | | | | | | | | | | | | | | |
in order to
| |
a. compensate for insensible and measured fluid losses during the previous 24
| | | | | | | | | | | |
hours.
b. equal the expected urine output for the next 24 hours.
| | | | | | | | | |
c. prevent hyperkalemia, which could lead to serious cardiac dysrhythmia.
| | | | | | | | |
d. prevent the development of complicating hypostatic pneumonia.
| | | | | | |
A ~ Fluid replacement volumes are usually calculated on the basis of some
| | | | | | | | | | | | |
fraction of the previous days urine output plus an amount (e.g., 400 ml) to
| | | | | | | | | | | | | |
account for the usual insensible loss that occurs during a 24-hour period.
| | | | | | | | | | |
What is the normal lab value for serum ALBUMIN?
| | | | | | | |
3.5-5.5 g/dL |
The nurse is conducting an admission assessment on a school-age child with
| | | | | | | | | | | |
acute renal failure. Which are the primary clinical manifestations the nurse
| | | | | | | | | | |
expects to find with this condition?
| | | | |
a. Oliguria and hypertension
| | |
b. Hematuria and pallor
| | |
c. Proteinuria and muscle cramps
| | | |
d. Bacteriuria and facial edema
| | | |
A ~ The principal feature of acute renal failure is oliguria; hypertension is a
| | | | | | | | | | | | | |
nonspecific clinical manifestation. Hematuria and pallor, proteinuria and muscle
| | | | | | | | |
cramps, and bacteriuria and facial edema are not principal features of acute renal
| | | | | | | | | | | |
failure.
|
The nurse explains that a cation exchange resin such as Kayexalate will
| | | | | | | | | | |
a. decrease diastolic blood pressure.
| | | |
b. stimulate diuresis by osmosis.
| | | |
c. increase appetite by decreasing insulin degradation.
| | | | | |
d. increase gastrointestinal potassium excretion.
| | | |
,D ~ Hyperkalemia is probably the most dangerous imbalance because of its
| | | | | | | | | | | |
contribution to cardiac dysrhythmias and arrest. Cation exchange resins such as
| | | | | | | | | | |
sodium polystyrene sulfonate (Kayexalate) may be administered orally or rectally
| | | | | | | | | |
to facilitate excretion of potassium from the gastrointestinal (GI) tract.
| | | | | | | | |
The nurse is caring for a child with acute renal failure. Which clinical
| | | | | | | | | | | | |
manifestation should the nurse recognize as a sign of hyperkalemia? | | | | | | | | |
a. Dyspnea
|
b. Seizure
|
c. Oliguria
|
d. Cardiac arrhythmia
| |
D ~ Hyperkalemia is the most common threat to the life of the child. Signs of
| | | | | | | | | | | | | | | |
hyperkalemia include electrocardiograph anomalies such as prolonged QRS | | | | | | | |
complex, depressed ST segments, peaked T waves, bradycardia, or heart block.
| | | | | | | | | | |
Dyspnea, seizure, and oliguria are not manifestations of hyperkalemia.
| | | | | | | |
What is the normal lab value for serum PHOSPHORUS?
| | | | | | | |
2.4-4.1 mg/dL |
A client with oliguric ARF would exhibit
| | | | | |
a. a BUN/creatinine ratio of 30:1.
| | | | |
b. hematuria.
|
c. proteinuria.
|
d. a urine specific gravity of 1.001.
| | | | | |
A ~ In oliguric ARF, urine production usually falls below 400 ml/day. The
| | | | | | | | | | | |
BUN/creatinine ratio is significantly elevated, reaching levels of 10:1 to 40:1.
| | | | | | | | | | |
What is the Normal Osmolality of Urine?
| | | | | |
300-900 mOsm/kg |
When a child has chronic renal failure, the progressive deterioration produces a
| | | | | | | | | | | |
variety of clinical and biochemical disturbances that eventually are manifested in
| | | | | | | | | | |
the clinical syndrome known as:
| | | |
a. uremia.
|
, b. oliguria.
|
c. proteinuria.
|
d. pyelonephritis.
|
A ~ Uremia is the retention of nitrogenous products, producing toxic symptoms.
| | | | | | | | | | | |
Oliguria is diminished urinary output. Proteinuria is the presence of protein,
| | | | | | | | | | |
usually albumin, in the urine. Pyelonephritis is an inflammation of the kidney and
| | | | | | | | | | | | |
renal pelvis. |
The nurse explains to a client's family that the most common overall
| | | | | | | | | | | |
manifestation of ARF is that | | | |
a. expected urine output is altered.
| | | | |
b. the client's breath develops a fruity odor.
| | | | | | |
c. urine specific gravity is greater than 1.040.
| | | | | | |
d. urine develops a root beer color.
| | | | | |
A ~ The most common overall manifestation of ARF is alteration in the expected
| | | | | | | | | | | | | |
urine output. Usually this is oliguria or anuria, although polyuric ARF accounts for
| | | | | | | | | | | | |
30% of cases. | |
What is the normal lab value for Serum Creatinine?
| | | | | | | |
0.6-1.2 mg/dL |
Which is a major complication in a child with chronic renal failure?
| | | | | | | | | | |
a. Hypokalemia
|
b. Metabolic alkalosis
| |
c. Water and sodium retention
| | | |
d. Excessive excretion of blood urea nitrogen
| | | | | |
C ~ Chronic renal failure leads to water and sodium retention, which contributes
| | | | | | | | | | | | |
to edema and vascular congestion. Hyperkalemia, metabolic acidosis, and
| | | | | | | | |
retention of blood urea nitrogen are complications of chronic renal failure.
| | | | | | | | | |
A client has been on dialysis for 6 weeks. The family is complaining that instead of
| | | | | | | | | | | | | | |
feeling grateful at this second chance at life, the client has become irritable with
| | | | | | | | | | | | | | |
them and seems depressed. The most helpful response by the nurse would be
| | | | | | | | | | | |
