NUR 209/NUR209 Exam 3 V1 | Medical-
Surgical Nursing II Q&A with Rationale |
Fortis College
1. A nurse is caring for a client with acute kidney injury (AKI) who is in the oliguric phase.
Which clinical manifestation should the nurse expect to observe?
A. Urine output of 1,500 mL/day
B. Metabolic alkalosis
C. Hypovolemia
D. Hyperkalemia
Correct Answer: D
Expert Explanation: In the oliguric phase of AKI, the kidneys are unable to excrete
potassium, leading to hyperkalemia. This phase is characterized by a significant drop in
urine output, typically less than 400 mL per day. The nurse must monitor the client closely
for cardiac dysrhythmias associated with high potassium levels.
2. A client with chronic kidney disease (CKD) is prescribed epoetin alfa. What is the primary
purpose of this medication?
A. To treat anemia by stimulating red blood cell production
B. To lower serum potassium levels
C. To prevent calcium loss from the bones
,D. To reduce phosphorus levels in the blood
Correct Answer: A
Expert Explanation: Clients with CKD often develop anemia because the kidneys fail to
produce sufficient erythropoietin. Epoetin alfa is a synthetic form of this hormone that
stimulates the bone marrow to produce red blood cells. Effective treatment is measured by
an increase in hemoglobin and hematocrit levels over time.
3. Which assessment finding in a client receiving peritoneal dialysis should the nurse report to
the provider immediately?
A. Cloudy or opaque dialysate drainage
B. Clear, straw-colored effluent
C. Abdominal discomfort during inflow
D. Small amount of blood around the exit site during the first week
Correct Answer: A
Expert Explanation: Cloudy or opaque effluent is the primary indicator of peritonitis, a
serious complication of peritoneal dialysis. The nurse should also assess for fever, rebound
tenderness, and malaise in these clients. Immediate notification is required so that cultures
can be obtained and antibiotics started.
4. A nurse is assessing a client’s arteriovenous (AV) fistula in the left arm. Which finding
indicates the fistula is patent?
A. Presence of a radial pulse in the left arm
, B. Absence of a bruit on auscultation
C. Palpation of a thrill over the site
D. Redness and warmth at the site
Correct Answer: C
Expert Explanation: A palpable thrill and an audible bruit are normal findings that
indicate the AV fistula is patent and functioning. The thrill is a vibration caused by high-
pressure arterial blood flowing into the low-pressure vein. If these are absent, it may
indicate a clot or obstruction requiring surgical intervention.
5. A client is diagnosed with prerenal acute kidney injury. Which condition is a common cause
of this type of injury?
A. Benign prostatic hyperplasia (BPH)
B. Severe dehydration or hypovolemia
C. Nephrotoxic medications
D. Kidney stones
Correct Answer: B
Expert Explanation: Prerenal AKI is caused by factors that reduce systemic circulation,
leading to decreased blood flow to the kidneys. Severe dehydration, hemorrhage, or heart
failure are classic causes of decreased renal perfusion. This differs from intrarenal causes,
which involve direct damage to the kidney tissue itself.
Surgical Nursing II Q&A with Rationale |
Fortis College
1. A nurse is caring for a client with acute kidney injury (AKI) who is in the oliguric phase.
Which clinical manifestation should the nurse expect to observe?
A. Urine output of 1,500 mL/day
B. Metabolic alkalosis
C. Hypovolemia
D. Hyperkalemia
Correct Answer: D
Expert Explanation: In the oliguric phase of AKI, the kidneys are unable to excrete
potassium, leading to hyperkalemia. This phase is characterized by a significant drop in
urine output, typically less than 400 mL per day. The nurse must monitor the client closely
for cardiac dysrhythmias associated with high potassium levels.
2. A client with chronic kidney disease (CKD) is prescribed epoetin alfa. What is the primary
purpose of this medication?
A. To treat anemia by stimulating red blood cell production
B. To lower serum potassium levels
C. To prevent calcium loss from the bones
,D. To reduce phosphorus levels in the blood
Correct Answer: A
Expert Explanation: Clients with CKD often develop anemia because the kidneys fail to
produce sufficient erythropoietin. Epoetin alfa is a synthetic form of this hormone that
stimulates the bone marrow to produce red blood cells. Effective treatment is measured by
an increase in hemoglobin and hematocrit levels over time.
3. Which assessment finding in a client receiving peritoneal dialysis should the nurse report to
the provider immediately?
A. Cloudy or opaque dialysate drainage
B. Clear, straw-colored effluent
C. Abdominal discomfort during inflow
D. Small amount of blood around the exit site during the first week
Correct Answer: A
Expert Explanation: Cloudy or opaque effluent is the primary indicator of peritonitis, a
serious complication of peritoneal dialysis. The nurse should also assess for fever, rebound
tenderness, and malaise in these clients. Immediate notification is required so that cultures
can be obtained and antibiotics started.
4. A nurse is assessing a client’s arteriovenous (AV) fistula in the left arm. Which finding
indicates the fistula is patent?
A. Presence of a radial pulse in the left arm
, B. Absence of a bruit on auscultation
C. Palpation of a thrill over the site
D. Redness and warmth at the site
Correct Answer: C
Expert Explanation: A palpable thrill and an audible bruit are normal findings that
indicate the AV fistula is patent and functioning. The thrill is a vibration caused by high-
pressure arterial blood flowing into the low-pressure vein. If these are absent, it may
indicate a clot or obstruction requiring surgical intervention.
5. A client is diagnosed with prerenal acute kidney injury. Which condition is a common cause
of this type of injury?
A. Benign prostatic hyperplasia (BPH)
B. Severe dehydration or hypovolemia
C. Nephrotoxic medications
D. Kidney stones
Correct Answer: B
Expert Explanation: Prerenal AKI is caused by factors that reduce systemic circulation,
leading to decreased blood flow to the kidneys. Severe dehydration, hemorrhage, or heart
failure are classic causes of decreased renal perfusion. This differs from intrarenal causes,
which involve direct damage to the kidney tissue itself.
