Scienc Medicin Nursin
NSG 252 Exam 1
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NSG 252 exam 2 (exemplars NSG 252 exam 1 (exemplars Exam 2 - NSG 25 HESI
588 terms 483 terms 137terms 98 terms
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Terms in this set (120)
The nurse is caring for a client admitted with a diagnosisAnswer: B
of acute kidney injury (AKI). The client asks the nurse, "Are
my kidneys failing? Will I need a kidney transplant?" Explanation: Acute kidney injury (AKI) is often resolved without the need for
Which response by the nurse is the most appropriate? transplant if treatment is initiated quickly. There is no need to start lining up
donors or wait for the provider to arrive to explore options. Telling the client that
A) "No, don't think that. You're going to be fine." everything will be fine is condescending, provides no information, and is not
B) "In most cases, your condition can be reversed with within the nurse's ability to know
prompt treatment and usually will not destroy the
kidneys."
C) "Kidney transplantation is highly likely, so it would be a
good idea to start talking to your family members about
organ donation."
D) "When the doctor comes to see you, we can talk about
whether you will need a transplant."
A client diagnosed with frequent urinary tract infections Answer:
is A, B, E
seen in the urology clinic. The nurse reviews the client's
medical history and determines that the client is at risk for
Explanation: Dehydration, renal calculi, and hypertension can all precipitate acute
acute kidney injury. Which items in the client's history kidney injury (AKI). Ineffective wound healing has not been shown to cause renal
support this conclusion? Select all that apply. failure unless the infection becomes systemic. A low serum albumin does not
cause AKI.
A) Dehydration
B) Renal calculi
C) Ineffective wound healing
D) Low serum albumin
E) Hypertension
,A young school-age client is in the hospital with an
Answer:
acute D
kidney injury diagnosis following a streptococcus
infection. The client's parents primarily speak Spanish
Explanation:
but Clients with streptococcus are at risk for kidney and cardiac
have a limited ability to understand English. Through
sequelae.
an In this case, the child has no evidence of a congenital defect leading to
interpreter, the parents ask the nurse what mistake
acute
they
kidney injury (AKI). A low-protein or low-calcium diet will not lead to AKI.
made that caused their child to be so sick. Which
response by the nurse is the most appropriate?
A) "Your child does not eat enough dietary protein."
B) "Your child has a congenital defect that led to renal
failure.
" "Your child's renal failure has been caused by a low
C)
calcium level."
D) "Your child's recent infection may have caused the
renal failure."
The nurse is planning care for a client diagnosed Answer:
with A
acute kidney injury (AKI). The nurse plans the client's care
based on the nursing diagnosis of Excess Fluid Volume.
Explanation: The client in acute kidney injury (AKI) will likely be edematous,
Which assessment data supports this nursing diagnosis?
because the kidneys are not producing urine. Wheezing in the lungs is an
assessment consistent with asthma, not AKI. Bowel sounds in four quadrants is a
A) Pitting edema in the lower extremities normal assessment finding. Generalized weakness may be due to whatever
B) Bowel sounds positive in four quadrants disease process precipitated the kidney failure.
C) Wheezing in the lungs
D) Generalized weakness
A client diagnosed with acute kidney injury (AKI) Answer:
is C
receiving peritoneal dialysis. The nurse is explaining the
dialysis process to the client and family. Which statement
Explanation: The peritoneum acts as a semipermeable membrane, allowing
should the nurse include in this discussion? substances to move from an area of high concentration (the blood) to an area of
lower concentration (the dialysate). Metabolic waste products and excess water
A) "The peritoneum is more permeable because of
canthe
be eliminated through osmosis and diffusion using the peritoneum as the
presence of excess metabolites." semipermeable membrane.
B) "The metabolites will diffuse from the interstitial space
to the bloodstream mainly through diffusion and
ultrafiltration.
" "The peritoneum acts as a semipermeable membrane
C)
through which wastes move by diffusion and osmosis."
D) "The solutes in the dialysate will enter the bloodstream
through the peritoneum."
The nurse is caring for a client diagnosed with acute
Answer: A, B
kidney injury (AKI). When reviewing the client's laboratory
data, which findings should indicate to the nurse Explanation:
that the Creatinine is the metabolic end product of creatine phosphate and is
client has met the expected outcomes? Select allexcreted
that via the kidneys in relatively constant amounts. BUN, a measurement of
apply. the nitrogen portion of urea, is also excreted in urine and is a good indicator of
renal function. Neutrophils, lymphocytes, and erythrocytes are not used to
A) Decreasing serum creatinine monitor the return of renal function.
B) Decreasing blood urea nitrogen (BUN)
C) Decreasing neutrophil count
D) Decreasing lymphocyte count
E) Decreasing erythrocyte count
,What is the most frequent complication during Answer: B
hemodialysis?
Explanation: Hypotension is the most frequent complication during hemodialysis.
A) Hemorrhage It may result from changes in serum osmolality, rapid removal of fluid from the
B) Hypotension vascular compartment, vasodilation, and other factors. Bleeding is another
C) Localized infection possible complication, although it does not occur as often as hypotension.
D) Hypertension Infection is also commonly associated with hemodialysis, although it occurs
following treatment rather than during dialysis.
A client diagnosed with acute kidney injury (AKI) Answer:
will be A
discharged to home in the next few days. When
conducting dietary instruction, the nurse should teach
Explanation:
the Eggs are an excellent source of essential amino acids and are
client to choose proteins that are high in biological
recommended
value. as part of the diet for a client with acute kidney injury (AKI) who is
Which client statement indicates that this teaching
on has
a protein-restricted diet. Legumes, nuts, and vegetables do contain protein,
been effective? but they are incomplete proteins and thus not as good a protein source as eggs.
A) "I will be sure to include eggs in my diet."
B) "I should include vegetables at every meal."
C) "Legumes should be included in my diet, because they
are complete proteins."
D) "I will eat nuts daily because they are high in protein."
The nurse is planning care for a client admitted with
Answer:
a D
diagnosis of heart failure. Based on this diagnosis, which
type of kidney failure is the client at an increasedExplanation:
risk for Heart failure is one possible cause of prerenal kidney failure due to
experiencing? low cardiac output. In comparison, causes of prerenal kidney failure due to
hypovolemia include hemorrhage, dehydration, burns, wounds, and excess fluid
A) Prerenal hypovolemia loss from the gastrointestinal tract. Causes of intrarenal kidney failure due to
B) Intrarenal glomerular injury glomerular injury include glomerulonephritis, disseminated intravascular
C) Intrarenal acute tubular necrosis coagulation, vasculitis, hypertension, toxemia of pregnancy, and hemolytic uremic
D) Prerenal low cardiac output syndrome. Finally, causes of intrarenal kidney failure due to acute tubular necrosis
include ischemia resulting from conditions associated with prerenal failure, toxins,
hemolysis, and rhabdomyolysis.
The nurse is concerned that an older adult client Answer:
is at riskA, B, C
for developing acute kidney injury (AKI). Which data in
the client's history supports the nurse's concern?Explanation:
Select Older adults develop acute kidney injury more frequently because of
all that apply. the higher incidence of serious illnesses, hypotension, major surgeries, diagnostic
procedures, and treatment with nephrotoxic drugs. Decreased kidney function
A) Diagnosed with hypotension associated with aging also puts the older client at risk for acute kidney injury.
B) Recent aortic valve replacement surgery Hypotension, aortic valve replacement surgery, and receipt of high doses of
C) Prescribed high doses of intravenous antibiotics
intravenous antibiotics increase this client's risk for developing acute kidney injury.
D) Total hip replacement surgery 5 years ago A previous history of hip replacement surgery and current treatment for type 2
E) Taking medication for type 2 diabetes mellitus diabetes mellitus are not identified risk factors for the development of acute
kidney injury.
, The community nurse visits the home of a youngAnswer:
child A, D, E
who is home from school because of sudden onset of
nausea, vomiting, and lethargy. The nurse suspects
Explanation:
acute Pediatric manifestations of acute kidney injury characteristically begin
kidney injury (AKI). Which clinical manifestations with
support
a healthy child who suddenly becomes ill with nonspecific symptoms that
the nurse's suspicions? Select all that apply. indicate a significant illness or injury. These symptoms may include any
combination of the following: nausea, vomiting, lethargy, edema, gross hematuria,
A) Elevated blood pressure oliguria, and hypertension. Postural hypotension is a manifestation of acute kidney
B) Postural hypotension injury in an older person. Wheezing is not a manifestation of acute kidney injury.
C) Wheezing
D) Edema
E) Hematuria
A client diagnosed with acute kidney injury (AKI) Answer:
has B
jugular vein distention, lower extremity edema, and
elevated blood pressure. Based on this data, which
Explanation: Jugular vein distention, edema, and elevated blood pressure are all
nursing diagnosis is most appropriate? indications of excess fluid. Thus, the diagnosis Excess Fluid Volume should be
selected to guide this client's care. Oliguria or reduced urine output would be a
A) Ineffective Renal Tissue Perfusion symptom associated with Ineffective Renal Tissue Perfusion. Alterations in heart
B) Excess Fluid Volume rate and rhythm would be symptoms associated with Risk for Decreased Cardiac
C) Risk for Decreased Cardiac Tissue Perfusion Tissue Perfusion. The client is not demonstrating any manifestations that indicate a
D) Risk for Infection Risk for Infection.
A client agrees to receive long-term hemodialysisAnswer:
to treatD
acute kidney injury (AKI). Based on this information, the
nurse should prepare the client for which surgicalExplanation: For long-term vascular access needed for hemodialysis, an
procedure? arteriovenous (AV) fistula is created. The fistula is created by surgical anastomosis
of an artery and vein, usually the radial artery and cephalic vein. It takes about a
A) Insertion of a double-lumen catheter into the month for the fistula to mature so that it can be used for taking and replacing
subclavian artery blood during dialysis. A double-lumen catheter inserted into a major artery is
B) Placement of a peritoneal catheter used as temporary vascular access for continuous renal replacement therapy. A
C) Insertion of a subarachnoid-peritoneal shunt peritoneal catheter is used for peritoneal dialysis, not hemodialysis. A
D) Placement of an arteriovenous fistula subarachnoid-peritoneal shunt is used to remove excess cerebrospinal fluid and
not for hemodialysis.
A client with acute kidney failure is complaining of
Answer:
a A
metallic taste in the mouth and has no appetite. Based on
this data, which intervention by the nurse is the most
Explanation: A metallic taste in the mouth is due to uremia. The nurse should
appropriate? provide mouth care before meals to reduce this taste sensation and improve the
client's oral intake. An antiemetic would be prescribed for nausea. Restricting
A) Provide mouth care before meals. fluids would not reduce the metallic taste in the mouth. Encouraging intake of
B) Administer an antiemetic as prescribed. protein, salt, and potassium would exacerbate the uremia that is causing the
C) Restrict fluids. metallic taste in the mouth.
D) Encourage the intake of protein, salt, and potassium.
A client diagnosed with recurrent urinary tract calculi
Answer: C
would be at elevated risk for which of the following types
of acute kidney injury (AKI)? Explanation: Obstructive causes of AKI are classified as postrenal. Any condition
that prevents urine excretion
—including urinary tract —
calculi
can lead to postrenal
A) Prerenal AKI AKI. In comparison, prerenal AKI results from conditions that affect renal blood
B) Intrinsic AKI flow and perfusion, and intrinsic AKI (also called intrarenal AKI) is characterized
C) Postrenal AKI by acute damage to the renal parenchyma and nephrons.
D) Intrarenal AKI
NSG 252 Exam 1
Students also studied
NSG 252 exam 2 (exemplars NSG 252 exam 1 (exemplars Exam 2 - NSG 25 HESI
588 terms 483 terms 137terms 98 terms
SLB_1 Preview SLB_1 Preview CarlyLauren8 Preview ag
Terms in this set (120)
The nurse is caring for a client admitted with a diagnosisAnswer: B
of acute kidney injury (AKI). The client asks the nurse, "Are
my kidneys failing? Will I need a kidney transplant?" Explanation: Acute kidney injury (AKI) is often resolved without the need for
Which response by the nurse is the most appropriate? transplant if treatment is initiated quickly. There is no need to start lining up
donors or wait for the provider to arrive to explore options. Telling the client that
A) "No, don't think that. You're going to be fine." everything will be fine is condescending, provides no information, and is not
B) "In most cases, your condition can be reversed with within the nurse's ability to know
prompt treatment and usually will not destroy the
kidneys."
C) "Kidney transplantation is highly likely, so it would be a
good idea to start talking to your family members about
organ donation."
D) "When the doctor comes to see you, we can talk about
whether you will need a transplant."
A client diagnosed with frequent urinary tract infections Answer:
is A, B, E
seen in the urology clinic. The nurse reviews the client's
medical history and determines that the client is at risk for
Explanation: Dehydration, renal calculi, and hypertension can all precipitate acute
acute kidney injury. Which items in the client's history kidney injury (AKI). Ineffective wound healing has not been shown to cause renal
support this conclusion? Select all that apply. failure unless the infection becomes systemic. A low serum albumin does not
cause AKI.
A) Dehydration
B) Renal calculi
C) Ineffective wound healing
D) Low serum albumin
E) Hypertension
,A young school-age client is in the hospital with an
Answer:
acute D
kidney injury diagnosis following a streptococcus
infection. The client's parents primarily speak Spanish
Explanation:
but Clients with streptococcus are at risk for kidney and cardiac
have a limited ability to understand English. Through
sequelae.
an In this case, the child has no evidence of a congenital defect leading to
interpreter, the parents ask the nurse what mistake
acute
they
kidney injury (AKI). A low-protein or low-calcium diet will not lead to AKI.
made that caused their child to be so sick. Which
response by the nurse is the most appropriate?
A) "Your child does not eat enough dietary protein."
B) "Your child has a congenital defect that led to renal
failure.
" "Your child's renal failure has been caused by a low
C)
calcium level."
D) "Your child's recent infection may have caused the
renal failure."
The nurse is planning care for a client diagnosed Answer:
with A
acute kidney injury (AKI). The nurse plans the client's care
based on the nursing diagnosis of Excess Fluid Volume.
Explanation: The client in acute kidney injury (AKI) will likely be edematous,
Which assessment data supports this nursing diagnosis?
because the kidneys are not producing urine. Wheezing in the lungs is an
assessment consistent with asthma, not AKI. Bowel sounds in four quadrants is a
A) Pitting edema in the lower extremities normal assessment finding. Generalized weakness may be due to whatever
B) Bowel sounds positive in four quadrants disease process precipitated the kidney failure.
C) Wheezing in the lungs
D) Generalized weakness
A client diagnosed with acute kidney injury (AKI) Answer:
is C
receiving peritoneal dialysis. The nurse is explaining the
dialysis process to the client and family. Which statement
Explanation: The peritoneum acts as a semipermeable membrane, allowing
should the nurse include in this discussion? substances to move from an area of high concentration (the blood) to an area of
lower concentration (the dialysate). Metabolic waste products and excess water
A) "The peritoneum is more permeable because of
canthe
be eliminated through osmosis and diffusion using the peritoneum as the
presence of excess metabolites." semipermeable membrane.
B) "The metabolites will diffuse from the interstitial space
to the bloodstream mainly through diffusion and
ultrafiltration.
" "The peritoneum acts as a semipermeable membrane
C)
through which wastes move by diffusion and osmosis."
D) "The solutes in the dialysate will enter the bloodstream
through the peritoneum."
The nurse is caring for a client diagnosed with acute
Answer: A, B
kidney injury (AKI). When reviewing the client's laboratory
data, which findings should indicate to the nurse Explanation:
that the Creatinine is the metabolic end product of creatine phosphate and is
client has met the expected outcomes? Select allexcreted
that via the kidneys in relatively constant amounts. BUN, a measurement of
apply. the nitrogen portion of urea, is also excreted in urine and is a good indicator of
renal function. Neutrophils, lymphocytes, and erythrocytes are not used to
A) Decreasing serum creatinine monitor the return of renal function.
B) Decreasing blood urea nitrogen (BUN)
C) Decreasing neutrophil count
D) Decreasing lymphocyte count
E) Decreasing erythrocyte count
,What is the most frequent complication during Answer: B
hemodialysis?
Explanation: Hypotension is the most frequent complication during hemodialysis.
A) Hemorrhage It may result from changes in serum osmolality, rapid removal of fluid from the
B) Hypotension vascular compartment, vasodilation, and other factors. Bleeding is another
C) Localized infection possible complication, although it does not occur as often as hypotension.
D) Hypertension Infection is also commonly associated with hemodialysis, although it occurs
following treatment rather than during dialysis.
A client diagnosed with acute kidney injury (AKI) Answer:
will be A
discharged to home in the next few days. When
conducting dietary instruction, the nurse should teach
Explanation:
the Eggs are an excellent source of essential amino acids and are
client to choose proteins that are high in biological
recommended
value. as part of the diet for a client with acute kidney injury (AKI) who is
Which client statement indicates that this teaching
on has
a protein-restricted diet. Legumes, nuts, and vegetables do contain protein,
been effective? but they are incomplete proteins and thus not as good a protein source as eggs.
A) "I will be sure to include eggs in my diet."
B) "I should include vegetables at every meal."
C) "Legumes should be included in my diet, because they
are complete proteins."
D) "I will eat nuts daily because they are high in protein."
The nurse is planning care for a client admitted with
Answer:
a D
diagnosis of heart failure. Based on this diagnosis, which
type of kidney failure is the client at an increasedExplanation:
risk for Heart failure is one possible cause of prerenal kidney failure due to
experiencing? low cardiac output. In comparison, causes of prerenal kidney failure due to
hypovolemia include hemorrhage, dehydration, burns, wounds, and excess fluid
A) Prerenal hypovolemia loss from the gastrointestinal tract. Causes of intrarenal kidney failure due to
B) Intrarenal glomerular injury glomerular injury include glomerulonephritis, disseminated intravascular
C) Intrarenal acute tubular necrosis coagulation, vasculitis, hypertension, toxemia of pregnancy, and hemolytic uremic
D) Prerenal low cardiac output syndrome. Finally, causes of intrarenal kidney failure due to acute tubular necrosis
include ischemia resulting from conditions associated with prerenal failure, toxins,
hemolysis, and rhabdomyolysis.
The nurse is concerned that an older adult client Answer:
is at riskA, B, C
for developing acute kidney injury (AKI). Which data in
the client's history supports the nurse's concern?Explanation:
Select Older adults develop acute kidney injury more frequently because of
all that apply. the higher incidence of serious illnesses, hypotension, major surgeries, diagnostic
procedures, and treatment with nephrotoxic drugs. Decreased kidney function
A) Diagnosed with hypotension associated with aging also puts the older client at risk for acute kidney injury.
B) Recent aortic valve replacement surgery Hypotension, aortic valve replacement surgery, and receipt of high doses of
C) Prescribed high doses of intravenous antibiotics
intravenous antibiotics increase this client's risk for developing acute kidney injury.
D) Total hip replacement surgery 5 years ago A previous history of hip replacement surgery and current treatment for type 2
E) Taking medication for type 2 diabetes mellitus diabetes mellitus are not identified risk factors for the development of acute
kidney injury.
, The community nurse visits the home of a youngAnswer:
child A, D, E
who is home from school because of sudden onset of
nausea, vomiting, and lethargy. The nurse suspects
Explanation:
acute Pediatric manifestations of acute kidney injury characteristically begin
kidney injury (AKI). Which clinical manifestations with
support
a healthy child who suddenly becomes ill with nonspecific symptoms that
the nurse's suspicions? Select all that apply. indicate a significant illness or injury. These symptoms may include any
combination of the following: nausea, vomiting, lethargy, edema, gross hematuria,
A) Elevated blood pressure oliguria, and hypertension. Postural hypotension is a manifestation of acute kidney
B) Postural hypotension injury in an older person. Wheezing is not a manifestation of acute kidney injury.
C) Wheezing
D) Edema
E) Hematuria
A client diagnosed with acute kidney injury (AKI) Answer:
has B
jugular vein distention, lower extremity edema, and
elevated blood pressure. Based on this data, which
Explanation: Jugular vein distention, edema, and elevated blood pressure are all
nursing diagnosis is most appropriate? indications of excess fluid. Thus, the diagnosis Excess Fluid Volume should be
selected to guide this client's care. Oliguria or reduced urine output would be a
A) Ineffective Renal Tissue Perfusion symptom associated with Ineffective Renal Tissue Perfusion. Alterations in heart
B) Excess Fluid Volume rate and rhythm would be symptoms associated with Risk for Decreased Cardiac
C) Risk for Decreased Cardiac Tissue Perfusion Tissue Perfusion. The client is not demonstrating any manifestations that indicate a
D) Risk for Infection Risk for Infection.
A client agrees to receive long-term hemodialysisAnswer:
to treatD
acute kidney injury (AKI). Based on this information, the
nurse should prepare the client for which surgicalExplanation: For long-term vascular access needed for hemodialysis, an
procedure? arteriovenous (AV) fistula is created. The fistula is created by surgical anastomosis
of an artery and vein, usually the radial artery and cephalic vein. It takes about a
A) Insertion of a double-lumen catheter into the month for the fistula to mature so that it can be used for taking and replacing
subclavian artery blood during dialysis. A double-lumen catheter inserted into a major artery is
B) Placement of a peritoneal catheter used as temporary vascular access for continuous renal replacement therapy. A
C) Insertion of a subarachnoid-peritoneal shunt peritoneal catheter is used for peritoneal dialysis, not hemodialysis. A
D) Placement of an arteriovenous fistula subarachnoid-peritoneal shunt is used to remove excess cerebrospinal fluid and
not for hemodialysis.
A client with acute kidney failure is complaining of
Answer:
a A
metallic taste in the mouth and has no appetite. Based on
this data, which intervention by the nurse is the most
Explanation: A metallic taste in the mouth is due to uremia. The nurse should
appropriate? provide mouth care before meals to reduce this taste sensation and improve the
client's oral intake. An antiemetic would be prescribed for nausea. Restricting
A) Provide mouth care before meals. fluids would not reduce the metallic taste in the mouth. Encouraging intake of
B) Administer an antiemetic as prescribed. protein, salt, and potassium would exacerbate the uremia that is causing the
C) Restrict fluids. metallic taste in the mouth.
D) Encourage the intake of protein, salt, and potassium.
A client diagnosed with recurrent urinary tract calculi
Answer: C
would be at elevated risk for which of the following types
of acute kidney injury (AKI)? Explanation: Obstructive causes of AKI are classified as postrenal. Any condition
that prevents urine excretion
—including urinary tract —
calculi
can lead to postrenal
A) Prerenal AKI AKI. In comparison, prerenal AKI results from conditions that affect renal blood
B) Intrinsic AKI flow and perfusion, and intrinsic AKI (also called intrarenal AKI) is characterized
C) Postrenal AKI by acute damage to the renal parenchyma and nephrons.
D) Intrarenal AKI
